COSMETIC
VENEERS
Feldspathic, Layered eMax, Layered Zirconia, Monolithic. Single tooth to a full-mouth complete smile makeover. For best results, we recommend straightening crooked teeth with Invisalign prior to making the veneers. Teeth in their ideal locations can have the least amount of preparation: minimal and no-prep is more possible. Veneers technically only resurface the front part of the tooth. If more coverage is needed due to cracks, cavities, or defects on the tooth, then a crown or 3/4 crown can be done. Compared to a veneer, there’ no differenace in appearance or cost and insurances are more likely to provide benefits if there’s a problem with the tooth.
VENEER REVISION
Replace veneers that you're not happy with. Replace also if they're chipped, broken, or have a cavity developing.
NO PREP / MINIMAL PREP
If your teeth are in good health and your goals are purely cosmetic, then no preparation or minimal preparation veneers will be the most conservative option. By default, every veneer case we’ll study to see if no-prep is a viable option. However, if there are too many limitations to the aesthetic results, then the next option would be minimal prep. These differences can be explained more in the Veneer Consultation appointment.
WAXUP
Initial Draft Prototype design to develop the shape of your new veneers, crowns, or implant project based on the goals discussed in the consultation appointment. Detailed notes will be sent to the lab to design and shape your new teeth, incorporating any specific requests from the consultation appointment. The changes are made on CAD software and a new model of the teeth are 3D printed. An inverse mold is made from this design which lets the dentist fill with liquid plastic that sets within a few minutes. This is how the computer-generated design becomes transferred to your own teeth in the form of temporary plastic teeth. Modified easily with you and the dentist to develop the look, shape, and shade that you’re happy with. When you’re happy with the temps, a copy and photos will be sent to the lab as their blueprint design to make the finals into porcelain. Study and find 1-2 Veneer cases you like the best in our WORKS section and show doctor during the consultation. A photo of that case can be sent to the lab as a guide when making yours veneers.
DESIGN-DRIVEN PREPARATION
Applying the prototype design (waxup) on your teeth before making preparations. This makes the preparation as minimally invasive as possible since we’re only reducing tooth structure and creating space based on what we’re needing (the lab needs a minimal thickness for porcelain). This can be helpful when you’re wanting larger teeth than what you have, some teeth are naturally smaller, or have worn down. The deficient areas on these teeth do not need additional tooth structure removal. By adding the Prototype Design first, we will make the necessary space based on the ideal future design — not automatically reducing and drilling everywhere on your existing situation. This textbook approach takes more time and has some minimal additional costs, but is very conservative. Not every case needs this approach, the best way to figure out your situation is to have a Veneer Consultation.
CROWNS
Full coverage on a tooth vs. a veneer is only on the front of the tooth. Can look the same as a veneer. A 3/4 crown typically refers to anterior teeth, which is more coverage than a veneer but less than a crown. An onlay is similar but refers to posterior teeth and covers at least 1 cusp.
LASER
Gum tissue removal or gingivectomy used to make a veneer or crown larger. Removing excess gum tissue healing process is very minimal, with mild soreness for a few days. Mild pain meds may be needed with most patients reporting not needing them more than a day or two.
INVISALIGN
Straightening teeth in the right positions can dramatically improve the appearance of your teeth. Clear aligners can correct misaligned teeth. Time frame ranges from 3 months to several years. Patients can using bleaching gel to whiten during the Invisalign treatment. If your teeth need straightening and you’re considering veneers, we recommend Invisalign first for best results.
AIRWAY-DRIVEN VENEER DESIGN
Heavily worn teeth and a narrow arch can result in less available airway during breathing. This can result in worse sleep quality. If you think this describes your situation, we can order a sleep study and go over the best options available. By repositioning and rebuilding teeth to ideal, the airway space and breathing can be significantly improved.
