Specialist Spotlight- Opus One Dental Lab

When having a crown or bridge placed, your ultimate goal is to have it look, feel and function like the natural tooth that was there before it. While this process is never “easy,” it becomes even more difficult when dealing with anterior (front of the mouth) teeth. For these complicated lab cases, we are proud to work with Opus One Dental Lab and it’s owner, Uri Yarovesky.

Uri standing with his many awards and honors. 

Uri has over 40 years of experience in the dental field as a technician, lab owner and world recognized lecturer. He has made crowns and bridges for celebrities, heads of states and even as prosthetics for blockbuster movies. His credentials include countless awards from the most prestigious dental publications and institutions. Opus One Lab was designed as an extension of his years of experience- cutting edge techniques with a personal touch. In addition to the typical technologies and instruments you would find in most labs,this office houses a research facility used to develop and manufacture new ceramic technologies. For some of the services the lab offers, they are the only location in the entire world with this technology available.

Crowns on anterior teeth need to be a near identical match to the surrounding teeth. Small deviations in coloration, shape, size or translucency can translate to a product that looks “fake” or out of place. It takes careful examination and years of experience to deliver a perfect prosthesis that feels great. Opus One delivers this by offering customs shade matching appointments, where you meet with Uri one on one to design and perfect your dental crown. He and his team have a deep appreciation for dental restorations and can meet your desires on shade, feel and even age appropriateness.

We love working with Opus One because they are both a local business and a global leader in dental technology. Uri’s lab understands the importance of both esthetics and function in delivering a quality product. Their crowns and bridges fit and look great, which results in happier and more satisfied patients.

Cosmetic Bonding

Often times, patients will be very satisfied with their oral esthetics aside from one feature. Thier teeth can be straight, white and well spaced, saving for a single tooth. In these cases, orthodontics may be impossible or unnecessary for purely esthetic results. Here, cosmetic bonding proves to be the most predictable and reliable treatment to a perfect smile.

In this case, bonding was added to compensate for a short lateral incisor (left of center).

Cosmetic bonding is one of the most underappreciated cosmetic procedures offered in dental offices. Using the same tooth colored material as fillings, we rebuild and recontour teeth to better fit and fill out your smile. This material is extremely durable, and can be used to lengthen, widen or "even out" the appearance of your front teeth. Our patients are always satisfied with the results, as the transition from natural tooth to filling material is virtually undetectable.

Here, bonding was used to close the gap between the patient's two front teeth.

Your appointment will begin with a short consultation on esthetics and a few photographs. We strive to match your expectations and desires before we start working in your mouth. Once a decision has been made on how and where to add bonding, we use high pressure air abrasion to temporarily roughen the tooth surface. This step is comparable to rubbing wood with coarse sandpaper before painting. After the tooth surface is prepared to accept composite, we add our bonding agents to the indicated area, followed by the tooth colored composite. Our composites come in a variety of shades and color, and can match practically any tooth shade. The material is added slowly, contoured to your tooth, and set solid via a high intensity curing light.

After we select an appropriate tooth color and light cure it, we begin shaping the material to resemble a completely natural tooth. The refinement process utilizes  sanding discs, polishing points and a number of sensitive techniques. The results look and feel completely natural in your mouth.

However, there are limitations to cosmetic bonding. It can generally compensate for deficiencies in tooth structure, but cannot address size issues such as overcrowding. Additionally, once structure has to be built out over 3-4mm, bonding becomes a less reliable long term cosmetic solution. For these in-depth cases, we typically recommend more involved esthetic procedures. Finally, bonding can interfere with teeth whitening or whitening results. Since bonding material does not respond to hydrogen peroxide, it does not change shade proportional to your natural teeth. Hence, we recommend you complete a bleach treatment prior to performing esthetic bonding.

Many consider veneers, orthodontics and whitening  as the standard of dental esthetics. However, we urge you to consider bonding to address your mild to moderate cosmetic dental concerns. The minimally invasive nature of these procedures makes them convenient and accessible to many patients. Feel free to call our office with any questions or concerns you have about the process, materials or results behind cosmetic bonding.

Removal of Amalgam Fillings

One of the hundreds of beautiful amalgam swaps we have performed at our office. 

Amalgam fillings are a tested and proven dental material and have been in effective use for over 100 years. There are many aspects of these metal fillings that make them excellent candidates for tooth restoration; they are durable, easy to place and have many of the same physical properties as natural tooth structure. However, they are not perfect (there are no perfect materials in dentistry). Over time, amalgams can crack, “leak” or become surrounded with decay. Furthermore, they are not as esthetically pleasing as tooth colored materials and can tarnish from silver to black very quickly.

