Patient Q&A

Ask Terrie about Patient Q&A at your Carson City dentist at Advanced Dentistry by DesignAdvanced Dentistry by Design has a new patient coordinator, Terrie, and she’s already answering all our questions! Do you have a question you’d like to ask Terrie? Click Here.

Botox® at the Dentist?

Dr. Kelly Euse offers Botox at our office, Advanced Dentistry by Design.  We thought we would let you know a few reasons you might want to speak with us about your next Botox® treatment.

Why Dr. Kelly Euse makes an excellent clinician choice for administering Botox and dermal fillers:

  • Dr. Kelly Euse has had specialized university education in head and neck anatomy.
  • She understands the importance of reviewing your medical history and performing a complete exam.
  • She is highly trained and experienced in providing facial injections.
  • She works in a clinical setting.
  • She understands the importance of asepsis and always use sterile instruments or ‘once only’ disposables.
  • She has appropriate liability insurance.
  • She can discuss and treat all of your aesthetic concerns regarding your teeth, smile, and face.

Our Thank You Program Explained:

For many people, finding a healthcare provider can be a daunting and tedious task. Trusting your health or your family’s health with someone who just happens to be on your insurance plan leaves many feeling unsure and uncomfortable. Statistics show that 70% of patients in a dental practice come by way of a recommendation from an existing patient.

At Advanced Dentistry by Design, we make it a point to let our community know we are available to provide personalized, compassionate dental care to any new patients. You may have seen us in the newspapers, on our website, via social media or on signs driving down the road. However, we find most of our new patients come by referral from an existing patient. Recommending our care to your friends and family is the highest compliment we could ever receive and now we are making a point to show our appreciation.

We promise to work hard to earn the trust of any person you invite to our office and help them feel confident in coming to a trusted healthcare provider and not just some name on a list. We feel honored to show our appreciation to our patient and their friend with a special gift. Contact us today to discover the special gifts and invitation we have ready for you and your friend or family member when they join our dental practice! Please call our office for more details at (775) 400-2533. We would love for you to like us and/or write a great recommendation to share with others: Facebook.com/AdvancedDentistryByDesign or visit our website at AdvancedDentistryByDesign.com


I think I have an actual Dental Phobia!  How do I know for sure?

Dental phobia (also called odontophobia, dentophobia, dentist phobia, dental anxiety or dental fear) refers to the fear of dentistry and receiving dental care.  It is estimated that as many as 75% of adults experience some degree of fear from mild to severe.  Many dentally fearful people will only seek dental care when they have an emergency such as a toothache or abscess.  People who are very fearful experience what is called a “cycle of avoidance”, in which they avoid care due to fear until they experience an emergency requiring invasive treatment, which can reinforce their fear.

The causes of fear can be a result of a direct experience, such as a traumatic, difficult, and/or painful firsthand experience.  An indirect experience would be Vicarious Learning (hearing about others’ negative experience), Mass Media (negative portrayal), Stimulus Generalization (result of a previous experience) and Helplessness and Perceived Lack of Control (perception of lack of control leads to fear).  Yes, even those of us who have worked in the dental field for more than 20 years experience this one! As your trusted Carson City dentists, it is our hope that you will so fully understand the treatment and process that your fears will be lessened.

People fear what they do not understand and dislike pain. With a combination of digital x-rays and photographs, we will explain to you what treatment is needed, and take the time to answer any of your questions. For those whose fear is so great that the above management technique is not enough, we offer oral sedation, anti-anxiety medication taken in pill form, and Nitrous Oxide (laughing) gas. While these sedatives may help people feel calmer and sometimes drowsy during treatment, patients are still conscious and able to communicate with the dental staff.

The most important part of overcoming fear is your comfort. We will try and make your visit with us as pleasant as possible.  It is also important to us that you know what is being done and why. Our doctors and team members are here for you, and there are never too many, or silly questions.  We encourage you to bring an iPod or other form of music device for distraction, and we are always available for hand holding and reassurance.

Make an appointment today for a NEW PATIENT exam with your Carson City dentists, Dr. Clint Euse, Dr. Kelly Euse, or Dr. Randy Wright. A NEW PATIENT exam is an easy and non-evasive way to meet our doctors and friendly team! We look forward to meeting you soon!

 


What’s the connection between oral health and overall health?

Like many areas of the body, your mouth is loaded with bacteria — most of them harmless. Normally the body’s natural defenses and good oral health care, such as daily brushing and flossing, can keep these bacteria under control. However, without proper oral hygiene, bacteria can reach levels that might lead to oral infections, such as tooth decay and gum disease.

In addition, certain medications — such as decongestants, antihistamines, painkillers, and diuretics — can reduce saliva flow. Saliva washes away food and neutralizes acids produced by bacteria in the mouth, helping to protect you from microbial invasion or overgrowth that might lead to disease.  Also, saliva helps keep the pH (or acidity level) in your mouth at optimal levels and decreases chances for cavities.

Studies also suggest that oral bacteria and the inflammation associated with periodontitis — a severe form of gum disease —plays a role in some diseases. In addition, certain diseases, such as diabetes and HIV/AIDS, can lower the body’s resistance to infection, making oral health problems more severe.

What conditions may be linked to oral health?
Your oral health might affect, be affected by, or contribute to various diseases and conditions, including:

  • Endocarditis. Endocarditis is an infection of the inner lining of your heart (endocardium). Endocarditis typically occurs when bacteria or other germs from another part of your body, such as your mouth, spread through your bloodstream and attach to damaged areas in your heart.
  • Cardiovascular disease. Some research suggests that heart disease; clogged arteries and stroke might be linked to the inflammation and infections that oral bacteria can cause.
  • Pregnancy and birth. Periodontitis has been linked to premature birth and low birth weight.
  • Diabetes. Diabetes reduces the body’s resistance to infection — putting the gums at risk. Gum disease appears to be more frequent and severe among people who have diabetes. Research shows that people who have gum disease have a harder time controlling their blood sugar levels.
  • HIV/AIDS. Oral problems, such as painful mucosal lesions, are common in people who have HIV/AIDS.
  • Osteoporosis. Osteoporosis — which causes bones to become weak and brittle — might be linked with periodontal bone loss and tooth loss.
  • Alzheimer’s disease. Tooth loss before age 35 might be a risk factor for Alzheimer’s disease.
  • Other conditions. Other conditions that might be linked to oral health include Sjogren’s syndrome — an immune system disorder that causes dry mouth — and eating disorders.

Because of these potential links, be sure to tell your dentist if you’re taking any medications or have had any changes in your overall health — especially if you’ve had any recent illnesses or you have a chronic condition, such as diabetes.

How can I protect my oral health?
To protect your oral health, practice good oral hygiene every day. For example:

  • Brush your teeth at least twice a day.
  • Floss daily.
  • Eat a healthy diet (vegetables, fruits, nuts)—avoid sugary/sticky foods and foods high in carbohydrates; limit between-meal snacks.
  • Replace your toothbrush every three months or sooner if bristles are frayed.
  • Schedule regular dental checkups.

Contact your dentist as soon as an oral health problem arises. Remember, taking care of your oral health is an investment in your overall health


Trudenta – An Answer To Headache Pain

Last week we talked about headaches, both TTH (tension-type headaches) and migraines, possible causes and solutions.  This week I would like to tell you about Trudenta, a revolutionary new treatment offered by Advanced Dentistry.

What is TruDenta headache pain treatment? The TruDenta System is an approach to chronic headache relief that addresses and treats the cause of the problem instead of masking the pain.  Using a combination of techniques derived from sports medicine therapies, TruDenta targets the improper muscle forces in the head, neck, and jaw areas that cause the painful conditions.

Why would I want TruDenta treatment? Research has shown that the cause of chronic migraines, tension headaches, vertigo, tinnitus (ringing in the ears), TMJ, and face, jaw, and neck pain may all be interconnected.  The cause could be unbalanced forces in your mouth that affect the muscles of these areas.  This leads to changes in the chemical and nerve reactions that result in chronic pain.  The symptoms could be from an accident, head trauma, bad posture, or extensive or poorly done dental work. How does TruDenta work? Based on the findings during an extensive evaluation, a personalized in-office treatment will be prescribed. Your treatment works by

How does TruDenta work? Based on the findings during an extensive evaluation, a personalized in-office treatment will be prescribed. Your treatment works by retraining the muscles and nerves connected by the trigeminal nucleus (nerve responsible for sensation in the face and motor functions such as biting and chewing) to function properly. TruDenta treatments last about one hour and include the use of several proven, FDA-cleared technologies. Depending on the severity of your diagnosis, your treatment may consist of one to 12 treatments completed weekly along with prescribed home care which includes wearing a specially designed orthotic (night guard). What are treatments like? Don’t worry – you may be at the dentist office, but your TruDenta appointment will be free of poking or prodding.  In our office, the room is a tranquil environment with a water feature and relaxing music.  Each treatment is completely non-invasive and

What are treatments like? Don’t worry – you may be at the dentist office, but your TruDenta appointment will be free of poking or prodding.  In our office, the room is a tranquil environment with a water feature and relaxing music.  Each treatment is completely non-invasive and drug-free, and a large part of the rehabilitation process involves gentle pain-relief technology like ultrasound, microcurrent, cold laser therapies, and massage. Who performs the therapies? All four of our dental assistants have been highly trained to perform therapy.  Apryl and

Who performs the therapies? All four of our dental assistants have been highly trained to perform therapy.  Apryl and Kadie are both trainers for TruDenta and travel monthly to work with other offices all over the United States.


June is National Headache Month

Headaches are one of the most common reasons people see physicians, and Headache Awareness Month is the perfect time to learn about the two main types of headaches (tension and migraine), and the lesser known cause, orofacial disorders.

A tension-type headache (TTH) is the most common and causes mild to moderate non-pulsating pain felt on both sides of the head or neck.  A TTH can last from 30 minutes to several days and is not usually aggravated by routine physical activity. A migraine headache causes moderate to severe pulsating pain felt on one or both sides of the head.  This type of headache is aggravated by activity, and is usually accompanied by either nausea and/or light and sound sensitivity.

The TMJ is the delicate ball joint of your jaw; it is what allows your jaw to open and close and move from side to side.  The human jaw exerts enormous amounts of force, and any kind of change to the way that it moves can cause imbalances over time that often result in chronic pain not only in the jaw, but also in the network of nerves that run through the neck, face, and head.

A common problem among headache sufferers is the overuse of pain medication.  Whether prescribed by a doctor or over-the-counter, using medication too frequently (two or three days a week) can lead to withdrawal or rebound headaches.  Pain medications may initially dull the pain, but over time, the body becomes immune to the dosing, and thus requires an increase in medication.  This is obviously a vicious, dangerous, and addictive cycle, and does NOT solve the cause of the problem. The best solution for headaches is prevention.  Prevention is safer, more convenient, and beneficial to overall health.

In the coming weeks, we will talk about Trudenta, a comprehensive system that helps our dentists treat many different orofacial disorders including: headaches, migraines, tinnitus (ringing in the ears), vertigo, and TMJ Disorder, by balancing forces of the head and neck. Advanced Dentistry by Design, bringing overall health to you and your family.


Tell me about crowns done in one day…..

At Advanced Dentistry by Design, we use a technologically advanced method of creating restorations in one day! Traditionally, dentists had very few options to repair decayed and damaged teeth other than amalgam (silver), gold, and other metals.

With CEREC technology our doctors are able to use strong, tooth colored ceramic materials to restore your teeth to their natural strength, beauty, and function. Our doctors will make sure you are comfortable and numb prior to beginning. We will prepare your tooth for a CEREC restoration similar to traditional methods. However, CEREC then uses a state-of-the-art digital 3D camera to create an optical impression; this replaces the physical impression of traditional crowns–that means no goop in your mouth!

Our CEREC software allows us to design every detail of your new restoration.  In a matter of minutes, your all ceramic, color-matched restoration will be completed, fitted, polished, glazed, and bonded to your existing tooth structure, thus avoiding a second trip to the dentist for cementation of your permanent crown. CEREC also makes ill-fitting crowns a thing of the past.  Your CEREC restoration will fit and look like your natural tooth, and blend beautifully!

If you have any questions or would like to learn more about CEREC technology, please contact us at (775) 400-2533.


Education made simple – Provided by our Dental Assistant, Apryl!

Have you ever been listening to someone tell you how something is built and you don’t have a clue what they’re talking about? It’s certainly happened to me, and not only do I mentally start trailing off, but I leave the conversation feeling frustrated! Because I realize through my own experiences how easily this can happen, I try my very best to explain dentistry so that everyone can understand. For example, let’s say someone has an old silver filling in their tooth and it’s just broken your tooth. WOW! That’s a lot to take in. But if I broke it down in terms everyone could understand, I’d probably tell it like this:

Your old silver filling is expanding and contracting when you eat hot and cold foods and beverages. (I would be using my arms in this situation, like an elevator door opening and closing.) When you eat cold things, the silver contracts, making a small space open up between your tooth and where the filling meets. Bacteria (that we ALL have in our mouths) loves to creep down between this space of filling and tooth. When you eat hot foods, the silver filling expands, cracking your precious tooth.

You might wonder why it cracks. That’s easy! Because the silver filling is not ‘glued’ to the inside of your tooth, it’s simply ‘pushed’ into your tooth. This is called ‘mechanical’ retention. The tooth ‘cracks’ over time because 1) the bacteria has been able to eat under and around the silver filling, and 2) the constant expansion and contraction finally breaks the tooth. The funny part of it all is that most people come in and say they were “just eating a sandwich and their tooth broke!” This is because the suction of bread finally pulled the piece off that was cracked and decaying around that old silver filling. This is a super common cause of tooth breakage, and being able to explain this process makes me happy.

This is just one example of how educating can be made simple.


Why Botox?

As we age, our skin changes. Over time, repetitive movements of the facial muscles (such as squinting and frowning), loss of volume and elasticity, and the forces of gravity cause unwanted wrinkles and folds to develop.

It is now possible to smooth out these wrinkles and folds without surgery. Botox® is a safe and non-invasive procedure that provides therapeutic results, as well as treats the signs of aging naturally, precisely, and non-surgically.

Dr. Kelly Euse and our team have recently completed extensive hands-on training at the Pacific Training Institute for Facial Aesthetics.  We encourage you to speak with us if have any questions regarding the benefits of Botox® and how it can compliment your smile.


What is an Oral Cancer screening?

April is Oral Cancer Awareness Month, and we thought it was important to address. At Advanced Dentistry by Design, we continually look for diagnostic advances to ensure that we are providing the optimum level of oral healthcare to our patients. Oral cancers can easily go undetected because early symptoms are painless and almost impossible to see, even for a dentist.

At Advanced Dentistry by Design, we use a special device called the VelScope, which utilizes phosphorescent light and looks for changes in the tissue. The exam is painless and takes just minutes. Any area of concern will show up as black under the blue-green light.

In the past, individuals who used tobacco were the most likely to get oral cancer, but that is no longer the case. The Oral Cancer Foundation states the fastest growing segment is now non-smokers ages 25-50, and HPV (human papilloma virus) is now one of the dominant causes. Like every cancer, the key to survival is early diagnosis. When detected early, the survival rate can be 80 to 90 percent. The test itself takes about 3 minutes and is included in our new patient exam. Please call us today, to schedule your new patient exam and oral cancer screening with the VelScope.


