Services



New Braunfels Teeth Whitening

Having a beautiful smile may be even easier than you think. Many people achieve the look they’ve been dreaming of with our simple “bleaching” procedure.

It’s safe, quick, and inexpensive. Just let us know at any appointment if you would like to begin bleaching. You can lighten only your upper teeth or both the upper and lower, depending on how much of each shows when you talk and smile.

In only a day or two your custom bleach splints will be ready for you. We provide you with a special bleaching agent that you put into the clear, nearly invisible splints. With only a few hours of wear per day, our special bleaching agent bubbles stains right out of your enamel in a very short time without altering tooth structure or existing dental work in any way. When your teeth reach the brightness you want, only occasional treatment is needed to maintain your new smile. We’ll want to take “after” photos at your next appointment.

Dental bleaching can be used to correct many tooth discolorations. These discolorations may have been caused by staining, aging, or chemical damage to teeth. Using the latest in bleaching technology, we can offer a safe method for creating a beautiful, “brilliant” smile. In cases of extreme tooth discoloration, crowns, or veneers may be the only choice. However, because of the low cost of bleaching treatments, bleaching is nearly always worth a try.

Key Benefits

  • Corrects brown, yellow, and mottled tooth staining
  • Works on people of all ages.
  • Is a near permanent solution for a “dull” smile, restoring brightness, and bringing a smile alive.

How Is It Done?

An impression is taken to make a specialized “mouthguard” or “stent” to hold the bleach against the teeth. The material is used each night for about three to four hours for a week or two, after which significant teeth whitening will occur. In some cases, the change is nothing short of brilliant. For confidence in appearance, bleaching technology offers improvements in yellowing, aging, or stained teeth. For very severely stained teeth, crowns, or veneers may be more appropriate. A newer less costly method involves a product called Tres White from a company called Ultradent. These are a kit of ten upper and ten lower trays that you compress onto your teeth and wear for only an hour per session. They have a built in desensitizer and are more comfortable than over the counter strip type whiteners.

Considerations

Over-the-counter bleaching agents are available at drug stores and pharmacies; however, since these products can harm the gums and teeth, it’s better to use products that our practice recommends.



Veneers

What Are Porcelain Veneers?

Porcelain veneers are thin shells of ceramic that bond directly to the front and top surfaces of the teeth. They are an ideal choice for improving your smile and have become increasingly popular due to their simplicity and versatility. With veneers as an alternative, there is no reason to put up with gaps between your teeth, teeth that are stained, badly shaped, or crooked. A veneer placed on top of your teeth can correct these maladies, simply and quickly and help you achieve a beautiful 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. Peck will ensure that your veneers are crafted from the highest quality porcelains and are bonded with the most advanced and proven materials available.

The Procedure

This procedure will require three appointments:

  • Diagnosis and treatment planning
  • Preparation
  • Bonding

Diagnosis & Treatment Planning

You will want to take an active role in planning your smile design. Dr. Peck will review the corrective limitations of this procedure and help you plan your new smile.

Preparation

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. In some cases, temporary veneer will be placed at this time. The permanent veneer should be ready in approximately one to two weeks.

Bonding

At the time of your third appointment, Dr. Peck will first place the veneer on your teeth with water or glycerin to check the 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 cleaned 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.

Care & Follow-Up

Brush and floss daily. Return for a follow-up visit after one to two weeks.

Maintenance Of Your New Veneers

Brush and floss as you normally would. Don’t be afraid that you will damage your veneers by doing so. Non-abrasive toothpaste is recommended. A good home care regimen will insure the best aesthetic 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 in 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. Peck may recommend a soft nightguard 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.



Crowns

Most dentistry looks like dentistry. Our goal is to provide dentistry that is undetectable. We replace existing crowns and fillings with restorations that look and feel like your natural teeth.

Where damage to a person’s teeth is extreme and apparently beyond repair, we can use porcelain or porcelain fused to high noble metal crowns to make the smile appear “as new”. This is an extremely reliable technique for repairing the most severe dental problems, even permanently replacing missing teeth to offer a complete smile and a functional bite. We are renowned for the quality of our work and the fantastic changes we make for people using this technology. These treatments are used for a long-lasting correction of major dental problems. It is usual for these treatments to last for 20 to 30 years, which is as close to permanent as dental treatment can get.