IMMEDIATE IMPLANT VENEER
If you’ve had a veneer break off and it doesn’t look like there’s much tooth structure remaining, it’s possible it may not be saveable / restorable (more common in root canal treated teeth). Fortunately, Dr. Heldt is well-trained, highly experienced, and has State-of-the-Art technology to extract the tooth and place a solid titanium implant the same day as the tooth is removed. A temporary crown can be immediately installed on a dental implant the same day as it has been placed. Requires enough primary stability of the dental implant (35nm+). Made possible with the NobelActive dental implant by Nobel Biocare. TempSnap abutment used to attach the temporary implant crown to the dental implant. Offices that don't have this technology, will provide you a removable denture as your temporary (not ideal). Read more about implants in our Implant Section and see this type of treatment in the Works Page.
IMPLANT
If you're missing a tooth or teeth, or about to lose them, then the best option is to have it replaced with a dental implant. If planned and performed properly, it can look just like your other teeth. See implant section for more information.
BONDING
Composite fillings with various shades and translucencies available.
WHITENING
In-office, take home kits, bleaching gels with Invisalign aligners or custom bleaching trays.
IMPLANT
PLANNING
SURGICAL GUIDE
Requires a CT scan and digital copy of patient's teeth. Merges the information on DTX Implant Studio (implant software) to plan out the ideal positions of the implants. A surgical guide (drill guide) is 3D printed. This is custom-fitted to the other teeth. The implant is inserted through the guide to the same computer-planned positions ("Fully-Guided" Surgical guide). The most accurate and precise way to get a dental implant. The implant placement is planned prior to the surgery and built to spec: "Architectural Implant Placement".
CT SCAN
On-site Morita X800 CT Scan. Various resolutions and Fields of View available. Dr. Heldt can plan out your implants at the consultation to see what kind of implant treatment is possible for you. A CT Scan is about the same amount of radiation as getting a full set of X-Rays. You can safely get several of these in a year since our machine uses CBCT, which is exponentially less radiation than a medical grade CT scan.
AESTHETICALLY-DRIVEN IMPLANT PLANNING
Your implant is planned for maximum aesthetic results. This means all phases of the implant is planned and specified: surgical placement, abutment type, crown type, shade, appearance, etc. For front teeth or cosmetic cases, we will take portraits photos to make sure the final results can reach maximum beauty.
SURGICAL
EXTRACTIONS / BONE GRAFTING
Allograft or Xenograft placed in the socket after extraction. This is called ridge preservation. See implant section for more information on replacing the tooth with a dental implant.
SURGICAL IMPLANT PLACEMENT
Replaces a missing tooth by installing a post in the jaw. The implant takes several months to heal before the final abutment and crown can be installed. See implant section for more information. NobelActive, NobelParallel, NobelPearl. This appointment is typically about 2 hours, depending on how many implants you are having placed. Larger cases will need more time.
RIDGE AUGMENTATION
Adding bone to a narrow or deficient part of the jaw to provide enough bone for a dental implant to be placed.
SINUS LIFT
Adding bone in the maxillary sinus to provide enough bone to support a dental implant.
CONNECTIVE TISSUE GRAFT
Grafted from the patient's own palate or tuberosity. Adds thickness to gum tissue. It may alter the appearance of your gum tissue.
ALVEOLOPLASTY
Reducing / leveling infected, diseased, or unstable bone to make space for a prosthetic. Typically done for All-on-X procedures so the junction between the prosthetic and your gum tissue (transition line) is not visible when you smile. If not enough bone is reduced, this line can become unsightly. This prosthetic reconstruction is considered FP3 (tooth, bone, and gum tissue defect). In contrast, FP1 is a tooth only defect (no gum tissue reconstruction). Everyone's situation and goals are different and it may be more aesthetic and stable long-term to have FP3. Discussed in the implant consultation.
IMPLANT REMOVAL / REVISION
Removing an implant due to infection, bone loss, or prosthetic complications If there’s adequate bone, it’s possible we can remove the implant and place a new implant and temporary crown the same day (more common in front teeth implants than back teeth).
