Vancouver WA Dentist, Dr. Michael Koceja, DDS
A standard of excellence in personalized dental care enables us to provide the quality dental services our patients deserve. We provide comprehensive treatment planning and uses restorative and cosmetic dentistry to achieve your optimal dental health. Should a dental emergency occur, we make every effort to see and care for you as soon as possible.
A Positive Experience
Building a foundation of trust by treating our patients as special individuals is vital to our success. We understand how uneasy some patients may feel about their visits, and how we can make a difference in providing a relaxing and positive experience. Our entire team is dedicated to providing you with excellent, personalized care and service to make your visits as comfortable and pleasant as possible.
We thank you for allowing us to take care of your dental needs and look forward to seeing you!
If a natural-looking smile is important to you, your dentist can now repair and restore your teeth with tooth-colored fillings, inlays, onlays, crowns and veneers that when placed look just like your own teeth. Made of a complex composite of plastic and zirconia/silica, tooth-colored restorations bond to your tooth, helping prevent any filling leaks or chances of any cracking or breaking of the tooth. They also feel, look and function like your natural teeth, and are ninety to ninety-five percent as strong as a healthy tooth; whereas silver fillings are only forty to forty-five percent as strong.
Composite Inlays & Onlays
When your decayed tooth needs more than a filling but less than a crown to repair it, your dentist will use either an inlay or an onlay to bring your tooth back to a healthy state. Inlays are used when the decay is within the indented top surface (cusp) of a tooth; an onlay is used when the cavity involves one or more cusps. Composite inlays and onlays are made of a combination of plastic and zirconia/silica which is bonded to the tooth. They are tooth-colored in appearance and actually strengthen the structure of the tooth by up to seventy-five percent; and because of the composite materials from which they are made, they can last up to thirty years.
Crowns and Bridges
A dental crown becomes necessary when a tooth has become weakened by decay or fracture. It can also be used for cosmetic purposes. A dental crown is placed by first grinding away the tooth so that it is smaller. A crown or cap is then placed over the tooth and secured. If you are missing one or more teeth, your dentist may suggest the use of a fixed bridge and dental crowns. Since the gap left by a missing tooth can cause the remaining teeth to shift or move, it is important for your oral health to replace the missing tooth or teeth; and fixed bridges are one of the solutions for doing so. Bridges consist of a pontic (artificial tooth) and crowns, which are “caps” that go over the teeth on both sides of the bridge and serve as anchors to stabilize the bridge. Traditional bridges are usually made from porcelain fused to metal or ceramics.
These wafer-thin shells that are most often made from porcelain or ceramic are bonded to the front surface of a tooth to cover teeth that are discolored, stained, chipped, cracked or even misaligned or have gaps between them. Your dentist makes impressions of your teeth and then a mold of the way your teeth will look once the veneers are placed. The mold is sent to a dental lab where the veneers are created. Once they are returned to your dentist’s office (typically in five to ten business days), your dentist uses a special cement to apply the veneer to your tooth or teeth.
Once the veneer is placed and both you and your dentist are happy with the way it looks, a special light is used to harden the cement and permanently attach the veneer to your tooth.
Veneers are made in a tone and translucency that either matches your teeth or whitens and improves the look of your teeth. Veneers typically last for five to ten years and do not require any special care – just brushing, flossing and regular visits to the dentist.
Your dentist can help you determine if your teeth and gums are healthy and good candidates for teeth whitening, and which whitening process will give you even, natural looking results. If the discoloration or stains on your teeth will not respond well to whitening, your dentist will have other options that will work for you. If teeth whitening is a good option for you, in-office whitening will give almost immediate results; and teeth whitening trays and gels created by your dentist can be used at home over the span of three days to two weeks.
Periodontal Disease (or gum disease) is a serious infection in your gums that is mainly caused by bacterial plaque that is constantly forming on your teeth. When plaque isn’t removed by brushing, flossing and regular dental cleanings, it can turn to tartar – a hard substance that can be removed only by a dentist. When left in your mouth, plaque and tartar can cause inflammation of your gums. This can develop into infections below the gum line, causing the gum to separate from your teeth, creating pockets that become infected and can even fill with pus.
As the pockets deepen and the disease becomes more pronounced, bone and gum tissue are destroyed, which can ultimately result in tooth loss. Periodontal disease is stealthy – usually giving few, if any, signs of its existence. Regular dental checkups can detect periodontal disease at even its earliest stages. Since periodontal disease is created by plaque and tartar buildup on your gums, good dental hygiene is a must in preventing gum disease.
Along with good daily oral hygiene habits, regular visits to your dentist for checkups and professional cleanings (involving scaling and root planing that will remove plaque or tartar buildup) will help keep your gums healthy and free of periodontal disease and infections.
Root Canal Therapy
The space within the root of each of your teeth is called a “root canal”; and within that canal there is dental pulp, which consists of soft tissue, nerves and blood vessels. Tooth decay or trauma can cause damage to your dental pulp. This results in infection that, if left untreated, can spread to the bone around your tooth, resulting in the loss of the tooth. To save the tooth, your dentist will first remove the dental pulp. Then the area that held the pulp is cleaned and shaped to hold a specialized filler material that will protect your tooth from any more infection and reduce any sensitivity of the tooth. Once the root canal is cleaned, filled and restored, your tooth is capped with a crown that protects the mended root canal and looks and functions like a normal tooth.
