Meet our award-winning, top-rated dental team
Behind every great dental experience is a team that truly cares.
At Apex Family Dentistry, our doctors, hygienists, assistants, and administrative team work together to create a welcoming, patient-first environment for families throughout Apex, Cary, and the surrounding Triangle community.
We are proud to be your local dental home — where experience, kindness, and attention to detail come standard.
Your Apex Dental Team
When patients search for a “family dentist in Apex, NC,” they are often looking for more than credentials. They are looking for people they can trust. Our team combines clinical expertise with a calm, reassuring approach. From routine cleanings to restorative care, we prioritize clear communication, conservative treatment planning, and long-term dental health.
You will notice the difference from the moment you walk through our doors.
Our Doctors
Our doctors are committed to providing high-quality general and restorative dentistry in Apex, NC. With a focus on continuing education and modern techniques, they deliver care that is both clinically sound and thoughtfully personalized. Every treatment plan is designed with long-term health, comfort, and aesthetics in mind. We believe dentistry should feel collaborative — never rushed or overwhelming.
Dr. Anna Evans Keene brings a rare blend of clinical excellence, leadership, and genuine warmth to Apex Family Dentistry. A North Carolina native, she attended the University of North Carolina at Chapel Hill on the prestigious Morehead Scholarship, where she was also a four-year starter on the varsity softball team and earned All-Conference honors during her sophomore season. Her experience as a student-athlete instilled the discipline, teamwork, and commitment to excellence that continue to shape her approach to dentistry today.
Dr. Keene remained at UNC to earn her Doctorate of Dental Surgery from the UNC School of Dentistry in 2011. Following graduation, she completed an Advanced Education in General Dentistry residency at the Veterans Affairs Medical Center in Fayetteville, North Carolina, where she gained extensive experience treating complex cases and delivering comprehensive, evidence-based care. She remains deeply committed to lifelong learning and regularly pursues advanced continuing education, while also staying actively involved in her local study club.
In 2015, after three years as an associate, Dr. Keene purchased the dental practice from Dr. Trent Landenberger, DDS and has since led its evolution into what is now, a top-rated dental office, Apex Family Dentistry. Under her leadership, the practice has grown into a trusted community dental home known for thoughtful treatment planning, modern diagnostics, and a patient-first philosophy. Dr. Keene enjoys caring for patients of all ages and is passionate about helping individuals and families achieve long-term oral health through proactive, personalized care.
Outside the office, Dr. Keene is an avid sports fan who enjoys attending local high school, college, and professional sporting events. She also loves reading, cooking, and spending time with her husband, Chris, and their three children, Connor, Skylar, and Levi.
Dr. Nahal Miller brings a global perspective, deep clinical expertise, and an unmistakably warm presence to Apex Family Dentistry. Born on the island of Mallorca, Spain, she lived in multiple countries before settling in the United States as a teenager. As the daughter of Iranian parents and what is often described as a “third culture kid,” Dr. Miller developed an early appreciation for diversity, connection, and understanding different perspectives, qualities that shape her approach to caring for patients from all backgrounds.
Fluent in Spanish, Dr. Miller is passionate about serving Spanish-speaking families and ensuring every patient feels fully understood and comfortable in their care.
Drawn early to the sciences, Dr. Miller discovered her passion for dentistry through summer college programs and hands-on learning. She earned her Bachelor of Science in Biology with a minor in Chemistry from the College of Charleston, then went on to receive her Doctor of Dental Medicine degree from the Medical University of South Carolina in 2004, graduating cum laude. She further advanced her training through the Advanced Education in General Dentistry residency at the University of North Carolina, completing the program in 2005 before beginning her dental career in the Triangle area.
