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Cosmetic Dentistry Frequently Asked Questions
Provided by Dr. Lance Timmerman of Seattle


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Bonding


Bonding is a procedure in cosmetic dentistry that is used to fix chips or fill gaps. Bonding is achieved by applying a type of thin white—colored plastic to the outside of the teeth. As technology has advanced, there are now more options than simple bonding.


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Porcelain Veneers


Porcelain Veneers, sometimes also termed dental veneers or dental porcelain laminates, are one of cosmetic dentistry′s more recent developments. These wafer—thin shells of porcelain which are bonded onto the front side of teeth can be an excellent cosmetic solution for teeth that are stained, chipped, or slightly misaligned.

Porcelain Veneers are used in dental extreme makeovers in cosmetic dentistry practices everyday. Porcelain veneers are used to: close gaps in teeth, fix chipped teeth, improve a gummy smile, lengthen short teeth, and improve your overall smile. Many Hollywood stars have porcelain veneers put on as an alternative to traditional teeth whitening methods. With porcelain veneers you can actually choose the shade you want and they are resistant to staining. Porcelain Veneers Seattle will give you the whitest smile imaginable.

What is the dental science behind porcelain veneers ?
Porcelain veneers are the most recent application of the art and science of cosmetic dental bonding. For decades dentists have had available to them materials which can create a durable bond to tooth enamel. Porcelain veneer technique utilizes the bonding capabilities of these materials to securely attach a thin sheet of porcelain (the porcelain veneer) to a tooth. Although porcelain is inherently brittle, when it is firmly bonded to a sturdy substructure (a tooth) it becomes very strong and durable.

What are the advantages of Porcelain Veneers over other types of cosmetic dental bonding?
Two of the greatest advantages of porcelain veneers over other types of cosmetic dental bonding are:

A) Porcelain Veneers create a very life—like tooth appearance.
You might be surprised to learn that while yes, a major component of teeth is enamel, they are not solid enamel. The enamel component of a tooth is actually only an outer shell.

B) Porcelain veneers resist staining.
Cosmetic dental bonding materials utilized in the past had the shortcoming of being susceptible to staining and discoloring. This was especially a problem for those people whose teeth had excessive exposure to tea, coffee, red wine, or cigarette smoking.

A significant advantage of porcelain veneers over other types of cosmetic dental bonding is related to the fact that a porcelain veneer's surface is just that, porcelain. Since porcelain is a ceramic, and therefore glass-like, its surface is extremely smooth and impervious. This means that the surface of a porcelain veneer will not pick up permanent stains.

What are the advantages of Porcelain Veneers ?
Porcelain veneers (porcelain laminates) can often be an effective method by which to make cosmetic changes in teeth that are chipped, worn, stained, crooked, or discolored. Please note that case selection is an extremely important factor in the success of this technique. Porcelain veneers cannot be utilized in every situation.

Only an examination by your dentist can determine if porcelain veneers are an appropriate method by which to make the changes you desire. Even if you find that porcelain veneers are not appropriate for your circumstances, your dentist will most likely be able to suggest other treatment options that are suitable.

One property of this enamel covering is that it′s translucent. This means that when light strikes a tooth's surface it is not immediately reflected off, but instead penetrates into the thickness of the enamel. This light will subsequently be reflected off the non—translucent tooth structure that lies beneath the enamel. This property of translucency is an important part of what gives teeth their characteristic appearance.

Historically the cosmetic dental bonding materials dentists have had available to them were only semi—translucent. This means that most of the light striking the tooth did not penetrate into the bonding layer but instead was reflected off the bonding's outer surface. The net result was that while the bonding did give the tooth an improved appearance, there was no sense of depth projected. No sense of a tooth's characteristic translucency.

Porcelain veneers, because they are glass—like, have a great advantage over other types of cosmetic dental bonding by the fact that they are translucent. When they are bonded onto a tooth′s surface they mimic the light handling characteristics of enamel.

Light striking a porcelain veneer will penetrate its thickness, and then subsequently be reflected back out once it has reached the opaque cement and tooth structure lying underneath the veneer. This translucency effect provides a sense of depth, and thus a very life—like appearance.

