Smile design, without careful consideration to functional and biological health of your smile can only be wrought with failure in the longer term. In the proper hands, training and experience, esthetic enhancements to your smile should not only improve the appearance of your teeth, but also improve their health and longevity.    It is our mission to identify these critical issues that are causing this deterioration and listen to what your concerns are to improve your smile.  It is only with this information that we can design a plan that is best for you to create the most predictable results for the long term and improve your dental health.

So how is this process completed, and how do you know what it is going to look like in your mouth when it is completed?  How long will it take and how much will it cost?  How do I pay for it?  Is it the right thing to do?  These are often questions that patients have that create hurdles in achieving the smile that they desire.

The process all begins with a complete exam.  We start with an interview to listen to your concerns and understand what your goals are in achieving a great smile.  After a review of your medical history, we begin to collect data through the use of a clinical exam, dental radiographs, digital photography, diagnostic mounted models and computer assisted technologies to help quantify occlusal forces on your teeth that often result in wear and fractured teeth and restorations.  From a study of this information, the restorative dentist can create a Dental Blueprint that begins to marry the functional health design requirements with the desired esthetic result.  This Blueprint can then be evaluated by the dentist and the patient through two modalities: imaging of dental photographs and a diagnostic wax up of the patient’s actual smile.  This diagnostic wax up is essentially a simulation in 3 dimensions of your smile that allow us to test our design.  From this 3 dimensional study we can then create a series of templates that allows us to be efficient and conservative when we begin that actual preparation of teeth.  All the steps in treatment up to this point are completed without implementing any actual changes to the teeth.

Once the dental blueprint is created, and all the aspects of treatment are understood and anticipated, the definitive treatment can be completed.  We want your visit to be as comfortable as possible.  We understand the anxiety that is normal with every procedure whether it is a single tooth or an entire smile.  We will discuss those protocols and options that are available to you to insure that your time spent in the dental chair is a pleasant one.

Act fast
The sooner you get to stains, the less likely they are to stick. “The tannins and polyphenols in foods such as coffee, tea, marinara sauce and red wine adhere to the surface of your tooth in under an hour,” cautions Jonathan Levine, D.D.S., founder of GoSmile, a dental-products company in New York City. Combined with plaque, which can trap dark pigments and harden into tartar in 8 to 24 hours, stains will become increasingly tougher to tackle over time, so break out the toothbrush as soon as possible after eating culprit foods.

Chew on this
No brush? No biggie. In a pinch, any gum that’s sugar-free (an absolute must for dodging tooth decay) can help keep your pearly whites gleaming. “Both whitening and regular gums work on the same principle—saliva flows over your teeth, flushing away stains,” says Lana Rozenberg, D.D.S., founder of the Dental Day Spa in New York City. Even rinsing with a swig of water or chomping on some crudités does the trick; heavy chewing generates saliva. But make sure you stick with non-sugary options. Sorry, trick-or-treaters, that means caramel chews and nougats don’t count.

Make fluoride your friend
Don’t count on a whitening toothpaste alone to safeguard your smile; it doesn’t have a high enough concentration of peroxide or stay in contact with teeth long enough, according to Debra Glassman, D.D.S., a cosmetic dentist in New York City. Abrasive ingredients like silica or baking soda in whitening pastes gently polish away surface stains caused by foods, but a whitening toothpaste that also contains fluoride is your best bet; it helps strengthen the tooth’s enamel, which is more porous after bleaching. This will also soothe sensitivity and prevent stains and plaque from ruining your smile, Dr. Glassman says.

Brush up on brushing
While most of us probably abide by the twice-a-day mandate, a cursory 30-second cleaning isn’t really cutting it to rid teeth of plaque or bacteria that stain enamel. You actually need to brush for a full two minutes—and cover the entire terrain. “Think of your mouth as divided into quadrants,” Dr. Levine suggests. Then brush each one (upper right, lower right, upper left, lower left) for approximately 30 seconds. But be careful not to overdo it: Scrubbing teeth too vigorously and for too long, especially if you use a hard-bristled brush, can wear away the enamel. Instead, opt for a soft-bristled brush (replace it every three or four months), and keep an eye on the clock. You’ll be able to give all your teeth equal attention, so choppers stay spotless. Now, if only keeping the kitchen clean were this easy.