April is Oral Cancer Awareness Month

Let’s continue our conversation of oral cavity and oropharyngeal (middle part of the throat that includes the base of the tongue, the tonsils, soft palate, and the walls of the pharynx) cancer and risk factors.

Some people who have these cancers have few or no known risk factors, and others who have several risk factors never develop the disease. Some, such as your age or race, can’t be changed, and others may be related to personal choices. General factors include gender (twice as common in men), age (average age is 62 years old), and exposure to ultraviolet light (more common in people who work outdoors or others with prolonged exposure to sunlight). Genetic syndromes such as Fanconi anemia (blood condition caused by inherited abnormalities) and Dyskeratosis congenita (a genetically linked syndrome that can cause aplastic anemia) also carry a very high risk of mouth and throat cancer.

Lifestyle choices such as tobacco and alcohol use are among the strongest risk factors. About 80% of the people with oral cancer use tobacco and 70% are heavy drinkers. For those who smoke and drink, the risk is as high as 100% more than those who do not smoke or drink. Human papillomavirus (HPV) virus is a group of more than 150 types of viruses. Many HPV’s cause warts, but some are involved in cancer. HPV can be passed from one person to another during skin-to-skin contact. One way HPV is spread is through sex, including vaginal, anal, and oral sex. Smoking also increases the risk of oral HPV infections.

Follow us next week when we discuss how to lower your risk of contracting this disease. To learn more, call Advanced Dentistry by Design at 775-883-7244 to schedule an evaluation. We look forward to smiling with you!


Insurance Benefits

Patients tend to be concerned about using their insurance benefits at the beginning of the year and often “save” them for the end in case there is an emergency somewhere in between.  In order to avoid last minute decision making and scheduling, we suggest the following:

  1. Know your plan year.  Not all insurances run on a calendar year; the State of Nevada, for example is a fiscal year and runs July 1st through June 30th.  If your treatment involves phases, you can begin in one plan year and complete in the second to best utilize benefits.
  2. Do the treatment recommended by your doctor.  Left untreated, dental work never gets better and can to lead to more costly restorations.
  3. Ask your front office staff or treatment coordinator to prioritize your treatment and to help you to maximize benefits so there aren’t any left on the table at the end of your year.
  4. If you do happen to need additional work, ask your office about financing options.  At Advanced Dentistry by Design, we offer a 5% discount for cash or check, CareCredit at 0% interest for 12 months and additional case-specific loans.

Our team at Advanced Dentistry has the right personnel to answer all of your questions to help you determine the best treatment for you and your family.  Call us today at 883-7244, we look forward to hearing from you.


When do my dental benefits renew? They just did!

Many people do not take advantage of their annual dental insurance and let it expire each year. Know your plan and your plan year to best utilize your benefits. A majority of insurance companies run on a calendar year so benefits expire on December 31, and renew for the coming year on January 1. However, this is not always the case and plans can be on a fiscal or plan year.

Again, I encourage you to know your plan, plan year, and any applicable waiting periods. If you know that you are going to need some extensive work done you can plan your dental visit for later in the plan year, then dental benefits will renew to complete treatment. This makes it more affordable to have large procedures done such as root canals and crowns, by using the available benefits from two plan years. Please remember on major services the deductible will apply in both plan years.

To make the most of your benefits, make sure to get your annual checkup and cleanings which are normally paid at 100% under the preventative coverage of your plan. Call your dental plan administrator for information on your policy or one of our friendly staff members at Advanced Dentistry by Design who are able to obtain this information for you as well.


How do you get the most out of your dental benefits?

December, the month when a dental employee’s thoughts turn to….calendar year benefits!  A majority of the insurance companies we work with run on a calendar year and any unused benefits on December 31st are lost.  Now is the time to schedule for your treatment to maximize your benefits!  At Advanced Dentistry by Design in Carson City, it is our goal to not only help you to maintain a healthy mouth but to best utilize your insurance plan.

As a courtesy, we send out reminder letters to patients that their plan is about to expire and offer to help them calculate the remaining coverage available as we did with the State employees for their fiscal year plan.  Unsure of your plan year or benefits available?  Call Paula, Stacy, or myself at (775) 400-2533 and let us help you determine what is available and help you schedule for a date and time convenient for you.

Not a patient?  We will be more than happy to verify the information for you and help you to establish in our practice and complete the necessary work in a timely manner.  Call your Carson City dentists today, we look forward to smiling with you soon!!


Does Bleaching Damage Your Teeth?

There are various types of stains on teeth, and different ways to prevent and remove them. Superficial stains that exist on the surfaces of teeth can usually be removed by using toothpaste and brushing regularly. At Advanced Dentistry by Design, we recommend using a Sonicare(R) Toothbrush twice daily, which significantly removes surface stains.

If stains are tenacious, they may need to be removed by your hygienist. Embedded stains are discolorations that have soaked into your teeth. The two worst examples are tobacco and coffee stains. Toothpastes and professional cleanings won’t remove these. They require a professional whitening treatment in which a peroxide gel is allowed to soak into your teeth for a period of time. During this procedure, the gel releases oxygen inside the tooth, which chemically bleaches the stain and eliminates it.

Structural stains are those that are present when the tooth was formed such as tetracycline stains (antibiotic) and fluorosis (consuming too much fluoride). These are a part of your tooth structure and need to be covered with bonding or porcelain veneers. Whitening toothpastes are generally ineffective at permanently whitening teeth because the toothpaste in not on the teeth long enough. Penetration is what is required for significant whitening.

At Advanced Dentistry by Design we use the Sinsational Smile(R) whitening method. This procedure includes the use of an LED accelerating light that helps to activate the gel’s whitening ingredients at a faster rate, resulting in a brighter smile and whiter teeth in less time. As part of your procedure, you will also receive a take-home maintenance pen to further extend your new brighter smile.

Teeth whitening is a safe and effective method to enhance your overall appearance. All whitening procedures work best on natural, healthy teeth and should not be used by people with poor oral health, active decay, or anyone advised by their dentist not to have their teeth whitened. Please contact our office, Advanced Dentistry by Design, for further information (775) 400-2533. We look forward to helping you achieve the brighter, whiter, smile that you desire!


Holiday with a Hero

My family and I have participated in Angels Trees during the holiday season for years.  When the boys were little, they chose a child off a tree (usually a boy about their same age) and then I let them be the decision maker on the gifts.  As they have gotten older, they choose their own angels and do the shopping and wrapping but it is a tradition that we share as a family.

When we decided to participate in Holiday with a Hero last year as an office, I thought it would be much the same as the Angel Tree experience.  With $100 each to spend I assumed we would have 200 kids and Heroes in the toy section, however, what we encountered was amazing!  We ended up in the food section buying huge bottles of peanut butter and loaves of bread, choosing scarves and gloves for grandparents, and household items for parents.

We did end up in the toy section but it was for brothers, sisters, cousins and friends – very little for the children themselves.  What was left over was spent on undergarments, warm clothes, and shoes that they put on immediately because the ones they were wearing were too small.  They also chose pillows and blankets, as they had none of their own. With their intentions so driven on others, items were purchased by the Heroes themselves for their child so they did have something of their own to open on Christmas morning. I was both a bit embarrassed and humbled by my assumptions.

Each of our employees took away something different as we weren’t all shoppers, there were also wrappers and baggers who ensured that the correct packages got to the children’s’ schools.  We have continued the Hero spirit throughout the year by paying to wear jeans once a month so we can sponsor children in addition to the office’s generous donation.

At Advanced Dentistry by Design, we are proud to be called “Heroes” and look forward to many more years of partnership with this worthy organization.  Happy Holidays from Dr. Wright, Dr. Euse, Dr. Kelly, and staff!


I’m not sure what I need to have done, so what should I make an appointment for?

We get this question often and wanted to revisit it.

If you are having an emergency, we are here to help! We make every effort to see a patient, established or new, on the day they call to relieve their discomfort. An x-ray will be taken of the offending tooth and the doctor will provide a limited exam. A course of treatment will be proposed and performed if time allows. If additional services are needed, either within our practice or with a specialist, those arrangements will be made for you.

If you are establishing as a new patient, I would like to share our approach to service with you. Preventative dentistry is our goal for every patient. It involves daily care, good nutrition, and periodic check-ups and cleanings. Preventive dentistry may not be where we start with every patient, but it is where we like to finish.

Restorative dentistry is basic repair of the mouth. We restore broken or leaking fillings, build crowns and bridges, fit partial and full dentures, and realign your bite. Where necessary, gum disease is treated, or root canal therapy recommended. The belief behind our restorative therapy is helping you to keep your teeth for your lifetime. Cosmetic dentistry is coming of age with new materials and procedures that make a beautiful smile accessible to everyone. Because our preventive and restorative programs have been so successful, we now have the luxury of considering cosmetic treatment for chips, gaps, and otherwise less than perfect smiles.

As described in previous articles, new patient exams include diagnostic x-rays, oral cancer screening, and a comprehensive exam with a doctor. Call a member of our Advanced Dentistry by Design team today, (775) 400-2533.


My insurance benefits say I get two free visits. Is this any visit?

Most insurance carriers will pay for two cleanings per year under your preventative portion of the plan.  It used to include your exam and x-rays in the past, but it has become common practice to charge the deductible for these services.  This amount is also deducted from your annual maximum, for most plans.

Insurance companies (normally) pay 100% of a prophylaxis (cleaning) two times per year.  A “prophy” is for patients who do not currently have or have never had an issue with periodontal (gum) disease.  It is the scaling and polishing of the crowns of the teeth to remove plaque, tartar (calculus), and stains.

Periodontal disease can be described as inflammation and/or infection of the gums and the bone which support teeth.  Your hygienist will do periodontal probings at your cleaning appointment.  Any reading of 4 millimeters (mm) or higher are indications of early to moderate gum disease.  Periodontal maintenance is usually covered at 80% after the deductible has been met under most insurance plans, and allows for two visits per year.  Most periodontal patients see their hygienist every three to four months, as in any chronic condition, successful long-term control of the disease and prevention of tooth loss depends on continual, possibly lifetime maintenance.

The number of times you have your teeth cleaned should be personalized between you, your hygienist, and your doctor, and not set by your insurance carrier.  It is a mistake to let benefits be your sole consideration when you are making decisions about your dental care. Your teeth, smile, attractiveness, ability to chew, and general sense of well-being are dependent on your dental health.  It is worth the extra time and expense to keep your teeth for a lifetime.


Candy at the Dentist Office?

At both Paula and Stacy’s desks, we have a bowl of suckers and get teased a lot that we are trying to encourage cavities!  Quite the contrary actually…
The suckers we offer contain xylitol which is a natural sweetener that can be found in a variety of fruits and vegetables.

Some of the most common xylitol-rich foods include berries, mushrooms, corn, and lettuce. Studies indicate that 4 – 20 grams of xylitol each day, divided into three or more servings, can reduce tooth decay and cavities by as much as 70%.

It may be hard to consistently eat four or more cups of fruit or vegetables each day; as a point of reference, a single cup of berries contains a little less than one gram of xylitol.  For this reason, xylitol is also available as a sugar substitute, a gum, as a concentrate in healthy foods and yes, in the suckers offered by your dental office.


Are you in network with my insurance?

I know I say this over and over, but to know for sure you need to check with your carrier. The list is usually available on the company website; many times searchable by zip code for the nearest to your location.  Providers are added and deleted frequently, so the printed version you may have isn’t necessarily up to date.

If you have a dentist that is not in your plan network, you should determine if the discount is substantial enough for you to change.  A really good dentist, whom you like and trust, is sometimes hard to come by and you are the best judge of what your finances are. Some dental plans are indemnity plans and allow you to choose your own provider without any type of penalty.

Some PPO (preferred provider organizations) plans pay based on UCR (usual, customary and reasonable fees) but know that these fees are based on the state of the home office of the insurance company.  A cleaning in Kansas, for example, is most likely less than the cost of the one in Nevada.  Other PPO plans are paid on MAC fees (maximum allowable charge for the plan).

If your dentist is not a part of your plan, you are responsible for the difference between what the office charges and what your insurance pays. A word of caution: there are some PPOs that will pay no benefits if you use a doctor outside the plan.  Others pay the patient, therefore the doctor’s office will ask for direct payment from you at the time of service. Your dental front office staff can assist you in finding the information, but the ultimate responsibility is yours.


Do you accept Delta Dental?

As we are not “in-network” with Delta, we ask for full payment at the time of service as they will pay the subscriber directly. We do bill Delta as a courtesy and they reimburse the subscriber within three weeks on average.

If we are not in-network with your plan, you should determine if the discount is substantial enough to entice you elsewhere. A really good dentist that you like and trust are sometimes hard to come by and you are the best judge as to whether or not the potential savings are worth seeing another doctor.

If you choose a dentist who is not part of the dental network, some PPO pans will pay based on UCR (usual, customary and reasonable fees) but most out-of-network benefits are paid based on MAC (maximum allowable charge) for the plan. Simply stated, you are responsible for the difference between the charges for your treatment and what your insurance pays.

We do have a large percentage of patients who are out-of-network but, due to the level of care and advanced technology that we offer, the small provider discount offered through their insurance does not outweigh the benefits of being treated in our office.


What are dental sealants, who should get them, and how long do they last?

Dental sealants are a plastic coating placed on the chewing surfaces of permanent teeth to protect them from decay. The chewing surfaces of the molars and premolars have pits and grooves (fissures) that make them vulnerable to decay.  These fissures can be deep, are difficult to clean, and can even be narrower than a single bristle of a toothbrush.

Plaque accumulates in these areas, and the acid produced by the bacteria in the plaque attacks the enamel, which can lead to cavities. The sealants provide extra protection for the grooved and pitted areas providing a smooth surface covering over the fissured area.

The American Academy of Pediatric Dentistry recommends placing sealants on your child’s first permanent molars around age six, and then on second molars around age 12.  Sealants have been used and been proven effective since the 1970’s and last for several years under the normal wear and tear of childhood chewing.

The procedure is painless and simple.  First the teeth are cleaned and roughened with a solution that helps the sealant adhere to the tooth.  The sealant material is painted on and hardened using a curing light.

For more information on sealants or any other services offered by Advanced Dentistry by Design, please contact us today!


What’s the difference between an Amalgam (silver) filling and a Composite (resin/white) filling?

It has been years (many of them in fact) since I have seen amalgam used in a dental practice.  There is a controversy over the potential adverse effects of silver fillings, which are close to 50% mercury and a mixture of silver-tin alloy and copper.  Although mercury is toxic, it has been thought that it was not released to the body.

Recent research, however, seems to show that these fillings release a very small amount of mercury vapor during chewing.  Whether or not this amount is harmful is the subject of the controversy.  While it has not been proven that it is harmful, there is no proof that it is not harmful, either. Use of the amalgam filling goes back hundreds of years; while early history of the composites goes back to the early 70’s with improved technology developed to bond the filling in the ’80’s.

