- + Veneers
Veneers are very thin pieces of porcelain, which are bonded to the enamel on the front surfaces of the front teeth. Veneers are typically utilized to enhance esthetics by changing the shape or coloration of teeth. There are many types of veneer restorations on the market, and selection should be done on a case-by-case basis to obtain the best result. Dr. Last has completed extensive study in the field of cosmetic dentistry and is excited to provide you with consultation on smile design.
It is important to understand that, in most cases, whenever a tooth has been veneered, even in cases where very little preparation is required, the tooth will ALWAYS need to be veneered. Many people mistakenly believe that veneers can be taken off and the tooth will go back to its original state. Veneers do not last forever and will have to be replaced at some point in a patient’s lifetime. It is important not to act hastily in the decision to have veneers placed, because once they have been placed, they always must be maintained.
- + Teeth-In-A-Day (Implants)
Dr. Last is very excited to provide the service of immediate implant restorations in conjunction with her very well-qualified oral surgeon and periodontist. Single teeth can be replaced in a single day as well as all of the teeth (full mouth restorations).
If you’re about to lose a tooth in the front of the mouth, it is nice to know you can have a new implant supported tooth in place the same day that the tooth is extracted. If you’ve been told you need to lose a single front tooth or all of your teeth, be sure to ask Dr. Last about how you can have your teeth replaced in a day!
- + Bleaching
Dr. Last offers several types of bleaching to enhance the shade of your natural teeth: High-speed in-office whitening, custom tray bleaching and disposable tray bleaching.
During in-office bleaching, a special solution of high-strength carbamide peroxide is placed on the teeth and activated for approximately one hour. Typically, patients can achieve several shades of whitening during this procedure. Impressions are also taken for at-home bleaching trays so that the results achieved by the in-office bleaching can be maintained.
At-Home Custom Tray Bleaching
This is the most effective and long-lasting method for bleaching teeth. Molds are made of the teeth, which are then used to fabricate thin, clear plastic trays that fit perfectly over the teeth. A solution of bleaching gel is then placed in the tray, which is worn for a period of several hours. Over the course of 1-2 weeks, significant shade changes can be seen. Maintenance bleaching is usually required every six months to a year. Research has shown that this type of bleaching is the most effective to achieve long-lasting and predictable results.
Disposable Bleach Trays
Dr. Last also offers disposable bleach trays, which will form to any individual mouth. These disposable trays are similar to other commercially available whitening strips (like those you find at the grocery store) except that they have a higher concentration of bleaching agent and therefore work more quickly than store-bought brands. Disposable bleach trays are typically not as comfortable as custom trays.
Sensitivity can develop with any type of bleaching and permanent damage can occur. Therefore, it is important to consult with a dentist any time bleaching is performed. Additionally, recent research has shown that bleaching may result in decreases in dentin (the inner part of the tooth) strength; therefore care should be taken when any bleaching is performed.
- + Laser Esthetic Gum Surgery
Dr. Last is fortunate to be able to use a high-powered CO2 laser for many procedures performed in her office. One service that is particularly beneficial is use of the laser to improve esthetic appearance of the gums by changing their height and shape. The benefit of using the laser for this procedure, instead of the traditional scalpel, is that it is typically much more comfortable and precise. Sometimes, the procedure can even be performed without the use of anesthetic.
- + Composite (tooth-colored) Fillings
Dr. Last is highly skilled at the placement of tooth-colored composite fillings. Composite fillings are much more esthetic than traditional silver fillings, and they do not contain any mercury. Many questions have been raised about the existence of BPA in composite fillings. The filling materials used in Dr. Last’s office do not pose a significant risk for BPA exposure. Please click on this link to read additional information about BPA in dental fillings.
Typically, insurance companies will NOT pay for tooth colored fillings in back teeth, they will only cover silver (amalgam – mercury) fillings. For those patients who still prefer silver fillings, Dr. Last will provide this service, per patient request. However, many patients are concerned about the presence of mercury in silver fillings. Dr. Last is very sensitive to this issue and is happy to discuss healthy alternatives to silver fillings. Dr. Last will always discuss your treatment plan and available options prior to any procedure.
- + Implants
Dr. Last is fully qualified to restore all types of implants in the front and/or back of the mouth. She is also trained to fully replace all teeth with implants, either with an implant-supported denture or implant-supported bridge. Dr. Last is also excited to announce that she is now able to provide implant restorations in the same day!
There are three components to a dental implant:
1. The implant: This is typically a titanium post that is placed in the jaw bone by an oral surgeon or periodontist.
2. The abutment: A metal piece that is connected directly to the implant and provides support and retention for the crown.
3. The crown: This is the porcelain or gold tooth, which is placed over the abutment and functions to replace the natural tooth.
Dr. Last does not place implants into the bone at her office, because she believes that the surgical component of dental implant placement is best provided by a fully trained oral surgeon or periodontist. Dr. Last works with the oral surgeon and/or periodontist to plan for the best location to place an implant in a particular site and then she restores the implants with an abutment and crown, bridge or denture.