The examiners evaluate cases based on a point system that identifies minor, major, and catastrophic faults. A passing score is -7 or better. The examiners are also given the latitude to reward the candidate with a +1 point, in situations where the result deserves additional merit. Dr. Shimizu’s case passed unanimously with scores that ranged from -5 to -7. Almost all of the criteria faults were identified as minor and two examiners rewarded Dr. Shimizu with a +1. No case is perfect; the goals of Accreditation are to create a vision and demonstration of excellence, not perfection. Dr. Shimizu achieved a wonderful result for his patient. The preoperative indications for treatment supported the final treatment plan. Dr. Shimizu extended treatment to include eight teeth because of the clinical indications. The indications for treatment are driven by the functional and health needs of the patient. Dr. Shimizu followed an established treatment protocol that helped to ensure a predictable result. The examiners identified several common deficiencies in this case; often, these criteria are inter-related:

• One of the initial observations was the excessive length of connectors and the effect this had on the periodontal health and architectural harmony (Criteria #64, #71, and #72). An accepted guideline that is observed in nature relates to the proportion and size of the apparent contact zone or connectors between adjacent teeth. Typically, the ideal connector zone between the central incisors is 50% of the length of the centrals.The size of these connectors decreases in a symmetrical fashion as you move posterior. The effect of excessive connector length in this case appears to contribute to the impingement upon the cervical embrasures and the blunting of the papilla. The Illustration by Dave Mazierski The comprehensive understanding of materials, preparation designs, and adhesive techniques should facilitate conservation of tooth structure while still meeting the parameters of function and health.

• Criteria #87 focuses on the visual harmony of contralateral teeth. The examiners identified a lack of symmetry of the visual width of the lateral incisors. This requires the careful management of the facial line angles and can be readily identified from the occlusal view. Although the occlusal view is not how teeth are typically viewed in a social setting, it is a valuable perspective in helping to appreciate the impact that these line angles have on the reflective surfaces of the teeth. In this case, the occlusal view is helpful in visualizing why the facial plane of #10 appears narrower compared to #7. The cuspids also lack similar balance in contour and shape.

• Criteria #56 identifies the effectiveness in utilizing translucency to mimic nature and to harmonize with the balance of the smile. Several of the examiners found the intensity, volume, and pattern of the translucency to be slightly excessive and not reflective of what would otherwise be observed in nature. Accreditation presents a consistent measurement of excellence in providing esthetic functional restorations of our patients’ smiles.

Dr. Shimizu has demonstrated his ability to meet this standard. He should be very proud of the result he achieved for his patient.

Dental Implants Can Replace One or All Missing Teeth
Dental implants can be used to replace one tooth, missing as a result of trauma or congenital defect. For patients missing several teeth, dental implants may also be prescribed either alone or in combination with a dental bridge. Some patients who are missing or at risk of losing all of their upper or lower teeth may also be candidates for dental implants. Using the Teeth In A Day procedure, a patient can have all of their teeth replaced using dental implants and a fixed denture to restore natural function and esthetics.

Failing to Plan is Planning to Fail
Ninety percent of all failures are a result of improper, inadequate or absence of planning. Treatment planning is especially critical in the dental implant process. Most dental implants procedures are a coordinated effort between a restorative dentist or cosmetic dentist and an oral surgeon or periodontist. It is important to select restorative dentist or cosmetic dentist who has specific experience working with dental implants. During this process, the restorative dentist will act like a quarterback, mapping out a plan for the whole team to follow to ensure predictable and successful results.

Technology is Great…If You Know How to Use It
While the latest and greatest technology can be very helpful to dentist when performing a dental implant procedure, if you don’t know how to use the technology correctly or interpret the data it transmits, then the technology is useless. Technology can not replace education, practical training and hands on experience. Used inappropriately, technology will only get you into trouble faster.