 

How Long Does It Take?

Fitting a crown requires at least two office visits. Initially, we will remove decay, shape the tooth, and fit it with a temporary crown of either plastic or metal.

On the subsequent visit, we will remove the temporary crown, and then fit and adjust the final crown. Finally, we will cement the crown into place and you have a new beautiful looking tooth.

Key Benefits

  • Replaces missing teeth
  • Offers support to misshapen teeth or badly broken teeth
  • Looks completely natural
  • Fixes “smile” and functional chewing problems.

 

What Is The Capability Of A Crown?

Crown and bridgework is a very reliable solution for major dental problems caused through accidents, diseases, or wear and tear. Major problems can usually be corrected using these techniques. Materials used in these repairs are either high-grade porcelain or porcelain bonded to gold. The higher strength of the porcelain and gold materials is recommended to treat the most serious of dental problems. Where accidental damage has occurred resulting in lost teeth, or teeth have broken away through excessive wear, or as the result of old fillings breaking, crowns and/or bridges can be used as a long-term solution.

Many people have unexplained pain from filled back teeth that is usually due to hairline cracks in the chewing part of the tooth. Placing crowns on these teeth relieves the pain and allows a return of full dental function for these teeth. In front teeth, older fillings can both weaken the teeth and cause appearance problems due to staining or chipping. Porcelain crowns and bridges are suitable in cases where porcelain veneers are not. In teeth with root canal fillings, crowns can prevent breakage.



Fillings

A dental restoration or dental filling is a dental restorative material used artificially to restore the function, integrity and morphology of missing tooth structure. The structural loss typically results from caries or external trauma. Dental restorations may be fabricated out of a variety of materials:

Dental composites

Dental composites (also known as tooth colored fillings) allow us to restore your tooth in a manner that allows both strength and beauty. These materials are bonded to the tooth and along with our cavity detecting dye and the high power microscope allow us to have a high degree of predictability. We take more time doing these procedures than you may be used to, but feel it is time well spent when you experience less sensitivity and more longevity from your filling.

Many people still have silver/mercury fillings in their mouths from years past. These fillings are not particularly pleasing to the eye, and we know that by unavoidable design, silver/mercury fillings ultimately result in a weaker tooth structure. Porcelain inlays and tooth-colored restorations (onlays) create fillings that are not only beautiful (or unnoticeable), but also add strength to weakened teeth. These restorations are aesthetically pleasing and very strong thanks to new bonding technologies.

Disadvantages Of Silver Fillings

Silver fillings have many drawbacks. The edges of the silver filling can wear down, become weak or break. This results in the tooth not being protected and creates an environment where cavities get started once again. With age, the metal of a silver filling expands, contracts, and can split. This is why we choose not to perform this type of filling.

Silver fillings contain 50 percent mercury. They can corrode, leak, and cause stains on your teeth and gums.

Fortunately, silver fillings can safely be replaced with tooth-colored restorations.

Advantages of Tooth-Colored Restorations

There are many advantages to tooth-colored restorations. Resin onlays are bonded to the teeth creating a tight, superior fit to the natural tooth. Such restorations can be used in instances where much of the tooth structure has been lost. The tooth remains intact and stronger.

Since the resin used in tooth-colored restorations contain fluoride this can help prevent decay. The resin wears like natural teeth and does not require placement at the gum line, which is healthier for your gums!

The result is a beautiful smile!

Exam and Preparation

First, your Dentist examines the tooth and determines the appropriate treatment. It could be a simple filling, or a full crown, depending on how much healthy tooth structure is remaining and the clinical judgment of your Dentist. Next, he or she administers an anesthetic and prepares your tooth for the restoration, removing decayed and weakened tooth tissue. This preparation is just like he or she would do for many other restorative techniques. Replacing Silver Fillings With A Tooth-Colored Restoration

You can have your silver fillings replaced with tooth-colored restorations (onlays). This process requires two appointments.

Your First Appointment

  • The old filling is removed and any additional decay.
  • An impression is made of your teeth. A model of your teeth is made and sent to the lab.
  • A temporary onlay is placed on the tooth.