The definition of “filling” is: replacing and restoring tooth structure that is removed due to decay or fracture with a material. The cheapest, and potentially most toxic choice for fillings are the silver-tin, alloy, copper, and mercury that sets up hard and silver-colored. While it is possible these fillings may last longer than composite fillings, they may also lead to tooth fracture, discolored teeth, and an inability to blend in aesthetically. On the other hand, composite fillings are primarily a resin that has been “filled” with other inorganic materials.  This compound makes a composite more resistant to wear, color adjustable, and easier to polish.  The advantages to the composite include a more natural appearance, strengthening of the filled tooth, and bonding to the natural tooth to create a better seal.

Most insurance companies will not cover the white (resin/composite) fillings on back teeth and hence, substitute payment for the cheaper amalgam.  Why?  Your insurance company is a for-profit company; they are in business to make money.  Composite is expensive to place (up to 25% more), and the policy of the insurance company is to cover the cost of the least expensive treatment which happens with a lot of procedures, not just fillings.

Unsure if your insurance company will “down code” to the lesser restoration?  Call your Carson City dentists today at (775) 400-2533, and let one of our friendly staff members do research on your individual mouth to find out what Advanced Dentistry by Design can do for you!


What is a Root Canal and why was I referred to another doctor?

To understand a root canal, it helps to know about the anatomy of teeth.  Inside the tooth, under the white enamel and a hard layer called the dentin, is a soft tissue called the pulp.  The pulp contains blood vessels, nerves and connective tissue, and helps to grow the root of your tooth during development.

A fully developed tooth can survive without the pulp because it continues to be nourished by the tissue surrounding it.  Endodontic treatment (root canal) treats the inside of the tooth when the pulp becomes inflamed or infected.  The infection can have a variety of causes: deep decay, repeated dental procedures, faulty crowns, or a fracture of the tooth.  Left untreated, the infection can cause pain or an abscess.

During the root canal, the inflamed or infected pulp is removed inside of the tooth and is cleaned and disinfected.  It is then filled with a rubber-like material and the the tooth is restored with a crown or filling for protection. All dentists receive training in endodontics in dental school.  However, they often refer to a specialist because they believe it is in the patient’s best interest due to the difficulty of the treatment.

An endodontist has special training in diagnosing and treating problems associated with the inside of the tooth.  To become a specialist, they must complete dental school and have an additional two years or more of advanced training in endodontics.  As they only do root canals in their practice, you will be referred back to your general dentist for the final restoration.

At Advanced Dentistry by Design, your comfort and care are of highest priority for your Carson City dentists and we will always do what is in your best interest, whether it is treatment in our office or referring you to a specialist.  Call us today at (775) 400-2533 – we look forward to smiling at you!


From our registered dental Assistant, Apryl:

I open the door to the waiting room and the person is sweating and shaking. My first thought is “awesome”! Why you might ask? The answers is simple, I love what I do! Helping a nervous person trust and relax at the dentist is easy when you love what you do. I believe that by explaining how I truly understand their fear and showing them how Advanced Dentistry by Design is, they typically leave excited that they have finally taken the first step of walking thru that door.

A few examples of these changes are easy. Lets start at X-rays, they used to be pokey cardboard objects shoved in the mouth and held down for what felt like an eternity. Now a small sensor is used and held down for less then two seconds. This huge change helps the patient who either hates the pain or the patient that has an over-active gag reflex.

A change in kindness is an immediate reflection of the type of office I choose to represent. I want that nervous person to see my eyes, my smile, my hand shake and the calm, kind and fun person that I am. For someone who is nervous, this is exactly what they need. I love to take the time to listen to what fears they have  and explain what our team can do to turn their fear into trust, and a pleasant experience.


Benefits of Chewing Gum Containing Xylitol

There are oral health benefits to chewing gum, especially gum containing xylitol. Chewing gum increases the production of saliva, aiding in stabilizing the pH balance of the oral cavity, thus reducing the incidence of decay. Chewing gum containing xylitol has been proven to decrease the incidence of decay by the xylitol decreasing the growth of the bacteria that causes decay.

What is Xylitol and how does it decrease cavities? 
Xylitol is not a sugar, it is a natural sugar alcohol. Streptococcus mutans are primary bacteria contributing to tooth decay, which can’t utilize xylitol like sugar. Over time with xylitol use, the quality of the bacteria in the mouth is altered and fewer and fewer decay causing bacteria survive. Less plaque forms, and the level of acids attacking the tooth surface is decreased.

Xylitol containing gum can reduce your children’s incidence of decay.  Studies show that Streptococcus mutans bacteria are passed from parents to their newborn children, thus beginning the growth of decay producing bacteria in the child. Regular use of xylitol gum by mothers has been shown to significantly reduce the transmission of bacteria to their child.

How often must I chew xylitol gum for it to be effective?
Xylitol gum used 3-5  times a day is considered optimal. Because the frequency and duration of exposure is important, gum should be chewed for approximately 5 minutes. As xylitol is digested slowly in the large intestine, large amounts can lead to soft stools or have a laxative effect. However, suggested amount for cavity reduction are far lower than those typically producing un-welcomed symptoms.

What to keep in mind  
Although chewing sugar-free gum can be beneficial in most instances, there are some cases in which chewing gum is not recommended. For example, if you are experiencing any type of jaw pain or temporomandibular disorder symptoms (TMD/TMJ), you should refrain from chewing gum and talk to your dentist about what options are available to you.


A Message from Dr. Kelly Euse

I have exciting news I wanted to share with you!   The Nevada State Dental Board has just issued a release that dentists in Nevada can now administer Botox and dermal fillers.

It is with great pleasure to announce that I will now be offering Botox as a service to our patients!  We will be sending out more information as well as facts and commonly asked questions regarding Botox via our Advanced Dentistry by Design Facebook page and email, so keep an eye out.

Why would my dentist offer Botox?
Dentists deal with the head and neck region more than most physicians.  Additionally, dentists administer injections all day long, and are thus very adept with the fine motor skills needed to administer Botox.
I became interested and introduced to Botox when I was at a dental course.  I have since attended lectures, demonstrations, and hands-on courses with a variety of professionals including dentists, physicians, nurses, and physician assistants.  It became apparent in lectures that my dental training and experience involving the facial muscles placed me in an advantageous position within these groups.  In effect, I already knew the anatomical content that some were learning for the first time.  Additionally, I had the experience of handling and administering a variety of injections.

Why do I love Botox? 
1.    It has been scientifically proven that Botox makes people happy (seriously… happy brain chemicals are released   creating pleasure when Botox is administered in certain facial muscles J)
2.   Botox softens wrinkle causing muscles, creating a smoother and improved appearance
3.   Botox can be used as a preventative measure for wrinkles
4.   Botox can be used to treat headaches and migraines
5.   Botox is not permanent, effects can last up to 3-4 months
6.   Botox can be used to enhance your smile
7.   Botox makes you look and feel younger

Studies have shown that people who feel good about the way they look:  are happier, more successful, can actually live longer, lead more productive lives, and have less anxiety and depression; wow!

At Advanced Dentistry by Design, our goal has always been to take excellent care of our patients.  Offering Botox as a service enables us to not only enhance the beauty of your smile, but to also improve the overall appearance of your face and make you look as young on the outside, as you feel on the inside!  Please call our office today for more information and pricing.  We will be offering competitive pricing.  We can’t wait to talk with you!

In Good Health,
Kelly Euse, DDS


Meet Our New Dental Hygienist, Kari

I have been in the dental field for almost ten years. I started out as a dental assistant, and worked with Dr. Kelly for four years. After feeling comfortable in the field, seeing how well patients can be treated, and how positive patients left after treatment, I knew I wanted to be involved more. I strive to make my patients as informed and comfortable as possible. I am very excited and proud to be at Advanced Dentistry by Design and look forward to helping make my patients smile.

When I am not in the office, I am usually helping my family out on the farm. I also enjoy going to concerts, traveling, and having fun with my family and friends.


Why do I need x-rays, and how safe are they?

In the past we have discussed how digital x-rays are different from traditional x-rays, and how safe they are.  However, they continue to be an area of concern for patients, so it is worth reviewing. Doctors cannot make complete diagnostic decisions based off visual exams alone.  Therefore, x-rays are a vital part of your treatment.  X-rays can detect even the slightest traces of oral health problems at their earliest stages, such as cavities, gum disease, oral infections, and some types of tumors.

X-rays are energy in the form of waves, identical to visible light.  In fact, the only difference between light and x-rays is that light doesn’t have enough energy to go through your body and x-rays do. Our patients often ask us about exposure to radiation and x-rays. The National Council on Radiation Protection (NCRP) says the average resident in the U.S. receives 360 mrem every year from sources such as radioactive materials in the earth, and in the food we consume.  Other sources of exposure are from smoke detectors, living in a brick house, cooking with natural gas, and even flying in an airplane.  A typical dental x-ray exposes you to only about 2 or 3 mrem.

At Advanced Dentistry by Design in Carson City, we have several x-ray units available for prevention and diagnostic purposes.  A full mouth series (FMX) consists of 14-21 x-rays, and is taken every 3-5 years depending on the patient’s needs and history. Bitewings (4) are usually taken once a year and are called “check-up x-rays.”  They are used to check for decay between the teeth.  They also help to detect infection and bone loss from a severe gum infection.

We have recently installed a Galileos 3D cone beam CT scanner in our dental office.  This x-ray scanner helps the doctors look through layers of bone, measure bone for implant placement, and can also be used as a tool for making surgical guides for more precise implant placement.  The CT scanner additionally shows a broad view of the jaws, teeth, nasal/sinus areas, and TMJ joints. These do not detect cavities, but do show potential problems such as impacted teeth, bone abnormalities, cysts, infections and fractures.

As always, your comfort and safety are our primary concern and every precaution will be taken such as wearing a lead apron to protect the rest of your body from exposure. Call us today at (775) 400-2533 to schedule your exam and x-rays with Dr. Clint Euse, Dr. Kelly Euse, or Dr. Randy Wright.  We look forward to smiling with you!


Meet our new Dental Assistant Kristan

My dental career started as a fluke over 14 years ago when my friend helped me obtain a position as a sterilization tech with the orthodontist she worked for. That was how it began. 14+ years later and I am still loving what I do!

I am a native Nevadan having lived in Reno, Gardnerville and Carson City. I graduated in 1993 from Douglas High School. After graduation, I moved away and have lived in Las Vegas, Sacramento and the Bay Area but always felt the pull to come back home. Upon moving home, I was blessed to have the opportunity to work with a general dentist who was willing to train me on the job and show me the ropes. I am very thankful he did because dentistry is what I love! The best part of my job is the people I have the privilege of working with and the people I get to meet everyday. I strive to make every dental visit the best it can be and make the patients feel comfortable and welcome.

I am the proud wife to my husband, Matt, and the very lucky Mama to Tony (19), Makenzie (17), Zacary (8) and Lucas (19mos). When I’m not chairside or spending time with my amazing family, you can find me singing my heart out with my band, Jake’s Garage 5.0, or with my live band karaoke group, Karaoke Rockstarz! My family is also very active in our community working with my daughter’s kindness groups (Be the Stone and the Kindness Krew) volunteering at various local events, fundraisers and anything where kindness and love is spread! I may be busy but I honestly wouldn’t have it any other way! I look forward to spending many wonderful years with my family at Advanced Dentistry by Design and making a difference in our patients lives!


Meet our new Hygiene Assistant Heather

Hello! My name is Heather Andersen. I was born in California, then raised here in Carson City. I graduated Carson High School, class of 2010, and went on to Western Nevada College. I have credits from WNC and Idaho State University in Pocatello Idaho.

One thing that has drawn me to this line of work is my interest in lifetime health. I am fascinated as I learn more about how the smallest things that you do (what you put in your mouth-the time you take to properly address hygiene) affect the health of your mouth, and in turn your body. I am also interested in all of the new technology that we get in the office. I’m impressed how new procedures are becoming more comprehensive, and less invasive.

Outside the office, I have a very involved life. I am married, and a mother of two, (Kaylee-3yrs, Colt-2yrs). Outside of work, I enjoy going on drives, walks and bike rides with my kids and taking them to the park. We are surrounded by my family, and love spending time with my mother and grandmother when we can.


Prophylaxis vs Periodontal Maintenance

There is a difference between a “regular cleaning” and a periodontal maintenance visit. A regular cleaning (or prophylaxis, in dental terms) is defined as prevention of disease, and is the removal of plaque, calculus and stain.  This is done with instruments that remove the deposits by an electric device called an ultra-sonic, or sonic scaler and hand instruments. Calculus is also known as tartar, and is a hard, mineralized deposit.  Plaque is a soft, sticky substance that forms on teeth which is composed of bacteria and bacterial by-products.

A regular cleaning is recommended for persons who do not have any bone loss, periodontal disease, or infection around their teeth. There should also be no bleeding, mobility of teeth, or receded areas where the gums have pulled away from the teeth. Periodontal disease is a chronic inflammatory disease caused by bacteria that cannot be cured, but can be controlled. If you have periodontal disease, you may require root planing to remove diseased deposits and bacteria from below your gum line.

Periodontal disease needs to be closely monitored and controlled, or it can quickly get worse, destroying your bone and gums, eventually causing tooth loss. With this said, after the disease process is under control, a regular cleaning is not enough. Instead, you will have an on-going procedure known as periodontal maintenance to keep your mouth healthy.  As this is a treatment and not a preventive service, your insurance will cover this as a basic service. Most periodontal patients see their hygienist at three month intervals to keep this chronic condition under control. Remember that insurance plans limit the number of treatments that they will pay for; however, it was never designed to pay for everything.  Most plans pay minimally regardless of what you might need as an individual.  Your visits should be designed by your doctor and your hygienist for your best benefit and not regulated by the insurance company.


Meet Amy, a new hygienist at our office!

My journey started in the dental field as front office in 1998. I also gained some experience and knowledge working at Patterson Dental Supply for a few years before deciding to follow in my aunt’s footsteps into dental hygiene. I graduated from University of Louisville in 2006 and have since been fulfilling my passion serving and building relationships with my patients.

I enjoy helping patients understand why good oral health is so important to our overall health. I am excited and thankful to be part of Advanced Dentistry by Design where patients are treated like family. I appreciate the up to date technology we offer to our patients and great team atmosphere.

My husband and I look forward to raising our 2 daughters in Virginia City where I grew up. We have fun camping, skiing, dirt biking and making memories with our girls. Spending time with our entire family is the most important thing to us!


Meet Kallee, a new hygienist at our office!

I was raised in Reno, NV and relocated to the Carson area in 2004 with my family. I love the area and I am proud to be part of such a great community. I graduated in 2006 from Truckee Meadows Community College’s nationally-recognized dental hygiene program. I have been practicing as a registered dental hygienist in the area for the last ten years.

I feel very blessed to now be working with such a great team at Advanced Dentistry by Design. I have thoroughly enjoyed my career in dental hygiene. I take pride in serving my patients with thorough and gentle care. I enjoy building relationships with my patients at each of their appointments, while caring for my patient’s dental needs with the highest quality of care.

I am a proud parent of two children that are now grown. My daughter is a medic in the Army. My son is attending WNC. In my free time, I love to enjoy the various lakes and wide open spaces in Northern Nevada and California. Our family enjoys desert racing and exploring the more remote areas of this state.


What causes bad breath, and what can be done about it?

