Our office specializes in cosmetic dentistry for Los Altos, San Francisco and San Jose patients. Cosmetic dentistry is a unique aspect of dental care that can treat a wide variety of cosmetic and health issues.
Creating or renewing a beautiful smile can be accomplished easily in as few as two visits. Spaces, gaps, chips, or irregular teeth can be transformed to ideal proportions and color. Excessively short or long teeth can also benefit from cosmetic dentistry. Discolored, stained, or yellowed teeth can be made bright again with teeth whitening or veneers. Old metal dental work, including gold, silver/mercury fillings or metal-based porcelain crowns (caps) can be made to look natural again. Even a smile that shows too much gums can be reshaped to ideal proportions with laser assisted periodontal therapy.
How can all this be done? The following techniques explain how.
(click a left column link for more information)
Amalgam Filling Removal
Dr. Hartley, Dr. Field, Dr. McFarlane, and Dr. Shile are aware that many patients are concerned about amalgam (silver) filling removal and mercury vapors in regard to their health. Because of this concern, they strive to remove amalgam (silver mercury) fillings in a safe way and replace them with metal-free, biofriendly, bonded restorations. To accomplish this, they utilize removal protocols based on recommendations of the International Academy of Oral Medicine and Toxicology (IAOMT) and other prominent biological and holistic dental organizations.
, Dr. Field
, Dr. McFarlane
& Dr. Shile
are aware that many patients are concerned about amalgam (silver) filling removal and mercury vapors in regard to their health. Because of this concern, they strive to remove amalgam (silver mercury) fillings in a safe way and replace them with metal-free, bio friendly, bonded restorations. To accomplish this, they utilize cosmetic dentistry
removal protocols based on recommendations of the International Academy of Oral Medicine and Toxicology (IAOMT) and other prominent biological and holistic dental organizations.
Some of the precautions taken include:
- Use of a rubber dam – a barrier that reduces our patients’ exposure to amalgam slurry that is created when the filling is drilled out.
- Use of high volume suction – both over and under the rubber dam to reduce our patients’ exposure to mercury vapor
- Option of pure oxygen – for our mercury sensitive patients who may need an alternative source of air.
We also have a special amalgam filter that separates and isolates the old mercury fillings so that they can be disposed of properly.
Due to questions concerning the safety of mercury (amalgam) fillings, the Peninsula Center of Cosmetic Dentistry does not use amalgam in its practice. Instead, PCCD uses dental composites — hard plastic that bonds to teeth. Amalgam fillings, which have been around since the 1870s, are now considered a less optimal material. Since composites come in the color of teeth, they look much better than silver fillings. Composites are very safe, very effective and are now BPA-free as well.
While some studies have shown mercury in amalgam fillings can leach into the mouth, studies vary widely on the amount or its effect on humans. Nevertheless, mercury from labs and dental practices contributes to increased levels of the toxic metal in wastewater and the environment. Dr. Field and the Peninsula Center of Cosmetic Dentistry are proud to put the environment and patient health first by using the latest technology in composite fillings and porcelain crowns.
Dental bonding is a special resin composite that adheres to your teeth and becomes as hard as your own enamel. Bonding can solve many cosmetic dentistry problems at an affordable price. Stained, gapped, chipped or misaligned teeth can be bonded to give you a reshaped smile, usually in one office visit. The color of the bonding material must match your other teeth so that it appears natural. This may require getting your other teeth to a pleasing color first, through teeth whitening or other services. Compared to porcelain veneers, bonding is not a long-lasting solution. Depending on your oral habits, it can last up to 10 years or more, before requiring a new treatment. It is a good alternative for patients who want dental reconstruction but are not candidates for tooth replacement including dental implants or teeth in a day.
Call us today (650) 948-5524 and schedule your initial consultation for a smile evaluation with a Bay area dentist.
Los Altos dentistry
patients often must decide between dental bonding
and porcelain veneers
for correction of common cosmetic problems. There are a number of differences between the two, as outlined below.
Which is more natural looking?
In general, porcelain veneers tend to look slightly more natural.
