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RITA KUTSIKOVICH, DDS. MPH Prosthodontist
29001 Cedar Road., Suite 550
Lyndhurst, Ohio 44124

How It Works

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Your smile is important. It’s one of the first things you notice when you meet someone. A whiter, brighter smile is beautiful – aside from making a positive impression, it can help you feel better about yourself and your smile. Many things we do on a regular basis contribute to stained teeth, such as drinking coffee, tea, cola and red wine, or smoking. Although your lifestyle and  the aging process can stain and darken your teeth, whitening can transform your smile. You should look for a whitening procedure that is:

Compare Zoom!

Other whitening systems don’t compare to the Zoom! Chairside Whitening System. Nothing whitens better or faster. Treatment Time Improvement

What to expect

Treatment Time Improvements What to Expect
ZOOM! Chairside 45 minutes Average of 8 shades Immediate results
Long lasting
Less fade-backSafe and comfortable
Performed by a dental professional
At Home Trays 7-14 days 6 shades Self-applied
Trays
No immediate results
Whitening Strips/Paint-on Gel 7-30 days 3-4 shades Inconsistent tooth whitening
No immediate results
Toothpaste 1 month or more 1-2 shades Results fade if you stop using the toothpasteSuperficial stains only

How it Works:

The procedure is simple. It begins with short preparation to cover your lips and gums, leaving only your teeth exposed.
We then apply the proprietary
Zoom! whitening gel, which is designed to be used specifically with the Zoom! light. The light and gel work together to gently penetrate your teeth, breaking up any stains and discoloration.

Make an appointment today for your Zoom! Teeth Whitening

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Teeth stains are inevitable due to our consumption of a variety of foods and drinks (soda, spicy food, coffee, etc.). However, advanced teeth whitening technology has enabled dentists to whiten teeth without adversely affecting the tooth structure.

Almost all whitening methods are similar in concept, but some are much more effective because of the way the whitening material is delivered to the teeth. Another contributing factor is the concentration of the material, which is why less potent over-the-counter whitening systems usually don’t give patients the results they are hoping for.

The two main methods of professional whitening are tray whitening and in-office whitening. In tray whitening, an impression is taken and a custom tray is made for the patient. Then, a supply of whitening gel is given to the patient and he/she wears the tray for a few hours each day (techniques differ) for a period of time until an acceptable result is achieved. The sensitivity of the teeth is a normal side-effect of this whitening method and is almost always transitional.

On the other hand, in-office whitening is the most efficient means of whitening. There are a number of different types used, but the process is very similar for these methods; you can have your teeth whitened in one session and achieve significant results. Your dentist can give you more detailed information and help you decide which method is more suitable for you and your teeth.

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This is one way to quickly get that beautiful smile. Veneers and Laminates are a thin shell of porcelain or resin that is bonded to the surface of the teeth. This can change their shape, shade, and position to improve the cosmetics of your teeth and smile. They are also used to replace and restore any lost tooth structure where indicated.

Your dentist will do a complete examination of your teeth to determine if veneers are ideal for you. Veneers often provide the opportunity to dramatically transform the aesthetics of your teeth and smile.

Veneers can enhance the shape of your teeth, make your teeth as white as you want, and give you the smile you have always desired. Additionally, Veneers are bonded to your tooth structure, which gives them strength.

Since they are very thin, Veneers are considered one of the most conservative cosmetic treatments available. Most of the time, very little or no tooth structure is removed before placing veneers. Ask your dentist how veneers can improve your smile.

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TMJ is the joint that connects the lower and upper jaw. The term TMJ stands for Temporo-mandibular Joint. This is one of the most complex joints in the entire body, capable of forward and backward movement, rotations, and side-to-side movements. TMJ often refers to complications and problems with this joint. Some of the most common symptoms of TMJ problems are:

Some potential causes of the disease include genetics, hormones, low-level infections, auto-immune diseases, trauma, and clenching or grinding of the teeth. Diagnosis and evaluation of such conditions are performed by dentists experienced in TMJ problems and treatments. Some common treatments are Night Guards, Bite Guards, and Bite Adjustments. Your dentist can guide you toward the best treatment for you.

