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We are pleased to offer the following services and technologies to our patients.
Click on a service below for more information:

Oral Hygiene Care
Maintaining good oral hygiene is one of the most important things you can do for your teeth and gums. Healthy teeth not only enable you to look and feel good, they make it possible to eat and speak properly. Good oral health is important to your overall well-being. Daily preventive care, including proper brushing, flossing and irrigation will help stop problems before they develop.
In between regular visits to the dentist, there are simple steps that each of us can take to greatly decrease the risk of developing tooth decay, gum disease and other dental problems. These include:
* Brush thoroughly at least twice a day and irrigate and floss daily
* Eat a balanced diet and limit snacks between meals
* Visit your dentist regularly for professional cleanings and oral exams
* Replace your toothbrush every 3-4 months

The following are indications of good oral hygiene:
* Your teeth are clean and free of debris
* Gums are pink and do not hurt or bleed when you brush or floss
* Bad breath is not a constant problem

Dental Maintenance
A dental cleaning is a professional cleaning you receive from a dentist or dental hygienist. Most dental cleanings take only between 25 and 30 minutes although with the necessary periodontal, oral cancer and microscopic exam, your visit time may be 50-60minutes. Prevention cleanings should be performed every 6 months to prevent excessive plaque buildup. Plaque left untreated can lead to unhealthy gums and tooth decay. A routine dental cleaning should include scaling with hand and ultrasonic instruments and possibly selective polishing.

*/Scaling:/* this is the process of removing plaque and tartar from all tooth surfaces using a variety of methods, depending on the amount of plaque and tartar.
Dental hygienists traditionally perform scaling by hand. However, new and advanced technology has led to more modern methods such as ultrasonic scalers. This sophisticated tool allows dental cleanings to be performed more efficiently and most often, more comfortably. To achieve the best results, both ultrasonic and manual scaling methods are combined for dental cleanings.

*/Deep scaling (also known as root planning):/* this is the process of cleaning pockets in the gums to treat and prevent gum problems.
Deep scaling is used to treat moderate to advanced gum diseases. When the gum is inflamed, gum pockets become deeper and may lose connections to the bone inside. The deeper the pockets, the easier it is for plaque deposits to become trapped and worsen gum problems.
Deep scaling involves gently using scalers under the gum to clean tarter buildup. Depending on the degree of difficulty, deep scalings may take several appointments and a local anesthesia may be used to make you comfortable.

*/Selective Polishing:/* this is the last step in tooth cleaning and involves removing stain to make the teeth clean. We only polish when there is an esthetic concern since polishing removes tooth structure that we can not replace. If you have any questions about our over 20 year stand on selective polishing, please ask one of the clinicians when you have your continuing care visit.

Halitosis
Halitosis is a sophisticated word for “bad breath”. Depending on the cause, bad breath may strike on occasion or be a persistent condition. The most common cause of bad breath is bacteria. Because the mouth is moist and warm, it creates perfect conditions for the millions of bacteria that live in the mouth. In fact, approximately 80% of bad breath is caused by something in the mouth.
Some types of bad breath, such as “morning mouth,” are considered fairly normal and are not usually health concerns. However, persistent bad breath may be a sign of more serious problems with the gums and teeth.
Bad breath may be caused by the following:
* Poor dental hygiene can leave food particles to decay in the mouth
* Infections in the mouth such as periodontal (gum) disease
* Respiratory tract infections such as throat infections, sinus infections and lung infections
* External agents including foods such as garlic, onions, and coffee, as well as cigarettes and chewing tobacco
* Dry mouth caused by salivary gland problems or by breathing through the mouth
* Systemic illnesses such as diabetes, liver disease, kidney disease, lung disease, sinus disease, reflux disease and others
Call our office promptly if you have bad breath with painful, swollen gums that bleed easily or loose teeth. We will perform a full and comprehensive examination of your mouth to determine the cause. If we discover that systemic problems are the cause, we may refer you to your family physician. In severe cases of gum disease, we may recommend a periodontal specialist.

Bonding
Bonding involves adhering composite resin material that is matched to the color of the tooth, to the front of the tooth. This is performed to repair damage caused by decay or trauma, to alter alignment of the tooth, close gaps between the teeth, or for other cosmetic purposes.
First, the surface of the tooth is roughened in order to accept the bonding. A gel is applied so that the resin will adhere to the surface of the tooth. The composite is then placed on the tooth and the bonding agent hardens with intense light. The last step is shaping and polishing to give a lustrous finish.