What happens during the procedure?
Patients need three appointments for the entire procedure: diagnosis and treatment planning, preparation, and bonding.

Diagnosis and treatment planning: It′s critical that you take an active role in the smile design. Spend time in the decision—making and planning of the smile. Understand the corrective limitations of the procedure. Have more than one consultation, if necessary, to feel comfortable that your dentist understands your objectives.

Preparation of teeth: This appointment will take from one to two hours. To prepare the teeth for the porcelain veneers, the teeth are lightly buffed to allow for the small added thickness of the veneer. Usually, about a half a millimeter of the tooth is removed, which may require a local anesthetic. At this appointment, a mold is taken of the teeth, which is sent to the laboratory for the fabrication of the veneers. This can take about one to two weeks. If the teeth are too unsightly a temporary veneer can be placed, at an additional cost.

Bonding of veneers: This appointment will take about one or two hours. First, the dentist places the veneers with water or glycerine on the teeth to check their fit and get a sense of the shade or color. While the veneers are resting on your teeth, view the esthetic results, and pay particular attention to the color. At this point, the color of the veneers can still be adjusted with the shade of the cement to be used. The color cannot be altered after veneers are cemented. To apply the veneer, the tooth is cleansed with specific chemicals to achieve a bond. Once a special cement is sandwiched between the veneer and tooth, a visible light beam initiates the release of a catalyst to harden the cement.

How about maintenance?
For about a week or two, you will go through a period of adjustment as you get used to your "new" teeth that have been changed in size and shape. Brush and floss daily. After one or two weeks, you′ll return for a follow—up appointment.


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Porcelain Onlays and Inlays


Porcelain Onlays and Inlays are another procedure to consider. Onlays and Inlays are a good option for restoration of teeth. They are effective in particular for fixing the back area of your teeth. An Onlay covers all points while an Inlay is similar to a filling. Both the Onlay and Inlay are formed from a composite resin. This resin is tooth colored and painlessly bonded to the tooth. The resin structurally reinforces the tooth ensuring your smile lasts for a long time.


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Resin or Tooth Colored Fillings


Resin fillings, also referred to as composite, white fillings or bonding, can make a substantial improvement in the appearance of the teeth in a short period of time. Resin is what dentists use to repair small cavities or chips in front teeth, as well as fill cavities cosmetically in back teeth. Resin can do virtually the same thing as porcelain veneers with respect to improving the appearance of the teeth. Using resin instead of porcelain veneers for cosmetic dentistry saves time and money, however there are disadvantages with resin. They are not as strong as porcelain veneers, and require repairs every few years. Resin can discolor over time, and does not have as much natural beauty as porcelain veneers. Resin cosmetic procedures can usually be completed in about an hour.


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Bonded-Bridge


A bonded—bridge can replace a missing tooth in far less time and for less money than a porcelain bridge or an implant. It is basically a resin or porcelain tooth with resin or metal wings on each side of it. It is ideal for a missing tooth in the front of the mouth, where biting forces are not that strong. The procedure involves removing a small amount of the inside of the teeth on either side of the missing one and then taking an impression or mold. The laboratory makes the bonded—bridge, which can then be adhered to the backs of the teeth surrounding the missing one.

I prefer the all resin bonded bridge because it is more esthetic (no metal shows through and "grays" the surrounding teeth) and does not fall out and have to be re-cemented nearly as much as a metal bonded—bridge.


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Gum Lifts


Gum—lifts (gingivectomy) involve the removal of gum to make the teeth appear longer, and the gum-line even. People who have excess gum covering the front teeth and an upper lip that comes up high when they smile are often self-conscious about their "gummy" smile. An uneven gum-line can make the teeth appear to have different lengths, which takes away from the appearance of an attractive smile.

To correct these problems, the dentist numbs the area and removes the excess gum. The patient is instructed to use an antiseptic mouth rinse such as Peridex on a Q—tip and apply upward pressure on the gums as they heal. The procedure is not painful, but some mild discomfort can be expected a day or two after the procedure. The gum is not damaged due to the procedure as long as the dentist has experience, and removes the proper amount. The procedure can usually be completed in about 30 minutes.