Dr. Miller is known for delivering high-quality, comprehensive dental care with compassion, approachability, and just the right touch of humor. She values building genuine relationships with her patients and believes strongly in collaborative treatment planning, ensuring patients feel informed, comfortable, and confident in decisions about their oral health. In addition to her clinical work, she serves on the Advisory Committee for Wake Technical Community College’s Dental Assisting Program, helping support and shape the next generation of dental professionals. She also served on the Executive Board of the Raleigh-Wake County Dental Society for approximately eight years, concluding her board service last year after a long-standing commitment to advancing dentistry in the local community.
Outside of the office, Dr. Miller enjoys traveling, staying active, and cheering on the Clemson Tigers. She loves working out alongside her husband and favorite prankster, Trevor, and embraces life with the same energy and curiosity she brings to her work.
Dr. Terese M. Walters is a compassionate and highly skilled general dentist who brings a calm, thoughtful approach to patient care at Apex Family Dentistry. Known for her attention to detail and patient-centered philosophy, Dr. Walters is committed to providing comprehensive, evidence-based dentistry while ensuring every patient feels heard, informed, and comfortable throughout their care.
Dr. Walters earned her Doctor of Dental Medicine degree from the Medical University of South Carolina, where she developed a strong foundation in general and restorative dentistry. Following dental school, she completed an Advanced Education in General Dentistry (AEGD) residency through the United States Air Force. This advanced post-graduate training provided extensive experience in comprehensive treatment planning, complex restorative procedures, and delivering high-level care in diverse clinical settings. Her clinical approach emphasizes preventive care, clear communication, and long-term oral health, allowing her to tailor treatment plans that meet each patient’s individual needs and goals.
Patients appreciate Dr. Walters for her gentle chairside manner, thorough explanations, and genuine desire to build trust. She believes the best outcomes come from collaboration, empowering patients to take an active role in decisions about their dental health. Her calm presence and steady expertise are especially reassuring for patients who may feel anxious about dental visits.
Dr. Walters is dedicated to ongoing professional growth and staying current with advances in dentistry to ensure her patients benefit from modern techniques and thoughtful care.
She is an active member of the Raleigh-Wake County Dental Society and the American Academy of Dental Sleep Medicine, reflecting her commitment to professional excellence and whole-health dentistry. She is proud to be part of a team that values integrity, quality, and relationships, and she enjoys serving patients and families in the Apex, NC community.
Dental Hygienists
Our hygienists play a critical role in preventive dental care. They focus on early detection, patient education, and maintaining healthy smiles at every stage of life. Many of our patients have built long-standing relationships with their hygienists over the years — something we are incredibly proud of. If you are searching for a gentle dental hygienist in Apex, NC, our team is here to make your visits comfortable and thorough.
Holly
Holly has been part of Apex Family Dentistry since 2005 and is proud to work in a practice known for high-quality dentistry, a clean environment, and an extraordinarily friendly team. With more than 24 years of experience in the dental field, she enjoys reconnecting with longtime patients and welcoming new ones at their hygiene appointments.
She graduated from the University of North Carolina at Chapel Hill with a Bachelor of Science in Dental Hygiene and is CPR–BLS certified with a SPICE certificate in infection control. As the office’s OSHA and CDC Officer, Holly focuses on maintaining the highest standards of safety for both patients and staff. She is also a member of the American Dental Hygienists Association and has previous experience in pediatric, periodontal, and endodontic practices.
Outside of the office, Holly enjoys scenic walks, digital scrapbooking, reading, and spending time with her family.
Pam
Pam is a Registered Dental Hygienist at Apex Family Dentistry who believes great dental care starts with teamwork and a positive attitude. She values being part of an amazing group of teammates who work well together and share a commitment to putting patients first.
For Pam, good customer service means providing the very best care possible, always with a smile. She strives to make every hygiene visit comfortable, thorough, and encouraging for the families we serve in Apex, North Carolina. Pam is CPR certified and dedicated to helping patients maintain healthy smiles through preventive care and education.
Nithya
Nithya is a Registered Dental Hygienist at Apex Family Dentistry who is passionate about preventive care and patient education. She enjoys helping patients understand the connection between daily habits and long-term oral health.
