He hung out with my office manager afterward and went on and on about how relieved, hopeful, and genuinely excited he was. He knew he could have good dental health and how we were going to help him with sedation dentistry to get a few things back under control. He could have confidence in himself again and the dentist wasn’t going to be the enemy any more. As a dentist, this is what it is all about for me: helping people get to a better place in their lives.

It is almost a daily goal and practice for me to help people get past their fears, resentments, and shame related to their dental health. When I meet new people, I try to find out what they want for themselves and what obstacles they need to overcome, like fear, trust, and shame. I see people start to relax as they realize I want to know what is on their mind. They slowly drop their walls as they realize that I’m not going to tell them how bad they are.

Instead, I help them see what the status of their health is and explain what they can do for themselves. We talk about what is important to them and a reasonable phased approach of how to get there. The confidence and trust build over time. I have seen so many guarded personalities become warm wonderful professional friends over the years. I know that is why our out-of-state population continues to grow. It just comes from walking the talk. And we are guilty of trying.

At Donaldson and Guenther, we do our work when it is right for you, our patients. In these hard times, there are many people we are just keeping stabilized until they can do more definitive work later. We do world class dentistry at realistic fees… Work that rarely needs to be re-done. Comprehensive Care in a supportive environment: implants, sleep apnea and snoring devices, root canals, cosmetic and restorative dentistry, and general care. More and more patients are making use of sedation dentistry with excellent results and little memory of the process.

It is for good reason that people like the man I saw this week sometimes try to hold back tears. In this world is seems unfortunately hard to find old-fashioned caring blended with state of the art quality. We do it every day at Donaldson and Guenther. Real people, real caring, real talent. Yep…. For real.

At Donaldson & Guenther, it is making the ordinary extraordinary. The only buzz word here is service.

When your insurance denies your claim, we continue to fight for coverage when others may say, “sorry, that is between you and your insurance carrier.”

When your health savings or pre tax account administrator needs documentation to validate a charge, we go to work and provide exactly what you need to remove the hassle, when others may say, “sorry, it is important to save your receipts.”

When you have no idea what or how a health savings account works, we can provide information to “fill in the gaps.” We help lessen the confusion and pave the way to utilizing a great benefit, when others may say, “sorry, it is in your plan booklet.”

We are excited every day to have the opportunity to provide the highest level of service to each patient. It is a pleasure to know that by doing a little something extra on our part makes a big difference to someone else.

Most of the major new clinical directions I have taken have come from this organization. This year, the subject is on failures in dentistry. As Kristin and I listened to today’s speakers, we had a tremendous sense of commitment to how we do dentistry. We know we are committed to “doing it right.” We always have been. But today, listening and seeing the problems that develop from lack of attention, not listening to patients, poor choice of materials, not taking the extra time to shape teeth correctly etc., we were more convinced than ever that quality is the best value.

Other approaches cost patients and dentists far too much because work needs to be redone prematurely. In this time of economic stress, I know there are pressures to go cheap – both for patients and dentists. The public is bombarded with cheaper, easier answers like Lumineers and instant or overdone dental implants. What a tragic mistake that becomes in often too short a time.

How I practice is not just a personal choice. It is also about integrity, ethics, caring, and commitment. I see the bulk of practices competing on price. At Donaldson & Guenther, we will remain committed to dentistry that enhances people’s lives. It will be quality and patient satisfaction that lasts long after treatment is completed or a fee paid. It is best to do it right the first time. We may not be perfect, but we are guilty of trying. I like trying. It makes my patients happy and I sleep well. Today’s dentistry can do amazing things. It is great to be a part of it.

Cosmetic Services

Bleaching or tooth lightening:

Lightening natural teeth is done with the help of peroxide based materials, from tooth pastes, over the counter applications, thin custom fitting clear trays that hold the lightening gel on the teeth, and in office accelerated treatment. Toothpastes are the most mild and basically help maintain existing color. Over the counter products show mixed results from terrific to disappointing. They work best for mild to moderate enhancement of front teeth. The gel-in-custom tray system is the most widely used and accepted. A patient wears the tray on their teeth for a period of hours each day. Lightening occurs and slows down over a period of weeks. Improvements are more predictable on teeth that are “yellow/orange” in tone and more difficult on teeth that are “blue/gray” in tone. In-office procedures (like Zoom) basically give the equivalent of a two week “jump start” to lightening. It is best to continue with the tray technique to reach optimum desired results.