Dental Implant Restoration
If you are missing one or more teeth or wear partial or full dentures, dental implants can be the perfect solution. An implant is a titanium screw that is placed in your jaw, where it functions like a tooth root and stimulates the bone and tissue to keep them from disintegrating. An abutment is fastened to the implanted screw and an artificial tooth is attached to the abutment that protrudes from the gum. Once the artificial tooth is placed on the abutment, it looks, feels and functions like a natural tooth. Dental implants can also be used to secure partial or full dentures; and instead of attaching an artificial tooth to the abutment, the dental plate or partial is fitted with an O-ring that snaps on to the abutment. For a partial denture, as few as one implant may be needed; for full dentures, it will take four or more implants to securely hold the prosthesis in place. Implant-supported partials or dentures function just like normal teeth, allowing you to bite and chew just as you did with your permanent teeth; but the dentures can still be removed for cleaning.
Scaling and Root Planing
Even with good daily oral hygiene, some plaque still remains in your mouth; and over time it can harden and become tartar (also known as calculus). If left in your mouth it will cause periodontal disease. Tartar can be removed only by a dentist or dental hygienist with a process called “scaling”, in which either ultrasound vibrations or a manual tool called a “scaler” is used to remove tartar from the portion of your tooth that is below the gum line.
Since plaque and calculus love to grab onto rough surfaces of the tooth, once the built-up tartar has been removed from your tooth, the rough or irregular surfaces are smoothed away with a process called “root planing”. This process is used to prevent periodontal disease, reverse any early signs of gum disease and to prevent any existing periodontal disease from spreading.
Wisdom Teeth Extraction
At one time in the history of man, wisdom teeth (or third molars) were most likely an important part of our entire tooth structure; but that is no longer the case. Because of a lack of adequate space in the jawbone for them, wisdom teeth (that usually come in somewhere in our late teen years) often come in sideways, pushing at an already established tooth. This causes the wisdom tooth to only partially erupt through the gums or, in some cases, does not push through the gums at all, but stays impacted under the surface.
Bacteria can grow around a partially erupted wisdom tooth, causing periodontal disease; or food can get caught between the wisdom tooth and the adjoining tooth, creating tooth decay in both teeth. When a fully erupted wisdom tooth needs to be extracted, it is pulled like any other tooth. However, if the tooth is partially or fully impacted under the gum line and in the jawbone, an incision has to be made in the gums; and the tooth, as well as a portion of the bone that is covering the impacted tooth, has to be removed.
Removable Partial Dentures
If several teeth are missing in either your upper or lower jaw, a removable partial denture that is either supported by adjoining teeth or by an implant can be used to replace the missing teeth thus giving you the ability to chew more naturally, keep your remaining teeth from moving into the space left by the missing teeth, ensure proper jaw alignment and support the structure of your face. A removable partial denture is either held in place by clasps that hook on to adjoining teeth or by securing to the abutment of a titanium screw that is implanted in your jawbone. Partial dentures are easily removed for brushing and cleaning.
When all of your permanent teeth need to be extracted from either your upper or lower jaw because of decay, periodontal disease or trauma, complete dentures are created in a dental lab to replace your missing teeth. Over time, dentures can loosen because of the loss of gum tissue and jawbone that deteriorate when they no longer have tooth roots to keep them stimulated. This can result in the use of dental products to keep them adhered to your gums. The other option is to have your dentures secured with implants that are placed in your jawbone and, through a process called osseointegration, take the place of a tooth root. In either case, your dentures are easily removable for cleaning.
In a way, bonding is like a simplified version of a veneer or a crown. While it can’t withstand the kind of abuse that those solutions can, bonding works well in a variety of situations. This is a process in which a tooth-colored resin material is used to repair chips and cracks on teeth as well as to change the shape of a tooth or to close gaps between teeth. It can also be used to repair a decayed tooth or to fully restore badly damaged teeth. The resin that is used is matched closely with the color of your teeth so that it looks exactly like your natural teeth when the process is done. The procedure typically takes from thirty to sixty minutes per tooth. It begins with slightly roughening the surface of the tooth and applying a conditioning liquid. Then the putty-like resin is put on the tooth surface and molded to create the desired result. Once the tooth repair or correction is done, a special light is used to harden the resin and bond it to your tooth. Bonding materials usually last from three to ten years before needing to be touched up or replaced.
Enamel shaping is the opposite of dental bonding. Also known as contouring, this is a process that can be used to fix minor problems in the shape or texture of your teeth – such as small chips or pits in a tooth’s enamel or even irregular or uneven teeth. During the process, your dentist will use a sanding disk or fine diamond burs to sand your tooth or teeth to remove any roughness or pits, or to slightly reshape them. Once your teeth are smoothed and/or reshaped, they will be polished to finish the process.
ClearCorrect is essentially an invisible way to straighten your teeth without the use of traditional braces. The ClearCorrect system employs a series of clear, removable aligners that move your teeth, over time, to give you the smile you always dreamed of. ClearCorrect is very versatile, helping to correct a wide range of dental and orthodontic issues such as over-crowded teeth, widely spaced teeth, overbite and underbite. These situations can contribute to gum disease and wearing of teeth, as well as painful jaw and joint problems.
Read more about Laser Dentistry.