Nithya values building trusting relationships and strives to make each hygiene visit thorough, comfortable, and encouraging. She is proud to be part of a team committed to delivering compassionate, high-quality dentistry to the Apex community.
Marylin
Marylin is a Dental Hygienist with 23 years of experience who is passionate about helping every patient feel comfortable, cared for, and confident in their oral health.
She graduated from Fayetteville Technical Community College with an Associate’s Degree in Dental Hygiene and is known for creating a gentle, relaxed experience—especially for patients who may feel anxious about dental visits.
Marylin recently earned her Bachelor’s Degree in Christian Counseling from Manna University and plans to pursue a Master’s degree to become a licensed professional counselor. This training enhances her ability to understand patients, offer reassurance, and bring a calm, supportive presence to each appointment.
Her goal is simple: treat every patient like family and ensure they leave the office feeling healthier, supported, and proud of their smile.
Yanet
Yanet is a compassionate Registered Dental Hygienist who brings enthusiasm, attention to detail, and a strong focus on patient education to Apex Family Dentistry. A 2023 graduate, she provides up-to-date, evidence-based preventive care and is committed to helping patients build healthy habits that support long-term oral health.
She joined Apex Family Dentistry part-time in 2024 and transitioned to full-time in 2025, quickly becoming a valued member of the team. Bilingual in Spanish, Yanet enjoys serving Spanish-speaking patients and ensuring every visit feels comfortable, clear, and encouraging.
Outside the office, Yanet enjoys spending time with her husband and their dog, Luffy. She loves photography and watching movies and series, especially the Harry Potter series.
Dental Assistants
Our dental assistants ensure that each procedure runs smoothly and efficiently. They support both doctor and patient throughout treatment, helping create a calm and organized experience. From preparing treatment rooms to walking patients through post-care instructions, their attention to detail helps everything feel seamless.
JoAnn
JoAnn has been a valued part of Apex Family Dentistry for nearly 14 years and truly considers it her home away from home. She loves the strong support she shares with her fellow team members and the culture they’ve built together. As she puts it, everyone shares the same goal: providing excellent dentistry while putting the patient first in a warm, fun, and welcoming environment.
JoAnn brings both experience and dedication to her role as a Dental Assistant. In 2004, she earned her DAII and Dental Radiation Technologist certification from the Dental Assisting National Board (DANB) in Maryland before relocating to North Carolina in 2006. Her years of clinical experience and attention to detail help ensure patients at Apex Family Dentistry feel comfortable and well cared for during every visit.
Outside of the office, JoAnn enjoys spending time with her husband, two children, and friends. She loves exercising and lifting weights, relaxing beachside, and visiting family in Maryland — especially during football season. (Go Ravens!)
Tea
I completed the Dental Assisting program in 2022 at Wake Tech Community College, where I proudly graduated with the Highest Academic Achievement Award. That same year, I earned my Certified Dental Assistant (CDA) credential.
I stay committed to my profession by completing continuing education courses and renewing my certification every year—because in dentistry, there’s always something new to learn!
Originally from Bosnia and Herzegovina, I feel lucky to now call Apex home and to serve this wonderful community as part of the amazing team at AFD. I especially enjoy restorative dentistry alongside three of the best dentists in North Carolina. There’s nothing better than seeing beautiful same-day results and watching patients leave feeling confident, happy, and proud of their smiles.
I also love sharing photos of my dog, Tippi, with patients. She’s basically my unofficial emotional support assistant and has become quite popular—honestly, she might be responsible for a few extra smiles around the office!
Outside of work, North Carolina has truly become my second home. I love the warm weather, camping, cooking, the occasional well-deserved nap, and spending time outdoors with my family and Tippi. We’re always looking for our next little adventure and enjoying everything this beautiful state has to offer families.
Jolie
Jolie is a dedicated Dental Assistant at Apex Family Dentistry who supports our doctors in delivering thoughtful, high-quality care to every patient. She values creating a calm and welcoming environment where patients feel comfortable and well cared for throughout their visit.