Materials & Methods
Dental bonding utilizes a composite similar to the material used for dental fillings to build up layers upon layers of resin on the tooth. Porcelain veneers involve bonding a thin layer of porcelain to the tooth.
Dental bonding tends to be more cost effective than porcelain veneers and only requires a single visit, but dental bonding tends to break down faster than porcelain veneers.
Bonding has a shorter lifespan – five to ten years or less, depending on the habits of the patient. Additionally, with dental bonding, patients need to be more careful eating certain foods. Patients with porcelain veneers do not have to exercise as much caution.
After a tooth is removed the jaw bone begins to atrophy or is reabsorbed. When this happens it leaves a condition where there is either too little bone or poor quality bone for implant placement. In these situations most patients are not candidates for dental implants without intervention. In dentistry we have the ability to grow bone where needed. This not only gives us the ability to place implants of proper dimensions but is also restores the esthetic appearance.
Bone grafting is commonly needed prior to implant placement. In some cases it can be done concurrently with implant placement. The graft material acts as a scaffolding to dictate where the new bone needs to develop. Over the period of a few months, the graft material is absorbed by the body and the new natural bone that is deposited. The graft material can be constituted from either your natural bone harvested from a different area of your mouth, or made from a bone substitute material. These substitute materials are derived from a bone bank after undergoing a very rigorous sterilization process. Both materials are very safe and effective. Together with Dr. Field, the best choice for your treatment can be made.
Cerec Porcelain Crowns & Onlays
The revolutionary Cerec Cad/Cam technology allows our Los Altos / San Jose cosmetic dentists to create beautiful new crowns or partial crowns (onlays) in just a single visit! No more temporary crowns or messy impressions! These bonded restorations contain no metal and are the ultimate in strength, beauty, and longevity for your back teeth. They are custom-made by the doctor to precisely fit individual teeth. They can be used to replace old porcelain or gold crowns, unsightly metal fillings, and any back tooth in need of repair. They can last for decades and look great. Dental veneers are another more permanent and natural-looking option to correct damaged or discolored teeth.
In a normal crown procedure, the dentist takes a mold of the mouth, grinds down the tooth, and prepares it for a crown. The patient returns home with a temporary cap for a few weeks while the dentist sends the mold to a lab, where a technician carves a new crown out of porcelain and ships it back to the dentist. When the patient returns, the temporary tooth is removed and the crown seated. It’s a double dose of trips to the dentist!
With a Chairside Economical Restoration of Esthetic Ceramics, or a CEREC crown procedure, a 3-D digital photograph of the tooth is taken, and Dr. Field uses a computer to draw the shape of the crown. The patient’s tooth is ground to make a seat for the crown, then his or her new crown is carved out of a block of porcelain in minutes. With the help of state of the art computers and a three-dimensional, diamond-tipped miller, Dr. Field seats the crown during the same visit. The whole appointment takes approximately ninety minutes.
An instantaneous CEREC crown has several benefits over a traditional crown. An instant crown via CEREC helps reduce pain and sensitivity as well as bacterial leakage commonly found from wearing a temporary cap for a few weeks. After the CEREC procedure, patients can eat, floss and brush as normal.
These tooth-colored resin fillings have state-the-art status in cosmetic dentistry as the material of choice for small cavities or to replace small existing silver/mercury fillings. They are not a permanent solution, lasting usually 5 to 10 years. They are beautiful, durable, and take only one visit to place. Contact our San Francisco cosmetic dentistry practice today at 650-948-5524 to learn more.
According to the Peninsula Center of Cosmetic Dentistry’s satisfied patients in San Jose, Los Altos and the San Francisco area, dental implants are an ideal way to replace missing teeth. A dental implant is a synthetic root that supports a replacement tooth, bridge or denture. Implants are made out of titanium alloy or zirconium. Once you decide to get dental implants, Dr. Hartley and Dr. Field collaborate to create a plan that provides you with stable, beautiful and functional new teeth.
Whether you want to replace a single tooth or to create a full mouth of secure, stable new teeth, implants are a proven, long-lasting alternative to bridges and dentures. As substitute teeth roots, implants bond with the bone to form a stable foundation for permanent replacement teeth that look, feel and function like natural teeth.