At The Lab

A resin is carefully placed into the model of your teeth. It is then designed to look like your natural tooth.

Your Second Appointment

  • The temporary onlay is removed.
  • A conditioning gel is placed on your tooth to prepare it for the new onlay.
  • Bonding cement is placed on the tooth and a high intensity light bonds the resin to the tooth.
  • The tooth is then polished.

Your teeth are restored to a natural look and feel, they are stronger and the tooth is protected!

Other Services

Sealants

Sealants are very effective in preventing decay on the biting surfaces of your chewing teeth. Sealants are 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.

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.

Inlays & Onlays

When over half of the tooth’s biting surface is damaged, we may recommend an inlay or onlay.

What Are Inlays & Onlays?

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.

Traditionally, gold has been the material of choice for inlays and onlays. In recent years, however, porcelain has become increasingly popular due to its strength and color that can potentially match the natural color of your teeth.

How Are They Applied?

Inlays and onlays require two appointments to complete the procedure. During the first visit, the filling being replaced or the damaged or decaying area of the tooth is removed, and the tooth is prepared for the inlay or onlay. To ensure proper fit and bite, an impression of the tooth will be taken and sent to our on-site lab for fabrication. Dr. Peck will then apply a temporary sealant on the tooth and schedule the next appointment.

At the second appointment, the temporary sealant is removed. Dr. Peck will then make sure that the inlay or onlay fits correctly. If the fit is satisfactory, the inlay or onlay will be bonded to the tooth with a strong resin and polished to a smooth finish.

Considerations

Traditional fillings can reduce the strength of a natural tooth by up to 50 percent. As an alternative, since inlays and onlays are bonded directly onto the tooth using special high-strength resins, they can actually increase the strength of a tooth by up to 75 percent. As a result, they can last from 10 to 30 years. In some cases where the damage to the tooth is not extensive enough to merit an entire crown, onlays can provide a very good alternative.

Bonding

An alternative to veneers, bonding can be used as a restorative procedure for teeth that are chipped, cracked, discolored, or misarranged.

How Does It Work?

The tooth is prepared for the procedure by lightly etching the surface and applying a bonding liquid. Once the liquid sets, a plastic resin is applied and sculpted into the desired shape by Dr. Peck. Once set, the resin is trimmed, smoothed, and polished to a natural appearance.

Considerations

The bonding procedure can often be completed in a single office visit, and can significantly improve the appearance of a tooth. However, since the plastic resin used is not as strong as your natural tooth enamel, it is more likely to stain, chip, or break than natural teeth. Bonding typically lasts three to five years before repair is needed.

Dental Implants

Dental implants are designed to provide a foundation for replacement teeth that look, feel, and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything and can smile with confidence, knowing that their teeth appear natural and that their facial contours will be preserved. The implants themselves are tiny titanium posts that are placed into the jawbone where teeth are missing. The bone bonds with the titanium, creating a strong foundation for artificial teeth. In addition, implants can help preserve facial structure, preventing the bone deterioration that occurs when teeth are missing. With dental implants, people are rediscovering the comfort and confidence to eat, speak, laugh, and enjoy life.

If, like many others, you feel implant dentistry is the choice for you, we ask that you undergo a dental/radiographic examination and health history. During these consultation visits, your specific needs and considerations will be addressed by Dr. Peck or by a specialist (an oral and maxillofacial surgeon or periodontist) suggested by our practice. Your questions and concerns are important to us. Out team will work with you very closely to help make your procedure a success.

Procedure

Dental implants are metal anchors that act as tooth root substitutes. They are surgically placed into the jawbone. Small posts are then attached to the implant which protrude through the gums. These posts provide stable anchors for artificial replacement teeth.

For most patients, the placement of dental implants involves two surgical procedures. First, implants are placed within your jawbone. For three to six months following surgery, the implants remain beneath the surface of the gums, gradually bonding with the jawbone. You should be able to wear temporary dentures and eat a soft diet during this time. At the same time, our office designs the final bridgework or denture, which will ultimately improve both function and aesthetics.

After the implant has bonded to the jawbone, the second phase begins. The oral surgeon or periodontist will uncover the implants and attach a small healing collar. Then, Dr. Peck will be able to begin making your new teeth. An impression must be taken. Following this, posts or attachments can be connected to the implants. The teeth replacements are then made over the posts or attachments. The entire procedure usually takes six to eight months. Most patients do not experience any disruption in their daily life.