If you experience any TMJ problems or symptoms please let us know. The doctor will be happy to evaluate your situation and offer the best treatment possible.

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Your comfort is Our #1 Priority

Who is a candidate for Sedation Dentistry?

People who have . . .

  • High fear
  • Traumatic dental experiences
  • Difficulty getting numb
  • A bad gag reflex
  • Very sensitive teeth
  • Complex dental problems
  • Limited time to complete dental care
People who . . .

  • Hate needles and shots!
  • Hate the noises, smells and tastes associated with dental care
  • Are afraid or embarrassed by their teeth

 

The Sedation Dental Care Standard

The standard of treating patients using sedation was set by physicians in the U.S. approximately 40 years ago. It is nothing new for patients to be sedated for operations on knees, feet, wrists, ears, noses, or practically anything else. Even patients who need an MRI and are nervous, ask to be sedated. Often patients ask dentists for sedation and the dentists do everything they can to talk them out of it. Most dentists do not want to go through the additional training and accreditation process that is necessary to sedate patients.

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You wouldn’t think of having an ear operation or a nose operation without sedation. But, you move one inch to the teeth and it becomes acceptable to endure time-consuming, strenuous, noisy, and uncomfortable procedures on the most sensitive, personal part of the body
(the mouth) with no sedation. Dentists attempt to work outside of the already established standard of using sedation. As a result, we as dentists treat only 50% of the population while physicians treat over 90%.

I have found that fearful patients psychologically have no problem being sedated for dental treatment. You ask a nervous patient, “Would you rather have this work done in six appointments over the next two months or in one appointment while you feel like you are sleeping?”, and they look at you like you’re crazy. “Sedate me,” is their reply.
Sedation for certain types of dental care has been used for over thirty years. If you asked one hundred patients who have had their wisdom teeth removed how they had it done, most would say they were put to sleep by an oral surgeon to have them removed. The problem is that dentists assume that root canals and drilling on teeth is not uncomfortable enough to warrant sedation. This is why 50% of the population does not go to the dentist. The patient is the one who should determine what is uncomfortable for them, not the dentist.
If you feel that sedation, which is the standard of care for the rest of the body, is necessary for your dental care, call us.

Type of Sedation

We offer different types of sedation: Nitrous Oxide and Oral sedation (pill) for several reasons:

  1. Many of our patients are needle-phobic so for those we have the pill form of sedation.
  2. With conscious sedation, we can work on patients for a longer period of time.
  3. Conscious sedation is very safe.

How You Will Feel

Our patients’ perception of this sedation technique is they feel that they have slept through the appointment. We most commonly hear, “I remember being sedated and the next thing I remember is waking up with my teeth fixed.” Most patients remember nothing about their treatment. A few will remember a little, usually at the end of the appointment when we are getting them ready to go home. You will need someone to bring you to our office on the day of your sedation appointment and you MUST have someone take you home afterward.

Safety

Conscious sedation is very safe. We have full control over your sedation state while receiving your dental treatment. Your vital signs are monitored continuously.

Decision

The only thing standing between you and getting the dental care you want is a call away.

Schedule an Appointment Today!

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Sealant purpose

A sealant is a clear or white plastic covering that is placed on the biting surfaces of back teeth to help prevent tooth decay.

The benefits of sealant

Back teeth have deep grooves and pits that are very difficult to keep clean. Plaque, which is a sticky, colorless film of food or bacteria, collects in these grooves. Plaque is nearly invisible, so to see it, we may stain the plaque with a harmless red dye.
Every time you eat, the bacteria in plaque forms acid. Without a protective sealant, this acid attacks the enamel to break down. Then, you get a cavity.