Jolie enjoys being part of a collaborative team that prioritizes both clinical excellence and a positive patient experience. She believes that attention to detail and a warm attitude make a meaningful difference in helping patients feel at ease.
Administrative Team
The first voice you hear on the phone and the first smile you see at the front desk matter.
Our administrative team includes a dedicated Patient Concierge and Insurance Coordinator who help with: Scheduling appointments, verifying dental insurance, explaining financial information, coordinating treatment plans, and answering billing questions
They are here to ensure your experience is as smooth outside the operatory as it is inside. If you have questions before your visit, we encourage you to call. We are always happy to help.
Gabby
Gabby supports the administrative team at Apex Family Dentistry by assisting with insurance coordination and patient communication. She enjoys being part of a collaborative environment where everyone works together to provide exceptional dental care to the Apex community.
Known for her positive attitude and teamwork, Gabby helps ensure patients feel comfortable and informed from start to finish. She believes that even behind-the-scenes roles play an important part in creating a smooth, welcoming experience at our Apex, NC dental office.
Khrysta
Khrysta is often the first friendly voice patients hear when they contact Apex Family Dentistry. As Patient Concierge and HIPAA Manager, she helps ensure every visit to our Apex, NC dental office feels welcoming, organized, and seamless.
With a background in healthcare administration, she understands that clear communication and attention to detail matter — especially when families are trusting us with their dental care. She enjoys being part of a supportive team that prioritizes both professionalism and kindness.
Carol
Carol helps patients at Apex Family Dentistry navigate dental insurance with clarity and confidence. She understands that benefits and coverage can feel overwhelming, and she works hard to make that process as straightforward as possible for families in Apex, NC.
Her detail-oriented approach and calm demeanor help patients feel supported when planning preventive or restorative treatment. She enjoys being part of a dental team that prioritizes transparency and long-term relationships.
Gail
Gail serves as Office Manager at Apex Family Dentistry and is often the steady presence ensuring every day runs smoothly behind the scenes. She believes a great dental experience begins long before a patient sits in the chair — with a warm welcome, thoughtful coordination, and a team that truly cares.
At our Apex, NC dental office, Gail helps create an environment where families feel known and valued. She enjoys working alongside a team committed to patient-centered care and takes pride in helping make Apex Family Dentistry a trusted dental home for the community.
Dentistry Built Around Prevention and Early Detection
Prevention is where the strongest patient outcomes begin, and it stays central even when care becomes more complex. Digital diagnostics, thorough exams, and consistent hygiene support make it easier to spot issues early and treat them conservatively. Small changes in enamel, gum health, or bite alignment can be addressed before they turn into larger procedures. Patients who prefer proactive care typically feel more in control of their oral health and spend less time reacting to emergencies.
Sign up for appointment
We know choosing a dentist in Apex, NC is an important decision for your family.
Our goal is simple: to provide excellent care in an environment that feels welcoming, consistent, and trustworthy. We look forward to meeting you.
Call (919) 362-7878 or schedule online to become part of the Apex Family Dentistry family.
FAQs
What should I expect at my first appointment?
At your first visit, we ask that you arrive 15 minutes prior to your scheduled appointment time to review your new patient paperwork and collect your insurance information, if applicable. You may relax in our reception area and enjoy complimentary Wi-Fi while we update your individual patient record.
Each patient will see one of our experienced hygienists for a cleaning and periodontal (gum) evaluation, as well as necessary x-rays, prior to their comprehensive exam with the dentist. This way, your dentist has the most current information about your dental health. If you have more complex dental needs, you may have a consultation scheduled with the dentist to develop your personalized treatment plan.
However, if you have a more urgent dental need (pain, broken teeth, etc), please let our staff know when you schedule your appointment. It may be necessary to see a dentist and receive treatment prior to scheduling a cleaning and comprehensive exam.
What should I bring to my first appointment?