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Braces


Orthodontics or braces can improve the appearance of teeth in children and adults who have crooked teeth or teeth with wide gaps. Having teeth moved with braces is very time consuming, requires multiple visits (at least twenty) and can be uncomfortable. It is most useful for children to straighten their teeth. The procedure can improve the appearance of the face and jaw during growth.

I sometimes recommend braces to my adult patients for cosmetic reasons, but very few are interested. They would rather use other cosmetic options that get results faster, usually within two weeks, and often for less money.


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Teeth Whitening


Sometimes a single tooth becomes discolored causing it to look out of place with the rest of your smile. In these cases you may want to consider having the tooth whitened to match the rest of your teeth.

How much can a tooth be whitened?
How white an individual tooth can become from bleaching and whitening is a common question. Some whitening procedures claim they can whiten your teeth by up to nine shades, but that is highly unlikely. A change of two or three shades will make a significant difference in just about anyone′s smile. There is no one standard system in the dental field to measure and determine tooth color. However, the Vita shade guide is the most used. This guide divides individual tooth color into four basic shade ranges:

A (reddish brown)
B (reddish yellow)
C (gray)
D (reddish gray).

In the A range there are five levels of darkness. Ranges B, C and D, each have four levels.

Not all of your teeth are the same natural color. As strange as it may sound, usually your eye teeth are darker than the others, and your front teeth are almost always the whitest, and molars tend to be a shade between those two. When your cosmetic dentist is whitening one particular tooth, they will take this into account. The goal for everyone is to achieve an overall whiteness while still looking natural. During your first consultation for tooth whitening, your dentist will go over what you personally can expect for your specific smile. How a white tooth will become will vary from person to person. The structure of your tooth and the type of procedure implemented will affect the outcome.

Types of Tooth Whitening Procedures
There are a few tooth whitening procedures available that correct discoloration of the tooth by removing the brown and yellow staining. While each work effectively, there are advantages and disadvantages to each procedure dependent upon your objectives and commitment to the processes. The type of procedures available should be discussed with your cosmetic dentist, and they will recommend the most appropriate tooth whitening procedure for you.

Laser Bleaching (In-Office)
Using a laser with a whitening gel, this is an in—office bleaching system. The translucent bleaching gel is applied to the tooth and a laser light is used to activate the crystals to absorb the energy from the light and penetrate the tooth enamel to increase the lightening effect on the tooth. The length of time in the cosmetic dentist′s chair depends on the degree of discoloration you have.

Tooth Bleaching (In—Office)
A small amount of the bleaching abrasive is applied to the tooth. This is the most common technique because it costs less, but is most effective for mildly stained teeth. This procedure is sometimes used in conjunction with the in-office laser bleaching if you have severe discoloration (dark gray or purple) or internal tooth staining.

Tooth Veneers (In—Office)
Often an alternative to crowns, veneers are very thin pieces of specially—shaped porcelain or plastic that are glued over the front of your teeth with little or no anesthesia needed. They are the cure for teeth that are severely discolored, chipped, have small holes or pits, misshapen or crooked, or for the correction of unwanted or uneven spaces. Unlike crowns, veneers won′t require the dentist to remove much of the tooth itself. Veneers are created from an impression taken in your cosmetic dentist′s office. Your custom veneer is then glued directly onto your tooth. Typically costing less than crowns, veneers won't stain, making veneers a very popular solution for many people seeking that perfect smile. Strong and very durable, veneers last from ten to fifteen years, and come in colors that will brighten dark teeth without the worry of them changing color.

Pros and Cons of Tooth Whitening

Advantages:

People typically have a tooth whitened to improve their appearance. Teeth that are all of the same bright color are associated with beauty and a healthier lifestyle. When people have a brighter smile, they tend to smile more often and are less self—conscious.

In addition, a whiter smile tends to minimize the appearance of facial wrinkles, giving way to a more youthful and energetic appearance.

