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A. No worries. While silver fillings are not the most aesthetic type of fillings because of their typically dark color, there is absolutely no scientific evidence at this time that would indicate that they are unhealthy or harmful to your health, based on leading university studies research compiled by the American Dental Association. However, Dr. Rivas will be happy to replace your silver fillings with tooth colored restorations for aesthetic purposes should you so desire, but he absolutely does not advocate removal of silver for so-called “health” reasons.

2) Q. I have children. Do I have to take them elsewhere or can Dr. Rivas see them too?

A. We have patients from ages 2 to 102, and welcome all ages. We offer most regular pediatric dental services, as well as aesthetic alternatives for missing teeth and to unsightly silver caps often placed on children’s teeth.

It is important to fix "baby" teeth because cavities can damage the secondary teeth.
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3) Q. I have one tooth in front of my top jaw that has a cap on it and I don’t like what my last dentist did with it; the color is way off and it doesn’t match. How do I know that Dr. Rivas can do any better in correctly matching it?

A. Dr. Rivas is an artist, has a trained eye for aesthetics, and more than a decade of experience performing these kind of procedures. In addition, Dr. Rivas is among a very small percentage of doctors in the world to use a color matching technology system released in early 2002, which takes the guesswork out of matching tooth colors. Until just recently, dentists all relied exclusively on their eyes and experience to get a correct match. Unfortunately, because of age, eye fatigue, or inconsistent lighting conditions, color is easily distorted in a phenomenon called “metamerism” and a restoration can be made in the wrong color. Dr. Rivas uses the Shade Vision System, manufactured by X-Rite, a world leader in instrumentation for measuring and management of color in a wide variety of color-critical applications.

 

A correct shade match can be ensured only by use of this technology, because of metamerism.

A special photograph is taken of the tooth to be matched with an integrated color-corrected light source and digital camera. The image is downloaded and analyzed by a computer program, which accurately measures the hue, chroma, and value of the tooth and maps the information on a grid of the photograph. This invaluable and previously unavailable information is then communicated to the ceramist fabricating the restoration allowing for a guess-free, precise match.

4) Q. My teenager has crooked teeth, should he get veneers or have braces?

A. Usually, in the case of any crooked teeth Dr. Rivas will refer a patient to the orthodontist for an evaluation. Whenever possible, we would prefer for them to straighten our patient’s teeth with braces in order to avoid alterations to teeth, if at all possible.

The photo on the right is a combination of veneers and orthodontics by Dr. Rivas..
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5) Q. My teenager recently finished orthodontic treatment where we used to live and we were told that he will need veneers and gum surgery for his smile to look right. Why is this necessary? Didn’t the orthodontist do a good job?

The photo on the right is after gum sculting and natural tooth recontouring.
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A. The orthodontist probably did the best job possible with the case, but sometimes circumstances such as tooth size discrepancy prevent a successful bite from looking aesthetic. Veneers can establish the correct proportions and attractive appearance to the successful bite created by the orthodontist. For the best results, a good working relationship between the dentist and the orthodontist is critical. Dr Rivas refers only to reputable orthodontic specialists who are trained in treatment and diagnosis of these kinds of problems.
Another common reason for teeth not looking their best after braces is that orthodontic patients sometimes require gum recontouring surgery to reestablish proper gum architecture. Failure to keep up with the extra cleanings required while braces are on or lack of at home care with all the hardware causes gums to become chronically inflamed. Laser surgery can return the normal appearance of size and shape to the straightened teeth. This is yet another reason why a close relationship between the dentist and the orthodontist is critical.

6) Q. What if I’m pregnant, should I still schedule an appointment?

A. It’s best to be on a normal 6-month schedule and be seen before becoming pregnant, but if you have become pregnant, it is still a good idea to keep up with your biannual visits. During pregnancy, there are many conditions that may develop and require treatment. Please let us know as soon as you can so that we may accommodate you. X-rays are usually bypassed until after delivery, but in the event that you experience an emergency, we can safely take an x-ray because of our computerized radiograph system which reduces radiation by 90% compared to traditional film x-rays found in most dental offices.

Example of emergency during pregnancy.

7) Q. I’m very fearful of dental treatment, should I expect it to hurt a lot?

A. While it is virtually impossible to make all dental treatment completely free of discomfort, Dr. Rivas and his associates strive to make your experience as comfortable as possible. Once the teeth/gums are numb, the actual treatment should not hurt at all. Getting numbed up is generally the only hard part for most patients. But we always use a strong topical anesthetic to help take the “edge” off before we apply the local anesthetic with the injection. For those who want or require sedation, prescription sedatives may be used.