Fillings (Direct Restorations)
A filling is a way to restore a tooth damaged by decay back to its normal function and shape. If you have a tooth that requires a filling, the dentist will first remove the decayed tooth material, clean the affected area, and then fill the cleaned out cavity with a filling material. A filling helps prevent further decay by closing off cracks or spaces where bacteria can enter.
There are a variety of filling materials available including gold, plastic and porcelain. The dentist will work with you to determine which material is best, depending on the extent of repair, where the filling is needed, and cost. Each filling material is briefly explained below:
* Composite (plastic) resins are custom made to the exact color of your natural teeth, creating a more natural appearance. While tooth-colored fillings may be less noticeable than other materials, they usually only last between 3 and 10 years and may not be ideal for large fillings as they may chip or wear over time. They can also become stained from coffee, tea or tobacco.

Fillings (Indirect Restorations)
* Gold fillings are custom-made in a laboratory and then cemented into place. While gold fillings are often the most expensive choice, many consider it the best filling material. Gold inlays are well-tolerated by gum tissues, fit the tooth the best and most last more than 20 years.
* Porcelain fillings are called inlays or onlays and are custom created in a lab and then bonded to the tooth. They can be matched to the color of the tooth, resist staining, and are about the same cost as gold fillings. A porcelain restoration generally covers most of the tooth, making the filling nearly undetectable.
If decay or a fracture has damaged a large portion of the tooth, a crown (or “cap”) may be recommended. Decay that has reached the nerve may be treated through root canal therapy or through a procedure called pulp capping.

Non-Surgical Gum Treatments
The gums, ligaments and bone around the teeth form the foundation for teeth. These structures are also referred to as the periodontium. When the periodontium is not healthy, it jeopardizes the teeth just as a bad foundation would threaten the stability of a house. Signs of unhealthy periodontium include: gums that are red and bleed easily, persistent bad breath, gums that are pulled away from the tooth, loose teeth, and changes in the position or bite of the teeth. With proper gum treatments, it may be possible to return gum tissue to a healthy state. If you’re having a problem, come in and see us so we may treat it right away. The treatment usually involves a deep cleaning (root planning) done under a local anesthetic, along with local antibiotic agents. It is important to have gum problems checked promptly, as gum disease left alone may eventually need treatment through surgery or extraction.

Advanced Procedures

Crowns & Bridges
Crowns and bridges are used to restore and enhance teeth that are damaged or to take the place of missing teeth. A crown (also referred to as a cap) is used to entirely cover a damaged tooth. A crown not only strengthens a tooth, but it can dramatically improve a tooth’s appearance, shape and alignment.

Crowns may be used to:
* Replace a large filling when there is little tooth structure remaining
* Protect a weak tooth from fracturing
* Restore a fractured tooth
* Attach a bridge
* Cover a dental implant
* Cover a discolored or poorly shaped tooth
* Cover a tooth that has had root canal treatment

A bridge is an ideal method to fill the space created by missing teeth. A bridge is one or more artificial teeth cemented into place using the teeth on either side for support. This is an option for filling the space created by a missing tooth. Bridge work is as much an art as it is an exact science since it replaces a missing tooth both functionally and cosmetically. The materials used may be gold alloys, porcelain bonded to metal alloy, or all ceramic material made to match your natural tooth color. The choice of material depends on requirements for strength, wear, esthetics and biocompatibility.

It is important that a missing tooth be replaced as soon as possible. If not treated, the teeth surrounding the gap begin to shift inward. Since teeth use their neighbors for support, if one is missing they begin to “fall, and shift into the open spaces. This may worsen the bite because of the changes in pressure and can eventually result in problems with the jaw such as TMJ issues.
Bridges and crowns are made by first taking an impression of your mouth. The impression is sent to a dental lab where your crown or bridge will be custom-made to fit your mouth and match your natural tooth color. A temporary crown or bridge will be placed into your mouth until your permanent crown or bridge is ready and cemented into place.

Bridges and crowns are very durable and can last a lifetime with extra care, good oral hygiene and a healthy diet.