Placing sealant

To place the sealant, we thoroughly clean and dry your teeth. Next, a conditioning solution is applied. Then we brush the sealant material into the grooves of your back teeth. Some types of sealants harden on their own, while others harden when exposed to a special light.
A sealant is an effective shield that can defend your back teeth against cavities and help preserve your oral health.
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Every tooth consists of three different layers. The outermost and hardest layer is enamel, and the second layer is dentin. The third is pulp, which is the cavernous space where the live tissue and nerve of each tooth is located.

If for any reason the pulp space is exposed to the outside, the tissue becomes contaminated and eventually infected. The exposure of pulp happens in many circumstances, such as when you have a large cavity or a fractured tooth. Your dentist can explain the exact reason for damage to this tissue. In these cases, the treatment is usually root canal treatment.

Root canal treatment is the process of going inside the pulp space and removing the infected, dead tissue. The space is then disinfected and sealed with special materials. Nowadays, root canal treatments are performed with advanced techniques and materials, making them far more comfortable and faster. After root canal treatment is complete, your restorative dentist will usually place a crown on your tooth to safeguard against fracture.

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Why a Prosthodontist?

As our population ages, the role of the prosthodontist becomes critical in maintaining a high standard of dental care. Prosthodontists are trained to do the type of procedures that our aging population needs to provide optimum function and esthetics for their dental condition.
A Prosthodontist is a fully trained specialist in Prosthetic Dentistry. This specialty is one of eight dental specialties recognized by the American Dental Association. The typical prosthodontic training includes four years of dental school and three years of prosthodontic training in areas of dentistry that include crowns, bridges, dentures, cosmetics, temporomandibular joint function and dental implants.
A prosthodontist provides an extremely high level of care for patients who are missing teeth or have significant damage to their existing teeth. Prosthodontists deal with congenital defects as well as problems arising from trauma and neglect. The Prosthodontist can aid in the rehabilitation of a complete dentition or merely in the replacement of one or two teeth. With the advent of dental implants as a viable means of replacing teeth, the prosthodontist’s role has expanded substantially. The prosthodontist can supply the control and expertise that is necessary to make an implant supported restoration look and function properly.

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Please select the procedure you received to see a summary of post-op instructions. Call us if you have any questions:


Extraction:

1- Pressure should be placed on the gauze pad that has been put over the extraction site for one hour. If the bleeding continues new gauze should be placed and pressure applied for another 45 minutes.

2- If you are supervising children who have had an extraction done, make sure they don’t bite on their numb lips or tongue (it can cause serious injury to their soft tissue).

3- Avoid eating or drinking anything hot on the day of your extraction. Also, do not rinse your mouth and do not use a straw for drinking. Do not spit and do not drink carbonated beverages. Do not brush on the day of the surgery; you can gently resume your brushing and flossing the day after.

4-You may experience some pain, bruising around your lips, and/or some swelling, especially after extraction of impacted wisdom teeth. Ice bag application and medication prescribed for you will help to minimize your discomfort.

5- Please take all the medication you have received based on the provided instructions.

6- During the first 2-3 days after surgery a diet of soft food and liquids is recommended (soup, yogurt, milkshakes and juice).

7- For more complex surgical procedures, including Impacted Wisdom Tooth Extraction, Implant Surgical Procedures, etc: You will receive an ice wrap which should be worn for the rest of the day until you go to bed on the day of surgery (10 minutes on and 5 minutes off). Instructions for various surgical treatments will have some unique directions, which will be supplied to you at the time of your treatment.

8- Call our office if you experience excessive bleeding, severe pain or swelling, or if you have any questions or concerns. In case of serious emergencies call 911.


Fillings:

1- Do not eat on your new filling for one hour and until your numbness is gone.

2- If you are supervising children who had fillings done, make sure they don’t bite on their numb lips or tongue (it can cause serious injury to their soft tissue).