Dr. Finlay: The Right Training, The Right Experience and The Right Tools
Dr. Finlay & Associates have over 25 years experience treating patients successfully with dental implants. Dr. Finlay can replace one tooth using dental implants or an entire set of upper or lower teeth using the Teeth In A Day process. Comprehensive treatment planning is at the heart of Dr. Finlay’s practice. He carefully evaluates each patient, considering all factors – esthetic, functional and financial to determine the most conservative and appropriate treatment modality.
Never satisfied with the status quo, Dr. Finlay is dedicated to post graduate training and excelling in the field of modern dentistry. He is a Senior Faculty member of The Dawson Academy where he teaches and collaborates with the nation’s top dentists. Dr. Finlay is also an Accredited Fellow of the American Academy of Cosmetic Dentistry, an esteemed title held by fewer than fifty dentists in the entire United States. He is the only Accredited Fellow in the Annapolis area.
To remain on the cutting edge of dental implant technology, Dr. Finlay works with the finest dental laboratories in the country and the leading oral surgeons in the Baltimore Annapolis region. This team approach ensure the best results for each patient. Dr. Finlay employs state-of-the-art technology including iCat radiographs for 3-D imaging and CAD/CAM, computer aided design and manufacturing for creating precise restorations. His training, experience and collaboration with other top professionals within the dental industry ensure he has the skills to put these technologies to their best and fullest use.

If you have missing teeth, contact the office of Scott Finlay, DDS & Associates, PA to schedule a consultation and learn more about what treatments, including dental implants, are right for you.

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Dental crowns differ from veneers in that a veneer only covers the front of a tooth, while a crown covers the entire tooth, thus offering more protection.

In the past, most dental crowns were made of metal materials. These metal materials often discolored the gum area around the crown and were quite obvious in a person’s mouth.

Advantages of Dental Crowns:
• Dental crowns are made to match the color of your teeth
• They are very natural looking
• Comfortable and safe

Uses of Dental Crowns:
• Offer support to a tooth with a large filling
• Protect a weak tooth from further damage and breaking
• Restore a broken or cracked tooth
• Cover a badly discolored or misshapen tooth
• Cover a dental implant

Types of Dental Crowns:
• Porcelain-fused-to-metal
• All-porcelain

Porcelain-fused-to-metal are very strong and durable crowns. All-porcelain crowns are thinner and suitable for areas of the mouth that are not used as frequently in biting and chewing.

How Long Does it Take to Get a Dental Crown?
Getting a crown usually requires two appointments. During the first appointment, the dentist will make impressions, or molds, of the tooth that is to be covered by the crown.

The tooth is fitted with a temporary crown between visits while the new crown is being constructed. Any decay is removed from the affected tooth. It is then accurately shaped to fit the new crown.

During the second appointment, the tooth is cleaned and fitted with the new crown.

How Long Do Dental Crowns Last?
Dental crowns can last anywhere from five to fifteen years. With the right kind of care, they can last indefinitely. Proper care involves regular checkups and exams as well as keeping the crown clean and free of plaque by practicing good oral hygiene habits.

Composite fillings are made up of a resin that contains tiny pieces of quartz. This can be sized and shaped to imitate the surface of a tooth. The result is very natural looking and many people are electing to replace old metal fillings with composites.

The first step to a composite filling is removing the current filling and any other decay or weakness that may be present. The composite is then molded into shape, adjusted for bite and sealed into place with a bonding material. The procedure takes longer than a standard filling but generally has longer lasting results, as a composite can restore a tooth to near its original integrity.

Composite fillings are very durable and will last for years. They provide comfort while eating and will blend with the other teeth to make a nice, bright smile. Many patients feel more confident after receiving composite fillings and have far fewer problems in the long term than with old style metal fillings, which have a tendency to leak or fall out especially if the tooth is further damaged or just weakens with age.

Any cosmetic dentist can install a composite filling, however, it is in the patient’s best interest to research and choose a dentist that is very experienced and only uses the very best materials. Everyone deserves a healthy, beautiful white smile and composite fillings are a good step toward this goal.

Because periodontal disease can creep up slowly over time, it has been called the silent killer of teeth. A thorough periodontal health screening can detect any active disease or problems with the health of your gums. It is important to address these issues as early as possible to reduce the amount of damage done to the health of your teeth and gums.