Bad breath (medically called halitosis) can result from poor dental habits and may be a sign of other health problems.  It can be made worse by the types of foods you eat and other unhealthy lifestyle habits. As food is digested and absorbed into the bloodstream, it is eventually carried to your lungs, and released in your breath.

When you eat foods with strong odors (such as garlic and onions), brushing and flossing only covers up the odor temporarily.  The odor will not go away completely until the foods have passed through your body. If you don’t brush and floss your teeth daily, food particles remain in your mouth, promoting bacterial growth between teeth, around the gums, and on the tongue.  This causes bad breath.

Smoking or chewing tobacco products also cause bad breath, stain teeth, reduce your ability to taste foods, and irritate your gums. Persistent bad breath or a bad taste in your mouth may be the warning signs of gum (periodontal) disease. Periodontal disease is caused by the buildup of plaque on teeth, and the bacteria cause toxins to form in the mouth, which irritates the gums. Below are nine tips to help you avoid being self-conscious or embarrassed by bad breath:

1.  Brush and floss more frequently.  All of us should brush at least twice a day.  If you are concerned about your breath, brush and floss more often.
2.  Scrape your tongue.  The coating that is found on the tongue can host foul-smelling bacteria.  When you brush your teeth, brush your tongue as well.  You can also use a tongue scraper to really get the tongue clean.
3.  Avoid foods that sour your breath.  Remember, brushing won’t help!  The only way to avoid the problem is to avoid eating them.
4.  Kick the habit.  Smoking damages the gum tissue and stains teeth, not to mention increasing your chances of getting oral and other types of cancer.
5.  Rinse your mouth out.  After eating, rinse your mouth with plain water, which helps your breath by eliminating food particles.  An anti-bacterial mouthwash also adds extra protection by reducing plaque-causing bacteria.  Make sure to use a mouthrinse that is alcohol-free!  Alcohol in mouthrinse is drying to the gum tissues, which can lead to cavities and more bad breath.
6.  Skip the after dinner mints.  Sugary candies promote the growth of bacteria.  Instead, chew gum (sugarless of course) which stimulates saliva, promoting the mouth’s natural defenses against plaque acids.
7.  Keep your gums healthy.  Bacteria gathers in pockets at the base of the teeth, creating bad odors.  If you have gum (periodontal) disease, your dentist may recommend a periodontist who specializes in treating this condition.
8.  Moisten your mouth.  Lack of saliva promotes tooth decay and can cause bad breath.  Drink plenty of water and chew sugarless gum.
9.  See your dentist!  Remember, if your bad breath continues despite your best efforts, it could be related to a medical condition that requires treatment.


What are the requirements and training for dental hygienists?

In the past, we have reviewed Dr. Randy Wright, Dr. Clint Euse, and Dr. Kelly Euse’s education requirements to become a dentist.  This week let’s review the education of our three hygientists, ReNon, Kayla, and Kristin. Dental hygienists receive their education through academic programs at community colleges, technical colleges, dental schools or universities.  Receipt of their degree allows a hygienist to take their examinations (national and state) to be licensed to work in a dental office.

A career as a hygienist offers a wide range of challenges.  In a practice, the dentist and the hygienist work together to meet the oral health needs of patients. Since each state has its own regulations regarding their responsibilities, the services performed by hygienists varies from state to state.  Some services provided include:

*patient screening procedures, such as assessment of oral health conditions, review of health history, oral cancer screening, head and neck inspection, dental charting, taking blood pressure
*taking radiographs (x-rays)
*removing calculus and plaque (hard and soft deposits)
*applying preventive materials to teeth (sealants and fluoride)
*teaching patients appropriate oral hygiene to maintain oral health (brushing, flossing)
*counseling patients about good nutrition and the impact on oral health

The most enjoyable aspect of the job for our hygienists is working with the patients.  Personal fulfillment comes from providing a valuable health care service while establishing a relationship.  As a result of their education and clinical training, ReNon, Kayla, and Kristin are valued members of our team. Dental hygiene education programs offer clinical education in the form of supervised patient care experiences. Additionally, these programs include courses in liberal arts (English, speech, sociology and psychology); basic sciences (anatomy, physiology, pharmacology, immunology, chemistry, microbiology and pathology); and clinical sciences (dental hygiene, radiology and dental materials).

ReNon graduated with a Bachelor of Science in dental hygiene from Oregon Institute of Technology.  She has worked at Advanced Dentistry since 2010. Kayla graduated with a Bachelor of Science from University of Nevada Reno and from Mohave Community College hygiene program.  She has worked at Advanced Dentistry since 2012. Kristin graduated with an Associate of Science from Rio Salado School of Dental Hygiene and received her Bachelor of Science from the University of Phoenix.  She has worked at Advanced Dentistry since 2013. All three of the ladies are recognized by the State of Nevada as Registered Dental Hygienist (R.D.H.) and like the doctors, must keep their license current by attending continuing education classes.

We are very proud of our hygiene staff and invite you to visit our Team page on our website for more information on our staff as well as our practice or, call us at (775) 400-2533 to schedule an appointment.


Dental Benefits of Xylitol

Tooth decay happens when bacteria in your mouth consume the sugar we eat.  When you eat food containing ordinary sugar (sucrose), it gives bacteria on your teeth energy, allowing them to multiply and start making acids that can eat away at the enamel on the teeth.

Xylitol is a sweet, white substance that looks and tastes like sugar, but has 40% less calories than sucrose and is diabetic friendly.  Xylitol is organic and natural – found in the fibers of fruits and vegetables like corn, berries and mushrooms and in the wood of trees like the birch.  It does not break down like sugar and can help keep a neutral pH level in the mouth.

Xylitol prevents bacteria from sticking to the teeth and that is how it protects them from decay. When the plaque bacteria absorb Xylitol, they cannot multiply, produce acids, or stick to teeth.  Toxic, cavity forming plaque bacteria die each time they are in contact with Xylotol.  As harmful bacteria are cleaned away, new Xylitol-resistant bacteria take their place.  These new bacteria do not produce acids, do not damage teeth and do not form sticky layers of plaque.  After 5 weeks of eating at least 6 grams of Xylitol each day, sticky plaque bacteria will no longer be found on teeth.  After 6 months, these bacteria are undetectable in saliva and on the tongue.

Studies indicate that 4 – 20 grams each day, divided into three or more helpings, can reduce tooth decay and cavities by as much as 70%.  It may be hard to consistently eat four or more cups of fruit or vegetables each day;  a single cup of berries contains less than one gram of Xylitol.  For that reason, it is available as a sugar substitute, gum, and in healhty foods.

At Advanced Dentistry by Design, we are interested in helping you reverse the rising trend of negative health and high health-care cost.  While we know it won’t happen overnight, improving your health can begin sooner than later.  Watch for future articles on Xylitol and other products available in our practice to help you to be the best YOU possible.


Balance your pH for a healthy YOU!

Maintaining a balanced, healthy diet is important not only for oral health, but for your overall health. A diet consisting largely of acidic beverages and foods, such as soft drinks and processed foods has a negative effect on the body’s pH level. When these levels are not balanced, we are unable to process essential minerals and nutrients correctly. Bacteria, viruses, and disease thrive in an acidic environment. When the pH level of saliva becomes acidic, teeth begin to decay.

However, an alkaline (basic) environment makes it difficult for disease and illness to survive. Therefore, working toward a balanced pH level will help to combat bacteria, viruses, disease, and make a healthier you! The pH level is a reflection of the foods you eat. A diet rich in sugar, dairy products, and animal fats produces acid. Eating a diet high in alkaline producing foods (like many vegetables, fruits, legumes, nuts, and seeds) along with properly hydrating may aid your body in balancing its pH more efficiently. The pH scale ranges from 0-14, with 0 being the most acidic and 14 being the most basic; a pH of 7 is neutral. When the pH in your mouth becomes acidic (below 5.5), the cavity-causing bacteria thrive, producing more acid, causing demineralization and cavities.

Your Carson City dentists at Advanced Dentistry by Design are passionate about improving the lives and smiles of our patients. We know that the effects of various drinks DO cause cavities. We want to help you and your family prevent them and invite you to pick up a pH drink chart and see where your favorite beverage rates. Coke, Pepsi, and Powerade have a pH of 2 (in the danger zone), while water, soy milk and green teas are a healthier pH of 7. We will also give you some test strips to measure the acidity of your favorite drink. Just dip the strips into your drink and match with a pH color chart to determine the pH level, and see if your favorite beverage is in the “safety zone” or the “danger zone.” Advanced Dentistry by Design is here for the health, beauty and function of your teeth, but we also care about your overall health.


What’s In A Name?

ad-vanced – adjective
far on or ahead in development or progress
synonyms: state-of-the-art, new, modern, developed, cutting-edge, leading-edge, up-to-date, the newest

den-tist-ry – noun
the evaluation, diagnosis, prevention and/or treatment of disease, disorder and/or conditions of the oral cavity
synonyms:  dentist, hygienist, tooth fairy, crown, filling, cavity, dental floss, denture, extraction, tooth brush

by de-sign – noun
purpose, a result of planning, intentionally, systematic process to build quality into a product from the inception to final output
synonyms:  blueprint, devise, formulate, plan, strategize

Advanced Dentistry by Design – A  state-of-the-art, modern dental office preventing and treating patients oral cavity by a systematic, well thought out process to achieve both the highest quality of treatment and success.

What’s in a name?  That which we call a rosae by any other name would smell as sweet.  William Shakespeare


What Causes Tooth Decay, aka Cavities?

To understand this subject, you need to understand where decay can occur. There are three places: on the smooth surfaces of the teeth, between the teeth (interproximal), and in the pits.

Smooth surfaces of teeth are significantly effected by brushing. Interproximal decay is out of the reach of the toothbrush, but can be reached by using dental floss. The pits of the teeth are created by deep grooves that occur naturally. The pits attract microscopic food particles and bacteria and are very prone to cavities.

Bacteria in plaque metabolize the foods that you eat, and then convert it to acids that attack the surfaces of your teeth, causing decay. Your body has natural defenses against cavities. Your saliva has minerals in it that your body uses to repair the spots attacked by the plaque’s acid. It is only when the rate of attack exceeds the rate of repair that you get decay.

So, how do you prevent cavities?

1.     Brushing helps prevent smooth surface decay, and decay in the pit areas of your teeth. If you remove the plaque right after eating, it halts the acid attack. A Sonicare toothbrush is the ideal toothbrush to use. Research shows that a Sonicare toothbrush removes up to 7x more plaque that a manual toothbrush.
2. Flossing helps prevent the cavities between teeth.
3. Fluoride strengthens the teeth on all surfaces to better resist decay.


Healthy mouth, healthy body:  The link between them may surprise you.

Taking care of your teeth isn’t just about having a nice smile and pleasant breath.  Recent research has found that your oral health might affect, be affected by, or contribute to various diseases and conditions, including:

* ENDOCARDITIS – infection of the inner lining of your heart.  Occurs when bacteria spread through your bloodstream and attach to damaged areas in your heart.
* CARDIOVASCULAR DISEASE – heart disease, clogged arteries and stroke might be linked to the inflammation and infections that oral bacteria can cause.
* PREGNANCY and BIRTH – periodontitis has been linked to premature birth and low birth weight.
* DIABETES – Research shows that people who have gum disease have a harder time controlling their blood sugar levels.
* OSTEOPOROSIS – causes bones to become weak and brittle – linked with periodontal bone and tooth loss.
* ALZHEIMER’S – tooth loss before age 35 might be a risk factor for the disease.
* OTHER CONDITIONS – including Sjogren’s syndrome – an immune system disorder that causes dry mouth – and eating disorders.

Because of these potential links, be sure to tell your dentist if you are taking any medications or have had any changes in your overall health, especially a recent illness or a chronic condition.
To protect your health, brush your teeth at least twice a day, floss daily, eat a healthy diet and limit snacks, replace your toothbrush every three to four months and see your dentist and hygienist regularly.

At Advanced Dentistry by Design, we look forward to helping you take care of you! Call us today to schedule an appointment, 883-7244.


What Products Do The Doctors At Advanced Dentistry Recommend To Help Prevent Cavities?

We are proud of the extensive supply of products on hand in our office to help you to achieve the best oral health possible.  Some of the products can be purchased in major chain stores, but we offer them here for your convenience and to provide you with clear instructions on how each product is to be used.

Today I would like to talk with you about CariFree which helps in the fight against cavities, which are caused by an imbalance between risk factors for the disease and protective factors keeping you healthy! The CariFree products can be purchased in the rinse, gel toothpaste, and the kit which contains the x4 rinse, x3 rinse and the gel toothpaste – a 3 month supply.

There are five treatment agents prescribed for managing the disease that causes cavities.  Each CariFree product is designed to provide the specific agents necessary as per each individual patient’s caries risk.  The higher the patient’s risk, the higher the recommended level of exposure to the five principal treatment agents.  The five agents are as follows:

  1. pH Neutralization – Reduces growth and acid production of cariogenic bacteria, supports healthy oral bacterial growth.
  2. Antibacterial – Significantly reduces total bacteria levels when high levels are identified.
  3. Flouride – Aids in remineralization and inhibits acid production of cariogenic bacteria.
  4. Xylitol – Reduces growth and acid production of cariogenic bacteria.
  5. Nano HA – Aids in remineralization with nano particles of hydroyapatite.

At Advanced Dentistry by Design we strive to both care for and educate patients, helping to achieve the highest level of health!


What happens when I reach my maximum coverage for the year?

After you reach your maximum, whether it is a calendar or plan year, you are responsible for the cost of dental procedures yourself. At Advanced Dentistry by Design, we will bill your insurance company so you will receive your PPO (preferred provider discount), if applicable. Offices that do not bill are participating in what is called “Balance Billing.” Balance billing is when the patient is billed for the “discount” from the insurance company.

If the dentist’s office submitted the charges to the insurance company, and the insurance company did not apply the discount, then the patient is responsible. The problem is between the patient and the insurance, not the doctor. However, if the insurance company did apply the discount and the dental office billed for the total amount, then the error needs to be brought to the attention of the dental office.

It is very important that you review your Explanation of Benefits (EOB), which you will receive prior to your dental office receiving their copy. It is imperative that you are aware of your plan benefits.


What is Six Month Smiles®?

At Advanced Dentistry by Design, we offer Six Month Smiles which is a cosmetic procedure specifically designed for adults and older teens that have crooked, crowded or spaced teeth, but do not have significant bite issues.  The latest technology and techniques include special nickel titanium wires with a primary focus on moving the teeth that show in your smile.

The tooth colored wires and brackets are more aesthetically pleasing than traditional braces and you don’t have to deal with the embarrassment of ugly metal brackets and wires dominating your mouth.  Treatment is generally less expensive than traditional braces and is possibly covered under your dental insurance.  Call your Carson City dentists today at (775) 400-2533 to schedule a no obligation consultation to see if your smile would be enhanced by Six Month Smiles!


A HEALTHY NEW YEAR!

As 2015 comes to an end, I hope that you have found the weekly articles informative and thought provoking.  I have learned a lot writing them, some of it surprising even for someone with 20+ years of dental experience.

I hope the New Year brings you peace and health! Let’s review some of the topics from this past year…….