3- Do not bite hard or chew on silver amalgam fillings for 24 hours.

4- You may experience cold and heat sensitivity and some gum soreness; this usually subsides within a few days.

5- Call our office if you experience pain or discomfort for more than a few days after the fillings, or if you have any questions.


Crowns and Bridges (also Inlays and Onlays):

1- Crowns and bridges usually take 2 or 3 appointments to complete. On the first appointment, the tooth/teeth are prepared, impressions are taken, and a temporary crown is placed on your tooth/teeth.

2- You may experience sensitivity, gum soreness, and slight discomfort on the tooth/teeth; it should subside after the placement of the permanent crown(s).

3- Whenever anesthesia is used, avoid chewing on your teeth until the numbness has worn off.

4- A temporary crown is usually made of plastic-based material or soft metal. It can break if too much pressure is placed on it. The crown may also come off; if it does, save the crown and call our office. The temporary crown is placed to protect the tooth and prevent other teeth from moving. If it comes off it should be replaced as soon as possible. To avoid losing your temporary, do not chew on sticky or hard food (chewing gum, ice). Try to chew on the opposite side of the temporary as much as possible.

5- Continue your normal brushing but be careful while flossing around the temporaries (remove the floss gently from the side). If it is difficult to get the floss between the temporary and surrounding teeth, refrain from flossing until you receive your permanent crown.

6- After the permanent restoration is placed you may feel slight pressure for a few days. Also, the bite may feel different for a day or two. But if after 2-3 days the bite still feels uneven or if you feel discomfort when chewing on the tooth, call our office. Delaying the necessary adjustments may damage the tooth permanently.

7- Call our office if you are in pain or if you have any questions.


Root Canal Treatment:

1- You may experience moderate pain and sensitivity to pressure on your tooth. Also, you may feel gum soreness for few days after your treatment. The healing process may take several days but the pain and discomfort should subside gradually.

2- Take any medication that was prescribed for you according to instructions.

3- Usually a temporary filling has been placed on your tooth; do not bite on the tooth for one hour and while you are numb. Also, until the permanent restoration is placed, be very gentle with the tooth. Try to chew with the opposite side.

4- Continue your brushing and flossing.

5- Follow up with the placement of your permanent restoration as you have been advised. Any unnecessary delay in placement of final restoration may damage the tooth permanently.

6- Call our office if you are in severe pain or experience swelling, or if you have any questions.


Teeth Cleaning (Deep Cleaning):

1- You may experience some cold and heat sensitivity (especially after deep cleaning).

2- If you have received anesthesia do not eat anything until the numbness has worn off.

3- Continue your regular brushing and flossing.

4- Some bleeding for a day or two after cleaning is normal, but if you experience any excessive bleeding call our office.

5- Call our office if you are in pain or if you have any questions.


Placement of Braces:

1- You may experience some pressure and discomfort on your teeth.

2- Be gentle with braces and avoid chewing hard and/or sticky food.

3- Brushing and flossing around braces is sometimes challenging and time consuming, but very important.

4- Call our office if you have any questions.


Gum Surgery:

1- You may experience some pain, swelling, and bleeding after the surgery.

2- Take all medication that was prescribed for you according to instructions.

3- Apply an ice bag on your face over the surgical site on the day of surgery for 10 minutes on and 5 minutes off.

4- Keep your next appointment on time for removal of sutures and follow up checks.

5- DO NOT raise your lips with your fingers to inspect the treated area.

6- DO NOT brush teeth near the surgical site. Brush teeth in the rest of your mouth.

7- There is often a temporary loss of feeling in the operated area and the tooth may feel loose.

8- Do not smoke, spit, or use a straw on the day of the surgery (avoid smoking for a few days after the surgery).

9- Should any difficulties occur, do not hesitate to call our office anytime. In case of serious emergencies call 911.


Implant Surgery:

1- You may experience some discomfort and bleeding the day of the surgery.