Tooth Extractions
Good oral hygiene should always be practiced since the loss of a singletooth can have major impact upon your oral health and appearance. Although dentists will use every measure to prevent tooth loss, there are sometimes occasions when it is necessary for a tooth may need to be extracted. A tooth may need to be extracted for the following reasons:
* Severe decay
* Advanced periodontal disease
* Infection or abcess
* Malpositioned teeth
* Fractured teeth or roots
* Impacted teeth
After careful examination and treatment, the dentist may advise a patient to have a tooth extracted. Before a tooth is removed, the dentist will take an x-ray in order to understand the shape and position of the tooth and surrounding bone. Based on the degree of difficulty, we may refer you to an oral surgeon specialist.
For a simple extraction, we will first apply a local anesthetic to prevent pain and discomfort. The tooth will be loosened with a tool called an elevator and then removed with dental forceps. Once the procedure is complete, the area may be closed with one or two stitches. We will then provide you with care instructions to alleviate discomfort and ensure proper healing.

Root Canal Treatment
Root canal treatment (also referred to as root canal therapy or endodontic therapy) is made necessary when an untreated cavity reaches all the way to the pulp. Treatment may also be needed when deep restorations or trauma to a tooth cause nerve damage.
Once the pulp becomes infected, the infection can begin to eat away at the surrounding bone (this is known as an abscess). If the pulp is infected, not only is it painful but it will require treatment since it cannot heal on its own. Symptoms that indicate the pulp has become infected may include sensitivity to hot, cold or sweets, pain, swelling, pain in response to biting or pressure, and a bad taste in the mouth. However, there are times when no symptoms are apparent and you may be unaware of any problem until a checkup.
A root canal is performed to clean out the infected tooth pulp and disinfect the canals of the tooth. Alternate treatment would be to extract the tooth. Once the infection is resolved, the canal is filled in to help prevent any further infection. Usually a core build-up and crown is recommended for restoring a tooth that has undergone root canal therapy.
For patients who may have an underlying, systemic immune challenge, root canal therapy may not be advised since the area around a root canaled tooth may always remain inflamed. Adding any further inflammation to the body might not be in your best interest and an extraction would be recommended.

Dental Implants
A dental implant is a tooth replacement for people who are missing one or more teeth as a result of injury, periodontal disease, or for any other reason. A dental implant is a metal post that a periodontist or oral surgeon surgically positions into the jaw. Once in place and bone surrounding the implant has had time to heal, a replacement tooth is attached to the post. While implants are typically more expensive than other methods of tooth replacement, they may provide superior benefits. Implants are stronger than natural teeth and generally last 10-20 years. They may also be a more favorable approach than bridgework since implants do not depend on neighboring teeth for support.
To receive implants, you need to have healthy gums and adequate bone to support the implant. You must also be committed to excellent oral hygiene and regular dental visits as these are critical to the long-term success of dental implants.

Dentures
A denture is a removable replacement for missing teeth and surrounding tissues. There are two types of dentures available: partial and complete dentures. Partial dentures are used when some natural teeth remain, while complete dentures are used to completely replace all teeth. Dentures are made to resemble your natural teeth so there should be no noticeable change to your appearance. In fact, dentures may even improve your smile!
This restoration method is used to restore your smile and mouth function if your teeth have been lost. The dentures are custom-created to resemble natural teeth and are positioned to take the place of natural teeth. Complete dentures are removable and may require adjustments in order to create a proper fit with the gums and mouth.
A removable partial denture is a device used when one or more natural teeth still remain in the upper or lower jaw. They usually consist of replacement teeth attached to a gum-colored plastic base which is held in place in the mouth.
New dentures may feel awkward or loose for the first few weeks until the muscles of your cheek and tongue learn to keep them in place and you are comfortable eating and speaking. Although this may require some practice, you will adjust and enjoy the benefits a full mouth of teeth can provide.

Nightguards & Mouthguards
Custom-designed mouthguards and nightguards are made of flexible plastic and molded to fit the shape of your teeth. Mouthguards are recommended to protect the jaw and teeth during physical activity and sports such as football, basketball, hockey, boxing or other activities where your mouth may be hit. Guards also protect the soft tissues of your tongue, lips and cheek lining. Nightguards are recommended for patients who clench or grind their teeth at night as a way to protect their teeth and bite.
If you have decided a guard is right for you, we will take an impression of your teeth which will then be sent to a lab to make a custom fit guard. In most cases you can choose from a variety of colors and styles. On average, guards last between 3 and 10 years.
Harmony Nutrition- Supportive Customized, Nutrition
Many patients who are interested in doing the most for their health know that we need to support our diet since we no longer get everything that we need from what we eat. Many, including myself, were already supplementing using products that are one size fits all. As we now know, all of us are different and are biologically individual as well. It only makes sense to take a program customized to your biologic makeup based on in-office testing. If you are interested in supporting your immune system, your liver’s ability to detoxify and optimizing other systems of your body, please avail yourself of Dr. Maureen’s advanced training in Nutrition Response Testing Dr. Maureen Viglielmo can help you get started for much less that you would think.

