General Cosmetic and Implant Dentistry for Adults in Milford, MA

DAVID M. WOLF / DDS

100 medway road / suite 203
milford, ma 01757

t: 508 473 4999
f: 508 473 7699
e: office@davidwolfdds.com

Dental exam

Dental cleaning

Dental fillings

Dental implants

Crowns

Bridges

Dentures

Porcelain veneers

Tooth whitening

Occlussal guards

Dental conditions

Insurance and payment options

DENTAL EXAM
A comprehensive dental exam will be performed by the dentist at your initial dental visit. This initial exam includes documenting the location of your existing teeth and filling locations. At regular check-up exams, the dentist and hygienist will include the following:

X-rays (radiographs): Used for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.

Periodontal evaluation: Check the gums and bone around the teeth for any signs of gingivitis or periodontal disease.

Examination of teeth: All tooth surfaces will be checked for decay.

Examination of existing restorations: Check current fillings, crowns, etc. for deterioration or recurrent decay.

Oral cancer screening: Check the lips, tongue and gum tissues for any signs of oral cancer.
DENTAL CLEANING
Dental cleanings (dental prophylaxis) are usually performed by Registered Dental Hygienists but may also be performed by the dentist. Your cleaning appointment will include a dental exam and the following:

Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation is called gingivitis and is the start of periodontal disease!

Removal of tartar: Calculus (tartar) is hardened plaque that has been left on the tooth for sometime and is now firmly attached to the tooth surface. Calculus forms above and below the gum line, and can only be removed with special dental instruments called scalers.
Polishing: Removes stain formed on the teeth by such things as nicotine, coffee or tea. DENTAL FILLINGS
There are many types of filling materials available, each with their own advantages and disadvantages. Composite fillings, along with silver amalgam fillings, are the most widely used today. Because composite fillings are tooth colored, they can be closely matched to the color of existing teeth, and are more esthetically suited for teeth. Amalgam fillings are made of metal and can provide a much more durable restoration. If needed, the dentist will discuss the best options for restoring your teeth. As with most dental restorations, amalgam or composite fillings will not last forever and will someday have to be replaced.

Tooth Colored (composite) Fillings
A composite filling can be used to repair a damaged tooth. The damaged portion of the tooth will be removed and then filled with a composite filling. Composite can also be used to fix minor cosmetics issues such as spaces between the teeth. Composites are used to repair both front and back teeth.

Silver (amalgam) Fillings
An amalgam filling can also be used to repair a tooth that is damaged. This material is most commonly used on back teeth that are either decayed or broken.
Dental Implants
Dental implants are titanium screws which act like artificial roots. They are surgically placed into the upper or lower jaw bone by an oral surgeon or periodontist.

Dental implants are a great way to replace one or more missing teeth they can also be used to support a full or partial denture.

Reasons for dental implants:
Replace one or more missing teeth without affecting adjacent teeth
Support a denture, making them more secure and comfortable

How are dental implants placed?
The process of getting implants requires a number of visits over several months.

The basis for successful dental implants is a good treatment plan or road map for the outcome. The workup involves dental X-rays and impressions of the jaw and teeth. Sometimes it is necessary to have a CAT- Scan to determine the bone thickness and height

Once the plan is finalized, the implant(s) are surgically placed. The implant(s) must heal in the bone, sometimes this process can take several months. After the implants heal a second procedure is completed to uncover the top of the implant, once this is completed the tooth or teeth can be attached to the implant(s).
Crowns
A crown (or cap) is a covering that encases the entire tooth surface restoring it to its original shape and size. A crown protects and strengthens tooth structure that is significantly weakened and would otherwise not be strong enough to support normal function.

Crowns are most commonly needed following root canal treatment but are also used to repair broken teeth. Crowns can also be used in the front to improve a person's appearance.

Crowns are most commonly made of porcelain for cosmetic reasons. There are many types of porcelain crowns. The best type for each person will be discussed by the dentist. Crowns can also be made from a precious metal alloy containing mostly gold.

How are crowns made?
A crown is generally placed in two steps. The first step involves shaping the tooth to allow the crown to fit onto the tooth. Afterwards a series of impressions are made of the prepared tooth and mouth which are used to make models of the person's teeth. These models of the mouth are sent to a dental laboratory where the custom made crown is fabricated. A temporary crown is placed after the first step to protect the tooth until the permanent crown is placed.

At the second appointment your temporary crown will be removed, and the new crown will be carefully adjusted to ensure the spacing and bite is accurate; finally the crown will be cemented with permanent cement.
Bridges
A dental bridge can be used to replace certain missing teeth; the missing tooth must be adjacent to two remaining teeth. These teeth are used as retainers called abutments to span the gap with a replacement tooth called a pontic.

Dental bridges are highly durable and will last many years, however they require regular maintenance and cleaning which can be difficult for some patients. If possible a dental implant is a better solution to replace a missing tooth. Unfortunately, implants are not possible in all cases.

How are bridges made?
A bridge is generally placed in two steps. The first step involves shaping the teeth to allow the bridge to fit onto the teeth. Afterwards a series of impressions are made of the prepared teeth and mouth which are used to make models of the person's teeth. These models of the mouth are sent to a dental laboratory where the custom made bridge is fabricated. A temporary bridge is placed after the first step to protect the teeth until the permanent bridge is placed.

At the second appointment your temporary bridge will be removed, and the new crown will be carefully adjusted to ensure the spacing and bite is accurate; finally the bridge will be cemented with permanent cement.