If you have periodontal disease, there are steps that your dentist can take to educate you and help you find a pathway to healthier oral hygiene practices. Sometimes they might use in-office treatments, different medications, and enhanced oral hygiene skills, including educating the patient to help stop the periodontal infection from getting worse.

Following an in-office oral exam, the dentist can set up a regimen that will help the patient maintain healthy teeth and gums. The condition of your gums not only can affect the beauty of your smile, but it can also affect your overall health. Periodontal infection must be treated and managed using the latest techniques to control your periodontal health.

Some things, such as pregnancy, aging, certain medical conditions and other factors can play a role in the condition of your teeth. Regular dental visits can help with early detection or changes in the health of your teeth and gums. The earlier a potential problem can be discovered, the easier it will be to come up with a treatment plan that is right for the patient.

Dentists recognize that prevention can play a huge role in a patient’s oral health. By calling Dr. Finlay’s office, you can schedule an appointment and learn more about their state of the art periodontal maintenance programs. By learning new ways of taking care of the health of your teeth and gums, you can be assured that you have a healthy smile that lasts for years to come.

 In the simplest sense, the hope would be that every dentist would be a cosmetic dentist.  After all, the ultimate goal in dentistry is to make teeth look and function like teeth.  The reality is however, that some dentists have had more training than others focusing on those criteria related to the health, function and appearance of the smile.  As with all professions, the journey to become proficient in one’s field requires a lifetime of learning.  In dentistry this learning continues from the day the dentist begins his or her practice until the day they retire.  Materials, procedures and knowledge evolve everyday, and it is the responsibility of the dentist as an advocate for the dental health of their patient’s to separate the hype from reality and seek those advances that will improve the predictability, durability and the absolute best esthetics possible. 

 The United States is undisputedly the leader in dental esthetics.  Dentists have the opportunity from all over the world to seek post-graduate education related to esthetics at centers that offer lecture and hands-on programs from coast to coast.  Those blue chip, founding continuing education centers that focus on a comprehensive vision of esthetics/function without the influence of hype and marketing include the Dawson Academy, the Kois Center, the Pankey Institute and the Spears Education Center.  Each center may present slightly differing concepts related to philosophy and techniques, but they represent the respected mainstream of literature-based knowledge for the practice of quality care today.  There are many other centers that offer advanced dental education as well related to dental esthetics.

 Currently, dental esthetics is not a specialty.  Any dentist in practicing in the US can perform these types of procedures.  However, there are credentials that are awarded on a peer review basis that designate those that meet a level of excellence that is recognized as the gold standard in dental esthetics.  These credentials or accreditation are measured by the American Board of Cosmetic Dentistry (ABCD) through the American Academy of Cosmetic Dentistry (AACD), which is the largest academy related to dental esthetics in the world.  These credentials, Accreditation and Fellowship, are simply a measurement of the dentist’s ability to create an excellent result through their clinical skill and knowledge.  The actual accumulation and training of this subset of skills may have been learned from a variety of sources.  Because of this anonymous and open examination process, the credential is not available for purchase or award simply because someone has attended a program.  It must be earned.  The achievement typically takes years to accomplish and requires written examinations, clinical documentation of actual cases and oral exams.  In the level of Fellowship, it represents a lifetime body of work demonstrating the skills related to esthetic care.  Currently there are less than 350 dentists and laboratory technicians that are Accredited by the AACD, and only 53 that have been awarded it’s highest honor: Fellowship.  Any dentist that is licensed certainly has the potential to provide an excellent result, with or without the credentials.  Credentialing only provides an irrefutable measurement by other dentists and lab technicians that are recognized experts in the field of cosmetic dentistry, who endorse those that avail themselves to this evaluation to confirm that candidates are who they say they are: qualified to provide excellence in cosmetic dental care.

 In providing restorative esthetic dental care, one of the team members that the dentist will rely on heavily is the laboratory technician when creating restorations like veneers or crowns.  This same credentialing process is available for the lab technicians.  Information related to locating a credentialed dentist or lab technician can be found at http://www.aacd.com/index.php?module=aacd&cmd=memberreferral.  The synergy of the team of the restorative dentist and the ceramist/lab technician is the key element in creating a predictable and beautiful result. 