Bonding:

The word “bonding” has multiple meanings. It can refer to applying tooth colored composite material to teeth as a filling to change tooth shape, or even as a one step add-on method of cosmetic veneers. Bonding is also the way dental restorative materials like composite and porcelain/ceramic is fused to teeth. The bond is achieved by first mildly etching the surface of a tooth to create a micro-rough surface. Fluid polymer materials are then painted on the etched surface and interlock the micro-roughness when set. The new polymer surface can actively link up to the filling materials like composite or porcelains that also have activated surfaces. The methods and materials of bonding have dramatically improved over the last 25 years. Today, bonding methods leave teeth strong, healthy, and beautiful.

Inlays and Onlays:

Inlays are bonded inside the tooth similar to a filling. Onlays also replace part or all of the biting surface. They are made outside the mouth and bonded in place similar to a cap or crown. Onlays help hold a tooth together more than an inlay. Porcelain inlays and onlays are state of the art precision restorations that can be the best of all worlds. They leave much more natural tooth structure so they are much less invasive than what might otherwise be a crown or cap. They have no metal, so light transmits naturally through the tooth, making them often nearly undetectable (even on an X-ray). Their rigidity and the fact that they are bonded to the tooth means that the tooth is re-strengthened by a well designed restoration. More real tooth, natural beauty, improved strength: win, win, win. They are more costly than a regular filling, but are also a more definitive, long term approach.

Veneers:

Porcelain veneers replace the outer face surface of teeth seen when you smile. They are a thin porcelain shell that gets fused to the underlying tooth to create the desired smile design. They are art. Subtle things make big differences. They take many forms and styles. They can create a beautiful smile from teeth that have unsightly surface coloring, spotting, spacing, poor shape, and poor positions. A patient’s preferences and priorities should dictate the final look; from very “natural” to very white, bright, straight and full – or anywhere in between.

A word of warning: Like acrylic nails, quality varies widely. Simple cheaper add-on style veneers can leave a person with thick edges that are hurtful to gum health and leave compromised speech patterns. A brand like Lumineers advertises widely about needing no tooth reduction. That sounds nice, but their small print lets you know tooth shaping may well be necessary. Their message is “easy, fast, cheap.” Food for thought.

Caps or Crowns:

Caps or crowns are the traditional way to rebuild a whole tooth. They are like an entire new outer shell of the tooth. They can be pure porcelain, porcelain with hidden metal underneath to increase strength, or gold for ultimate strength. Gold is still commonly used on teeth hidden in back that come under high pressures from clenching. Patient preferences again dictate the treatment of choice.

Improving the Gumline:

Lovely teeth alone do not make a beautiful smile. The gums around the teeth are the frame on the picture. If too much gumline shows, or the form is unbalanced, the appearance can be distracting. Finer dentists look at the gum architecture and may recommend getting the health and forms of gumlines good as part of cosmetic treatment.

Implants:

Implants have revolutionized dentistry as much or more than bonding techniques. In short; it is possible to re-create very natural looking and feeling teeth with implants. This is true for single, multiple, and even full arch restoration. Having the proper bone and surrounding gums is critical. It is very important to have your treatment coordinated if multiple providers are involved. Don’t just go and have an implant and expect the follow up dentist to get a perfect result. There is a growing number of highly trained and talented dentists that are able to do bone or gum grafting, implants, and the final restoration. Many cosmetic cases involve an implant in the mix.

Comfort:

Most people have some fear of dentistry. Some have a lot. Today, more dentists are using conscious sedation to help patients safely relax and have very positive experiences while receiving dental treatment. Most patients are happy with traditional local anesthesia, but the use of safe oral sedation protocols is becoming common. Patients are overwhelmingly pleased.

How do you find a great cosmetic dentist? I address that in another blog post

Kirk belongs to recognized national/international organizations including: The American Academy of Fixed Prosthodontics, American Academy of Implant Dentistry, and the Dental Organization for Conscious Sedation

Kirk is also a serious photographer (KirkDonaldsonPhotography.com).

Examples of case studies can be viewed on the blog and transformations pages of DGDent.com.

How Do I Find a Great or Excellent Cosmetic Dentist?

Check out websites. Look for dentists that show their own work and not just stock photos from some marketing group. Look also for customized sites that have some measure of artistry that appeal to you. The website’s aesthetic is an indication of the dentists artistic sense. Is it a custom look or just “off the shelf?” That may tell you about how the dentist picks a lab to make your teeth.