DENTURES
Dentures are prosthetic (false) teeth constructed to replace missing teeth. Conventional dentures are removable; however there are many different denture designs, some which rely on bonding or clipping onto teeth or dental implants. There are two main categories of dentures, partial and complete.
Partial dentures are for patients who are missing some of their teeth on a particular arch, they are generally held in by clipping to the patient's remaining teeth.
Conversely, complete dentures or full dentures are worn in patients who are missing all their teeth in an arch, these dentures rely solely on the shape of the jaw bone to hold them.

How are dentures made?

Dentures are made from a series of dental impressions which are sent to a dental laboratory. The laboratory fabricates the dentures but the final adjustment must be completed by the dentist to ensure a proper fit. It often takes multiple adjustments to get a denture to fit and function properly.
Porcelain Veneers
Veneers are very thin pieces of special dental porcelain that are custom made by a dental laboratory. They are bonded onto the front of teeth to create a beautiful and attractive smile.

Veneers can completely reshape your teeth and smile. They can often be alternatives to crowns on front teeth and the ideal solution in treating many cosmetic problems.

How are veneers placed?
Getting porcelain veneers requires two visits to complete the process. Depending on the type of veneers placed they may require little or no anesthesia during the procedure. If your case can be completed with Lumineers Tooth Whitening
Tooth whitening (or bleaching) is a simple, non-invasive dental treatment used to remove stain from natural tooth enamel and is an ideal way to lighten the shade of most teeth. Since whitening only works on natural tooth enamel, any existing fillings or crowns may not match after the tooth color has changed. If you have existing dental work on or in your front teeth it is important to have the dentist evaluate your teeth prior to starting any bleaching system.

There are several ways to whiten teeth. All the methods are based on a bleaching gel that is peroxide based. The difference between the methods is the strength and mode of applying this bleaching gel to the teeth. The most popular method is using a home tooth whitening system. The dentist can recommend which system would be best for you.

Tooth whitening is not permanent and can be repeated. Over time the teeth can accumulate new stains, this will occur faster if you smoke, drink coffee, tea, or wine.
Occlussal Guards
Bruxism is an oral para-functional activity observed in most people to some degree, includes clenching and/or grinding of the teeth. Bruxism affects a great portion of adults and estimates span from 50 to 95%. It is caused by the activation of reflex chewing activity; it is not a learned habit. Chewing is a complex neuromuscular activity that is controlled by reflex nerve pathways with higher control by the brain. These reflexes are triggered when the teeth touch. During sleep, the reflex part is active, while the brain control is inactive. The result is an abnormal chewing action known as bruxism. Some dentists believe it is due to a lack of symmetry in the teeth; others, that it reflects anxiety, digestive problems or a disturbed sleep pattern. Over time, bruxing shortens and blunts the teeth being ground, and may lead to pain in the joint of the jaw, the temporomandibular joint, or headaches. When bruxism causes the TMJ to become symptomatic and alter its normal function the condition is termed TMJ Dysfunction.

How is bruxism treated?

Unfortunately, there is no accepted cure for bruxism as yet. Ongoing management of bruxism is based on prevention of the abrasion of tooth surfaces by the wearing of an acrylic dental guard or night guard. These guards are very specifically adjusted to fit the patient's bite. Their primary function is to disassociate the trigger points on the biting surfaces of the teeth which cause the reflex chewing activity at night. In turn they protect the teeth from further wear and protect the muscles and joint from further strain and deterioration, decreasing the painful symptoms. Dental Conditions
Tooth Decay
Tooth decay is a destruction of the tooth enamel. It occurs when foods containing carbohydrates (sugars and starches) such as breads, milk, soda, raisins, cakes or candy are frequently left on the teeth. Bacteria that live in the mouth digest these foods, producing acids as a result. Over a period of time, these acids dissolve the tooth enamel, resulting in tooth decay.

Gingivitis and Periodontal Disease
Periodontal (gum) disease is an infection of the tissues surrounding and supporting the teeth. It is a major cause of tooth loss in adults. Because periodontal (gum) disease is usually painless, however, you may not know you have it.

Periodontal (gum) disease is caused by plaque, a sticky film of bacteria that constantly forms on the teeth. These bacteria create toxins that can damage the gums.

In the early stage of periodontal (gum) disease, called gingivitis, the gums can become red, swollen and bleed easily. At this stage, the disease is still reversible and can usually be eliminated by daily brushing and flossing.

In the more advanced stages of periodontal (gum) disease, called periodontitis, the gums and bone that support the teeth can become seriously damaged. The teeth can become loose, fall out or have to be extracted.

Root Canal
An abscessed (infected) tooth is caused when the pulp tissue (the nerve and blood vessels) inside a tooth are diseased or injured and can't repair themselves. The most common cause of pulp death is a cracked tooth or a deep cavity. Both of these problems can let germs (bacteria) enter the pulp. Germs can cause an infection inside the tooth. Left without treatment the infection spread to the bone which surrounds the tooth. This type of infection can be very painful. A root canal is the procedure to treat this type of dental infection. The procedure involves removing the infected pulp from inside the tooth and sealing the tooth with a special filling material.

For more information on many other dental conditions and treatments please visit ada.org Insurance and Payment Options
We have several payment options for your treatment.

We accept most dental insurances. If you provide your insurance information to us, we can confirm that your insurance is accepted prior to your first appointment.

We offer 3 month payment plans.

We also offer longer term financing for treatment plans which exceed $1,000 through Consumer Payment Solutions.