Welcome to Dental Expressions, where Dr. Sonal Bhoot and her team are pleased to provide superior dental services in Lee's Summit to you and your family. Our goal is to build a strong relationship based on trust and respect so that you will feel confident about the quality of care that you are receiving.
We invite you to review our patient services section along with our technology section to learn more about the cutting edge dentistry that we are excited to extend to our community.
For new patients, please take a look at the new patient information, new patient forms, and patient education section with web links to learn more about our services, and dental care. Please complete the forms, available online, prior to coming to our office so that we are better informed about your goals and needs and concerns prior to your arrival.
Our office strives to provide excellent, compassionate and personable care while developing a good rapport with our patients.
We look forward to meeting you! Thanks for choosing Dental Expressions.
Tooth Extractions - You and Dr. Bhoot may determine that you need a tooth extraction for any number of reasons. Some teeth are extracted because they are severely decayed; others may have advanced periodontal disease, or have broken in a way that cannot be repaired. Other teeth may need removal because they are poorly positioned in the mouth (such as impacted teeth), or in preparation for orthodontic treatment.
Invisalign - Invisalign is a new treatment that uses clear, invisible aligners to straighten teeth. It is like a contact lens for your teeth. It is offered to teens and adults that are candidates.
Dental hygiene involves the biyearly cleaning and checkup for patients with healthy dentitions. On that visit the hygienist scales and polishes the teeth also known as a prophylaxis. All changes in medical history are updated. Also films are taken. This hygiene appointment may occur more frequently for some patients based on the health of the gums.
Sealants - They are highly effective in preventing decay on the biting surfaces of your chewing teeth, sealants is a simple procedure in which a tooth-colored acrylic "coating" is painted onto the surface of the tooth. This effectively "seals" the deep grooves acting as a barrier, protecting enamel from plaque and acids.
Sealants protect the depressions and grooves of your teeth from food particles and plaque that brushing and flossing can't reach.
It is easy to apply, sealants take only a few minutes to seal each tooth. Sealants hold up well under the force of normal chewing and can last several years before a reapplication is needed. Children and adults can benefit from sealants in the fight against tooth decay.
Fluoride Treatment - Most children up to the age of 16 receive fluoride treatment on their regular hygiene appointment. Adults may receive this treatment as well if the caries rate is high or if they have very sensitive teeth. It is a topical treatment.
There are various reasons why a tooth may need root canal, some of which include infection, trauma, deep decay, positioning of the tooth, etc. At times, patients are given the option of endodontics vs. tooth extraction. Endodontics (root canal therapy) is a method of retaining the tooth in the dentition by removing the nerves in the tooth. Extraction involves removing the tooth entirely from the dentition.
Root Canal Therapy - Root canal therapy involves the cleaning, shaping and filling of the canal space within the root of the tooth.
Gum Disease - Periodontal (gum) disease is an infection of the teeth, gums and the bone that surrounds the teeth. It is the leading cause of adult tooth loss. Stopping this condition begins with a thorough diagnosis. To identify periodontal disease, we perform a comprehensive examination including periodontal charting and x-rays. If we detect periodontal disease, we will talk with you about treatment options and proper home care to minimize bone loss and restore the health of your gums.
Our approach is conservative. We use the non-surgical method whenever possible, using the latest antibiotic therapy techniques to fight the bacteria causing advanced forms of periodontal disease.
You and Dr. Bhoot may determine that you need a tooth extraction for any number of reasons. Some teeth are extracted because they are severely decayed; others may have advanced periodontal disease, or have broken in a way that cannot be repaired. Other teeth may need removal because they are poorly positioned in the mouth (such as impacted teeth), or in preparation for orthodontic treatment.
The removal of a single tooth can lead to problems related to your chewing ability, problems with your jaw joint, and shifting teeth, which can have a major impact on your dental health.
To avoid these complications, in most cases, Dr. Bhoot will discuss alternatives to extractions as well replacement of the extracted tooth.
The Extraction Process
At the time of extraction the doctor will need to numb your tooth, jawbone and gums that surround the area with a local anesthetic.
During the extraction process you will feel a lot of pressure. This is from the process of firmly rocking the tooth in order to widen the socket for removal.
You feel the pressure without pain as the anesthetic has numbed the nerves stopping the transference of pain, yet the nerves that transmit pressure are not profoundly affected.
If you do feel pain at any time during the extraction please let us know right away.