- + Crowns & Bridge Work & Inlays/Onlays
Dr. Last firmly believes in a conservative approach to dentistry that emphasizes maintaining as much natural tooth structure whenever possible. Accordingly, she offers several types of restorations that help protect and restore teeth. Additionally, Dr. Last only works with the most reputable and premier dental labs in Colorado to provide you with the best quality restorations available. These labs always provide documentation, which confirms the type and contents of each individual restoration.
- + Full Exams & Cleanings
Comprehensive Exam and Regular Cleanings
The American Dental Association recommends that every person receive a dental exam and thorough cleaning of their teeth every six months. During the dental exam, Dr. Last screens for potential problems and creates a proactive treatment plan that is aimed at reducing the possibilities of future pain and costs associated with treatment. Additionally, a regular exam always will include an oral cancer screening. During this screening, all of the oral tissues, including the gums, tongue and cheeks are thoroughly examined for signs of oral cancer. If any suspicious lesions are detected, Dr. Last uses a special light to evaluate the possibility of the lesion having a malignant potential.
- + Deep Cleanings & Periodontics
If debris (calculus) accumulates on a root surface and remains there for a period of time, it can result in an inflammatory response that leads to loss of the bone around the tooth. This is called periodontitis or gum disease. Sometimes a regular cleaning is not enough to remove all of the debris that can accumulate underneath the gum line on the root surface of a tooth, especially when bone loss has begun around the tooth. In these cases, it is often necessary to provide a deep cleaning or scaling and root-planing appointment. During a deep cleaning appointment, the gums are anesthetized (numbed) to allow the hygienist to clean more deeply around the root without discomfort and remove the accumulated debris. If the debris remains, the bone loss will continue and eventually the teeth will loosen and potentially fall out.
- + TMJ, Splint Therapy & Occlusion (Bite)
Dr. Last is committed to helping patients who suffer from TMJ disorders and is excited to provide her patients with the most effective and scientifically based therapies available. As part of her passion for this area of dentistry, she makes this one of her primary focuses in her ongoing continuing education.
What is TMJ Disorder?
There are two components to TMJ (temporomandibular joint) disorders: problems within the joint itself and problems with surrounding musculature. A patient may have a problem in one or both of these areas at the same time. A grinding or clenching habit usually contributes to the exacerbation of these disorders. When problems develop within the joint they are usually related to the movement of the disc within the joint space. Or, joint problems may be due to trauma or development of a neoplasm (cancer) within the joint space. Issues with musculature are usually related to overworking of the muscles surrounding the joint. Excess activity in these muscles is often related to grinding or clenching. Sometimes, the muscles may be overactive due to discrepancies within a bite that create interferences and muscle pain.
Signs and Symptoms of TMJ
Chronic headaches, especially headaches located around the temple region or in the forehead
Awareness of a grinding or clenching habit
Tiredness or soreness in the jaw muscles
Popping or clicking noises within the joint itself
Treatments for TMJ Disorder
There are many different types of treatments available for TMJ disorders, among the most common are splint therapy and occlusal equilibration.
A splint is a dental prosthetic device made of clear acrylic, which is worn over the teeth. There are many types of splints available and each splint has a different purpose. Splints are used to deprogram the chewing muscles and position these muscles in a calm state where they can no longer be overactive. Additionally, splints position the TM joint in the most physiologically correct position. In this position the disc inside the joint has a better chance of resting in an appropriate and comfortable location. Splints take the pressure off of the joints and muscles, which often greatly reduces the signs and symptoms associated with TMJ dysfunction. Splints are also helpful in that they protect the teeth from additional wear, which is common in heavy clenching or grinding habits.
Occlusal Equilibration (Complete Bite Adjustment)
Occlusal equilibration is a process by which small amounts of enamel are selectively removed from the teeth to allow the bite to close in a more stable and healthy position. Incredibly, sometimes a little selective enamel removal is all that is necessary to help a person become free of TMJ pain. Dr. Last is well-trained in this procedure and will be happy to discuss whether this service may be beneficial in eliminating your TMJ disorder. Often, occlusal equilibration is also indicated before placement of extensive restorative dentistry, like crowns, implants and bridges.
- + Root Canal
Dr. Last is well trained in the performance of root canal therapy and is happy to provide this service in many cases. During a root canal therapy procedure, a small access hole is made in the center of the tooth, which opens into the pulp (nerve) space. Next, all of the infected pulpal(nerve) tissue is removed and the remaining canal space is thoroughly sterilized. Finally, an inert rubber material, called gutta percha, is placed into the canal space. This material fills and seals the canal space, which prevents bacteria from re-entering the canal and causing additional infection. Finally, a permanent restoration is placed in the hole where the access to pulp was made. Most often, a tooth that has had root canal therapy will also need a crown. Teeth that have had root canal therapy are much more susceptible to fracture, and a full coverage restoration (a crown) is necessary to prevent them from breaking.
- + Dentures
A denture, or plate, is a resin-based appliance that fits over the gum tissue and replaces teeth in a mouth that is completely edentulous (all teeth are missing). Dentures can be made that rely solely on the remaining gum tissue for support and retention, or they can be affixed to implants that hold them in place more securely. Dentures are typically worn during the day and come out at night.