Finally, a whiter smile gives people to whom you are speaking a place to focus on and gives you a friendlier appearance.

Disadvantages:

Although tooth bleaching is very effective, there can be short term disadvantages, such as sore gums or tooth from the bleach. This disappears when bleach use is discontinued. Some individuals are more chemically sensitive. If you are one of them, inform your cosmetic dentist so that you can be tested for sensitivity to the solution.

Research indicates that tooth bleaching is completely effective in more than 78% of people. In cases of serious tooth discoloration, bleaching may not be the best choice. Veneers or crowns may be the superior choice. Bleaching is usually the first solution to try due to its lower cost.


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Instant Orthodontics


Instant Orthodontics can transform a crooked, uneven smile to one that′s straight, even and white in only 2 to 3 visits, without the use of metal braces.

How? With the artistic application of porcelain veneers.

Veneers are thin shells of fired porcelain that are placed on the front surfaces of the teeth. Offering a natural look and feel, veneers allow the cosmetic dentist to dramatically change the length, width, color and shape of a tooth. Restoring teeth to their natural beauty, veneers also resist staining, creating an enduring white, bright straight smile.

Why spend years enduring the discomfort and unattractive look of braces when instant orthodontics can change your smile in a fraction of the time?

How It's Done:
Once it′s determined which teeth need to be veneered, the dentist takes an impression of the patient′s teeth. That impression is sent to a lab with precise instructions of what′s to be done. The lab creates a wax up — a wax model of how the enhanced smile will look. The patient and dentist review the wax up and either make changes or give the lab approval to proceed. From the wax up, the lab creates the patient′s new teeth of porcelain.

Once the wax up is approved, the dentist prepares the patient′s teeth and fits him or her with temporaries (temporary version of the new smile.) When the porcelain veneers are ready, the temporaries are removed and the veneers are bonded to the teeth.

Technology:
While each dentist employs a different set of technologies to help him, here are some common ones that you may encounter:

IntraOral Camera — this small, pen—like camera projects a magnified image of your teeth on a monitor to help the doctor diagnose the treatment needed for each tooth.
Digital Imaging — This technology allows the doctor to show you a digitally re—imaged photo of you with your new smile before you start the procedure.
Soft Tissue laser — This laser may be used to help recontour your gum line or surgically eliminate the frenum, a muscle that causes the common space between front teeth.
The Wand — this is a computer controlled anesthesia devise that makes injections essentially painless
Recovery/Post Op Expectations:
Patients can expect recovery to be about the same as with any dental procedure. The gums may be tender and a bit swollen for a couple days after the veneers are bonded to the teeth. Over the counter anti—inflammatory medications, such as ibuprofen, can ease any minor discomfort.

After a few days, the veneers may need to be adjusted to provide a more comfortable bite or fit.

Complications:
Luckily, complications from dental procedures are uncommon. A bacterial infection following the procedure may occur and can be easily treated with antibiotics.

Am I a Candidate?
If you answer yes to any of the following statements, you are a candidate for Instant Orthodontics:

I dislike the appearance of my smile.
My teeth are crooked.
My teeth are uneven.
I have unsightly gaps between my teeth.
I'm embarrassed to smile.
My smile is keeping me from fulfilling my personal and professional life.
I had braces as a teenager, but I still don't like the shape or appearance of my teeth


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Malocclusion and Orthodontics


Malocclusion, sometimes called having crooked teeth or a poor bite, is the improper fit and alignment of the teeth and jaws. A common cause of malocclusion is teeth that have too much or too little room in the jaw. Inherited traits, such as tooth and jaw size, mostly determine how well your teeth fit together. The most obvious sign of malocclusion is crooked or protruding teeth.

During the childhood and early teen years, orthodontists use early growth modification techniques to reform the jaw, may remove (extract) selected teeth, and may use fixed or removable appliances to straighten the teeth.

In adults, treatment with braces can straighten the teeth to camouflage a jaw problem, but any restructuring of the jawbone must be done with surgery, sometimes in combination with orthodontic treatment.