Sectioning a Tooth
Some teeth require sectioning. This is a very common procedure done when a tooth is so firmly anchored in its socket or the root is curved and the socket can't expand enough to remove it. The doctor simply cuts the tooth into sections then removes each section one at a time.
Oral Surgery: After Care
Bleeding - Some bleeding may occur. Placing a piece of moist gauze over the empty tooth socket and biting down firmly for 45 minutes can control this.
Blood Clots that form in the Empty Socket - This is an important part of the healing process and you must be careful not to dislodge the clot.
Avoid rinsing or spitting for 24 hours after the extraction.
Avoid use of a straw, smoking or hot liquids.
Swelling - If swelling occurs you can place ice on your face for 10 minutes and off for 20 minutes. Repeat this cycle as you feel necessary for up to 24 hours.
Pain and Medications - If you experience pain you might use non-prescription pain relief medications such as acetaminophen or ibuprofen.
Eating - For most extractions just make sure you do your chewing away from the extraction site. Stay away from hot liquids and alcoholic beverages for 24 hours.
A liquid diet may be recommended for 24 hours.
Brushing and Cleaning - After the extraction avoid brushing the teeth near the extraction site for one day. After that you can resume gentle cleaning. Avoid commercial mouth rinses, as they tend to irritate the site.
Beginning 24 hours after the extraction you can rinse with salt water (1/2 teaspoon in a cup of water) after meals and before bed.
Dry Socket - Dry socket is when a blood clot fails to form in the socket where the tooth has been extracted or the clot has been dislodged and the healing is significantly delayed.
Following the post extraction instructions will reduce the chances of developing dry socket. Dry sockets manifest themselves as a dull throbbing pain, which doesn't appear until three to four days after the extraction. The pain can be moderate to severe and radiate from the extraction area. Dry socket may cause a bad taste or bad breath and the extraction site appears dry.
Dr. Bhoot will apply a medicated dressing to the dry socket to sooth the pain.
Healing - After a tooth has been extracted there will be a resulting hole in your jawbone where the tooth was. In time, this will smooth and fill in with bone. This process can take many weeks or months. However after 1- 2 weeks you should no longer notice any inconvenience.
Dental implants are fabricated to provide a foundation for replacement teeth that look, feel, and function like natural teeth. Implants offer the ability to have replacement teeth that are fixed in your mouth. One can have multiple implants or just one implant depending on the number of missing teeth. The person who has lost teeth regains the ability to eat virtually anything and can smile with confidence, knowing that teeth appear natural and that facial contours will remain intact.
The actual implant is a small titanium post that is placed into the jawbone where the tooth is missing. The bone bonds with the titanium, creating a strong foundation for artificial teeth. This process is called osseo- integration where the implant is beneath the surface of the gums undergoing this bond with the bone. In essence, the implant serves as the root of your tooth. After this initial placement of the implant, there is a healing process that takes place between 3-6 months.
phase 2 begins after this healing process takes place. The implant is then uncovered and a small healing collar is placed. Dr. Bhoot will then begin restoring the implant with a crown. The actual placement of the implant is normally done by an oral surgeon or periodontist. Dr. Bhoot takes an impression of the implant by which posts or attachments can be connected and then finally a crown is fabricated. A crown sits over the attachment (abutment) which interconnects with the implant.
The entire implant procedure typically takes between 6-8 months for completion. During this process most patients do not experience any disruption in their daily life. Implants are commonly done on a day to day basis and the success rate is excellent (95%). Our team works very closely to help you with any questions you may have. The dental/radiographic exam as well a thorough exam of your health history allows us to determine whether one is a candidate for dental implants.
A bridge attaches artificial teeth to adjacent natural teeth, called abutment teeth. Bridges are either permanently attached (fixed partial denture), or they can be removable (removable partial denture).
Fixed bridges are applied by either placing crowns on the abutment teeth or by bonding the artificial teeth directly to the abutment teeth. Removable bridges are attached to the teeth with metal clasps or by precision attachments.
A bridge is recommended when there is a missing tooth and on either side of the missing tooth there exists natural teeth. The natural teeth on either side serve as anchors (abutments) which attach the missing tooth in the center. A traditional bridge is a 3 unit piece and there are a total of 3 crowns. However, there are many instances where there is more than one tooth missing in between the natural teeth. In that case, a bridge can still be fabricated. Fixed bridges are bonded into place and can only be removed by a dental professional. Removable bridges (partials) can be taken out and cleaned. Fixed bridges offer more stability than their removable counterparts.