- + Partials
Partials are made to replace several but not all teeth in a patient’s mouth. This type of prosthesis is typically made of a combination of a metal plate that has acrylic affixed to it, and plastic teeth that are held into the acrylic. Usually, small amounts of enamel must be removed from the remaining teeth to allow room for metal clasps and rests. The partial is held in the mouth by clasps, or arms that hold on to the remaining teeth. Partials are usually worn during the day and are taken out at night.
- + Extractions
While her goal is to save every tooth that she can, Dr. Last understands that sometimes the battle for a tooth may be lost, and in that case she is highly capable of performing dental extractions.
- + All Digital Dental X-Rays
Dental radiographs (x-rays) are used to further examine the teeth and look for signs of decay and bone loss that may not be apparent clinically. Dental x-rays are VERY safe, especially DIGITAL x-rays, because they typically expose a patient to approximately 80% less radiation than traditional dental x-rays.
Dental x-rays are very important aids in the diagnosis of dental disease. Without radiographs, diagnosis of hidden problems becomes extremely difficult. In addition to decay and bone loss, radiographs may also reveal the presence of:
Dental Abscesses or Cysts
Cancerous and Non-Cancerous Tumors
Poor Root or Tooth Positions
Problems Located within the Tooth or Underneath the Gumline
How often do I need X-Rays?
The need for dental x-rays is always based on an evaluation of each individual’s needs. Dr. Last determines which x-rays are necessary based on each patient’s medical and dental history, dental examination, age considerations, signs and/or symptoms of disease, and risk for dental disease.
Typically, a full mouth set of x-rays is recommended for most new patients. A full set consists of 18 x-rays, which show all surfaces of each tooth, including the roots. A full set is usually recommended every 3-5 years depending on risk factors. Bitewing x-rays are films that only show the crowns of the top and bottom teeth when they are biting together. Bitewings usually are taken every year during cleaning and periodic exam appointments.
- + Oral Cancer Screening
During your first visit to our office for a comprehensive exam you will be given a complete oral cancer screening. During this procedure, Dr. Last will examine the lymph nodes in your neck and perform a thorough visual exam of the tissues in your mouth, including your cheeks, tongue, gums, roof of the mouth, tissue under the tongue and throat. Dr. Last also uses the Trimera Identifi 3000 to examine any areas of concern. This state-of-the-art tool utilizes different wavelengths of light to illuminate the oral tissues and help identify potential cancers. It is one of the most advanced devices available to help identify oral cancers.
If a lesion is suspected of being cancerous, a biopsy is always required to further identify and determine appropriate treatment. It is also important to recognize that while every effort is made to discover oral cancers at an early stage, some oral cancers do not always present as easily identifiable lesions in the mouth. Therefore, some cancers may not be detected during a routine oral cancer screening.
- + Deka CO2 Laser Technology
Dr. Last is fortunate to be able to use a high-powered CO2 laser for many procedures performed in her office. The laser is used for several procedures, especially those involved in changing the appearance or function of gum tissue. One service that is particularly beneficial is use of the laser to improve esthetic appearance of the gums by changing their height and shape. The benefit of using the laser for this procedure, instead of the traditional scalpel, is that it is typically much more comfortable and precise. Sometimes, the procedure can even be performed without the use of anesthetic.
- + High Speed Electric Kavo Hand pieces
Dr. Last uses electric hand pieces instead of traditional air driven drills when preparing teeth with cavities or for crowns. The benefit of using electric hand pieces is that they are quieter, faster and more efficient. Typically, utilization of these hand pieces result in an easier and more pleasant dental experience.
- + HD Monitors and BOSE Sound Canceling Headphones
Lay back, relax and listen to your favorite music or watch a movie while we provide you with your dental treatment. BOSE sound-canceling headphone technology helps drown out the noise of the dental hand piece, and watching your favorite movie helps take your mind off of what’s going on inside your mouth. You can have access to thousands of movies streaming from the internet on our NetFlix service. Or, choose from our DVD collection, which includes the BBC series Planet Earth and Life, as well as several Warren Miller films or Looney Tunes for our younger patients. We are also happy to offer streaming online music.
- + Massage Chairs
Our dental treatment chairs have built-in back massagers to lessen the stress and discomfort of being in the dental chair for long periods of time. We are also happy to offer neck and knee pillows to take away some the strain.
- + Nitrous Oxide & Oral Anxiolytics
For our patients who are anxious about receiving dental treatment, we are happy to offer nitrous oxide (laughing gas). For some patients, oral medications taken prior to your appointment are more effective at reducing anxiety about dental treatment. Both of these options are available for our patients. We will be happy to discuss which choice is the most appropriate for you at your initial exam visit.
- + Family Friendly & Quality Service
We are not a large corporate type practice and truly we want you to think of us as your dental home. It is our goal to provide you with personalized service, and we want you to feel comfortable asking any questions you may have about your teeth, procedures or services. Our hygienists spend a full hour with each patient during their cleaning appointments to make sure all questions and concerns can be addressed appropriately. Dr. Last is always on call to her patients of record and is happy to see new patients on an emergency basis during regular office.