These are some of the compelling reasons that we remove amalgam fillings at Thousand Oaks Family Dentistry. While we recommend replacement for ALL compromised fillings (both metal and tooth colored), we only replace amalgams for esthetics upon patient request. Additionally, we do not recommend removing metal fillings over concerns of mercury exposure. The long term safety of amalgam fillings and their associated mercury content is well understood and documented. Additional information can be found at http://www.ada.org/en/member-center/oral-health-topics/amalgam or by calling our office.

The result of an amalgam replacement procedure. While amalgam fillings are easy to spot, composite fillings blend very well with natural tooth structure. However, this difference in esthetics does not necessarily make one type of filling functionally superior. 

The removal process is a simple procedure that parallels how we place fillings on decayed teeth. We start by removing the existing amalgam from the tooth by carefully cutting it with a high-speed handpiece (“drill”). While amalgam fillings are very safe, there is a slightly elevated risk of mercury exposure upon their removal, as the material becomes loosened and aerosolized. To counteract this, we rely on two forms of suction and isolation to prevent any of the metal from being swallowed. Typically, we pair an Isolite suction/bite block with our high speed suction to gather any stray metal.

Once the amalgam is removed, we eliminate any decay under or around the filling and reshape the tooth to better accept the new composite. Once the tooth is “prepared,” we proceed by bonding and curing in tooth colored material. After it is set, we recontour the filling to the natural shape of your teeth and adjust so it feels natural in your mouth. The entire process takes under an hour, and can be considerably shorter depending on the size and shape of the existing amalgam.

If you have any questions, or would like more information on how and why we remove amalgam fillings, please call our office. We regularly remove amalgam fillings under a number of different scenarios, and would be more than happy to walk you through the process.

Teeth Whitening

Teeth bleaching is one of the most common and sought out dental treatments nationwide. There are numerous options and products offering whiter teeth, from toothpastes to bleaching “strips” and even professional procedures. At Thousand Oaks Family Dentistry, we offer two forms of whitening procedures: in-office bleaching and take home trays.

Firstly, it is important to understand how teeth whitening works. In actuality, there is no bleach (sodium hypochlorite) in any whitening products. The active ingredient in almost all whiteners is hydrogen peroxide. Peroxide works by oxidizing the molecules that cause staining, which in-turn prevents them from dying the teeth. These staining compounds reside in the layer of the teeth known as the dentin. This zone sits between the tooth enamel and nerve chamber and is composed by  thousands of tiny ducts known as tubules. Whitening sensitivity usually arises from these tubules opening, allowing the peroxide to penetrate and “bleach” the teeth.

Take home bleach trays combine flexibility and enduring results of whitening strips with the speed of professional strength bleach. After you decide to whiten using trays, we will take impressions of your teeth and turn those into plaster study models. We then vacuum form plastic to your model, making a perfect relief of your teeth. After trimming the plastic, your trays are ready to be picked up and used. The entire process can be completed in as little as two days (if necessary).

(From left to right)- We start by taking impressions which are turned into stone models. These models are used to make your custom trays. We then send you home with a supply of professional strength peroxide bleach.

We will send you home with a peroxide intensity appropriate to your comfort level and desired results. Many first time bleachers will opt into a lower peroxide percentage until they understand their personal level of sensitivity. Trays are typically used for one hour a day for two weeks, followed by one hour a day, once a month. This schedule allows for deep dentin bleaching and an enduring white smile. Patients who use this method typically reach a very stable tooth shade that lasts for many years.

In-office bleaching is a great whitening solution for those who want immediate results or cannot devote the time to slower bleaching methods. We start by retracting your lips and blocking out your gum tissue and mucosa. Once we have created an effective barrier between your teeth and other mouth structures (peroxide will remove color from any tissue it contacts), we apply a 40% peroxide bleach to the facial side of your teeth. We typically leave the peroxide on for two 20 minute sessions. In the meantime, you can enjoy netflix, pandora internet radio or cable tv on our in-operatory TVs.

Top left- Blockout material used to protect your gums. Bottom left- In-office bleach, before activation. Right- Cheek retractors commonly used in our whitening procedures.

Feel free to enjoy one of our many entertainment options during your whitening procedure. 

If you have any further questions on teeth bleaching or would like to schedule an appointment, feel free to call our office. We have helped hundreds of patients achieve healthy and beautiful smiles and can accommodate all of your esthetic needs and desires.