RESTORATIVE
IMPLANT CROWN
Final Implant crown made after the implant has “osseointegrated” and fused to the bone after several months. Options: screw-retained, cement-retained. Layered zirconia, layered eMax, or monolithic eMax or Zirconia. Screw-retained has the ability for us to easily remove the implant later if needed. There would be a small access channel on top which is filled with a resin composite filling. The dentist just needs to remove this filling to gain access to unscrew the abutment and crown. One minor disadvantage of this, is the filling can stain or wear out. It may need to be replaced every few years. In contrast, a cement-retained crown does not have an access channel so it looks much more aesthetic and doesn’t have the issue of the filling wearing out or staining. But it doesn’t have the option to easily remove it later if needed. The dentist would need to drill a channel on the crown or even possibly destroy the crown to gain access to the screw to remove the abutment.
ALL-ON-X FINAL PROSTHETIC
Full-arch implant supported bridge. Monolithic or layered zirconia. Customized pink porcelain to match gum tissue is possible for FP3 reconstruction.
CUSTOM ZIRCONIA ABUTMENTS
NobelProcera ASC Custom Zirconia abutment. TempSnap abutment for temporary crowns.
COVER SCREW
If your implant had low primary stability at the time of surgery (not sturdy enough), then we usually place a cover screw so the implant can heal under your gums, undisturbed by food, saliva, and other possible risk factors. This happens about 10% of the time. A small minor surgical procedure will need to happen later to “uncover” the implant since your gums will have healed over the cover screw. After uncovering the implant, a healing abutment will be placed to provide access to the implant. This procedure is much shorter and less painful typically. We recommend pain medications a few days for your comfort.
HEALING ABUTMENT
Temporary abutment placed on the day of the surgery so gums can heal and form around. This enables us to gain access to the implant later when ready to start the restoration process. The dentist only needs to unscrew the healing abutment when restoring.
SCAN BODY
Small part that attaches to the implant and allows the scanner to capture the position of the implant in relation to other teeth and gum tissue. This allows us to send the measurements of the space surrounding the implant so we can design and order a custom Nobel Biocare ASC abutment. High quality photos are usually taken so the lab can make a crown that perfectly match your other teeth.
MULTI-UNIT ABUTMENT
Stock abutment used for All-on-X cases. Comes in various configurations, angles, and options all with the goal of making your final prosthetic to be as slim and aesthetic as possible.
IMMEDIATE IMPLANT CROWN
Temporary crown attached to a temporary implant abutment.
ALL-ON-X TEMPORARY
3D Printed temporary prosthetic, full-arch implant supported bridge delivered the same day as having teeth extracted. This is “teeth in a day”. Working prototype developed with patient and doctor. Test drive new teeth before ordering the final. Shape and shade determination. Acceptable prototype will be blueprint for the lab to make the final bridge.
RESTORATIVE
CROWNS
Full coverage on a tooth. Same-day crowns, lab made crowns, 3D printed temporary crowns. CEREC eMax, CEREC Zirconia.
FILLINGS
Small repairs are made with resin composite fillings for cavities, cracks, or defects.
BIOMIMETIC DENTISTRY
Minimally invasive approach that restores damaged teeth by mimicking their natural structure, function, and aesthetics, preserving as much healthy tooth as possible using advanced bonding and materials to create strong, long lasting restorations.
ONLAYS / INLAYS
Partial coverage on a tooth. Made the same-day with the CEREC milling machine and our in-office porcelain lab.
BRIDGE
When a tooth is missing, the teeth adjacent can support a 3-unit bridge. The three teeth are connected together and flossing is not possible. Not ideal but better than no teeth. A dental implant is the best option to replace a missing tooth.
IMPLANT CROWN
Screw-retained, cement-retained. Layered zirconia, layered eMax, or monolithic eMax or Zirconia. This would be part of implant treatment. See the Implant Section for more information.