1) Brushing helps to prevent decay.  If you remove the plaque right after eating, it halts the acid attack.  Flossing helps to prevent cavities between the teeth and flouride strengthens the teeth to better resist smooth surface and between teeth decay.  Chewing gum increases saliva flow which helps to dilute the acids that attack the teeth and washes away food particles before the bacteria can digest them.  Sweets can cause decay but carbohydrates promotes it – especially those that stick to your teeth such as crackers or pretezels.

2)  Watch the pH balance in your drinks!  The pH scale ranges from 0-14, with 0 being the MOST acidic and 14 being the most basic; a pH of 7 is neutral.  When the pH in your mouth becomes acidic (below 5.5), the cavity causing bacteria thrive, producing more acid, causing demineralization and cavities.

3)  Xylitol is a natural substance that can be found in a variety of fruits and vegetables.  Studies indicate that 4 – 20 grams of xylitol each day, divided into three or more helpings, can reduce tooth decay and cavities by as much as 70%.  Some of the most common xylotol-rich foods include berries, mushrooms, corn, and lettuce.  A single cup of berries contains a little less than one gram of xylitol.  You can also get it as a sugar substitute, in gum and yes, even in candy.

4)  Get your annual oral cancer screening.  The use of Velscope makes screening pain-free and takes 1 – 2 minutes to complete.  Wear sunscreen and a hat to protect yourself and be aware of the risk your lifestyle imposes; smokers and drinkers are 70 – 80% more likely to develop oral cancer.

5)  There is no need to suffer from headaches!  We have proven results in our office with Trudenta therapy and two of the technicians in our office travel with the Trudenta team teaching this technology to offices all over the United States.

6)  Products!  We are proud of the extensive supply of products on hand in our office to help you achieve the best oral health possible.

7)  The Mouth-Body connection.  The health of your mouth affects your whole body.  The working relationship between diabetes and periodontitis may be the strongest of all connections.  Inflammation that starts in the mouth seems to weaken the body’s ability to control blood sugar; people with diabetes have trouble processing sugar because of a lack of insulin, the hormone that converts sugar into energy.  Remember oral infections can spread to the heart!

8)  Schedule regular appointments with your doctor and hygienist!  Every six months is the recommendation unless you have periodontal disease in which case you would be seen more frequently.

9)  We understand dental phobia is real!!  We practice “look, see, do” gentle dentistry in our office.  The most important part of overcoming fear is education.  It is important to us that you know what is being done and why, and we will take all the time necessary to explain it all to you.

10)  CHOCOLATE ACTUALLY HAS A DECAY INHIBITOR!!

We look forward to smiling with you in the New Year!!


What happens when I reach my maximum coverage for the year?

After you reach your maximum, whether it is a calendar or plan year, you are responsible for the cost of dental procedures yourself. At Advanced Dentistry by Design, we will bill your insurance company so you will receive your PPO (preferred provider discount), if applicable. Offices that do not bill are participating in what is called “Balance Billing”. Balance billing is when the patient is billed for the “discount” from the insurance company. If the dentist’s office submitted the charges to the insurance company, and the insurance company did not apply the discount, then the patient is responsible. The problem is between the patient and the insurance, not the doctor. However, if the insurance company did apply the discount and the dental office billed for the total amount, then the error needs to be brought to the attention of the dental office.

It is very important that you review your Explanation of Benefits (EOB), which you will receive prior to your dental office receiving their copy. It is imperative that you are aware of your plan benefits.


What are my options if I do not have dental insurance?

If you have planned for your dental treatment, or are experiencing a dental emergency, thinking about the financing can add additional pain!

Your simplest and easiest choice is to pay out of pocket. Dental insurance, unless provided by an employer, usually does not deliver a lot and waiting periods, even for preventative services, apply. Some offices will offer you a discount for paying in cash or with a check, and most accept major credit cards.

If you need dental work and cannot afford it, you may be able to get a loan. There are consumer loans offered through your bank or CareCredit (a dental financing company) which offers 0% financing to qualified borrowers.

A newer trend in dental financing is “in office” dental plans which for a set annual fee provides you with preventative and emergency services along with a discount on most treatments. At Advanced Dentistry by Design, we offer a plan called Quality Dental Plan (QDP), please call one of our friendly staff members for details.


Our Holiday Party

Holiday parties bring thoughts of women in sparking dresses and high heel shoes and men in suits with freshly starched shirts, exquisite dinners, and lots of friends.  At Advanced Dentistry by Design, our Christmas party is spent in jeans and tennis shoes in Wal-Mart, North Carson with a sack lunch.

We have once again chosen to forgo a traditional party and instead participate in Holiday with a Hero, which has been scheduled for Wednesday, December 16th.  Last year, the event had almost 200 students attend. This year nearly 400 students pre-K to 12th grade are expected at the event.  The students are chosen from the Children in Transition program, which offers free and reduced school lunches to Carson City students.

At the event, students will be provided lunch and paired with a Hero to use their $100.00 gift card and have the opportunity to see Santa who will arrive in a Care Flight helicopter.

To donate, anyone can drop off money to the Sheriff’s Office, one of the schools, or at Bank of the West.  All checks should be made out to Holiday with a Hero.  It is a non-profit 501(c) organization, so donations are tax deductible.

The organization is also taking non-monetary donations such as wrapping paper, bags, bows, and gift tags, which can be dropped off at the Sheriff’s Office and our office, 403 W. Nye Lane, Carson City.

Advanced Dentistry by Design, caring for you and our community.


Planning Your New Year’s Party?

It seems that holiday decorations have been on display for months and that people are posting the count down til Christmas on social media.  At Advanced Dentistry by Design, we too are planning for the end of the year, not for our holiday party, but for the expiration of insurance benefits!

A majority of the insurance companies run on a calendar year, so benefits expire on December 31st and will renew for 2016 on January 1st.  The remaining maximum on your plan will not roll over, it is a “use it or lose it” benefit.  If you are unsure of the dollar value left on your plan, you can either call your insurance company directly, or call our office and we will make the call for you.

If you know that you are going to need extensive work we can help you break it up into two plan years; 2015 and 2016 to best utilize your insurance and make large procedures more affordable.

As the year draws to an end, plan on seeing us to celebrate – celebrate a healthy you!  Our office will be open through December 23rd and then back after the first, so call soon so we can accommodate your busy holiday schedule.

Advanced Dentistry by Design 883-7244, we look forward to smiling with you!


Planning To Schedule?

As we approach the end of the year, dental treatment becomes even more pressing to utilize benefits, which will expire at the end of December.  To help you plan your schedule, please be aware of ours:

Dr. Wright will be out of the practice the week of November 2nd.
There will be no doctors in the practice the week of November 9th.
We will be closed for the Thanksgiving holiday on the 25th and 26th of November.

We will be closed on December 16th to once again participate in Holiday With A Hero.
From the 24th of December until we return on January 4, 2016, the office will be closed.

Call us today at 883-7244 to schedule your treatment – we look forward to smiling with you!  Best wishes for blessed holidays from all of us at Advanced Dentistry by Design.


What Causes Tooth Decay, aka Cavities?

To understand this subject, you need to understand where decay can occur. There are three places: on the smooth surfaces of the teeth, between the teeth (interproximal), and in the pits.

Smooth surfaces of teeth are significantly effected by brushing. Interproximal decay is out of the reach of the toothbrush, but can be reached by using dental floss. The pits of the teeth are created by deep grooves that occur naturally. The pits attract microscopic food particles and bacteria and are very prone to cavities.

Bacteria in plaque metabolize the foods that you eat, and then convert it to acids that attack the surfaces of your teeth, causing decay. Your body has natural defenses against cavities. Your saliva has minerals in it that your body uses to repair the spots attacked by the plaque’s acid. It is only when the rate of attack exceeds the rate of repair that you get decay.
So, how do you prevent cavities?

1. Brushing helps prevent smooth surface decay, and decay in the pit areas of your teeth. If you remove the plaque right after eating, it halts the acid attack. A Sonicare toothbrush is the ideal toothbrush to use. Research shows that a Sonicare toothbrush removes up to 7x more plaque that a manual toothbrush.
2. Flossing helps prevent the cavities between teeth.
3. Fluoride strengthens the teeth on all surfaces to better resist decay.


Spotlight Employee – Meet Kadie!

Kadie was born and raised in the Carson Valley and graduated from Douglas High School.  After graduation she attended Western Nevada College before entering the dental field.  She has been an assistant for 8 1/2 years, the last 5 1/2 at Advanced Dentistry. Kadie is mom to twin daughters Taylor and Kylie and is very involved in their outside activities which include soccer and Kadie - Team Member 12dance.  When not working, Kadie enjoys time with the girls, paddle boarding, snow shoeing, and time with life long friends.  She is also an instructor for Trudenta traveling with the team to teach the newest technology in headache relief to offices throughout the United States. Kadie’s personality is infectious which makes her a favorite among staff members and our patients!  Her passion for the job is obvious and she treats her patients as family often greeting them with hugs! If you need an office where you are treated with respect and compassion, come meet Kadie and our other outstanding staff members at Advanced Dentistry by Design, 883-7244.  We look forward to smiling with you.


The Dentist Recommended Treatment That My Plan Will Not Pay For.  Does This Mean The Treatment Really Isn’t Necessary?

The answer, absolutely NOT!!  The most important thing to remember when dealing with insurance companies is that they are “for profit” companies. Saying no to you keeps more money in their pocket. Your doctor recommends treatment based on his/her years of education and experience and your over all health.  The most common denial is for composite (white) fillings.  A majority of the insurance companies down code the posterior fillings to amalgam (silver) fillings.  Why?  Composite is up to 25% more expensive and the policy of the insurance companies is to cover the cost of the least expensive restoration.  However, there are potential adverse effects of silver fillings which are close to 50% mercury and a mixture of silver-tin alloy and copper.  Recent research shows that these fillings release mercury vapor during chewing. Another often denied but necessary procedure is a crown build up.  A material is placed in the tooth preparation for a crown when there is insufficient tooth strength and retention for the crown procedure.  In layman’s terms, it’s like placing rebar in a foundation.  Without the build up a large percentage of the crowns will fail and under the replacement clause of the policy, the insurance company will deny the new crown. There are many additional procedures with exclusions that we deal with on a daily basis.  We can help you by submitting a preauthorization to your carrier prior to treatment or help you with an appeal should they deny the claim after.  We work hard to be well versed in the major insurance companies so we can advise you of the limitations in advance so you and your doctor can make well-informed decisions. Call us today at (775) 883-7244.  We look forward to smiling with you!


What Products Do The Doctors At Advanced Dentistry Recommend To Help Prevent Cavities?

We are proud of the extensive supply of products on hand in our office to help you to achieve the best oral health possible.  Some of the products can be purchased in major chain stores, but we offer them here for your convenience and to provide you with clear instructions on how each product is to be used.  Today I would like to share with you about CariFree which helps in the fight against cavities which are caused by an imbalance between risk factors for the disease and protective factors keeping you healthy! The CariFree products can be purchased in the rinse, gel toothpaste, and the kit which contains the x4 rinse, x3 rinse and the gel toothpaste – a 3 month supply.  There are five treatment agents prescribed for managing the disease that causes cavities.  Each CariFree product is designed to provide the specific agents necessary as per each individual patient’s caries risk.  The higher the patient’s risk, the higher the recommended level of exposure to the five principal treatment agents.  The five agents are as follows: pH Neutralization – Reduces growth and acid production of cariogenic bacteria, supports healthy oral bacterial growth. Antibacterial – Significantly reduces total bacteria levels when high levels are identified. Flouride – Aids in remineralization and inhibits acid production of cariogenic bacteria. Xylitol – Reduces growth and acid production of cariogenic bacteria. Nano HA – Aids in remineralization with nano particles of hydroyapatite. At Advanced Dentistry by Design we strive to both care for and educate, helping to achieve the highest level of health!  Call us today at 883-7244 – we look forward to smiling with you!!


Can You Help Me Get My Records From My Previous Dentist?

If you are switching to a new dentist, ask your current office about their policies regarding your dental records. Most offices keep records for a number of years as required by law, but it is always a good idea to transfer the records as soon as possible to help establish yourself as a patient. Due to confidentiality of medical information and the dentist-patient relationship, all requests for records must be done so in writing with the patient’s signature authorizing the release. The management of patient records and the information contained is regulated by both state and federal law. The former dental office may ask for clerical costs incurred in locating and making the records available. At Advanced Dentistry be Design we know that obtaining the records from your previous dentist can be uncomfortable so, we do it for you! Upon receipt of the signed ‘Records Release Form’ we will contact the other office on your behalf, and have the information available at your new patient appointment. Please call us today at (775) 400-2533 and speak to our friendly front office staff. We look forward to smiling with you!


Staff Spotlight Dr. Randy Wright

Dr. Randy WrightThe team here at Advanced Dentistry by Design would like to congratulate Dr. Randy Wright on his 30th year of providing Carson City residents with healthy, beautiful smiles.  Dr. Wright is a passionate and dedicated dentist, who has and will contimue to put the health, well being, and happiness of his patients at the forefront of his practice.  Even after 30 years, he continues to educate hmself and his staff in order to better serve his community. Dr. Wright was born and raised in Reno.  He attended Reno High School where he played football.  Upon graduation he attended University of Nevada Reno and was accepted early into the University of the Pacific School of Dentistry.  Upon graduation he retuened to Northern Nevada and opened his practice in Carson City. Dr. Wright is an avid outdoors man who loves hiking, biking, and skiing enjoying all of these activities with his son, Lucan and daughter, Isabel. Call our office today to schedule an appointment with Dr. Wright, 883-7244.  We look forward to smiling with you!


2015 Nevada Appeal Best of Carson City

It is with great pride and gratitude that we accept the honor of Carson City’s “Best of” award in the dental category! Thank you to Carson City residents, the Nevada Appeal, and our patients for bestowing this honor upon our practice. What is it, you ask, that makes us different?  It is a combination of individuals that bring their A-game to work every day!  Three highly trained and experienced Doctors who are continually improving not only their own skills but the level of technology used in the office.  Three amazing hygienist and a hygiene assistant who are very active in their pursuit of a wonderful and educational experience for each patient.  Four very experienced dental assistants, one even the daughter of a dentist!  And last but not least, four front office staff members with combined experience of 68 years!  That is 15 people who take great pride in their profession and in our practice. It is also our commitment to give back to our community through our donations to Food for Thought.  Each Friday they provide a bag of food for hungry children allowing them to eat healthy over the weekend so they can arrive to school on Monday, nourished and ready to learn.  We also contribute financially and donate a day of work to the Holiday with a Hero program shopping with underprivilaged children for themselves and their families for Christmas. This day is our office Christmas party and we all look forward to it! Different?  Absolutely!  If you are looking for the best and most advanced dental practice in Carson City and surrounding areas, call us today to schedule your new patient appointment. 883-7244.  We look forward to smiling with you!


Get The Care You Deserve

We are excited and proud to introduce Compassionate Finance as our newest financial option for our patients. Over the last few years and specifically last several months, we have experienced a number of our patients being declined or only partially approved for financing.  In order to better serve our patients, we feel obligated to provide payment options that will make our care available and affordable regardless of credit history.  With Compassionate Finance, you can expect quick acceptance and payment plans that fit your budget. The two requirements for this option are a checking or savings account (payments are automatically withdrawn monthly) and a down payment.  Down payment requirements are dependent upon specific treatment amounts. This plan can be used even if you have insurance. Don’t put off treatment because of the cost.  Apply today and get the care you deserve!  Call us today at 883-7244.  We look forward to smiling with you!