Suitable Candidates for Dental Implants
Suitable dental implant candidates include individuals who are in good overall physical, mental and oral health. Patients with sufficient jaw bone height are ideal candidates for dental implants, but other options are available if needed. The best candidates do not have periodontal disease and have healthy gum tissue.
Tailored Dental Implant Treatment Plan
Renowned Bay Area dentist Dr. Field will create a tailored treatment plan for your dental implants, which includes how to position the implant(s). Depending on your individual needs, Dr. Field can replace a single tooth with a single implant and a porcelain crown, or he can replace several teeth with bridges supported by implants.
For patients who require dental implants in the upper back jaw (where patients typically have insufficient bone quality or quantity to support implants), Dr. Field may perform sinus augmentation to raise the sinus floor and amplify bone for proper implant placement.
Dr. Field is also able to account for jaw deformities that may make it difficult to position dental implants by performing ridge modifications. In this process, Dr. Field lifts the gum off the ridge to reveal any defects in the jaw bone. He then fills any imperfections with bone or synthetic bone matter to rebuild the ridge and optimize dental implant results.
How to Care for Dental Implants
You should care for dental implants and veneers in the same manner that you would care for regular teeth: Brush and floss daily, and visit the dentist regularly for check-ups and cleanings. Dr. Field will provide further instructions or schedule follow-up appointments for you, so he can monitor your dental health.
When considering dental implant options amidst other options like bridges and dentures, it is important to consider the point that dental implants last much longer than the other options.
A dental bridge, the creation of a tooth supported by anchors to real teeth on each side, requires grinding down adjacent teeth to make the bridge. Bridges cause increased tooth destruction and only last ten to fifteen years before requiring a replacement bridge. In contrast, implants can last a lifetime.
Dental implants have been perfected for over forty-five years, and consist of titanium, a similar material to what is used in orthopedic knee and hip replacements. With advances in implant techniques over the last ten years, implants have emerged as the ideal treatment option.
If a tooth is lost, the sooner an implant is installed, the better. Over time, bone loss at a missing tooth site can occur and losing too much bone can require a graft. Dental implant surgery takes about one hour. After an implant is placed, it heals for a few months, allowing time for the bone to fuse to the implant. Once fused, Dr. Field takes an impression of the mouth and uses it to fabricate the crown for the implant.
Patients sometimes have the wrong idea of what to expect after dental implant surgery, says Dr. Field. If you’ve lost a tooth due to extraction, it’s going to hurt much less than that. “I’ve had patients say it’s easier and less painful than having a crown done,” he says. Dental implant surgery has a success rate of anywhere from 96 to 98 percent.
Rare side effects and complications can include improper fusion of the implant to the jaw bone. If that occurs, the implant is removed, the bone heals, and the patient can try again.
Implant patients experience less alterations to life after an implant surgery, compared to a bridge or a denture. Implants can be brushed and flossed like a real tooth, unlike a bridge, where food particles can get wedged underneath the appliance and may require removal by a dentist. Dentures usually require regular removal and cleansing by the patient.
Full Mouth Reconstruction
The art of full mouth reconstruction (FMR) allows Dr. Hartley to fully rebuild worn, broken down teeth to ideal proportions and function. For many adults, years of mismatched dental crowns, fillings and other dental work can change the bite so significantly that the teeth work poorly. For others, years of grinding and wear have left the teeth short and flat. With FMR, not only are the teeth and bite restored, but also mid-face wrinkles or deep lines can be eliminated. Mid-face lines around the nose and mouth can be caused by a collapsed bite and worn down teeth. FMR rebuilds the teeth and bite which in turn supports and fills in the mid-face tissues and gives a young look to the face.
Advantages to having a full mouth reconstruction are numerous. The aesthetic result of full mouth reconstruction is unmatched in beauty since all of the teeth are restored for a perfect fit and cosmetic match. If you are in need of a dentist in Los Altos who can help you rebuild the health and beauty of your smile, contact our practice today at 680-948-5524.