 Our goal is obviously to have the smile you desire the first time it is done.  Improper care can result in:

• Bulky unnatural appearing restorations.  In a social setting, the desire is to have others observe your smile as natural and beautiful, and not be able to perceive that any dentistry was completed.  Bulky restorations can also result in tissue (gums) that bleed and are infected.
• Restorations that break or fall off.
• Restorations that are in the wrong position or are too big that affect speech or give the appearance of “bucked teeth”.
• Restorations that are monochromatic (one shade) that don’t reflect what we would normally see in nature.

Proper care can involve a significant investment.  Veneers or crowns delivered by a qualified provider can range from $1500 – 2500/ tooth depending upon the economic conditions of an area and the experience of the restorative dentist.  Finding the right dentist is the beginning of a long-term relationship to help insure the health of your smile.  Cost and insurance coverage can often be a limiting concern, but always keep in mind that having something done twice, because it didn’t meet expectations the first time is always far more expensive, often yielding a compromised result.  Some practices tout themselves as a destination practice for cosmetic dental care.  These are practices that offer cosmetic treatment without providing maintenance and recurring care with periodic check ups and visits with the “in house hygienist” after treatment is completed.  They provide the restorative care and you return to your “regular dentist” for “cleaning visits”.  This is a concern.  Ideally, you want the dentist that completed your care and has been intimately involved in what was done, to monitor and help maintain the result.  It is beneficial to find a professional, if possible, within a reasonable distance that you will be willing to travel to on an ongoing basis for maintenance and evaluation.

 So how does the public find a dentist that has the training, experience and tenure to predictably deliver the results they are seeking? Here are some recommendations in gathering information to help make this important selection:

•Contact friends and family and ask who their dentist is and what their experiences are. ?

•If you are looking for a cosmetic dentist, contact other dental specialists (such as an oral surgeon, orthodontist or periodontist) and ask for a referral.  Ask for the best in your area, who they would seek care from if they had an immediate concern. ?

•Call perspective offices and ask questions about the types of dentistry that the practice provides.  Is the staff member friendly and inviting?  Are they willing to take the time to answer your questions? ?

•Set up a visit to the practice for a visit.  Is the facility up to date, clean and reflect the professionalism that you expect.  Does the team enthusiastically support the doctor? ?

•Ask to look at photographs of examples of the treatment that the doctor has completed. ?

•Has the doctor made a career commitment to continuing education?  Is he passionate about the care he provides? ?

•Has the doctor earned additional credentials related to his field of practice?  Have other professionals recognized him as a leader in his field? Some potential resources on the Internet are www.AACD.com and www.MyNewSmile.com.

 In the end, you want to put yourself in the hands of a team of providers that has the training, credentials, experience and tenure to meet your needs.  The patient does not want to be overly focused on veneers, crowns or implants.  These are only products on the shelf that a qualified restorative cosmetic dentist has at his or her disposal.  Allow the dentist to design a plan that is best for you. It often will involve a variety of techniques and procedures. This will allow for the most conservative, predictable and durable result possible.

“This was my first time having Candy as my hygienist (ever or in a long time? – that I can remember) and I really enjoyed her. She was efficient, thorough and gentle. And not overly chatty! Thank you.
    March Bishop

“Your Dentist office is exceptional. I am always impressed by the professionalism, cleanliness, and aesthetically pleasing environment. It is quite evident that your staff anticipates the needs of your patients. I particularly like the fact that you are prevention focused. On more than one occasion I have had my blood pressure checked in your office. This is health care at its best…integrating health promotion into your specialty practice. I am also impressed by the up to date, current knowledge of your staff. Again, thank you for keeping your office in such wonderful condition and for your expertise.”
    Kim Stauffer

“Candy is the best. She does an outstanding job. Mary and Connie are also extremely helpful and go out of their way to resolve any issues.”
    Scott Priebe

“I’ve found everyone on your staff to be friendly, courteous, and very professional. I’ve been a patient for close to two years now, and I wouldn’t think of going anywhere else! I really like everyone there, and its always a good experience.”
    Tony Hawkins

“As always, great to be greeted by name by all the people at your office. I feel my family and I are not just patients but friends also.”
    Cecilia Flores