ENDODONTICS
Root canal treatment to clean out the tooth's root system. Necessary when a tooth's nerve system has been compromised. Allows the patient to continue using the tooth. Has limited lifespan and becomes brittle and more prone to fracture over time. Implant is the next best option when a root canal tooth is no longer saveable. See the Implant Section for more information.
RECONSTRUCTION
PROSTHODONTICS
A full jaw of worn down teeth can be restored to their original shape and size with crowns. Increasing the Vertical Dimension of Occlusion (VDO) requires all the teeth in the arch to be done. It’s not possible to increase the height of only a few teeth and not the others, it’s an all-or-none type of treatment. Worn down teeth typically aren’t shaved down more since the goal is to rebuild what has been lost. Full coverage crowns and possibly veneers provides maximum aesthetics and protection for the teeth. See an example VDO Case in our Works section.
TEMPORARIES
Draft prototype worn during the time the lab is making the porcelain or zirconia restorations.
ALL-ON-X
Implant-supported bridge that restores all lost teeth in a person's jaw or mouth. With modern technology, these can look just like regular teeth or even like veneers.
INVISALIGN
INVISALIGN
Clear aligners to straighten teeth. Time frame ranges from 3 months to several years, depending on complexity and aesthetic goals.
CLINCHECK
After taking photos and a digital copy of your teeth, a plan review appointment will show how many months of treatment are expected, the number of aligners, attachment locations, IPR locations (if needed), and elastics. A simulation will show how your teeth are now and how they are planned to look after Invisalign treatment has been completed.
REFINEMENT
Additional aligners can be ordered if the case did not track as expected. Wearing the aligners 22 hours of the day is the best way to have the case turn out as expected. However, it’s possible it may still not track perfectly for various other reasons. We won’t try to figure the reasons, but there is a small re-submission fee to order additional aligners within a certain time period. Details of your plan and package ware discussed in the ClinCheck / Plan review appointment.
VIVERA RETAINERS
Durable clear retainer that comes with a travel case. Total of 8 retainers (4 upper, 4 lower). Keeps your teeth in their current position, important after completing Invisalign, veneer, or implant treatment. Also acts to protect the teeth during sleeping.
SEDATION
ORAL SEDATIVE
An oral sedative can be prescribed prior to the appointment to help reduce anxiety. You will need a driver to your appointment and to drive you home. Unfortunately, we can’t work with Uber or Lyft since we’ll need the driver’s ID, phone number, and signature on pickup.
NITROUS OXIDE
Anxiolytic gas used during the procedure to reduce anxiety. Very safe and effective. Additional fees apply. The patient can drive home themselves, although we still recommend a driver for large procedures.
IV SEDATION
For extremely nervous patients. A dental anesthesiologist administers and monitors the sedation. Dual operator model means Dr. Heldt will be focused on your procedure and the anesthesiologist will manage the IV sedation, the safest way to receive IV sedation. Additional fees apply. You will need a driver to your appointment and to drive you home. Unfortunately, we can’t work with Uber or Lyft since we’ll need the driver’s ID, phone number, and signature on pickup.
PREVENTATIVE
COMPREHENSIVE EXAM + PROPHY
If you haven’t seen the dentist in a long time, it would be more efficient and cost effective to schedule a New Patient Comprehensive Exam. This would include a full set of X-Rays, checking the health of your gums, possibly some photographs, and an examination by the dentist. A detailed treatment plan with priorities will be made and discussed. We have a dedicated consultation room so there’s plenty of time to discuss the plans, review your X-Rays, and go over the treatment phases and sequences.
NIGHTGUARD
Worn only when sleeping, protects the teeth and prevents clenching. Separates the jaw joints for TMJ relief.
PERIODONTAL THERAPY
Below the gum cleaning to remove hardened calcium build up or calculus (tartar). More extensive than a regular cleaning.
SEALANTS
Seals the small grooves of teeth with a resin sealant. Prevents food impaction and reduces cavities from developing. They may need to be replaced every few years depending on wear.