Consider Invisalign to get the beautiful, straight teeth you’ve always wanted — without braces. A consultation with one of our doctors can determine if Invisalign is right for you. Invisalign is a breakthrough in orthodontic science and cosmetic dentistry treatment that straightens teeth using a series of nearly invisible, removable, thin plastic trays called Aligners. Using the latest advances in 3D computer technology, our doctors can diagnose and treat most cases in about half the time of traditional braces. It’s great for adults as well as teens.
Our office is one of the Top 1% Certified Invisalign Providers in the U.S.
Invisalign is much more aesthetically pleasing than braces, and much less irritating to the gums and cheeks. In some cases Invisalign works more efficiently than braces, and the cost can be comparable.
Since Invisalign aligners can be removed, patients must remember to put them back in after eating, making sure not to lose them.
Unlike traditional braces, patients who grind or clench their teeth during the day or in their sleep can damage the aligners, though this problem is rare. Typically the aligners help protect the teeth in these cases.
Our office is one of the Top 5% Certified Invisalign Providers in the US.
IV Sedation Dentistry
Los Altos dentists Dr. Hartley, Dr. Field, and Dr. McFarlane use four levels sedation:
- Deeper sedation – IV Sedation
- Moderate sedation – Nitrous Oxide and Oral Sedative in combination
- Light sedation – An oral sedative (a pill)
- Light sedation – Nitrous Oxide (laughing gas)
Intravenous sedation/conscious sedation is deeper, more reliable and controllable, and easily adjusted to each individual patient.
Mild or moderate sedation/procedural sedation in which you are awake but drowsy is a very effective way to relieve anxiety. With slightly deeper sedation, you will be breathing on your own while monitored but you will have no memory of your procedure when you wake.
The level of sedation will be adjusted according to your needs.
Most patients consider IV sedation for more invasive procedures, including porcelain veneers, dental implants, and dental crowns. However, certain levels of sedation can be used for all types of general and cosmetic dentistry.
Oral Sedation Dentistry
Dental anxiety is one of the reasons why many Americans don’t visit the dentist for regular check-ups as often as they should. However, the good news is that with sedation dentistry, there is a way for individuals to experience a stress-free visit to the dental clinic and have their tooth and gum issues resolved. We offer sedation dentistry at our Mountain View dental practice so you can receive the treatment you need while having a comfortable, relaxed experience.
Sedation dentistry does not necessarily involve inducing sleep, though many people mistakenly think so. As a matter of fact, the patient remains awake during the dental procedure. Sedation dentistry primarily involves calming the patient as they undergo the procedure. Some medications may cause sleepiness as a side effect, but the application of oral conscious sedation or nitrous oxide is only meant to calm anxious nerves. One of the reasons for the increasing popularity of sedation dentistry is the fact that sedatives don’t have to be injected. Instead they are taken orally in the form of pills. Besides, the procedures involved in sedation dentistry are proven safe for the patient, making it a great choice for them. Based on patient feedback, the sedatives work so well that details of the procedure including the smells produced are not recalled. This is how effective the approach is. However, there are a few precautions that need to be taken. For one, it is standard procedure for the patient to be accompanied by a relative or caregiver during sedation. There are sedatives that are given hours before the dental procedure or the night before. Patients are advised to refrain from driving a motor vehicle or engaging in strenuous physical activity during this period.
Here are some advantages associated with sedation dentistry:
- Anxiety is alleviated.
- Few side effects.
- More can be accomplished during each visit.
- No needles.
- No pain.
- Perfectly safe.
- Procedures seem to take less time.
There are three levels of sedation, namely mild, moderate, and deep. Meanwhile, there are three forms of dental sedative and the usage depends on the individual needs of the patient. These are oral conscious sedation, nitrous oxide, & IV sedation. There are procedures that the dentist has to follow before he can administer the sedative. A patient’s thorough medical history must be taken into account. Besides, current medications must be noted as well. Here is an outline of the dental sedatives being used today.