Meet the Staff – Kayla

At Advanced Dentistry by Design, we are fortunate to have three full time hygienist who work Monday through Thursday seeing eight patients per day.  A few weeks ago we met Kristin, and this weeks spotlight is on Kayla. Kayla was born and raised in Quincy, California and currently makes her home in Reno with her husband, Bobby and two English Pointer puppies, Kaden and Lucy.  Kayla began working in dentistry before graduating from Plumas Christian School knowing early she wanted to he a hygienist.  She graduated from the University of Nevada Reno with a Bachelor of Science degree in Biology before moving to Lake Havasue City, Arizona to attend hygiene school at Mohave Community College where she graduated in 2011.  Kayla has been with Advanced Dentistry since 2012, where she aspires to treat every patient as if they are family by practicing gentle, yet thorough treatment. When not working, Kayla enjoys remodeling her home with Bobby, being outdoors, playing with the puppies, and spending time with family and friends. Call Advanced Dentistry by Design and make an appointment to meet Kayla and the other friendly staff members, 883-7244.  We look forward to smiling with you!


“Why do you not quote prices over the phone?”  We get this question a lot!

At Advanced Dentistry by Design it is our policy to not quote over the phone so as not to create an expectation that cannot be met.  We do provide no cost consultations for dentures and implants so that you understand the process, and the materials used.  At that time, we would provide you with a written estimate and could pre-authorize with your insurance, as well. If you are calling from practice to practice to obtain quotes, know that most likely you are comparing apples to oranges.  We use top of the line materials and reputable laboratories to insure the best fit, performance, and longevity.  We also pride ourselves on having the most up to date and modern dental equipment, and our doctors spend hundreds of hours on continuing education and advanced training.  We provide high quality dental care, in a comfortable environment, where you can feel at ease and have peace of mind that you are getting excellent service and treatment for a long-lasting smile. Call us today at (775) 400-2533 so we can get you closer to the beautiful, confident, and comfortable smile you deserve!


TruDenta Works!

“For over a year now, I have had the honor to teach teams how to be a Dentomandibular Rehabilitation Therapist (DMRT) at the UNLV Dental School in Las Vegas, NV and the Nova Dental School in Ft Lauderdale, FL.  As a DMRT I have great pleasure teaching other dental teams how to implement the new equipment and teach the skills that it requires to becoming a DMRT in their own office. My teaching for this amazing program comes from personal experience.  In 1988 I had jaw surgery (TM joint) due to an accident years prior.  I was in daily pain on the right side of my face with headaches.  Being a mom, wife, and a full time dental assistant, I did not focus on the pain unless the headache became excruciating to the point that I would end up in the hospital.  As a daughter of a dentist, I can assure you that I have sought every avenue possible to relieve my pain. This includes an MRI, two artagrams (dye is shot in the jaw joint in front of the ear and moved around as each x-ray is taken) causing more pain because you are awake!  Bio feedback therapy, dental orthotics, pain medication, and muscle relaxers were constantly attempted.  Since we bought the Trudenta System and I have been both patient and teacher, I feel my life has gone full circle.  I am finally out of pain and I love sharing my experience with my patients here at Advanced Dentistry and with my new teams.”                   —Apryl, Dental Assistant and DMRT For more information on Trudenta, please call our office at 883-7244 to schedule a consultation.  We look forward to smiling with you!!


Final dental implant series installment

For the past couple of weeks we have discussed implants; the consultation, the placement, and today – caring for the implant. Dental implants are a major investment, and with proper care, can last a lifetime.  Personal hygiene must take place before, during, and after placement of the implant.  Proper monitoring and maintenance is essential to ensure durability and health of the implant.  The goal is to maintain a stable, infection-free, healthy environment. Cleaning around implants differs from natural teeth for two reasons:  The first is that each attaches to surrounding bone and gums in different ways; secondly, the materials that the implants are made of is very different from natural teeth. Your hygienist must select instruments for cleaning that will not damage the crown, abutment, or the implant itself.  The instruments, called scalers and curettes, are often made of plastics and resins so not to scratch the smooth surface of the abutment and crown.  If the surface is scratched it can attract and harbor bacteria.  Natural teeth don’t scratch and metal instruments are used to clean them. Hygienists may also use ultrasonic instruments to clean around implants, which have nylon or plastic tips to minimize damage.  They clean by using high-frequency vibrations, which may be necessary if large quantities of debris have accumulated.  They are used on a low setting with water irrigation, and sometimes antibacterial solutions. Home care is vital to the success of the implant, and at Advanced Dentistry by Design, our doctors and hygienists recommend an electric toothbrush (Sonicare), water flosser (WaterPik—on LOW setting), and a regular hygiene schedule. We welcome the opportunity to discuss implants and the many other services we offer.  Please call us today at (775) 400-2533 to schedule your new patient appointment, or for a consultation with Dr. Wright, Dr. Euse, or Dr. Kelly. We are located at 403 W. Nye Lane at the north end of Carson City.  We look forward to taking great care of your and your family’s smiles!


Part two of three in our answer series about Dental Implants

Last week we discussed what dental implants are and the steps to determine if this would be the right choice for you.  In review, dental implants are a safe procedure that have been in use since the mid 1960’s.  During the procedure, the tooth root is replaced with a metal, screw-like post, and replaces damaged or missing teeth with artificial teeth that look and function like real ones. The surgery may occur in stages and may involve several procedures. The major benefit of implants is the solid support for your new teeth – a process that requires the bone to heal tightly around the implant.   Because this healing requires time, the process may take many months. Implants are typically placed in a single sitting but require a period of time for osseointegration.  Osseointegration is the process in which the implant anchors to the jaw bone, that is, the jaw bone fuses to the implant post.  This process can take from three to six months to anchor and heal. The implant restoration is usually composed of a titanium material screw and a crown.  A small hole (pilot hole) is drilled to guide the titanium screw that holds the implant in place, it is slowly widened to allow placement. It is here that the dentist uses surgical guides that are created based on CT scans. Once in place, surrounding gum tissue is secured over the implant and a protective cover screw is placed on top (called a healing cap) to allow the site to heal.  After approximately six months of healing, the dentist will uncover the implant and attach an abutment (which holds the crown) to the implant.  During this time, provisional (temporary) restorations may be worn. Recovery time is usually minimal as well as the discomfort level.  Swelling of your gums and face may occur, as well as some minor bleeding and bruising at the implant site.  Pain medications may be prescribed by your dentist to relieve any pain or discomfort. For the first five to seven days after surgery, your diet is restricted to soft foods.  If temporary restorations were placed, it is important to clean them as you would your natural teeth to ensure the best possible healing and fusing of the implant.  Typically your doctor will use stitches that dissolve on their own.  If the stitches aren’t self dissolving, they will be removed in approximately 7-10 days. At Advanced Dentistry by Design, our doctors are well educated and skilled in the placement of implants. We have recently added a Galileos 3D digital x-ray machine (CBCT Scanner) to the office.  The CBCT Scanner is a computer-guided implant system for precise implant placement.  This new digital x-ray machine is used to ensure the highest success rate possible for our patients! Call us at (775) 400-2533 to schedule a consultation to see if this procedure is right for you. Next week in the final article of this series, “How to properly care for the implant.”


Part one of three in our answer series about Dental Implants

Dental implants have been in use since the mid 1960’s and are a safe way to replace tooth roots and provide a strong foundation for fixed (permanent) or removable replacement teeth that are made to match your natural teeth. There are many advantages to dental implants, including:  improved appearance, improved speech, easier eating, improved self esteem, improved oral health, durability, and convenience. Success rates of implants vary, depending on where in the jaw the implants are placed, but in general, dental implants have a success rate of up to 98% and with proper care, implants can last a lifetime. In most cases anyone healthy enough to undergo a routine dental extraction or oral surgery can be considered for an implant.  Patients should have healthy gums and enough bone to hold the implant.  They must be committed to good oral hygiene and routine dental visits.  Heavy smokers, those who suffer from uncontrolled chronic disorders – such as diabetes or heart disease – or patients who have had radiation therapy to the head/neck area will be considered on an individual basis. To determine if implants are right for you, a consultation is needed.  At that time you will receive a thorough examination of your teeth and gums and an evaluation of bone density and quantity.  This will involve x-rays and computer tomography scans (CT scans) to ensure there is sufficient bone structure for placing the implant(s), and to determine exactly where the implant should be placed. Check back next week for our next dental implant answer segment.


TruDenta Really Works!

“For years, I suffered from headache pain and a combination of Advil and Ibuprofen were a part of my daily diet.  There were also migraines, the medicine which seemed to make me even more sick, and the days spent in a dark room and isolation which were made even more difficult as a single mom.  The pain, headaches, stress, anxiety, and trauma was taking a toll  on my life but, I felt that I was coping the best I could. Doctor’s freely dispensed medication however, the reason(s) behind the headaches was never explored and I assumed it was forever.  Dr. Clint Euse assessed my head, neck, jaw, and teeth and asked me questions about any trauma (car accident, horse or bike falls, etc.) and explained to me how those had an affect on my dental foundation.  I had 12 in-office therapies that lasted one hour each, I wore a rehabilitation orthotic (night guard), did my home care, and am proud to tell you I have been headache free for over a year! Not covered by dental insurance and most medical carriers as well, it is an investment in you….in your life and in your health.  If you experience one or more headaches a week, miss work due to headaches, have pain in your jaw, face, neck, shoulders or arms, or experience ringing in your ears, this treatment is for you!” –Terrie, New Patient Coordinator at Advanced Dentistry by Design For more information on Trudenta, please call our office at 883-7244 to schedule a consultation.  We look forward to smiling with you!!


Trudenta, Yes It Really Does Work!

“At the age of 14, I was a typical kid in the ’80’s.  Life was GOOD!  I played outside, drank from the garden hose, and rode my bike as fast as I could without a helmet.  I wrecked on my bike regularly, like every other kid. As time went on I was not so happy-go-lucky.  I acquired regular migraines that were horrible and this went on into my 40’s.  I sought help from neorologists, multiple doctors, had many CT scans, regular x-rays, tried every medication that came out, massage therapy, electrical muscle stimulation in my neck, hypnosis, and multiple chiropractic appointments.  At my lowest point, I was told by a neurologist that I didn’t know what a true disability or spinal injury was like and I needed to get used to it.  I quit seeking help at this point. When Dr. Euse came to me with a new system to treat migraine sufferers in the office, I was skeptical to say the least.  What could a dentist do that a brain and spine specialist couldn’t?  He asked me to have an open mind and to give it a chance.  I am so glad I did.  I completed the full course of treatment some time ago and once again, life is GREAT!  I can function without the fear of a debilitating migraine ruining my day.  I did not believe this level of relief was possible.  I am grateful to the doctors and my coworkers at Advanced Dentistry by Design.”    -Karen, Office Manager at Advanced Dentistry by Design For more information on Trudenta, please call our office at 883-7244 to schedule a consultation.  We look forward to smiling with you!!


What can I expect on my first visit?

On your first (and every) visit, you will be greeted by our friendly front office staff.  A tour of our beautiful and highly technical facility will follow.  One of our well trained assistants will then take x-rays and gather information before you meet the doctor.  A comprehensive exam will allow Dr Wright, Dr. Euse, or Dr. Kelly to gain your confidence, and to formulate a treatment plan for your optimum care.  A stop in my office to review your treatment, insurance benefits (if applicable), out of pocket expense, and scheduling will conclude your visit of approximately one and a half hours.  New patient appointments are available Monday through Thursday and we look forward to meeting you soon! To schedule your first visit, please don’t hesitate to call us at (775) 400-2533.


How do I know what my dental insurance covers?

This seems like such a simple question, however, it is probably the most common question asked with regard to individual or group insurance, and the most difficult to answer. Dental practices do their best to obtain this information for you when asked but, please know that the insurance company representative always begins their conversation with “this is not a guarantee of benefits.” It is important for you to review your handbook and familiarize yourself with what is covered, excluded, or if a deductible or waiting period applies. Some plans pay a percentage of a service, such as 100% of preventative and others off a set of fee schedules. Some apply a deductible to all services, and some waive the deductible on preventative services. Again, know your plan prior to your appointment, and if you have questions, contact your insurance company or ask your dental office for assistance. At Advanced Dentistry By Design, Paula, our Insurance Coordinator, can answer your questions based on compiled information from the many companies we work with. We also offer a pre-authorization service so you have a more definite estimate of your out-of-pocket expense prior to treatment. Insurance and billing information offered by your dental office is a courtesy and does not guarantee coverage and/or payment for any service. If you have any questions about your insurance coverage or the cost of dental treatment, please don’t hesitate to call us at (775) 400-2533.


Meet the Staff

Paula - Team Member 6This week I have the pleasure of introducing you to Paula, our Insurance Coordinator. Paula has 19 years of dental experience, five of them here at Advanced Dentistry. She is extremely well versed at obtaining the information necessary prior to your treatment and working with the insurance companies to insure proper payment on your claims. Paula grew up in Lindsay, California and moved to Nevada in 1996. Paula and her husband David live here in Carson City and have three grown boys, Patrick, Kevin and Brad. Her hobbies include gardening, crocheting, and bowling in a league with her husband and children. Paula loves her job and it is evident by her cheery voice on the phone, her willingness to go above and beyond, and her infectious laugh that is enjoyed by patients and staff alike. Call Advanced Dentistry today at (775) 400-2533 and talk to Paula. We look forward to smiling with you!


Meet the Staff

KristinThis month’s spot light team member is Kristin!  Kristin was born and raised in Phoenix, Arizona and currently makes her home in Sparks with her husband, Damon.  Kristin graduated with an Associates of Science from Rio Salado School of Dental Hygiene and received her Bachelor of Science from the University of Phoenix.  She has worked at Advanced Dentistry by Design since 2013 when she relocated from California. Kristin serves on the Northern Nevada Dental Hygiene Association and curently holds the position of President-Elect.  In the dental field for 10 years, she loves interacting with patients, forming a trusting relationship as a healthcare provider, and helping patients become more confident with their smiles. In her spare time she enjoys traveling, hiking, and anything that involves being outside! Call Advanced Dentistry by Design and make an appointment to meet Kristin and the other friendly staff members, (775) 400-2533.  We look forward to smiling with you!


What makes Advanced Dentistry different?

I have been in the dental field for more than 20 years, and am most proud of my association with Advanced Dentistry by Design.  Being an “old dog” so to speak, I was overwhelmed by the training of the doctors and staff here, as well as the technology used.  As I approach my second year anniversary with ADBD I am confident both in the skill level and the ability to help patients for both myself as well as those that I work with. I am asked frequently what makes us different from other dental offices, and I know that it is our desire to be the best.  It is common place for patients to simply be a means to a paycheck,  for continuing education to be limited to only the units necessary to renew a license, or to no longer desire to be in the field.  None of those apply here! Our doctors, hygienists, assistants, and office staff are committed to dentistry, to each other and most importantly, to you. The level of education is beyond compare and is a priority of the practice.  Our doctors are continually striving for new technology and procedures for the patients’ care and comfort, and continuing education and training seminars are a constant. What makes us different?  We are more than a crown or a filling, we are concerned with your overall health and are here not only for treatment but for your education as well. Call us today at (775) 400-2533 we would love to smile at you!