Excellence in technical laboratory work is paramount to excellent cosmetic dentistry. Ask about the dentist’s lab support. Is it a big commercial lab or small and custom or in office? Ask to see examples of cases. Does the style and look match what you want? There may even be a link on their website.

Look for patient testimonials on the dentist’s site. We all love to read those. Get testimonials or talk to patients. Fine dentists have extremely pleased patients that would be glad to talk to you. Call the office you are interested in and ask.

Try calling your local gum specialists and ask them. Gum specialists (periodontists) like excellent dentistry because it makes for healthy gums. They hate bad dentistry. Things like “Lumineers” make a lot of us just cringe.

When you meet the dentist, is he/she interested in helping you get what YOU want or just selling you a bunch of dentistry? Fine dentists try to give patients enough clear information so the patient is empowered to make their own best choice. Well informed patients are also usually the happiest.

Credentials and organizations are helpful but not a guarantee of excellence. Advanced degrees and continuing education speak of training background and commitment. Belonging to organizations is important for a dentist engaged in his/her profession. Unfortunately, some organizations can be more about marketing than real quality care. I recommend that you look for good qualifications without having them thrown in your face as the means to impress you.

Use your own common sense and gut feeling. Treatment should fit your desires and into your lifestyle. You should be very comfortable with the dentist caring for you. A little homework will help you get what you have been hoping for. There are few things more beautiful than a light fresh healthy and happy smile.

For the last 17 years we have provided dentistry that rarely needs replacement, is beautiful and done in a comfortable caring way. I am constantly overwhelmed by how much patients appreciate how they are cared for. I am reminded of the saying, “Excellence is a habit, not a single occurrence.”

Kristin Guenther

There are several approaches. My most common way is to have my patient lightly sedated, so they are relaxed. After thorough numbing, I open the gumline so I can see the bone clearly. This helps me choose the precise orientation and height of my implant. A pilot hole is gently drilled in the bone, double checked and enlarged. The implant is then carefully rotated into place. In complex cases, I will use a CT scan and a digitally designed guide system to aid in precise implant placement.

I have seen too many poor results because implants were not carefully planned and placed. I generally prefer to close the gums completely while the patient’s bone fuses (integrates) to the implant over a period of 2 to 6 months. In the mean time, patients have a temporary tooth or teeth so they always have teeth in aesthetic areas. Back teeth are often left as just the natural gums during the integration period. The advantage to this approach is highest success rates ( high 90’s) and the best gums later.

I do some clever things to make the gums look very natural on most front teeth. This happens when we uncover the implant and make a beautiful temporary that promotes a natural looking gumline. It is one of the “art parts.”

In special carefully selected situations, we may remove a tooth, place the implant and build the temporary tooth all in one step. Placing implants and teeth all at the same time is becoming more common, but some of the precision and success rates can drop. It is a decision that is important to make with plenty of information.

Once the implants have integrated, the patient is ready to have their new teeth made. We are able to replace a single tooth or several; all the way to an entire arch. Many people do single individually flossable teeth. With two implants, we make lower dentures much more secure. With 4 – 8 implants we can make a whole arch of secure teeth that stay in place and are not removable.

Kirk Donaldson DDS MS

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Enjoy your smile again. Schedule an appointment today. Call us at (734) 971-3450.

Unfortunately, I almost squirm when I see a lot of the Hollywood smiles that almost scream, “FAKE!” Doing big bulky plain white teeth is easy. Lots of high volume production labs produce that stuff. When a dentist doesn’t need to pre-shape the teeth or gums, they are just going to bulk up the teeth like adding cheap false fingernails. The unfortunate consequence is usually a negative impact on the gum health, and difficulty speaking clearly and biting efficiently. How can you bite an apple when the edges of your teeth are two to four times their normal thickness? That is what happens with “instant” veneers and similar highly marketed procedures.

Too often, someone who buys the cheap, quick fix feels dissatisfied later and then looks for a more thoughtful approach. Treating something again is a lot more expensive than doing it well the first time. Quality is almost always the best long term value.

I have a saying; Run to failure, walk to success. Careful planning is essential to achieve consistent excellence. When I am doing important cosmetic, implant and restorative work for someone, I give reserve the time necessary to work on the small details that make that lifelike difference. It takes training, an eye and discipline. Some of the comments I hear patients make is, “ These are MY teeth. That’s how they feel! Not fake at all!” or, “ This is how they used to be! How did you know?”, or , “This is what I have always wanted. “ It’s why we say, “Dentistry As A Fine Art”.