There are many reasons why patients choose a bridge. A bridge helps support the lips and cheeks. The loss of a back tooth may cause your mouth to sink and your face to look older. However, the most important reason for a bride is to replace the missing tooth or teeth so that unusual stresses are not placed on the other teeth which can cause a number of harmful disorders. An increased risk of gum disease has shown to be a major side effect of missing teeth.
If takes two or three appointments to complete. At the first appointment Dr. Bhoot will prepare the teeth on either side of the missing tooth by reducing a portion of the enamel and dentin.
Since the bridge must be prepared very accurately to ensure correct bite and to match the opposing tooth, impressions of the teeth are taken and sent to a lab where the bridge will be constructed.
The bridge is permanently cemented to the abutment teeth. The tooth in the center (missing tooth) is called a pontic. The pontic is the replacement tooth.
There are many different materials used to construct a bridge. They are usually made from gold alloys, semiprecious alloys, and or porcelain.
A strong oral hygiene program needs to be in effect to up keep the health and function of a bridge. Home care involves brushing and flossing thoroughly to keep the surrounding teeth clean. This is important because it is the adjacent teeth which support the bridge.
Removable Partial Dentures
This is an alternative for replacement teeth when 3 or more teeth are missing in the upper or lower arch. This appliance is removable in that you can remove it at night or after meals to clean it. It consists of an underlying metal framework to which a plastic gum colored base is attached on which the replacement teeth sit. The partial has metal clasps which hook to the remaining teeth. Partial dentures come in different varieties including a metal-free flexible denture with metal free clasps as well. Precision attached partials are one of the more esthetic partials in that no clasps exist. Instead special attachments are placed on the crowns which anchor the partial in place. Dr. Bhoot can evaluate the type of partial which is best suited for each individual patient.
There are many questions that may come up with wearing a partial denture. Below are frequently asked questions.
Having replacement teeth should make it easier to chew evenly on both sides of your mouth. The recommendation is to start with eating soft foods, non-sticky foods until your mouth adjusts to the change.
Initially it is best to take the denture out in an area where it will not break upon removing it. Use a mirror to help you. Brush the denture after eating to remove plaque build up. The recommendation is a soft bristled brush specially designed for partials where the bristles are shaped to clean the denture. There are many denture cleansers available on the market. You can check the ADA website for more information.
With missing teeth it is often difficult to enunciate words because of loss of lip support. A partial often helps with that. However, initially it may feel bulky and therefore may alter your normal speech. In due time, your mouth will adjust.
After the initial delivery of the partial one may develop some minor sore spots which require adjustments by the dentist. This may involve adjustments to the bite or areas of the partial which are impinging on the soft tissue. Also over a period of time the gums and bone may shrink affecting the overall fit of the partial. It may become loose and may require a refitting to accommodate those changes in the mouth. It is strongly recommended that no adjustments be made at home as permanent damage can occur to the partial.
This type of prosthesis is necessary when all of the natural teeth have been lost due to periodontal disease, tooth decay, or trauma. With the aid of a denture, improvement of one's facial profile, musculature, and overall speech is highly improved as well as the support of the TMJ joint. There are various types of complete dentures.
A conventional full complete denture is placed only after the teeth have been removed and the tissues have healed over 6-8 weeks following the tooth extractions. If one already wears a complete denture and would like a replacement than there is no waiting period involved. It normally takes several short appointments to fabricate a precise fitting denture. Over that process the patient can take part in selecting the shape of the tooth as well as the shade.
An immediate denture is a type of denture in which the patient is not without teeth during the healing period. The back teeth are generally removed and the teeth in the anterior are preserved until the denture is ready to be delivered. That is the main advantage with this type of denture. Some of the negatives are the patient is unable to view their denture until it is delivered. Also the denture fit may change within 6 months as the gums have healed and may have shrunk. A refitting is normally required at this point.
An implant supported denture is one in which the denture is not retained solely by the anatomy of the ridge and the soft tissue. In many patients where the ridge especially in the mandible is not sufficient to hold a denture properly, implants are placed to anchor the denture and provide extra retention. These may also be placed in the maxilla if needed.
Dental Veneers & Lumineers
Porcelain veneers are thin shells of ceramic that bond directly to the front surfaces of the teeth. They are a great choice for improving your smile especially for teeth that have gaps, heavy stains, irregular shape or size. Veneers are a very conservative approach to creating a beautiful smile. They are very natural appearing and highly resistant to coffee and even cigarette stains.
Fabricating custom veneers requires extreme precision and a high level of technical skill. We place veneers routinely, and design each case individually to match and enhance the characteristics of each patient's smile.