2- Take all medication that was prescribed for you according to instructions.

3- Apply an ice bag on your face over the surgical site on the day of surgery for 10 minutes on and 5 minutes off.

4- Keep your next appointment on time for removal of sutures and follow up checks.

5- DO NOT raise your lips with your fingers to inspect the treated area.

6- DO NOT brush teeth near the surgical site. Brush teeth in the rest of your mouth.

7- There is often a temporary loss of feeling in the operated area and the tooth may feel loose.

8- Do not smoke, spit, or use a straw on the day of the surgery (avoid smoking for a few days after the surgery).

9- Should any difficulties occur, do not hesitate to call our office anytime. In case of serious emergencies call 911.


Denture Delivery:

1- You will experience some discomfort with any new denture for a few days. All new dentures need several adjustments to completely and comfortably fit your mouth.

2- You should take the dentures out every night and keep them in a clean container filled with water or denture cleaning solution. Your gums need to rest and be without the dentures every day for a period of time.

3- Clean dentures thoroughly with a brush and water before putting them back in your mouth.

4- It may be difficult to talk normally with the new dentures for a few days. One way to practice is to read a book or newspaper out loud for a period of time everyday. Your tongue and muscles will get used to the new dentures and you will talk normally very soon.

5- Call our office if you are experiencing pain, discomfort, or if you have any questions.


Apicoectomy (Root Canal Surgery):

1- Swelling, minor pain and/or skin discoloration may be experienced following the surgical procedure. This will be temporary.

2- In order to keep the swelling to a minimum, use an ice pack for the first few hours after surgery (on for 10 minutes and off for 5 minutes).

3- The day after the surgery, use lukewarm water rinses for the treated area following each meal. This should continue for the first 3 days following the surgical procedure.

4- Eat only soft foods. Avoid hard and chewy foods.

5- Get plenty of rest and insure normal intake of food, especially liquids such as fruit juices, soup, and milk. Use a vitamin supplement if desired. Try not to sleep on the operated area for 2-3 days.

6- DO NOT raise your lips with your fingers to inspect the treated area.

7- DO NOT brush teeth near the surgical site. Brush teeth in the rest of your mouth.

8- There is often a temporary loss of feeling in the operated area and the tooth may feel loose.

9- Take all medication that was prescribed for you according to instructions.

10- Should any difficulties occur, do not hesitate to call our office anytime. In case of serious emergencies call 911.


Bone Graft Surgery

You have just had surgery completed for the reduction of periodontal pocketing and/or for replacement of bone in an area where pathology existed, or in conjunction with endosseous dental implant surgical placement with or without platelet addition to the bone graft. You will be advised of the particular procedure and pertinent directions relative to your treatment modality. Whether you were put to sleep for this procedure or were only given local anesthesia, the post-operative instructions remain the same.

You will have several sutures (stitches) placed at the surgical site. These sutures may or may not be resorbable. If you have been told that you received external silk sutures, they have to be removed by us. The sutures will cause a pulling of your tissue over the bone grafting site. Since the bone graft site will have approximately 15 % more bone fill than what was naturally there, it is imperative that you do not pull up your lips or cheeks to show or examine the area. The undue pressure will cause the sutures to widen away from the  surgical site, expose bone, create more pain, and delay healing dramatically. This delay can lead to the need for the area to be sutured again when you are seen for your 1 week post-surgical evaluation. The sutures will remain in place for 2 to 3 weeks depending on the size of the graft, the severity of the pathology, and the condition of the tissue being sutured.

Your doctor will tell you what time period to expect, but keep in mind that this is not etched in stone and the doctor may extend the time before your sutures are removed to assure adequate healing and to avoid surgical regression.

You also may have a periodontal pack placed over the surgical site. The pack is pink in color and impregnated with antibiotic, which will protect the surgical site from infection and any washout of the particulate bone utilized to restore your jaw. The pack should be left in place for as long as possible. If a pack is placed the doctor will remove the packing at your 1 week follow up and decide if the packing should be replaced or kept off. Usually the packing is kept on for 7 to 10 days at a minimum. You must return to the office if  your pack falls off before you are seen for your 1 week follow up.