Medications
For tooth pain due to newly installed or adjusted braces for malocclusion, take regular doses of nonprescription pain medication, such as ibuprofen or acetaminophen, for 3 to 5 days. Do not give aspirin to anyone under the age of 20 without a prescription because of the risk of Reye's syndrome.

Malocclusion and Orthodontics
Surgery
Orthodontic surgery to create better alignment between an adult′s upper and lower jaw is sometimes combined with orthodontic treatment for malocclusion.

Surgery Choices
Orthodontic surgery

What to Think About
Surgery may be the only viable treatment for severe jaw′related problems. Orthodontic surgery is performed only on adults, after the jaw has stopped growing.

Before deciding on orthodontic surgery, consider getting a second opinion from another surgeon or orthodontist.

Malocclusion and Orthodontics

Other Treatment
Some adults with malocclusion may prefer to replace all or part of a tooth by having restorative dentistry, which is less costly and less time-consuming than orthodontic treatment.

Other Treatment Choices
A crown (restorative dentistry) can improve the appearance of front permanent teeth (incisors) that are properly spaced but crooked.

What to Think About
The timing of treatment is ultimately up to you. If you are given different treatment options to choose from, interview your orthodontist or dentist about the pros and cons of each option.

The success of orthodontic treatment depends on your and / or your child's cooperation and self—care. If it is not possible to keep appointments, practice careful dental hygiene, and wear appliances as directed, consider starting treatment at a later time or not at all.

Orthodontic treatment is not an exact science and can be unpredictable, sometimes taking longer than planned. Orthodontists sometimes have to sacrifice stability for improved appearance, or vice versa. If treated teeth are not stable, a retainer may be necessary for an indefinite period of years.

Other Places to Get Help
Online Resource
Orthodontics Online
American Association of Orthodontists
Web Address: www.braces.org. This site offers answers frequently asked questions about orthodontics, information about financing dental care, a glossary of orthodontic terms, and links to other orthodontic web sites.
Organizations American Academy of Pediatric Dentistry
211 East Seattle Avenue

How to make sure your orthodontist is properly trained to treat you.
Contents:

How to make sure that your orthodontists has been formally trained in orthodontics before committing to him or her.
How to make sure that your orthodontist follows the Center for Disease Control(CDC) and American Dental Association(ADA) guidelines on sterilization
How to make sure that you're Orthodontists does not take old braces out of someone else′s mouth and put them in your mouth or your child′s mouth.
How to make sure your orthodontists knows the symptoms of metals allergies and how to treat allergic patients.
How to make sure your orthodontist participates in a study club or other form of continuing education


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CEREC


CEREC by Sirona Dental Systems is the world′s only system for the fabrication of all ceramic dental restorations in one office visit. With CEREC at your dentist′s side, you can be in and out in a single visit with a permanent, all ceramic crown, onlay, or veneer! For you, the patient, this means fewer injections, less drilling, and less time out of your hectic schedule for dental care . So, why are thousands of people world wide choosing the CEREC restorative technique for their dental needs?

Most dental restorative methods require more than one visit to the dentist. This means that on the first visit, you get an injection of anesthesia. Your tooth prepared, an impression taken, and a temporary restoration put on your tooth. You make a second appointment for a couple of weeks later, get another injection, have the temporary pried off (if it hasn't fallen off already), and have a permanent restoration put on. Why go to the dentist a second time when you don't have to? With CEREC, the procedure in a single appointment, start to finish

Finest Seattle Dental Materials
A CEREC tooth restoration isn't just convenient, it is also healthy. Many years ago, dentists had few options to repair decayed and damaged teeth other than amalgam, gold, and other metals. With CEREC, your dentist can use strong, tooth colored ceramic materials to restore your teeth to their natural strength, beauty, and function. These materials closely match the composition of natural tooth structure. This means when you eat hot food and then drink something cold, the restoration and tooth expand and contract at almost equal rates. So, your tooth does not crack, and you can go on enjoying your evening. Also, the materials are chemically bonded to your tooth, so your dentist can save as much healthy tooth tissue as possible while providing you with a dental restoration that strengthens your tooth.