Extractions

You and Dr. Peck 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 are 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, Dr. Peck will discuss alternatives to extractions as well replacement of the extracted tooth with you.

The Extraction Process

At the time of extraction Dr. Peck 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. Despite the pressure, you will feel no pain as the anesthetic will have numbed the nerves, stopping the transference of pain. Yet the nerves that transmit pressure will not be significantly affected.

Dr. Peck will check with your regularly throughout the procedure to ensure you feel no pain.

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.

After Care

– Bleeding

Some bleeding may occur. Placing a piece of moist gauze over the empty tooth socket and biting down firmly for 30 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 drinking hot liquids.

 

– Swelling

If swelling occurs, you can place ice on your face for ten minutes and off for 20 minutes. Repeat this cycle as you feel necessary for up to 24 hours.

– Pain & Medications

If you experience pain, you might use non-prescription pain relief medications such as acetaminophen or ibuprofen.

– Eating

For most extractions, 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 & 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 an extraction site. Beginning 24 hours after the extraction, you can rinse with salt water (one teaspoon salt in a cup of warm water) after meals and before bed.

– Dry Socket

Dry socket occurs when a blood clot fails to form in the socket where the tooth has been extracted or the clot has been dislodged and healing is significantly delayed.

Following the postoperative extraction instructions will reduce the chances of developing dry socket. Dry sockets manifest themselves as a dull throbbing pain that usually 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 can appear dry.

Dr. Peck will apply a medicated dressing to the dry socket to soothe 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.

– Replacing Teeth With

  • Dental Implants
  • Bridges

Bridges

All of your teeth play an important role in speaking, chewing, and maintaining proper alignment of other teeth. Tooth loss doesn’t necessarily have to occur as you age. But if you do lose teeth, they must be replaced to maintain proper function of your mouth. Fortunately, there are options for correcting tooth loss.

Options

A bridge – a device used to replace missing teeth – attaches artificial teeth to adjacent natural teeth, called abutment teeth. Bridges are either permanently attached (fixed bridges) or they can be removable.

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.

If you’re missing one or more teeth, you may be aware of their importance to your appearance and dental health. Your teeth work together for many daily functions from eating to speaking. With missing teeth, it’s difficult to do these things. Missing teeth can and should be replaced. Fixed bridges are a great way to restore your dental health and appearance.

What Is A Bridge/Fixed Partial Denture?

A bridge (fixed partial denture) is a device that fills the gap where teeth are absent. Fixed bridges are bonded into place and can only be removed by a dental professional. Removable bridges, as the name implies, can be taken out and cleaned. Fixed bridges offer more stability than their removable counterparts.

Why Do I Need A Bridge?

Oral functionality and appearance are important reasons for wearing a bridge. A bridge helps support your lips and cheeks. The loss of a back tooth may cause your mouth to sink and your face to look older.

Dental health is the most important reason for a bridge. Teeth were designed to complement each other. Unusual stresses are placed on the gums and other oral tissues when teeth are missing, causing a number of potentially harmful disorders. Increased risk of gum disease has proven to be one of the worst side effects of missing teeth and can be minimized with a bridge. Missing teeth can cause speech disorders as they are used to make many of the sounds we use to speak clearly.

How Is A Bridge Attached?

The attachment procedure usually takes two or three appointments to complete. At the first appointment, Dr. Peck will prepare the teeth on either side of the gap by removing a portion of the enamel and dentin.

Since the bridge must be fabricated very precisely to ensure correct bite and to match the opposing tooth, impressions of the teeth are taken and sent our on-site lab where the bridge will be constructed.

Fixed bridges are typically cemented to the natural teeth next to the space left by the missing tooth. A pontic (false tooth) replaces the lost tooth. Crowns, which are cemented onto the natural teeth, provide support for the bridge.

What Materials Are Used?

Bridges can be constructed from gold alloys, non-precious alloys, porcelain, or a combination of these materials. Porcelain is often bonded to either a precious or non-precious metal.

How Do I Take Care Of My Bridge?