Please bring your new patient forms, your insurance card, and a photo ID, as well as any dental appliances that you use.
It is helpful to have your previous records transferred to our office, especially your most recent x-rays (Bitewings and Panoramic X-ray). To ensure we are able to provide the most accurate assessment of your dental health, we ask that you have your most recent x-rays forwarded to our office. Our email is: info@apexfamilydentistry.com
*Please note that most offices require a patient to complete a records release form, so the process of transferring your x-rays sometimes takes longer than 24 hours. Please plan accordingly. -All children under 18 years old must be accompanied by a parent or guardian at their first visit.
When should I bring my child for their first dental visit?
The American Academy of Pediatric Dentistry recommends children see a dentist at Age 1. At Apex Family Dentistry, we begin seeing children at Age 4. However, we are happy to answer questions or provide a referral to a pediatric dentist until your child is seen at our office.
If the situation allows, it is a great learning experience for your child to see a parent or older sibling have their teeth cleaned and evaluated. For example, bringing your 3 ½-year-old to your cleaning visit is a great ice breaker! That way, at your 6-month recall visit, your then-4-year-old is more familiar with our office and the dental experience.
If you’re unable to do this, it’s no problem! Our friendly staff loves the opportunity to introduce kids to our practice!! We encourage parents to keep your coaching positive, and tell your child that they will have their teeth counted and brushed/tickled, and pictures taken if they are needed.
What is a dental emergency?
A true dental emergency is defined as uncontrolled pain, bleeding, swelling, or infection. Acute trauma is also considered a dental emergency.
In the event of a dental emergency after hours, our doctors are available for consultation for patients of record. You may reach them via our practice voicemail at (919) 362-7878. Listen to the options given to contact your dentist.
How can I tell if I have gingivitis or periodontitis (gum disease)?
Four out of five people have periodontal disease and don’t know it! Most people are not aware of it because the disease is usually painless in the early stages. Unlike tooth decay, which often causes discomfort, it is possible to have periodontal disease without noticeable symptoms. Having regular dental check-ups and periodontal examinations are very important and will help detect if periodontal problems exist.
Periodontal disease begins when plaque, a sticky, colorless, film of bacteria, food debris, and saliva, is left on the teeth and gums. The bacteria produce toxins (acids) that inflame the gums and slowly destroy the bone. Brushing and flossing regularly and properly will ensure that plaque is not left behind to do its damage.
Other than poor oral hygiene, there are several other factors that may increase the risk of developing periodontal disease:
- Smoking or chewing tobacco – Tobacco users are more likely than non-users to form plaque and tartar on their teeth.
- Certain tooth or appliance conditions – Bridges that no longer fit properly, crowded teeth, or defective fillings that may trap plaque and bacteria.
- Many medications – Steroids, cancer therapy drugs, blood pressure meds, oral contraceptives. Some medications have side affects that reduce saliva, making the mouth dry and plaque easier to adhere to the teeth and gums.
- Pregnancy, oral contraceptives, and puberty – Can cause changes in hormone levels, causing gum tissue to become more sensitive to bacteria toxins.
- Systemic diseases – Diabetes, blood cell disorders, HIV / AIDS, etc.
- Genetics may play role – Some patients may be predisposed to a more aggressive type of periodontitis. Patients with a family history of tooth loss should pay particular attention to their gums.
Signs and Symptoms of Periodontal Disease
- Red and puffy gums – Gums should never be red or swollen.
- Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss.
- Persistent bad breath – Caused by bacteria in the mouth.
- New spacing between teeth – Caused by bone loss.
- Loose teeth – Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).
- Pus around the teeth and gums – Sign that there is an infection present.
- Receding gums – Loss of gum around a tooth.
- Tenderness or Discomfort – Plaque, calculus, and bacteria irritate the gums and teeth.
Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.
What can I do about stained or discolored teeth?
Since teeth whitening has now become the number one aesthetic concern of many patients, there are many products and methods available to achieve a brighter smile.