What causes bad breath, and what can be done about it?

Bad breath (medically called halitosis) can result from poor dental habits and may be a sign of other health problems.  It can be made worse by the types of foods you eat and other unhealthy lifestyle habits. As food is digested and absorbed into the bloodstream, it is eventually carried to your lungs, and released in your breath.  When you eat foods with strong odors (such as garlic and onions), brushing and flossing only covers up the odor temporarily.  The odor will not go away completely until the foods have passed through your body. If you don’t brush and floss your teeth daily, food particles remain in your mouth, promoting bacterial growth between teeth, around the gums, and on the tongue.  This causes bad breath. Smoking or chewing tobacco products also cause bad breath, stain teeth, reduce your ability to taste foods, and irritate your gums. Persistent bad breath or a bad taste in your mouth may be the warning signs of gum (periodontal) disease. Periodontal disease is caused by the buildup of plaque on teeth, and the bacteria cause toxins to form in the mouth, which irritates the gums. Below are nine tips to help you avoid being self-conscious or embarrassed by bad breath:

1.  Brush and floss more frequently.  All of us should brush at least twice a day.  If you are concerned about your breath, brush and floss more often. 2.  Scrape your tongue.  The coating that is found on the tongue can host foul-smelling bacteria.  When you brush your teeth, brush your tongue as well.  You can also use a tongue scraper to really get the tongue clean. 3.  Avoid foods that sour your breath.  Remember, brushing won’t help!  The only way to avoid the problem is to avoid eating them. 4.  Kick the habit.  Smoking damages the gum tissue and stains teeth, not to mention increasing your chances of getting oral and other types of cancer. 5.  Rinse your mouth out.  After eating, rinse your mouth with plain water, which helps your breath by eliminating food particles.  An anti-bacterial mouthwash also adds extra protection by reducing plaque-causing bacteria.  Make sure to use a mouthrinse that is alcohol-free!  Alcohol in mouthrinse is drying to the gum tissues, which can lead to cavities and more bad breath. 6.  Skip the after dinner mints.  Sugary candies promote the growth of bacteria.  Instead, chew gum (sugarless of course) which stimulates saliva, promoting the mouth’s natural defenses against plaque acids. 7.  Keep your gums healthy.  Bacteria gathers in pockets at the base of the teeth, creating bad odors.  If you have gum (periodontal) disease, your dentist may recommend a periodontist who specializes in treating this condition. 8.  Moisten your mouth.  Lack of saliva promotes tooth decay and can cause bad breath.  Drink plenty of water and chew sugarless gum. 9.  See your dentist!  Remember, if your bad breath continues despite your best efforts, it could be related to a medical condition that requires treatment.

A bonus tip: We have three amazing doctors and three wonderful hygienists all here to help you to maintain your oral health, and keep your breath fresh! For a healthier smile and fresher breath, please call us today to schedule, (775) 400-2533.


Meet the Team – Stacy

At Advanced Dentistry by Design, we believe our team, including the front office, the assistants, and the hygienists, are just as important as the doctors. We pride ourselves in hiring the best of their field, and team members participate in many hours of continuing education courses to ensure that they remain current. Over the course of the next several weeks, it will be my pleasure to introduce you to those that I happily call my co-workers and my friends. This week I would like you to meet Stacy. Stacy works in the front office and is the friendly voice on the phone when you contact the office, and for your confirmation call for your appointment with the doctors. Stacy started with Advanced Dentistry in July of 2005, and we look forward to celebrating her 10 year anniversary this summer! Stacy began her career in the dental field as an assistant in 1985 and was chairside for more than five years, bringing 30 years of experience to her job. She grew up in southern California and moved to Nevada with her fiance Dan in 2005. Stacy enjoys spending time outdoors which includes hiking, camping, fishing, working in her yard, and playing with her dog, Casee. Stacy and all of our other team members are listed on our website HERE. We look forward to smiling with you soon!


Find out the pH of your favorite beverage and WIN an iPad Mini!!

In review of pH balance and your health, your level is a reflection of the foods you eat and the acidic beverages you drink. We know on the pH scale, 0 is the most acidic and 14 is the most alkaline; a pH of 7 is completely neutral. It is important to keep your pH balance in a certain range; if it falls below 5.5 pH, teeth begin to demineralize, or deteriorate. Water is completely neutral at a 7pH and is a great option for staying hydrated and keeping your teeth in good shape. It is no secret that we all drink beverages other than water often. Your Carson City dentists at Advanced Dentistry By Design want to know what you are drinking and where it falls on the pH scale. Stop by our office to pick up your test strips, test your favorite, drink and then follow the instructions below to enter to win an iPad mini! Go to our Facebook page at Facebook.com/AdvancedDentistryByDesign and post a photo of the drink you test. Include your first and last name, the drink you tested and the pH level it was. Not on Facebook? Email your photo to info@advanceddentistrybydesign.com and include your first and last name, the drink you tested, and the pH level it was. By emailing us, you are giving permission for us to post your name and photo to our Facebook page. Advanced Dentistry By Design, here for your health, beauty, and function. Stop by our Carson City dental office today to pick up your test strips at 403 W. Nye Lane in Carson City. We look forward to smiling with you!


Experience is the Difference.

In previous weeks we have reviewed the doctors’ and the hygienists’ schooling and experience.  This week let me introduce you to our front office team. Together Stacy, Paula and I have 67 years of experience. Stacy started as an assistant and moved to the front office after five years.  Her training as an assistant makes her a great schedule coordinator as she is familiar with the procedures and the time it takes to complete.  She is also the friendly voice on your reminder phone call the day before your appointment.  She has been in the dental field for 29 years and with Advanced Dentistry for 10. Paula is our insurance coordinator and has 18 years of experience.  She is extremely well-versed at obtaining the information necessary prior to your treatment so you will know your coverage and estimated out of pocket. She is also able to review explanation of benefits for any discrepancy and prepare an appeal on your behalf if necessary.  She has been with Advanced Dentistry for five years. I have been in the dental field for more than 20 years in different capacities including new patient coordinator here for just over a year.  I am a part of the new patient exam through treatment, and work on the financial portion, as well.  I work closely with Paula and Stacy to ensure we are within insurance guidelines (if applicable) and are scheduled accordingly. Karen is our office manager, has 18 years of experience and like Stacy, began her career as a dental assistant.  She began working for Dr. Wright as his assistant in 1997 and after three years moved into a front office position.  In 2003 she was promoted to office manager and today presides over a practice of three doctors and 11 staff members. Your Carson City dentists include us in the training received for new techniques and procedures and we also attend classes and seminars to expand our expertise. All team members are featured on our website:   www.AdvancedDentistryByDesign.com.  Please call us today at (775) 400-2533 to schedule an appointment.  We look forward to smiling with you!


What’s the difference between an Amalgam (silver) filling and a Composite (resin/white) filling?

It has been years (many of them in fact) since I have seen amalgam used in a dental practice.  There is a controversy over the potential adverse effects of silver fillings, which are close to 50% mercury and a mixture of silver-tin alloy and copper.  Although mercury is toxic, it has been thought that it was not released to the body. Recent research, however, seems to show that these fillings release a very small amount of mercury vapor during chewing.  Whether or not this amount is harmful is the subject of the controversy.  While it has not been proven that it is harmful, it has never been proven that it is not harmful, either. Use of the amalgam goes back hundreds of years while early history of the composites goes back to the early 70’s with improved technology developed to bond the filling in the ’80’s.  The definition of “filling” is: replacing and restoring tooth structure that is removed due to decay or fracture with a material. The cheapest, and potentially most toxic choice for fillings are the silver-tin, alloy, copper, and mercury that sets up hard and silver-colored. While it is possible these fillings may last longer than the composite fillings, they may lead to tooth fracture, can discolor teeth, and are not esthetic. On the other hand, composite fillings are primarily a resin that has been “filled” with other inorganic materials.  This compound makes a composite more resistant to wear, color adjustable, and easier to polish.  The advantages to the composite include a more natural appearance, strengthening of the filled tooth, and bonding to the natural tooth to create a better seal. Most insurance companies will not cover the white (resin/composite) fillings on back teeth and hence, substitute payment for the cheaper amalgam.  Why?  Your insurance company is a for-profit company; they are in business to make money.  Composite is expensive to place (up to 25% more), and the policy of the insurance company is to cover the cost of the least expensive treatment which happens with a lot of procedures, not just fillings. Unsure if your insurance company will “down code” to the lesser restoration?  Call your Carson City dentists today at (775) 400-2533 and let one of our friendly staff members do research on your behalf.


What is a Root Canal and why was I referred to another doctor?

To understand a root canal, it helps to know about the anatomy of teeth.  Inside the tooth, under the white enamel and a hard layer called the dentin, is a soft tissue called the pulp.  The pulp contains blood vessels, nerves and connective tissue, and helps to grow the root of your tooth during development.  A fully developed tooth can survive without the pulp because it continues to be nourished by the tissue surrounding it.  Endodontic treatment (root canal) treats the inside of the tooth and is necessary when the pulp becomes inflamed or infected.  The infection can have a variety of causes: deep decay, repeated dental procedures, faulty crowns, or a fracture of the tooth.  Left untreated, the infection can cause pain or an abscess.  During the root canal, the inflamed or infected pulp is removed inside of the tooth and is cleaned and disinfected.  It is then filled with a rubber-like material and the the tooth is restored with a crown or filling for protection. All dentists receive training in endodontics in dental school.  However, they often refer to a specialist because they believe it is in the patient’s best interest due to the difficulty of the treatment.  An endodontist has special training in diagnosing and treating problems associated with the inside of the tooth.  To become a specialist, they have completed dental school and an additional two years or more of advanced training in endodontics.  As they only do root canals in their practice,  you will be referred back to your general dentist for the final restoration. At Advanced Dentistry by Design your comfort and care are of highest priority for your Carson City dentists and we will always do what is in your best interest, whether it is treatment in our office or referring you to a specialist.  Call us today at (775) 400-2533 – we look forward to smiling at you!


I think I have an actual Dental Phobia!  How do I know for sure?

Dental phobia (also called odontophobia, dentophobia, dentist phobia, dental anxiety or dental fear) refers to the fear of dentistry and receiving dental care.  It is estimated that as many as 75% of adults experience some degree of fear from mild to severe.  Many dentally fearful people will only seek dental care when they have an emergency such as a toothache or abscess.  People who are very fearful experience what is called a “cycle of avoidance”, in which they avoid care due to fear until they experience an emergency requiring invasive treatment, which can reinforce their fear. The causes of fear can be a result of a direct experience such as a traumatic, difficult, and/or painful experience.  An indirect experience would be Vicarious Learning (hearing about others’ negative experience), Mass Media (negative portrayal), Stimulus Generalization (result of a previous experience) and Helplessness and Perceived Lack of Control (perception of lack of control leads to fear).  Yes, even those of us who have worked in the dental field for more than 20 years experience this one! As your trusted Carson City dentists, it is our hope that you will so fully understand the treatment and process, that your fears will be lessened.  People fear what they do not understand and dislike pain. With a combination of digital x-rays and photographs, we will explain to you what treatment is needed, and take the time to answer any of your questions. For those whose fear is so great that the above management technique is not enough, we offer oral sedation, anti-anxiety medication taken in pill form, and Nitrous Oxide (laughing) gas.  While these sedatives may help people feel calmer and sometimes drowsy during treatment, patients are still conscious and able to communicate with the dental staff. The most important part of overcoming fear is your comfort.  We will try and make your visit with us as pleasurable as possible.  It is also important to us that you know what is being done, and why. Our doctors and team members are here for you, there are never too many, or silly questions.  We encourage you to bring an iPod or other form of music device for distraction, and we are always available for hand holding and reassurance. 🙂 Make an appointment today for a NEW PATIENT exam with your Carson City dentists, Dr. Clint Euse, Dr. Kelly Euse or Dr. Randy Wright.  A NEW PATIENT exam is an easy and non-evasive way to meet our doctors and friendly team!  We look forward to meeting you soon!


What is Six Month Smiles?

At Advanced Dentistry by Design, we offer Six Month Smiles which is a cosmetic procedure specifically designed for adults and older teens that have crooked, crowded or spaced teeth, but do not have significant bite issues.  The latest technology and techniques include special nickel titanium wires with a primary focus on moving the teeth that show in your smile.  The tooth colored wires and brackets are more aesthetically pleasing than traditional braces and you don’t have to deal with the embarrassment of ugly metal brackets and wires dominating your mouth.  Treatment is generally less expensive than traditional braces and is possibly covered under your dental insurance.  Call your Carson City dentists today at (775) 400-2533 to schedule a no obligation consultation to see if your smile would be enhanced by Six Month Smiles!


What is the difference between “General Dentistry” and “Cosmetic Dentistry”?

While “cosmetic dentistry” is not a legally recognized specialty, it does require extensive additional training that takes years.  This means a commitment of time and money on the part of the dentist and the desire to be as much of an artist as a dentist. Carson City Dentists, Drs. Clint Euse, Kelly Euse, and Randy Wright, are passionate about the appearance of their dental work by making it as beautiful as possible. When dentists graduate from dental school, they are considered “general dentists.”  That is, they are licensed to perform all aspects of dentistry (fillings, crowns, dentures, extractions, root canals, veneers, implants, periodontal procedures, etc), hence the name, “general dentist.” “Cosmetic dentistry” is the art of addressing the functionality while also understanding that esthetics play a major role.  Cosmetic dentistry can include any of the following procedures:  having a resin (or white filling) placed instead of a metal filling; bleaching, veneers, porcelain crowns, full-mouth rehabilitations, orthodontics, and even high-end dentures.  “Cosmetic dentist,” is a term that describes doing dentistry with the intent of the final result being beautiful, esthetic, and pleasing to the eye.  A creative and artistic eye is always needed when doing “cosmetic” dentistry. To have the skills associated with “cosmetic dentistry,” the doctors must dedicate themselves to extensive hours of continuing education after dental school.  They must learn the materials and  properties of numerous products that they just don’t have time to teach in dental school.  There are complex bonding agents, various porcelains, opaquers, tints, resins etc., that require a great deal of training and understanding.  There is the chemistry of bonding; different materials have different properties of texture, color, translucency, strength and polishability that all have to be mastered to produce beautiful and natural looking results.  Cosmetic dentists also study face shapes and the alignment of the teeth. At Advanced Dentistry by Design in Carson City, we offer the highest level of technical skills combined with the passion of cosmetic dentistry, making us the best at what we do:  creating beautiful, functional, and healthy teeth and smiles. We offer traditional and new restoration techniques for functionality and health as well as veneers, bonding, porcelain crowns, composite (white) fillings, bleaching, braces, and dentures for cosmetics.  We strive to meet the wants of our patients, and give them the confidence in their smiles that they deserve! Call us today to schedule at (775) 400-2533.  We look forward to smiling with you!


What are the requirements and training for dental hygienists?