Nitrous oxide, also known as “Laughing gas” has been widely used in dentistry for several years. It is a mild sedative that is administered while the procedure is underway via a nose hood. The primary effect of nitrous oxide is mood elevation. It also fosters a broad sense of well-being, relives any pain felt by the patient, and decreases anxiety. Some patients feel a tingling or numbness, but there are no side effects.
Oral Conscious Sedation
This method is the alternative choice for those who do not like needles very much. Since dental procedures usually require an injection, people who are in mortal fear of the needle can take this type of sedation prior to the procedure so that their senses are dulled. Afterwards, the patient will not remember noises, smells, and any sensation of pain due to the modest state of sedation that’s been induced. Dr. Shile is licensed by the State Board of California to administer oral conscious sedation.
What types of drugs are used in oral conscious sedation?
The drugs which are most commonly used in oral conscious sedation are benzodiazepines. These medications are indicated for reduction of spasms, seizures, insomnia, and anxiety. The effects depend on the half-life of the medication. The type of drug used depends on the length of the dental procedure that the patient will undergo. Below mentioned are some of the drugs that are used in oral conscious sedation:
Valium® is a drug with a long half-life and is most commonly used for complex procedures that take a long time. This drug has amnesiac properties.
Halcion® is a sedative and a drug used for treating insomnia. This is the drug of choice for short procedures. It also has amnesiac properties.
Ativan® is most effective at reducing anxiety. It has medium half-life and has amnesiac properties. For dental procedures that take less than couple of hours, dentists use this drug.
Versed® has the lowest half-life of all and is the least commonly used of the drugs presented here. It is ideal for procedures that take less than half an hour.
Laser Gum Reshaping
Lasers provide instant results with painless procedures and easy healing. Teeth that appear small or short can often be “lengthened” by recontouring the gum line using the laser.
This advanced cosmetic dentistry procedure is used to create a perfect, harmonious gum line in relation to the lips and teeth. It may be used in combination with veneers or dental implants to achieve the best results possible. Our dental hygienists are also highly trained in these effective and safe techniques that treat periodontal disease and other gum conditions.
This represents the latest in cosmetic dentistry at PCCD and in the dental industry. Porcelain veneers are handcrafted to create beautiful porcelain coverings for individual teeth. They are as strong as your own natural teeth and can be a permanent solution to most cosmetic dental problems. They will not discolor over time and resist chipping or fracture. Porcelain veneers will successfully treat gaps, chips, excessively small or large teeth and discolored or “antibiotic” stained teeth, and can even straighten misaligned or crooked teeth in as little as two visits.
Contact us today at (650) 948-5524 and learn how our Los Altos / San Jose dentists can improve the appearance of your smile with natural-looking veneers or dental crowns.
There are essentially two categories of dental veneers: dental Lumineers and porcelain veneers. Both are a thin layer of restorative material placed over the surface of a tooth to improve the appearance of the tooth and / or to protect a damaged surface. The main difference between the two lies in the conservation of the original tooth.
“Lumineers” is a trademarked name for what PCCD calls “thin prepless veneers.” Thin prepless veneers differ from traditional porcelain veneers, in that with traditional porcelain, tooth structure is removed to make room for the porcelain veneer. With thin prepless veneers, Dr. Hartley doesn’t have to remove any of the original tooth structure. This leaves the natural tooth intact and preserves the enamel. Porcelain veneers and thin prepless veneers look and function the same way after their creation, and they’re both long-lasting and stain-resistant.
Experienced dentist Dr. Hartley’s veneering approach is unique in that he utilizes full-contour mockups built directly on the teeth to ensure maximum satisfaction. Other dentists use a lab technician to design their patient’s teeth from a plaster model. Lab technicians cannot see how the new teeth will look with the patient’s lips and face, thereby making it difficult to model esthetic harmony. Dr. Hartley models the final appearance of a veneer in the patient’s mouth with the mock-up to immediately demonstrate how the final product will look. This prevents errors such as comically large veneers, sometimes referred to as “Chiclet teeth.”