Professional teeth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel and is an ideal way to enhance the beauty of your smile. Over-the-counter products are also available, but they are much less effective than professional treatments and might not be approved by the American Dental Association (ADA).
As we age, the outer layer of tooth enamel wears away, eventually revealing a darker or yellow shade. The color of our teeth also comes from the inside of the tooth, which can become darker over time. Smoking and fluids such as coffee, tea, and wine can also contribute to tooth discoloration, making teeth yellow and dull. Sometimes, teeth can become discolored from taking certain medications as a child, such as tetracycline. Excessive fluoridation (fluorosis) during tooth development can also cause teeth to become discolored.
It’s important to have your teeth evaluated by your dentist to determine if you’re a good candidate for bleaching. Occasionally, tetracycline and fluorosis stains are difficult to bleach and your dentist may offer other options, such as veneers or crowns to cover up such stains. Since teeth whitening only works on natural tooth enamel, it is also important to evaluate any old fillings, crowns, etc. before bleaching begins. Once the bleaching is done, your dentist can match the new restorations to the shade of the newly whitened teeth.
Since teeth whitening is not permanent, a touch-up may be needed every several years to keep your smile looking bright.
The most widely used professional teeth whitening systems:
Home teeth whitening systems: At-home products usually come in a gel form that is placed in a custom-fitted mouthguard (tray), created from a mold of your teeth. The trays are worn either twice a day for approximately 30 minutes, or overnight while you sleep. It usually takes several weeks to achieve the desired results depending on the degree of staining and the desired level of whitening.
In office teeth whitening: This treatment is done in the dental office and you will see results immediately. It may require more than one visit with each visit lasting 30 to 60 minutes. While your gums are protected, a bleaching solution is applied to the teeth. A special light may be used to enhance the action of the agent while the teeth are whitened.
Some patients may experience tooth sensitivity after having their teeth whitened. This sensation is temporary and subsides shortly after you complete the bleaching process, usually within a few days to one week.
What are my options if I have missing teeth?
With many state-of-the-art dental treatments and prevention options available in dentistry today, there are fewer reasons for having to extract (remove) teeth. When something does go wrong with a tooth, we try to do everything possible to restore the tooth to its original function. Removing a tooth is the last option because we know that removal may lead to severe and costly dental and cosmetic problems if the tooth is not replaced.
Losing a tooth can be a very traumatic experience and it’s very unfortunate when it does happen. Injury, accident, fracture, severe dental decay, and gum disease are the major reasons for having to remove a tooth. If teeth are lost due to injury or have to be removed, it is imperative that they be replaced to avoid cosmetic and dental problems in the future.
When a tooth is lost, the jaw bone that helped support that tooth begins to atrophy, causing the teeth on either side to shift or tip into the open space of the lost tooth. Also, the tooth above or below the open space will start to move towards the open space because there is no opposing tooth to bite on. These movements may create problems such as decay, gum disease, excessive wear on certain teeth, and TMJ (jaw joint) problems. These problems and movements do not result immediately, but will eventually appear, compromising your chewing abilities, the health of your bite, and the beauty of your smile.
Options for replacement of missing teeth:
Removable bridges – This type of bridge is a good solution for replacing one or more missing teeth, especially in complex dental situations where other replacement options are not possible. They are usually made of tooth-colored, artificial teeth combined with metal clasps that hook onto adjacent natural teeth. Removable bridges are the most economical option for replacing missing teeth but might be the least aesthetically pleasing. This is because the metal clasps on the appliances are often impossible to completely conceal.
Fixed bridges – This type of bridge is generally made of porcelain or composite material and is permanently anchored (cemented) to a natural tooth adjacent to the missing tooth site. The benefit of this type of bridge is that it is fixed (not removable), and it is very sturdy. The disadvantage is that in order to create a fixed appliance, two healthy, natural teeth will have to be crowned (capped) to hold the bridge in place.