Will they look like normal teeth?
When bonded to the teeth, the ultra-thin porcelain veneers are virtually undetectable and highly resistant to coffee, tea, or even cigarette stains. For strength and appearance, their resemblance to healthy, white tooth enamel is unsurpassed by other restorative options. Because they are thin, light can shine through them and they take on the natural color of the underlying tooth.
How durable are porcelain veneers?
With proper care, porcelain veneers will brighten your smile for well over a decade. Dr. Bhoot will ensure that your veneers are crafted from the highest quality porcelains and are bonded with the most advanced and proven materials available.
This procedure will require three appointments:
- Diagnosis and treatment planning
You will want to take an active role in planning your smile design. Dr. Bhoot will review the corrective limitations of this procedure and help you plan your new smile.
The second appointment will take one to two hours. Although the porcelain veneer is very thin, the teeth are lightly buffed to allow for the added thickness. Approximately one half of a millimeter of tooth is removed. This may require little or no local anesthesia.
Then a mold is taken of the teeth and sent to the lab for fabrication. A temporary veneer will be placed at this time. The veneer should be ready in approximately one to two weeks.
At the time of your third appointment, Dr. Bhoot will first place the veneer on your teeth with water or glycerin to check their fit and color. At this point the color of the veneer can still be adjusted by the shade of the cement used to adhere it. Once the color is determined, and the veneer is ready to be applied, the tooth is cleansed with specific chemicals to achieve a bond. A special cement is placed between the teeth and the veneer and a visible light beam is used to harden the cement. This appointment takes approximately one to two hours.
Brush and floss daily. Return for a follow-up visit after one to two weeks.
Brush and floss as you normally would. Don't be afraid that you will damage your veneers by brushing and flossing. Non-abrasive toothpaste is recommended. A good home care regimen will insure the best esthetic success of your veneer.
You may experience some sensitivity to hot and cold after placement of your veneer. This is due to the amount of enamel left on the tooth after preparation. Sensitivity is totally normal and should dissipate after one to two weeks. If sensitivity persists please call the office.
If you are a known clencher (bruxer), please be sure to let us know. Dr. Bhoot may recommend a soft night guard for you to wear to minimize stress placed upon your teeth while you sleep.
We hope that your new veneers fulfill your esthetic goal. With proper home care and scheduled visits, they are sure to provide you with a beautiful smile for years to come.
Lumineers are porcelain veneers that are ultra conservative. The thickness of this veneer is often equated with that of a contact lens. Lumineers offer a painless way to permanently improve your smile without having to grind or shave away a significant amount of healthy tooth structure. There is no local anesthesia required for this procedure because it is very noninvasive, and many times the procedure involves taking a simple impression. These can last over 20 years and they are completely reversible! They are designed for teeth that are stained, chipped, spaced, crooked, etc.
Cosmetic Dental Services
Here at dental expressions we offer a multitude of cosmetic services for you and your family. Some of these procedures include tooth whitening, metal-free fillings, porcelain crowns, porcelain inlays / onlays, and bonding.
There are many options available for tooth whitening depending on the health of your teeth and the degree of patient motivation. Patients may choose to whiten both the upper and lower arches as well as just individual teeth that appear in the smile zone. Whitening can be used to correct many tooth discolorations which may have been caused by staining, chemical damage to the teeth, or simply by aging.
Certain teeth may not lighten if there is extreme discoloration. They may require veneers or porcelain crowns. Zoom Before & AfterThe main advantage to whitening is that it corrects brown, yellow, and mottled tooth staining. It is a long lasting solution for restoring brightness to a smile, and it does work on people of all ages.
Take home whitening is a method by which custom trays are fabricated specifically for the patient based on impressions in the mouth. This is a very quick appointment at the dentist where impressions are taken. Within a few days, trays are ready for pick up along with the whitening material to take home. The whitening material is then applied to the tray at home and applied over a short period of time. Amount of time may vary but generally is 3-4 hours every night for a week. These trays are clear and can be applied even during daytime. With time, the whitening material takes the stain out of the enamel without altering tooth structure or any dental work. Once a brilliant shade has been reached, photos are then taken to compare before and after results.
In office whitening is a nice alternative for patients that do not want to wear whitening trays at home. This procedure takes a little over an hour in office. A special light accelerates the whitening process. Tooth Colored FillingsThe results are excellent!
Many of the products over the counter can be harmful if not applied properly or may not be approved by the ADA. They may be used with caution.
For more information on the exact components of the whitening material please visit the the ADA website.