Your dentist can use CEREC for more than just crowns and fillings. CEREC is capable of producing any single tooth restoration. Chipped or discolored front teeth can be repaired with beautiful CEREC porcelain anterior crowns or veneers. Your smile makes a lasting first impression. Enhance it with CEREC.

Worldwide, a CEREC restoration is placed every 20 seconds. With a history of nearly 20 years, this equipment has helped dentists place over 6 million restorations. Using metal free materials that are the closest to your natural enamel, CEREC gives you the highest quality restorative care. Ask your dentist today about single visit CEREC restorative care!


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Invisalign


Invisalign is the product of Align Technology Inc. The company was founded in 1997 by Zia Chishti and Kelsey Wirth. The author of this article started working with Align Technology in 1998 after completing a three year orthodontic residency at UCSF. Presented here are two cases that were treated with Invisalign. One of which is a lower interproximal reduction case and the other a lower incisor extraction case. The reader should keep in mind that both of these patients were treated in a small clinical trial conducted by the author and funded by Align Technology. The author does have proprietary interest in Align Technology.

Nov. 30, 2000 — Forget the gunmetal—gray strapping — it′s not the only way to get straight teeth. That′s essentially the marketing pitch behind a new type of orthodontic device that promises a straight smile while being easy on the eyes.

The Invisalign process uses a series of clear, plastic molds to gradually move the teeth. They're kept in place 24—hours a day — except for when brushing, flossing, and eating — and changed out every two to three weeks as the teeth straighten. The shape of the molds — and hence the final position of the straightened teeth —is determined by creating a three—dimensional movie of each patient′s mouth. It simulates, from beginning to end, the stages the teeth will go through as they′re adjusted.

The manufacturer of the system, Align Technology, Incorporated, of Sunnyvale, Calif., says the molds offer a more efficient way of straightening teeth, because at different stages in the process, only the teeth that need to be moved are moved. Still, that saves no time.

And there′s something else: Children can′t use them. The company says its computer imaging technology doesn't work for growing teeth.

So where’s the market? Right here: Twenty or 30 years ago we weren′t treating too many adults, says Michael Rennert, DDS, an orthodontist in Montreal and president of the American Association of Orthodontists. Today, I would say the average orthodontist in an urban practice probably has 20-30% of the practice in adults. That′s compared to about 5% in the past, he says. Rennert adds the new adult market has money and is concerned with both how the mouth looks and works. But not all of them can use the Invisalign system. It is certainly something that has a place in every orthodontist's armamentarium ... for select, minor adult cases.

Which does not necessarily mean the other adult cases have to stuff tire chains into their mouths. Rennert says today′s conventional braces are smaller and less conspicuous — and even work better than the old clunkers. The wire is still there, but the [newer] appliances are much more comfortable, he says. The traditional metal brace can be replaced by clear braces and braces from behind.

But hold on. Robert L. Boyd, DDS, chairman of the department of orthodontics at the University of the Pacific in San Francisco, says that even with more complicated cases, he has seen good results with Seattle Invisalign. There′s no doubt it will take its place as one of the methods to straighten your teeth, he says. On simple cases, it worked quite well. With moderate to moderate—difficult cases — those needing the equivalent of one year of treatment with braces — it worked very well. And that represents 40—50% of the market. Boyd, who conducted studies of Invisalign, says that in three short years, about half the orthodontists in the U.S. have learned to use the system — and patient demand is high.

Cost is not as much of an issue because it′s less doctor time. So we′re charging 20% to 25—30% more than conventional braces. Boyd says in his neck of the woods, few patients worry about the extra cost.

But that may not be the case elsewhere. The fees are high, says Elidio Deleon, DMD, chair of the department of orthodontics at the Medical College of Georgia in Augusta. Let′s say basic braces are $3,000. If you want Invisalign, there′s $500 for the set—up then X number of dollars for each retainer. If you′re in an area like California, where it′s more affluent, then patients are certainly willing to give it a try. In our area, an excess of money is just not available. Money is a driving force.