Dentures – This type of tooth replacement is used when most or all of the natural teeth are missing in one dental arch. Dentures are removable artificial teeth that are made to closely resemble the patient’s original teeth.
Implants – Are a great way to replace one or more missing teeth. They can also provide great support for ill-fitting dentures. A dental implant is an artificial root that is surgically placed into the jaw bone to replace a missing tooth. An artificial tooth is placed on the implant, giving the appearance and feel of a natural tooth. Implants are very stable, durable, and are the most aesthetically pleasing tooth replacement option.
If you are missing teeth, ask us if they need replacement and what options are available to you. Together we will select the best replacement option for your particular case. Prevention and early treatment are always less involved and less costly than delaying treatment and allowing a serious problem to develop.
What can be done about old, unattractive, or discolored fillings?
Most of us have fillings in our mouths that date back many years and some may have even been placed during our childhood. These fillings may now be old, dark, and unattractive, making us feel self-conscious when we smile, laugh, and talk. Old fillings are not only unattractive, they may also be defective. When a filling is old, the margins (space between the tooth and filling) may eventually open and allow bacteria and food debris to enter, potentially causing dental decay.
Your dentist can check your fillings and evaluate if they are defective and need replacement. Also, if you simply want to replace fillings that are unattractive, you and your dentist can decide which ones should be replaced first and what replacement options would best suit you. There are many state-of-the-art dental filling materials and procedures available today that are quick, painless, and cost effective for replacing old, unattractive or defective fillings.
Options for replacing old, unattractive, or discolored fillings:
Composite (bonding) fillings – These are tooth-colored fillings that can be closely matched to the color of your existing teeth. They are particularly well suited for use in front teeth or visible parts of teeth and are one of the best ways to improve the health and beauty of your smile.
Crowns (Caps) – These types of restoration are used when a tooth is too damaged and cannot be repaired with a filling or other type of restoration. A crown is a covering that encases the entire tooth surface restoring it to its original shape and size. A crown protects and strengthens the remaining tooth structure and can be made of gold, porcelain, and other tooth-colored materials.
Inlays/Onlays – These restorations are custom made fillings. They can be made of composite resin, porcelain or gold and are made by a dental laboratory and placed by a dentist. Inlays/onlays are usually best for the posterior chewing surfaces of teeth and are utilized to conservatively repair teeth that have large defective/unattractive fillings or have been damaged by decay or trauma.
Porcelain veneers – Used primarily in the front teeth, veneers are very thin shells of tooth-shaped porcelain that are individually crafted and permanently cemented to the front surface of teeth. They are a great solution for fixing discolored, pitted, shipped, malformed, or slightly crooked teeth. Veneers are also used if you have unwanted spaces. Veneers are very durable, natural looking, and do not stain. This makes veneers a very popular solution for restoring a smile impaired by old, unattractive fillings.
As you can see, there are various options for replacing old, unattractive fillings. These treatments will provide strong, natural, and long-lasting replacement solutions to enhance the health and beauty of your smile.
Is there a correlation between heart disease and periodontal disease?
Many people are unaware that having periodontal disease (the destruction of gum tissue and bone that hold our teeth in place) can affect your overall health. Periodontal disease is one of the most common infections – often more prevalent than the common cold! Periodontal disease is not only the number one reason people lose teeth; it can also affect the health of your body!
Periodontal disease is a bacterial infection, and in its earliest stages, it’s called gingivitis. It starts when an accumulation of plaque (a colony of bacteria, food debris, and saliva) is NOT regularly removed from the gums and teeth. The bacteria in plaque produce toxins/acids that irritate and infect the gums, eventually destroying the jaw bone that supports the teeth. When periodontal disease is not treated it can eventually lead to tooth loss!