Thin prepless veneers do not work for everyone. Patients with very crooked teeth may need to reduce a tooth to change its position and then apply a porcelain veneer. Nevertheless, Dr. Hartley can treat roughly 35 to 40 percent of veneer candidates with thin prepless veneers, a higher percentage than a traditional dentist that does not specialize in cosmetic dentistry.
How to Find the Right Dentist
When searching for porcelain veneers or Lumineers dentists, Dr. Hartley recommends choosing a dentist that specializes only in cosmetic dentistry, as opposed to a traditional dentist that performs root canals, fillings and other work. While it’s tempting to bargain hunt for cosmetic dentistry, a poorly done procedure will cost more in the long run to correct unsatisfactory work. Cosmetic dentistry is an art form and potential patients should seek out a full-time artist.
Thin Prep-less Veneers
This new porcelain veneers technique requires no removal of tooth structure, no anesthetic, and can totally transform a smile.
TPVs cost a little more than traditional veneers due to the difficulty in creating high-quality porcelain to the degree of thinness required. It took 20 years to develop porcelain that could truly deliver a natural, beautiful-looking result without having to grind away tooth structure. At PCCD, our dentists also use porcelain crowns to create more aesthetically pleasing tooth repairs.
Call our cosmetic dentistry Los Altos practice today for a consultation, to see if you are a good candidate for this revolutionary new technique.
to view the “TPV – Thin Prepless Veneers” document (pdf)
Zoom! Teeth Whitening
San Francisco, San Jose, Los Altos and Bay Area teeth whitening patients love Zoom! Teeth Whitening – a revolutionary in-office teeth whitening procedure that can lighten your teeth up to eight shades whiter in an hour.
Zoom! is a bleaching process that lightens discoloration of enamel and dentin. You may have seen the Zoom! process used on ABC’s “Extreme Makeover.”
Many things can cause tooth discoloration: drinking coffee, tea, red wine or dark soda, smoking, or simply aging. With Zoom! Teeth Whitening, Dr. Hartley
, Dr. Field
, Dr. McFarlane
, and Dr. Shile
use the Zoom Advanced-Power Chairside Lamp to activate the whitening gel, which contains 25-percent hydrogen peroxide. As the hydrogen peroxide breaks down, it releases oxygen molecules, which penetrate the tooth’s enamel and dentin. This process bleaches stains but leaves the tooth’s structure intact.
Before starting the Zoom! Whitening treatment, Dr. Hartley, Dr. Field or Dr. McFarlane will examine your teeth and gums to make sure that you have suitable oral health. They will also discuss your teeth whitening objectives, hygiene routine and lifestyle practices to ensure that Zoom! Whitening is right for you, as well as to determine the best course of action to help you achieve your teeth whitening goals.
Note that not all patients are suitable Zoom! Whitening candidates. Pregnant or lactating women, children under the age of 13, those with extreme tooth sensitivity and those with numerous veneers and crowns may not be suitable candidates for this treatment. If this is the case, the cosmetic dentist will offer other teeth whitening options.
Dr. Hartley, Dr. Field and Dr. McFarlane may advise patients to have a teeth cleaning prior to the Zoom! Whitening treatment. The actual Zoom! Whitening procedure takes about an hour. A dental assistant will prepare the area by covering the patient’s lips and gums, keeping teeth exposed. The treatment provider will then apply the whitening gel and leave the patient to relax while the gel is activated by the chair-side lamp and bleaches stains.
The treatment provider will apply new gel at 15-minute intervals three times during treatment for an overall procedure time of 45 minutes. Immediately following treatment, a fluoride gel will be applied to the teeth to reduce any sensitivity. Each patient will leave with aftercare and maintenance instructions.
Why choose us for teeth whitening? We offer the latest in bleaching treatments. Bleaching can whiten your teeth by removing the discoloration caused by coffee, tobacco, red wine, dark soda and aging. Naturally yellow or darker teeth will benefit greatly from bleaching.
Home bleaching requires an initial visit to determine if you are a good candidate for this procedure and to fit custom-made trays to your teeth. These thin, comfortable trays hold a special gel that usually whitens your teeth over a period of 7-10 days. You can wear them overnight or more often to speed up the process.