Inlay / Onlay
When more than half of the tooth's biting surface is damaged, Dr. Bhoot will often use an inlay or onlay. This is recommended in teeth where the size of the filling is too large to place a regular tooth colored filling, but smaller than that which would necessitate a crown. Traditional fillings can decrease the strength of a natural tooth by up to 50%.
Fillings Indirect CompositeAs an alternative, inlays and onlays, which are bonded directly onto the tooth can actually increase the strength of a tooth by up to 75 percent. As a result, they can last from 10 to 30 years.
What are inlays and onlays made of?
Inlays and onlays can be made of porcelain, gold, or composite resin. These pieces are bonded to the damaged area of the tooth. An inlay, which is similar to a filling, is used inside the cusp tips of the tooth. An onlay is a more substantial reconstruction, similar to the inlay but extending out over one or more of the cusps of the tooth.
In our office, inlays/onlays are milled in one visit through our virtual CAD/CAM technology called CEREC. It is a porcelain milled piece which has shown to provide significant strength due to new bonding technologies and a high level of aesthetics.
Metal Free Dentistry
If you had cavities as a child or a young adult more than likely the material used was amalgam which appears silver in color and contains a mixture of alloys. Amalgams contain 50% mercury which over time can corrode, leak, and cause stains to the existing teeth. The crowns that were made were metal-lined. Although they were the best materials back then, advances in technology have proven to increase the strength, function, and appearance of these restorations.
Why are my old metal fillings defective?
It has been discovered that the mercury fillings in your mouth function similarly to metal outside the mouth. When exposed to cold and hot temperatures, such as cold ice cream or hot coffee, the silver fillings in your mouth expand and contract. As they move, they eventually weaken the teeth and may cause the tooth to crack. This shifting also creates space between the filling and the tooth allowing bacteria to get in under the filling, causing decay underneath.
What material will you use to fill my cavity?
If your cavity is small and caught early, chances are Dr. Bhoot will use a tooth-colored composite resin to restore the tooth. This composite is stronger and lasts longer than silver-mercury fillings and is far more attractive. Also this resin contains fluoride which can prevent decay. In effect, the tooth remains intact and stronger.
If the cavity is large or if Dr. Bhoot is replacing older fillings, she will use an inlay or onlay to restore the health and function of the tooth.
The overall result is excellent.
This procedure is commonly performed to mend chips, cracks, discolorations, or misarranged teeth. It also is an alternative to veneers. This is a beautiful restoration that can be completed in a single office visit and can improve the overall look of a tooth tremendously. It is a tooth colored plastic resin similar to the tooth colored filling material placed in teeth. It can be smoothed and polished to the desired shape that is needed. The longevity of this restoration is 3-5 years. These restorations can stain, wear, and chip as its strength is not the same as natural enamel. It is a very convenient procedure in that it can be completed in a single office visit, and the results can be seen instantly. These restorations can be repaired and repeated over time as needed.
There are many instances where a tooth may necessitate a crown. This type of restoration is a long term solution in which the crown is permanently cemented to the tooth. Some of these factors which warrant a crown are fractures in teeth, root canalled teeth, trauma, disease, wear, and oversized failing fillings. There are situations where biting on a tooth may generate radiating pain due to hairline fractures. Also in a root canalled teeth the vitality is lost and the tooth is greatly weakened. Therefore, a crown helps to support the existing tooth structure. Further, malpositioned teeth may pose a great challenge to restore with simple bonding. In this instance a crown may rebuild the tooth in its most normal anatomical position and alignment. Moreover, certain teeth may appear more natural looking with a porcelain crown due to heavy discoloration. Crowns have a longevity of 10-20 years depending on the maintenance. In general the goal of a crown is for added support to the tooth with an extremely natural look that is durable, biocompatible, and beautiful.
A crown is fabricated in different types of materials based on the bite, esthetics, etc. Some of the materials used in our office are high grade porcelain, porcelain fused to metal, or all gold.
The traditional process by which a crown is fabricated is a 2 step process. On the first visit the tooth is prepared such that it is reduced to a specific size and shape. An impression is taken of this tooth and a shade is selected. A bite is taken. This is then sent off to a dental lab. In the mean time the patient is sent home with a temporary crown that is cemented in the mouth with temporary cement. This crown mimics a natural appearance of the crown to come. The 2nd appointment is for the cementation of the permanent crown. This appointment is usually made 2-3 weeks from the initial appointment.
Latest technology has introduced an all porcelain crown which can be fabricated in office called a CEREC crown.