In the past, we have reviewed Dr. Randy Wright, Dr. Clint Euse, and Dr. Kelly Euse’s education requirements to become a dentist.  This week let’s review the education of our three hygientists, ReNon, Kayla, and Kristin. Dental hygienists receive their education through academic programs at community colleges, technical colleges, dental schools or universities.  Receipt of their degree allows a hygienist to take their examinations (national and state) to be licensed to work in a dental office. A career as a hygienist offers a wide range of challenges.  In a practice, the dentist and the hygienist work together to meet the oral health needs of patients.  Since each state has its own regulations regarding their responsibilities, the services performed by hygienists varies from state to state.  Some services provided include:

  • patient screening procedures, such as assessment of oral health conditions, review of health history, oral cancer screening, head and neck inspection, dental charting, taking blood pressure
  • taking radiographs (x-rays)
  • removing calculus and plaque (hard and soft deposits)
  • applying preventive materials to teeth (sealants and fluoride)
  • teaching patients appropriate oral hygiene to maintain oral health (brushing, flossing)
  • counseling patients about good nutrition and the impact on oral health

The most enjoyable aspect of the job for our hygienists is working with the patients.  Personal fulfillment comes from providing a valuable health care service while establishing a relationship.  As a result of their education and clinical training, ReNon, Kayla, and Kristin are valued members of our team. Dental hygiene education programs offer clinical education in the form of supervised patient care experiences. Additionally, these programs include courses in liberal arts (English, speech, sociology and psychology); basic sciences (anatomy, physiology, pharmacology, immunology, chemistry, microbiology and pathology); and clinical sciences (dental hygiene, radiology and dental materials). ReNon graduated with a Bachelor of Science in dental hygiene from Oregon Institute of Technology.  She has worked at Advanced Dentistry since 2010. Kayla graduated with a Bachelor of Science from University of Nevada Reno and from Mohave Community College hygiene program.  She has worked at Advanced Dentistry since 2012. Kristin graduated with an Associate of Science from Rio Salado School of Dental Hygiene and received her Bachelor of Science from the University of Phoenix.  She has worked at Advanced Dentistry since 2013. All three of the ladies are recognized by the State of Nevada as Registered Dental Hygienist (R.D.H.) and like the doctors, must keep their license current by attending continuing education classes. We are very proud of our hygiene staff and invite you to visit our Team page on our website for more information on our staff as well as our practice or, call us at (775) 400-2533 to schedule an appointment.


My insurance did not cover what was estimated, what should I do now?

First, review your explanation of benefits (EOB) thoroughly to make sure that the claim was processed according to your plan benefits. Many times what is perceived to be a problem between your doctor and you, is really an issue between you and your insurance company. If the treatment completed was pre-authorized, review the claim, the pre-authorization, and payment for accuracy.  If it is incorrect, contact your carrier. Insurance information provided by your dental office and the actual billing, is done as a courtesy and does not guarantee coverage and/or payment. If you do have an outstanding balance, contact your Carson City dental office to see if payment arrangements can be made.


How does Advanced Dentistry improve the community?

Last week we discussed how Advanced Dentistry by Design was different from other practices because of our desire to be the best.  The same philosophy of excellence applies not only to our dental work, but to our desire of helping our neighbors as well. In our office, our team members have a combination of 25 children ranging in age from 2 to 33, and 5 grandchildren.  We are mothers, fathers, grandmothers, aunts and uncles, and the thought of children going hungry in our community is unfathomable. Once again we have teamed up with Food for Thought to raise donations as well as awareness for the children of Carson City and parts of Douglas County.   Each Friday, Food for Thought provides a healthy bag of food for hungry children allowing them to eat on the weekends and to arrive at school on Monday nourished and ready to learn.  We are currently offering up to a $100 credit on your account for each ten (10) items donated; treatment must be completed by December 31, 2014. HEALTHY food suggestions include:  microwavable soups, juice boxes, peanut butter or cheese crackers, fruit cups, single serving bags of beef jerky, instant oatmeal, granola bars, pre-mixed tuna and crackers and 8 oz. non-refrigerated milk cartons.  Donations may be brought to the office Monday through Thursday, and credit will be placed on your account for future work or can be brought with you to scheduled appointments. Please help us to help the children and to allow us to care for you in return!  Come by and see us to drop off your donation at 403 W. Nye Lane in Carson City or, call us at (775) 400-2533.  We thank you for your generosity in advance.


What are the requirements to become a dentist?

When you visit us at Advanced Dentistry by Design, you will be impressed by our high tech equipment and newest technology as well as the many diplomas and certificates that adorn our walls.  Dr. Randy Wright, Dr. Clint Euse, and Dr. Kelly Euse are Doctor’s of Dental Science (DDS) but, do you know how much education went into earning those degrees? First the doctor’s had to determine if they possessed the characteristics to become a doctor; an aptitude for science, outstanding manual dexterity, and good communication skills. Next was undergraduate courses – Dr. Wright received his degree from University of Nevada Reno, Dr. Clint Euse from Conzaga University, and Dr. Kelly Euse from University of Utah all focusing on chemistry, biology, physics, and math in preparation for dental school. Before being accepted to dental school, Dr. Wright at University of the Pacific in Stockton, California and the Doctor’s Euse at Creighton University in Omaha, Nebraska, they had to take the Dental Admissions Test (DAT) and apply for admission to their perspective schools.  Their undergraduate grades, score on the DAT, recommendations and interviews were all considered in the admissions process. Four years of dental school followed taking courses in anatomy, microbiology, biochemistry, and physiology in the classroom and lab.  They also had clinical courses in periodontics, restorative dentistry, endodontics, radiology, oral surgery, prosthodontics, and oral diagnosis. After graduation was the National and State Boards.  These exams are clinical and required them to perform treatment on patients.  Once the boards were passed and the licenses were received, the doctor’s began to practice dentistry. Dr. Wright practiced in Reno, Dr. Clint Euse in Iowa and Utah, and Dr. Kelly Euse in Utah before settling in Carson City. As you can tell by the strict requirements and the years of schooling, our doctor’s are passionate about their profession.  Each of them exceed the requirements for continuing education required yearly so that our patients receive the most advanced and up to date treatment available.  For more information on our doctor’s and the entire staff, please visit us on our website at advanvceddentistybydesign.com.


DMD vs. DDS, what’s the difference?

If you are looking to find a dentist you may notice that most are listed with “DDS”, but some may be listed as “DMD”.  They both mean the same thing – your dentist graduated from an accredited dental school.  The DDS (Doctor of Dental Surgery) and DMD (Doctor of Dental Medicine) are the same degrees and have the same education.  It is up to the universities to determine what degree is awarded and both use the same curriculum requirements as set by the American Dental Association.  Dr. Randy Wright, Dr. Clint Euse, and Dr. Kelly Euse all are Doctor’s of Dental Surgery at Advanced Dentistry by Design.  Do you know how much schooling went into earning this designation?  Read next weeks column for the answer as well as what is required of the doctor’s for continuing education requirements to keep their license active.


 Why did I receive a bill in the mail?

An outstanding balance with your dental office can happen for many reasons. Most bills sent by our office are a result of the dental insurance company not paying the percentage quoted.  Additionally, if the dental insurance plan has been maximized, you would expect to receive a bill.  Sometimes our patients need to be seen by a dental specialist (endodontist, oral surgeon, or orthodontist), and a portion of their dental benefits need to be used at the specialist’s office, thus utilizing a portion of the original benefits.  This would leave less benefits available to be used at our dental office, and thus the original quotes given at our office, could be incorrect, resulting in a bill if the patient has maximized their said benefits. Our computer system allows us to update insurance coverage for each procedure, and Paula our insurance coordinator, works hard to keep it current.  No treatment is performed without your consent and a signed financial estimate so you are aware of your out-of-pocket expense. While we strive to give you the best estimate possible, it is an estimate.  It would be impossible for any dental office to give you 100% accurate information 100% of the time. Insurance can be complex.  Therefore, you must know your plan and it’s exceptions.  We will work with you to understand your benefits, and the exceptions.  Please feel free to contact our office, Advanced Dentistry by Design at:  (775) 400-2533.  We look forward to navigating your insurance benefits with you!


Why Is It Necessary To Do A Bone Graft After An Extraction?

Any time that a tooth is extracted, you lose a minimum of 50% of the bone height and width because the hole where the tooth was sitting does not fill in completely with new bone. The sides of the socket collapse into the hole, lowering the overall height and width of the bone. The loss of bone has been shown to impact adjacent teeth. Adjacent teeth will shift if there is a space from a missing tooth. Shifting can create problems with chewing and further cause muscular collapse. Several conditions including aging, facial lines, and problematic dental restorations are often accelerated by premature loss of facial bone. Bone grafting (or socket preservation) is the conservation of the bone after tooth loss to preserve the height and the width of the jawbone. By maintaining the height and width of bone after an extraction, a patient has more favorable options and outcomes for future dentistry. For example, by grafting an extraction site, there is a better foundation for implant placement. Additionally, if grafting is completed, a wider, smoother ridge is left and thus much more comfortable for a removable prosthetic to sit upon. During the bone graft procedure, the grafting material is packed into the hole left by the extraction. As the socket heals, the immune system is stimulated by the graft material to grow new bone. The bone graft is done at the time of the extraction because that is when the blood supply is abundant and the bone is surgically stimulated which encourages lots of healing cells and a more favorable outcome. At Advanced Dentistry by Design, we make every attempt to save your natural teeth. However, if the removal of a tooth (or teeth) will improve your overall well-being, we have the technology to restore your mouth to complete functionality with a beautiful smile. Call us at (775) 400-2533, we look forward to meeting you!


What are dental sealants, who should get them, and how long do they last?

Dental sealants are a plastic coating placed on the chewing surfaces of permanent teeth to protect them from decay. The chewing surfaces of the molars and premolars have pits and grooves (fissures) that make them vulnerable to decay.  These fissures can be deep, are difficult to clean, and can even be narrower than a single bristle of a toothbrush.  Plaque accumulates in these areas, and the acid produced by the bacteria in the plaque attacks the enamel, which can lead to cavities. The sealants provide extra protection for the grooved and pitted areas providing a smooth surface covering over the fissured area.  The American Academy of Pediatric Dentistry recommends placing sealants on your child’s first permanent molars around age 6, and then on second molars around age 12.  Sealants have been used and been proven effective since the 1970’s and last for several years under the normal wear and tear of childhood chewing. The procedure is painless and simple.  First the teeth are cleaned and roughened with a solution that helps the sealant adhere to the tooth.  The sealant material is painted on and hardened using a curing light.  For more information on sealants or any other services offered by Advanced Dentistry by Design, please call us at 883-7244.


How do I know when my next appointment should be?

Before any treatment is performed in our office, you will be presented with a plan which will list the procedure, the cost, estimated insurance coverage (if applicable), and out of pocket expenses.  You will sign the treatment plan and be given a copy so you will be prepared financially on your appointment date.  The plans are presented in order of necessity, however we are able to arrange treatment to best utilize your insurance benefits and your financial limitations.   We understand that treatment may need to be spread out over time.  At Advanced Dentistry, we do not stand in judgment.  We are here to help you to achieve the best possible treatment in a manner best suited for you.  We look forward to seeing you soon!


What do I need to bring for my first visit?

Make sure to arrive 15 minutes early to complete all new patient paperwork.  Most required paperwork can also be completed on the dental office’s website.  At Advanced Dentistry by Design, we are very excited about our website.  You are able to gather more information about our office, our doctors, our team, and procedures provided.  You can also check out the doctors’ blogs, and of course the Q and A section with me, Terrie! Bring your insurance card with you.  The front office will help you navigate your insurance benefits and insurance questions, but we need to have your current card. If you have insurance, you need to be aware of the frequency limitations for your x-rays.  For most, the full mouth series (FMX) is current for five years and the bite wings (check-up x-rays) are once a year.  If you have current x-rays you will want to complete a release with your new office to have the x-rays transferred prior to your first appointment.  Doctors cannot make diagnostic decisions based off a visual exam alone, therefore x-rays are an important part of your first visit. Please make sure to bring a list of your current medications, dosage, and frequency in which you take the medications. Additionally, you will also be asked to complete a HIPAA form to protect your privacy. This will tell us anyone, other than yourself, who we can discuss your dentistry and appointments needed. The first appointment is easy and non-invasive, and a great opportunity to meet the doctor(s) and team to determine if the practice is a good fit for you.  We look forward to meeting you and your family soon!


What if I can’t make my appointment?

“Life happens”, they say.  Well, maybe that isn’t really what they say but we will go with that. Offices do appreciate a 48 hour notice for a cancellation, so there is time to fill the schedule.  However, emergencies or illnesses may not make that a possibility, and that is understandable.  Please know that your appointment in a schedule prevents someone else from being seen at that time, possibly an emergency. Habitual or cancelled appointments will result in a patient being dismissed from a practice.  At Advanced Dentistry by Design, we work hard to find dates and times convenient for you to help you to keep your scheduled appointment.  Please know that we too, will work hard to honor your schedule and to be on time as well. We have doctors and hygienist available Monday through Thursday, 8:30 – 5:00 and we would love to schedule an appointment for you.  Please call Paula, Stacy, or myself at (775) 400-2533.


My insurance benefits say I get two free visits. Is this any visit?

Most insurance carriers will pay for two cleanings per year under your preventative portion of the plan.  It used to include your exam and x-rays in the past, but it has become common practice to charge the deductible for these services.  This amount is also deducted from your annual maximum, for most plans. Insurance companies (normally) pay 100% of a prophylaxis (cleaning) two times per year.  A “prophy” is for patients who do not currently have, or have never had an issue with periodontal (gum) disease.  It is the scaling and polishing of the crowns of the teeth to remove plaque, tartar (calculus), and stains. Periodontal disease can be described as inflammation and/or infection of the gums and the bone which support teeth.  Your hygienist will do periodontal probings at your cleaning appointment.  Any reading of 4 millimeters (mm) or higher are indications of early to moderate gum disease.  Periodontal maintenance is usually covered at 80% after the deductible has been met under most insurance plans, and allows for two visits per year.  Most periodontal patients see their hygienist every three to four months, as in any chronic condition, successful long-term control of the disease and prevention of tooth loss depends on continual, possibly lifetime maintenance. The number of times you have your teeth cleaned should be personalized between you, your hygienist, and your doctor, and not set by your insurance carrier.  It is a mistake to let benefits be your sole consideration when you are making decisions about your dental care. Your teeth, smile, attractiveness, ability to chew, and general sense of well-being are dependent on your dental health.  It is worth the extra time and expense to keep your teeth for a lifetime.


What is a dental insurance deductible?

A deductible on a dental policy is the fee you agree to pay annually to receive dental services which is usually waived on preventative services. The deductible normally runs between $50 and $100 per plan year. The deductible is applied by the carrier for three reasons; a means to set premiums (higher deductible plans usually have lower premiums), to act as a deterrent for frivolous claims, and a way to classify policies (policies with high levels of coverage have low deductibles). Refer to your plan booklet so you are not surprised by your deductible and/or what services it is applied to. Most dental offices will ask for your deductible along with your estimated out of pocket for services at your first visit of the plan year. Still unsure? Call one of our friendly staff members at Advanced Dentistry by Design for assistance.

Call to schedule your next appointment today!

New Patients: (775) 400-2533

Existing Patients: (775) 883-7244

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403 W. Nye Lane, Ste A
Carson City, NV 89706