Cosmetic Dentistry
Cosmetic dentistry includes procedures which correct imperfections or enhance the appearance of the mouth. Tooth color, alignment, spacing as well as regularity of the teeth are the characteristics that give one’s overall appearance. Any of these can be enhanced to provide a stunning new smile.

Tooth Whitening
Tooth whitening is a popular procedure to make teeth whiter and brighter, and therefore more attractive. Bleaching can be used to whiten stained and discolored teeth, or simply to enhance a dull smile. Either way, tooth whitening is a relatively safe and painless procedure ideal for most patients. Our office offers take home strip or tray whitening.
For tray whitening we will first take an impression of your mouth to create a customized clear whitening trays for you to wear. Within a few days your trays will be ready to be picked up and we will show you how to apply the special bleaching material to the trays. The whitening gel trays should be worn 30-60 minutes up to twice a day. At the end of this period, you will see maximum whitening results that are nothing short of dazzling. Occasional treatment can be used at your convenience to maintain your new smile.

Invisalign Orthodontics
Orthodontics is the art of using appliances to straighten and align teeth. Most commonly it involves the use of metal braces to move teeth into proper positing. In this method, brackets are bonded to the teeth and arch wires are threaded through the brackets. The arch wires act as a track, guiding each tooth to its proper position. There are some malocclusions and patient compliance that would be best treated with conventional orthodontics and we will make that referral to local orthodontists that we feel are practicing at the level we expect in this day and age.
Invisalign is a proven system of tooth repositioning that use successive, clear trays that are almost imperceptible to the wearer and others. Impressions and a series of pictures are taken to start the treatment. After Align Technologies have digitized this information, Dr Jeffrey will meet with you to go over the process and you can visualize the final outcome. Once we both feel comfortable with what we see as our completion point we will order the aligners. Since the aligners need to worn 20+ hours a day and successive aligners can be changed by the patient, this is a patient directed treatment and office visits are minimized.

Veneers
Veneers are a dental procedure in which a covering is placed over the outside (visible area) of the tooth. Veneers are usually only applied to the part of the tooth that is visible when talking or smiling. The procedure can be direct or indirect.
The direct technique usually involves placing composite resin on the outside of the tooth using bonding. This method is usually referred to as bonding.
The indirect technique usually involves two appointments because the veneers will be fabricated at a dental laboratory. At the first appointment the teeth are prepared, impressions taken, and the teeth are given a temporary covering. In two to three weeks the veneers are back from the laboratory, the temporaries are removed and the veneers are bonded to the teeth. The laboratory fabricated veneers are usually made using porcelain or pressed ceramic and are very aesthetic.
The advantage of veneers versus crowns is that much less tooth material is removed, and the procedure is generally more comfortable. The preparation for veneers or crowns is dictated by the remaining sound tooth structure and is more of an art since the tooth is shaped to strengthen what remains while achieving the desired esthetic result.