Your maintenance during healing has to be completed carefully. You can brush in every area except where the periodontal pack is placed. It is imperative that you use NO ASTRINGENTS such as mouth wash or antiseptic solutions during the healing period of your bone graft. Listerine, Viadent, or any other potentially caustic agent can RUIN your bone grafting procedure if contaminated, and  require a replacement bone graft. The doctor and our staff will reiterate this to you at, during, and after your bone graft surgical procedure. After the first stages of healing are satisfactory, we will provide you with normal saline and instruct you on how to use it (with or without the addition of salt), as well as irrigation syringes for cleaning the surgical site.

Since bone grows and heals slowly, it requires conditions conducive to a proper environment and blood supply. Thus, it is imperative that immediately after your bone graft you alter your diet, as you would for any oral surgical procedure. This means that you should not eat anything that is too large, too hot, or too sticky. Your food should be tepid or on the cool side. Any food that is too hot will have a deleterious effect on your surgical procedure. Commonsense must be used in determining what should be done or avoided. If for some reason you have questions about anything post-surgically, please call the office and we will inform you of the proper action to take.

Smoking after any oral surgical procedure will ALWAYS delay or disrupt normal healing due to a decrease in oxygenation of the tissue that is healing. Smoking should therefore be stopped for the first 7 to 10 days to allow for adequate initial tissue closure. Complete epithilization (closure) and wound healing normally takes a minimum of 21 days from the day the surgery was completed under ideal healing conditions, and with no other underlying systemic causes such as Diabetes Melitus, etc.

Bone grafting is a very predictable surgical procedure when done correctly and when patient cooperation is adhered to. Please try to be reasonable in understanding that this procedure has inherent risks associated with it, as stated in your informed consents. Some of these risks are also pertinent to your post-operative care.

We want nothing more than a perfect outcome with the surgical procedures that you are having done to rehabilitate your bone. This can only be attained with your cooperation. Please feel free to communicate with us at any time to make sure that the procedures you are having are properly maintained. No question is ever perceived by our office as being silly or unreasonable. We would rather have questions answered immediately than risk the chance that the procedure will not go as planned, especially from omissions that are preventable.

As stated above and outlined in your informed consents, please remember that there are some instances when no matter what is done, the outcome is not perfect. There are even infrequent occasions when a surgery may have to be redone; these situations are neither the doctor’s nor the patient’s fault.

Thank you

Periodontal disease only controlled

Periodontal disease cannot be cured; it can only be controlled. That is why we need to examine the health of your gums at least every three months or sooner.

If periodontal disease is not closely monitored and controlled, the disease can quickly worsen, destroy bone and soft tissue, and eventually cause you to lose teeth.

Frequent maintenance visits are important

When we first find periodontal disease, we treat it with scaling and root planing to remove plaque, tartar and bacteria from beneath your gumline.

This treatment disrupts the growth of the bacteria, but some bacteria remain and may settle back into the pocket where they reproduce. In fact, the number of bacteria doubles every time they reproduce, reaching destructive levels in as few as 90 days.

Periodontal disease is unpredictable

It can be challenging to predict where in your mouth the symptoms of periodontal disease may recur or when, and frequently, it does not hurt.

The only way to find and control periodontal disease is with a professional exam that specifically looks for the disease.

This also means that a twice-a-year cleaning schedule just is not safe for those who have periodontal disease.

The maintenance appointment

It is important that you come in every three months, or more, for a periodontal maintenance appointment which may include—

If necessary, we may also re-treat the teeth with scaling and root planing or apply a medication or antimicrobial rinse.

Periodontal maintenance visits help us break the stronghold of bacteria in your gums and slow or eliminate their destructive effects.

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