A strict regimen of brushing and flossing will keep the bridge and surrounding teeth clean. This is of critical importance since the bridge relies on the neighboring teeth for support.

Dentures

A denture, or a complete denture, is an appliance that is inserted in the mouth, replaces natural teeth and provides support for the cheeks and lips.

Most dentures are made of acrylic material and can be fabricated two different ways.

  • A conventional denture is made after all teeth have been extracted and the tissues (gums) have healed.
  • An immediate denture is fabricated and inserted immediately after the teeth are extracted and the tissues are allowed to heal under the denture.
  • An upper denture has acrylic; usually flesh colored, that covers the palate (roof of the mouth).
  • A lower denture is shaped like a horseshoe to leave room for the tongue.

The denture teeth are made of plastic, porcelain or a combination thereof. Dentures can be fabricated to fit over endodonticly treated teeth and a complete denture can be attached to dental implants to allow for a more secure fit of the appliance.

Dentures, over a normal course of time, will wear and need to be replaced or relined in order to keep the jaw alignment normal. The alignment will slowly change as the bone and gum ridges recede or shrink due to the extraction of the teeth. Regular dentist examinations are still important for the denture wearer so that the oral tissues can be checked for disease or change.

Nitrous Oxide (Laughing Gas)

Nitrous oxide has been the primary means of sedation in dentistry for many years. Nitrous oxide is safe; the patient receives 50-70 percent oxygen with no less than 30 percent nitrous oxide. It is a sweet smelling, non-irritating, colorless gas which is inhaled. The patient is able to breathe on his or her own and remain in control of all bodily functions.

The patient may experience mild amnesia and may fall asleep not remembering all of what happened during their appointment

There are many advantages to using nitrous oxide

  • The depth of sedation can be altered at any time to increase or decrease sedation.
  • There is no after effect such as a “hangover”
  • Inhalation sedation is safe with no side effects on your heart or lungs
  • Inhalation sedation is very effective in minimizing gagging
  • It works rapidly reaching the brain within 20 seconds. In as few as two to three minutes, it’s relaxation and pain-killing properties develop.

Reasons Not To Use Nitrous Oxide

Though there are no major contraindications to using nitrous oxide, you may not want to use it if you have emphysema, chest problems, multiple sclerosis, a cold, or other difficulties with breathing.

You may want to ask Dr. Peck for a five-minute trial to see how you feel with this type of sedation method before proceeding.

Sleep Apnea

Click here to see a video of Dr. Peck discussing sleep apnea mouthguards.

Sleep apnea is a sleep disorder with symptoms ranging from abnormal pauses in breathing or low breathing during sleep. The pauses in breathing are called apnea, and can last from a few seconds to minutes. They may occur 5 to even 30 times an hour. Sleep apnea is diagnosed through an overnight sleep study.

There are three forms of sleep apnea: central (CSA) at 0.4% of cases, obstructive (OSA) at 84% of cases, and complex or mixed sleep apnea (a combination of the other two) at 15% of cases. In CSA, breathing pauses due to a lack of respiratory function. In OSA, breathing is interrupted by a physical block to airflow.

Usually, a person with sleep apnea will not know they have it. They may feel extremely tired and fatigued during the day. Often, a person sleeping the same room will notice the person’s lack of breathing regularity.

A night mouthpiece may be a helpful solution for mild to moderate sleep apnea or snoring if a CPAP machine is not appropriate. These devices hold the lower jaw forward and help relieve the physical blockage to breathing.

Clinching and Grinding

Click here to see Jim Peck talk about clinching and grinding treatment

At some point in their life, most people will clinch or grind their teeth. This occasional occurence is typically harmless. However, when teeth grinding happens on a regular basis, it can be a big problem.

Teeth grinding can be a symptom of stress or anxiety and often occurs during sleep, so people are sometimes unaware they’re doing it. Headaches, a sore jaw, or someone who sleeps nearby are often how a person discovers the issue. Grinding can cause your teeth to break, become loose, or wear down. It can also affect your jaws, resulting in hearing loss, or TMJ.

A night guard is a simple, very effective solution to teeth grinding. Dr. Peck and quickly fit one to a person’s mouth structure and give instructions on how the wearer can adjust the device at home for an even better fit.