Furthermore, that money could be wasted if patients aren′t compliant, Deleon says. This appliance is totally dependent on whether the patient chooses to wear it. Yet to be determined is whether Invisalign can also move teeth in complex cases — such as when a pulled tooth has created a large space or if there is excessive crowding.

Still, there′s no doubt that Invisalign has created a buzz — even in lower—income areas. People believe that a smile is critically important to their success and they′re really jumping on it, Deleon says. A lot of people are calling here about it. But, he adds, for every ten that do, just one has a mouth that might benefit.

Seattle Invisalign vs. Braces
Another option for the vain at heart is Invisalign. Patients wear a series of clear, removable orthodontic aligners that are adjusted as the teeth shift into place without metal or wires. A series of custom-made aligners are worn each for a period of two weeks. Each aligner moves the teeth progressively into place. Average total treatment time: a few months to 1 1/2 years. While orthodontists say Invisalign can be a good alternative to traditional braces, there are limitations.

Invisalign does not do a great job on vertical problems, where the teeth are at different heights, teeth are lower or higher than others. It doesn′t not do a good job on teeth that are severely rotated, and it does not do a good job at correcting bite issues, says Sebastian, who also says Invisalign would also not be the best option for fixing severely overcrowded teeth.

Sebastian says Invisalign can cost an average of $500 more than a one—year treatment with traditional braces.

Case Study
Invisible Braces:
The Orthodontics Industry Goes Wireless
A new high profile start—up company, Align Technology, says its 3D computer imaging and manufacturing systems are key to straightening adult teeth without uncomfortable metal braces. Their system, called Invisalign (www.invisalign.com), utilizes 3D scanning hardware, automatic surfacing software, 3D animation programs, and rapid manufacturing systems --powered in part by Geomagic technology —to produce customized, removable, clear plastic appliances called aligners. Combined with an orthodontist's treatment plan, these retainerlike aligners provide an innovative alternative to traditional braces.

Align Technology will make history as the first company to lead the wave of mass customization in the 21st century. — Ping Fu, President and CEO, Raindrop Geomagic

How Seattle Invisalign Works

Step 1
The patient meets with an Invisalign—certified orthodontist who takes an impression and x-rays of the patient′s teeth, prescribes a treatment plan, and sends the impression to the Align Technology lab.

Step 2
At Align′s lab, a physical model is cast from the patient′s impression. That model is then digitized using a 3D scanner. Next, the data is imported into the Invisalign computer system, where it′s used to produce precise, manufacturable digital models and start to finish 3D animations of the patient′s personal treatment plan.

Step 3
The orthodontist reviews the 3D models and animations and approves the treatment plan. From these images, Align Technology manufactures a unique set of clear, plastic aligners that are custom fitted to the patient′s teeth and mouth.

Step 4
The patient wears each stage of aligners for approximately two weeks before switching to the next in the series. Week by week, the patient's teeth are straightened, millimeter by millimeter. Total treatment time is similar to traditional braces and usually ranges from six to 24 months depending on the complexity of the case. A single patient′s treatment series may contain up to 60 pairs of upper and lower aligners.
Our rapid design and manufacturing processes require automation, throughput, and customization -- all of which Geomagic has the unique ability to provide. -- Zia Chishti, CEO, Align Technology
The Invisalign system has received FDA clearance, meeting all medical device specifications. Raindrop Geomagic′s patented technology and engineering services enable Align to optimize its manufacturing process to meet current demand and increase capacity in the future.
Imagine viewing a 3D animation of the next two years of changes to your daughter′s teeth — the day after her first visit to the orthodontist. — From Raindrop Geomagic′s first corporate brochure, 1997


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Sleep Dentistry


General anesthesia — or Sleep Dentistry — is available in most cosmetic dental offices on an appointment basis. Sedation Dentistry bridges the gap between new technology and patient comfort. After an initial consultation, your Sedation Dentistry appointment will be scheduled. You are given a small pill or IV to make you snooze through your dental appointment. Even though you are not technically asleep, most patients describe the experience as seeming to be asleep. You will have little or no memory of the appointment. You will not even remember any sounds or smells.