8) Q. Does Dr. Rivas accept my insurance?

A. It depends on the type of insurance; we accept all indemnity insurances. We do not accept HMO plans. You should be familiar with your insurance benefits and if not, please request the following information from your benefits administrator within your Human Resource Department: 1) the name of your insurance carrier, 2) their address and phone number, as well as, 3) a group number and identifying subscriber number (usually a Social Security number, though this is not always the case.) We will be happy to confirm and accept your benefits with the correct information. NOTE: If Dr. Rivas is not listed as a provider of services in your insurance directory this does NOT necessarily indicate that you cannot have services performed by our office. If you have any questions regarding whether or not we are able to bill an insurance company on your behalf, we’ll be more than happy to call the insurance company to verify your benefits information.

9) Q. I have heard that insurances don’t cover any aesthetic procedures, is this true?

A. Insurances typically will not cover any purely cosmetic procedure (e.g. teeth whitening, changing functional silver fillings to tooth-colored fillings just to make them white, etc). However, if there are missing teeth, decay, fracture, gum problems associated with a restoration or other problems, insurances will usually cover a portion of the cost of most restorations (including crowns and bridges).

As a courtesy to our patients, after your exam we will fill out the necessary paperwork on your behalf, send out the doctor’s evaluation and your x-rays to your insurance for a “pre-estimate”. This document will provide you with a fairly accurate estimate of what your insurance will agree to cover for the proposed services and what your estimated cost responsibility will be.

10) Q. What forms of payment does Dr. Rivas accept?

A. We accept cash, check, Visa, Mastercard, American Express and the Discover Card.

11) Q. Is it possible to be in the treatment room with my spouse or child during a procedure?

A. Before any treatment is ever rendered, a patient is examined and a written treatment plan is made for the responsible party. Then a parent or spouse is informed of the needs of the patient and allowed to discuss at length, any questions that either may have directly with the doctor. This is the opportunity to gain a full understanding about what is needed, what can be done, and what the patient can expect with the treatment. The treatment rooms are designed to accommodate the patient, the doctor, and trained staff only. There are many sophisticated instruments and computers along with lasers, x-ray machines, and anesthetic gases that could pose a problem to a bystander. The patient and the treating staff are well protected, but for safety and insurance purposes, only the patient is allowed in the treatment room.

12) Q. When I come to my first visit, can I expect that I will get a cleaning?

A. A. A cleaning will normally be done on the first visit, as long as time permits to properly clean the teeth. A standard cleaning (also known as a “prophy”) takes approximately 25-45 minutes and removes tartar and plaque above the gums. Sometimes a patient will need more than a prophy if deposits of tartar are allowed to accumulate over time. A “deep” cleaning (also known as a “scaling/root planning”) extends under the gums and on to the roots of the teeth. The procedure takes two, sometimes three visits of 60-90 minutes each depending on the severity of the deposits and inflammation. Scaling/root planning is far more extensive than a prophy often requiring local anesthetic, medicinal irrigation, extensive charting of the conditions, possibly the use of the laser, and oral hygiene instruction. Because it is impossible to know the periodontal (gum) condition of a new patient over the phone, one may need to return for one or several cleaning visit after an initial exam.

13) Q. My teenager’s wisdom teeth are coming in. Do they need to come out and if so, when is the best time to remove them?

A. In the majority of cases wisdom teeth (known to dentists as 3rd molars) are malformed, misaligned, or there is simply no way to keep them clean, so most often they are best removed as early as they enter into the oral cavity. Sometimes wisdom teeth are “impacted” which means they do not present themselves in the mouth and are only detectable with x-rays or symptoms from a patient. Dr. Rivas refers these patients for removal to Dr. Scott Podlesh, a board certified Oral and Maxillofacial surgeon. Dr. Rivas also works closely with Dr. Podlesh on implant cases, TMJ and other surgical procedures.

14) Q. I have a piercing in my mouth and have heard that as long as I use surgical stainless steel, I will be ok. Is this accurate?

A. In the majority of cases wisdom teeth (known to dentists as 3rd molars) are malformed, misaligned, or there is simply no way to keep them clean, so most often they are best removed as early as they enter into the oral cavity. Sometimes wisdom teeth are “impacted” which means they do not fully present themselves in the mouth and may be only detectable with x-rays or symptoms from a patient. Dr. Rivas refers these patients for removal to an Oral and Maxillofacial surgeon. Dr. Rivas works closely with them on implant cases, TMJ and other surgical procedures.