CT SCAN
On-site Morita X800 CT Scan. Various resolutions and Fields of View available. Utilized in implant, diagnostic, and endodontic work. Cancer and infection screening.
URGENT
LIMITED EXAM + XRAYS
Schedule this type of exam if you have an urgent issue needing to be fixed such as a chipped front tooth, crown coming off, pain, infection, or accident. Depending on scope of damage, at minimum a few X-Rays will be taken. If the scope involves potential damage in the jaw or bone, then Dr. Heldt may recommend a CT Scan which is a 3D X-Ray. By studying both the regular 2D X-Rays, CT scan, and performing a visual exam, Dr. Heldt can determine the source of most dental problems.
COMPREHENSIVE EXAM
If you haven’t seen the dentist in a long time, it would be more efficient and cost effective to schedule a New Patient Comprehensive Exam. This would include a full set of X-Rays, checking the health of your gums, possibly some photographs, and an examination by the dentist. A detailed treatment plan with priorities will be made and discussed. We have a dedicated consultation room so there’s plenty of time to discuss the plans, review your X-Rays, and go over the treatment phases and sequences.
CT SCAN
On-site Morita X800 CT Scan. Various resolutions and Fields of View available. Utilized in implant, diagnostic, and endodontic work. Cancer and infection screening.
ENDODONTIC TREATMENT
If you have a blister, infection, or abscess around a tooth, it’s possible the nerve has been compromised. This can happen if a cavity goes untreated and reaches the inner part of the tooth, where there’s the nerve and blood supply. If the damage is not too severe, it may be possible to restore the tooth but the roots would need to be cleaned out and filled with a biocompatible material. This is called root canal treatment. Even though the tooth no longer has a nerve, the tooth can still be utilized for additional years. However, it becomes more brittle over time and many root canal treated teeth fracture. After 15-20 years, the lifespan is less predictable and a lot start to break down, crack, or fracture. When this happens, then next best option is replace the tooth with a dental implant. The great thing about implants, is if properly performed and maintained, there’s a 96% chance it will last you your life. See the Implant Section for more information.
NEW CROWN OR VENEER
If you lost a crown or veneer, needing one to be replaced, or are needing a new one, we have the technology to complete this the same day with our in-office porcelain lab. This CEREC technology can even make an exact copy of your existing crown or tooth so the new crown will be the same shape and appearance. This is helpful when you currently have a nightguard or retainer already and don’t want to order a new one. This in-office made crown is acceptable in most situations, especially if it’s in the back tooth. The process takes about 2 hours to complete. However, if the crown or veneer is more in the aesthetic zone or area where people can see, then it may be better to order a lab made restoration. The restorations we make in the office are limited to monolithic, which have limited options for appearance. If your other teeth have a lot of complexity or translucency, then layering the restoration with porcelain will be able to duplicate those features and match your other teeth perfectly. Everyone’s teeth are different, so we just need to study them to see what would turn out the best. Sending to the lab would take a few weeks for the case to return. Study the difference between types of restorations in the Works section.
EXTRACTIONS / BONE GRAFTING
A tooth that is non-restorable means it cannot be saved. The only option is to have the tooth removed by an extraction procedure. After the tooth is removed, there will be a socket or hole in the bone from where the root was previously. Dr. Heldt always recommends to have a bone graft to preserve the ridge. This is easily done at the time of extraction where Allograft or Xenograft is placed in the socket after extraction. A collagen membrane is placed over the bone graft and PTFE sutures secure the membrane (another appointment in 2-3 weeks is needed to remove the stitches). This is called “ridge preservation”. These particle bone chips will be replaced and harden with your bone because bone is constantly turning over, similar to your skin, hair, and finger nails. The exfoliation process happens through your body’s blood supply. After several months, it will be solid enough to place a dental implant. See Implant Section for more information on replacing the tooth with a dental implant.