With Seattle Sedation Dentistry — Sleep Dentistry, you will find that your treatment is performed more comfortably than you might ever have thought possible. You will be drowsy and unaware of the time passing by. During the entire appointment you will be monitored continually by our specially trained team of professionals.

What this provides is a way for the very fearful or especially sensitive patient to benefit from complete dental care without having to deal with the actual drilling.

When a patient asks for Sleep Dentistry, they usually have to go thorough medical assessment; to be sure there are no complications that would put the patient at risk.

Then, the office will consult with the anesthesiologist regarding scheduling and fees. If everything is OK, the office will normally schedule the appointment.

Usually all the necessary dental treatment is done in one visit. Treatment durations can range from one to three hours, and require that the patient have a ride to and from the office. And most dentists have certain dietary restrictions for the Sleep Dentistry patient the morning of the treatment.

Other than that, the use of Sleep Dentistry Seattle can be very normal and uncomplicated.

As many dental patients can attest, dental phobia is paralyzing fear that keeps people from obtaining regular dental care. We know that an estimated 9-15% of all Americans avoid regular dental care due to fear surrounding the dental visit. Over 35 million Americans have some level of anxiety when it comes to going to the dentist. But for many, it is more than being afraid. Some of our patients have had a traumatic experience in a dental chair; others come from a painful past. But regardless of your personal history, we are here to help. We understand that your fears may have kept you from a dentist, but there is no need to feel embarrassed. We are not here to judge you; we are here to help you and encourage you so that you can have the confidence a beautiful smile can bring.

If you or someone you love suffers from a dental phobia, you know that shame and embarrassment become very real issues affecting a person′s quality—of—life, social life and self esteem. When the patient finally gathers the inner courage to make a call to the dentist, they must be able to reach out to a team that understands the very real nature of their fears.

A good sleep dentist supports the unique needs of phobic patients from the moment they make the first call.The dental office should ask the patient′s dental history, his/her concerns, and any history of trauma to the mouth. Then the office should listen to the patient and fully understand the magnitude of the fear. Then they should discuss the easiest and safest way to bring comfort and care to the patient. If sleep dental procedure are still needed for the dental patient then they need a medical evaluation and possible seen by an anesthesiologist before treatment can be approved.

The dental office should have a full a treatment plan where all treatment can be completed in one comprehensive visit — utilizing optimal sedation (sleep dental treatment) options. When a dental patient chooses the option of I.V. sedation or general anesthesia, their sedation/anesthesia is administered and monitored by a physician anesthesiologist. Then the oral / cosmetic surgeon operates with a team approach and coordinates multiple specialties so that Periodontists, Endodontist, etc. complete all necessary work in one visit. Some dentist will give you a small pill to take an hour prior to your dental appointment. Your companion will accompany you to the office. By the time you arrive, you will be very drowsy.

When you arrive in the dental office, you should be escorted into the comfort room, covered with a thick, warm blanket and placed on a monitor to watch your vital signs. After you are comfortable, the dental, oral or cosmetic surgeon and the experienced clinical team will take care of your dental needs.

When your treatment is completed, your companion will return you home to finish your comfortable, relaxing day.

Am I a Good Candidate for Sedation — Sleep Dentistry?
Seattle Sedation — Sleep Dentistry is especially useful for adult patients who:

Have high anxiety about dental visits
Have had traumatic dental experiences in the past
Have difficulty getting numb
Have a strong gag reflex
Have TMJ troubles and cannot open their mouth for extended periods
Are afraid of needles
Have sensitive teeth
Hate the noises and/or smells associated with dental care
Simply do not have the time for multiple visits
Sedation Dentistry is only for adult patients. Dental offices should schedule a consultation appointment first to answer any questions and screen for any medical reasons you may not be eligible for Sedation — Sleep Dentistry.


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Lance Timmerman, DMD
Dental Excellence

Office Address:

7100 Fort Dent Way
Suite 270
Tukwila, WA 98188
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