There are numerous studies that have looked into the correlation between gum disease and major medical conditions. These studies suggest people with periodontal disease are at a greater risk of systemic disease. They also indicate that periodontal disease can allow oral bacteria to enter the bloodstream and travel to major organs, beginning new infections. Research suggests that periodontal bacteria in the blood stream can:
- Contribute to the development of heart disease
- Increase the risk of stroke
- Compromise the health of those that have diabetes or respiratory diseases
- Increase a woman’s risk of having a preterm, low-birth weight baby
While there is still much research to be done in order to fully understand the link between periodontal disease and systemic diseases, research has shown that infections in the mouth can wreak havoc elsewhere in the body.
To ensure a healthy, disease-free mouth, we recommend the importance of regular dental check-ups and cleanings, which include a periodontal evaluation. Also, diligent home care and a proper diet can help reduce plaque and bacteria in the mouth.
Remember the mouth body connection! Taking care of your oral health can contribute to your overall medical health!
When are sealants recommended?
Although thorough brushing and flossing removes most food particles and bacteria from easy to reach tooth surfaces, they do not reach the deep grooves on chewing surfaces of teeth. More than 75 percent of dental decay begins in these deep grooves (called pits and fissures). Toothbrush bristles are often too large to clean most of these areas, thus sealants play an important role.
A sealant is a thin plastic coating that covers and protects the chewing surfaces of molars, premolars, and any deep grooves or pits on teeth. Sealant material forms a protective, smooth barrier covering natural depressions and grooves in the teeth, making it much easier to clean and help keep these areas free of decay.
Who may need sealants?
Children and teenagers – As soon as the six-year molars (the first permanent back teeth) appear or any time throughout the cavity prone years of 6-16.
Infants – Baby teeth are occasionally sealed if the teeth have deep grooves and the child is cavity prone.
Adults – Tooth surfaces without decay that have deep grooves or depressions that are difficult to clean.
Sealants are easily applied by your dentist or dental hygienist and the process only takes minutes per tooth. After the chewing surfaces are roughened with an acid solution that helps the sealant adhere to the tooth, the sealant material is “painted” onto the tooth surface, where it hardens and bonds to the teeth. Sometimes a special light will be used to help the sealant material harden.
After sealant treatment, it’s important to avoid chewing on ice cubes, hard candy, popcorn kernels, or any hard or sticky foods. Your sealants will be checked for wear and chipping at your regular dental check-up.
Combined with good home care, a proper diet, and regular dental check-ups, sealants are very effective in helping prevent tooth decay.
What should I do if a tooth is knocked out?
We’re all at risk for having a tooth knocked out. More than 5 million teeth are knocked out every year! If we know how to handle this emergency situation, we might be able to save the tooth. Teeth that are knocked out can possibly be re-implanted if we act quickly and follow these simple steps:
- Locate the tooth and handle it only by the crown (chewing part of the tooth), NOT by the roots.
- DO NOT scrub or use soap or chemicals to clean the tooth. If it has dirt or debris on it, rinse it gently with your own saliva or whole milk. If that is not possible, rinse it very gently with water.
- Get to a dentist within 30 minutes. The longer you wait, the less chance there is for successful reimplantation.
Ways to transport the tooth
- Try to replace the tooth back in its socket immediately. Gently bite down on gauze, a wet tea bag or on your own teeth to keep the tooth in place. Apply a cold compress to the mouth for pain and swelling as needed.
- If the tooth cannot be placed back into the socket, place the tooth in a container and cover with a small amount of your saliva or whole milk. You can also place the tooth under your tongue or between your lower lip and gums. Keep the tooth moist at all times. Do not transport the tooth in a tissue or cloth.
- Consider buying a “Save-A-Tooth” storage container and keeping it as part of your home first aid kit. The kit is available in many pharmacies and contains a travel case and fluid solution for easy tooth transport.
The sooner the tooth is replaced back into the socket, the greater the likelihood it has to survive. So be prepared, and remember these simple steps for saving a knocked-out tooth.
You can prevent broken or knocked-out teeth by:
- Wearing a mouthguard when playing sports
- Always wearing your seatbelt
- Avoiding fights
- Avoid chewing hard items such as ice, popcorn kernels, hard breads, etc.