Safe Mercury Amalgam Removal
Having an education in biology and chemistry, I questioned the use of mercury in dental restorations since I first learned that it was a constituent of this filling material. I actually had 6 or 7 small amalgams placed in my mouth as a child, probably they could have been a small sealant type restorations if done today. I, as are all other dental students in this country, was taught that the mercury is bound and rendered inert in the amalgam when placed in a patient’s mouth. I believed my instructors since I was paying a fair amount of money to learn all I could about dentistry during that time.
Since school I did use amalgam for many years but kept wondering if it was the best for our patients or myself. In 1999 my wife and I joined a custom health company, Ideal Health, where I was able to meet many medical and dental professionals who were more progressive and forward thinking that I was at the time. I found many who questioned standard medical protocols and dental materials. I was introduced to the International Academy Of Oral Medicine and Toxicology where I was shown the science behind the condemnation of mercury in body systems.
In response to this information, I immediately had my amalgams removed and replaced the ones my parents and wife had. I began purchasing the systems to protect my patients, staff and myself from the mercury released during removal. Firstly, I use a special suction tip called Cleanup which concentrates the suction where the amalgam is removed. I attempt to section the amalgam to do as little cutting as possible while removing. I obtained a larger air cleaner from Tact Air with special mercury filters which captures much of the vapors not grabbed by the introral suction. We also provide a clean air source to our patients during the removal while my assistant and I wear a respirator to further limit our exposure. In our treatment room we installed a Tact Air ionizer which plates out even more mercury that escaped into the room air. We also offer a charcoal swish and swallow pre-removal option to capture any mercury that contacts the tissue of the mouth or is ingested.
We also insist all our patients who feel that mercury may be a cause of their systemic challenges work with a medical professional for identification of mercury burden and possible removal of mercury from the tissue (chelation).

Dental Technology
In order to provide nothing but the best to our patients, our office uses state-of-the-art technologies in all our procedures. These new technologies allow us to treat dental cases with extreme precision, detect dental concerns at early stages, and provide stunning and customized restorations. When you visit our office you can be confident that you are receiving on the finest and most advanced in dental care. We proudly offer and use the following advanced equipment:

Digital x-rays
X-rays are a focused beam of x-ray particles passed through bone which produce an image on special film, showing the structure through which it passed. This provides the familiar black and white images doctors and dentists use to diagnose problems and disease. Without an x-ray of the whole tooth and supporting bone and gum tissues, there would be no way to detect infection or pathology that requires attention.
In our office we use digital radiography which allows us to take x-rays using up to 90% less radiation than conventional film x-rays. Using this technology, we are able to take an x-ray of your mouth by using a small sensor which records the image of your teeth and sends it to a computer. The result is a highly detailed image of your mouth that can easily be enhanced to better diagnosis dental concerns and determine the very best treatment for each case.

Paperless Records
Our office is a completely digital (paperless) dental office. This means all x-rays and charting are made and recorded with the aid of the computer. This technology allows us to maintain your dental records electronically, and cuts down the unnecessary paperwork used with traditional paper charting. Traditional paper charting is difficult to keep standardized from doctor to hygienist to assistant. Even handwriting differences and coding make the charts look different. The computer eliminates this problem by using consistent charting methods that are accurate and precise, making it easy to read your dental chart and see up-to-date information. Digital charting standardizes the charting process so it is clear, easy to understand, and enables us to provide on the most accurate and precise care to our patients. When needed, this method also allows us to quickly and securely share information with your other health care providers.

Automated Appointment Reminders
We use an automated appointment reminder system that will call your home two days prior to your scheduled appointment time to remind you of your appointment. Please listen to the message carefully and follow the prompts to confirm your appointment. If you do not respond to the message, our office staff will contact you to confirm your scheduled visit. If are not home, a message will be left on your voicemail. Failure to notify our office of a cancellation may result in a charge. See our missed appointment policy for more information.

Digital Imaging
We use digital imaging software in our office, which allows us to take a digital picture of you and use our imaging system to predict how a particular treatment or cosmetic procedure would change the appearance of your teeth.
This software is beneficial for patients who are considering cosmetic procedures but are not sure if they’re ready for dramatic changes. Digital imaging also allows us to document your dental case and procedures very well. We take digital images of your face, teeth and smile to provide us with a permanent dental record and to provide visual documentation of treatment.

Electronic Claim Processing
Our office utilizes electronic claims processing. This means that rather than sending your dental claim through the mail, it is sent electronically to your insurance company with the click of the button every evening. By filing your claim electronically, information is submitted more efficiently and with fewer errors. This benefits our patients because the turn around time on claims is faster and fewer claims are returned or denied. We are happy to submit your dental claims to your insurance company on your behalf.

Intraoral Imaging
We use small cameras about the size of a pen, called intraoral cameras, to help clearly see the condition of your teeth and gums. With this advanced technology we can zoom in on small diseased areas, cracks, chips and worn metal fillings with extreme precision.
The full-color images taken with the intraoral camera are sent to a computer screen so we can clearly see and diagnose dental problems much earlier than with traditional dental technology. Because images are displayed on our screens, patients will also be able to see areas being worked on and are able to gain a better understanding of dental procedures being performed.