Services
Dr. Pulsipher is focused on combining the premium care of a large Missouri dental practice with the personalized attention of a smaller office. We’re always accepting new patients. Before beginning treatment, you’ll visit our conveniently located Howell County dental office, where Dr. Pulsipher will take the time to discuss what you’d like to accomplish in regard to your dental health and the appearance of your smile. During this initial consultation, your expert Missouri dentist will address all of your questions, concerns, goals, and fears, ultimately helping you choose a treatment plan you’re comfortable with.
To ensure long-term dental health, we recommend periodic x-rays, periodontal exams, and regular cleanings to prevent cavities and gum disease. We offer a wide range of services at our West Plains, MO dental practice, ranging from preventative measures to corrective treatments.
COSMETIC DENTISTRY
Today, many people desire a whiter, more beautiful smile. When a person feels confident about their appearance, they have a strong self image, and are more comfortable interacting with the public. A healthy, beautiful smile is a high attribute to a confident self image.
Is there anything that concerns you about the appearance of your teeth?
- stains, discoloration
- dark fillings in your smile
- spaces between teeth
- teeth out of proportion
- old crowns with a dark line at the gums
- red, swollen, bleeding gums
- crooked, crowded, or chipped teeth
Cosmetic Dentistry is a solution to many patients apprehension about their teeth/smile. There are more options available than many people realize to achieve the healthy beautiful smile they have always wanted.
- whitening
- veneers
- porcelain crowns
- tooth colored fillings
These are all things that can improve a smile. We would be happy to help you assess your smile and create a treatment plan. For the smile you have always wanted, ask us how cosmetic dentistry could benefit you.
BACK TO TOP
VENEERS
A veneer is a thin layer of tooth colored material that is placed over the front surface, usually to improve the shape and or color of a tooth or teeth. They are frequently used to lighten the color or shade of a patient’s teeth. They are also a cost effective method of correcting crowded or crooked teeth allowing patients to avoid more expensive long-term orthodontic treatment.
There are two materials commonly used for veneers; porcelain and composite resin. Porcelain veneers are most commonly requested. While porcelain is a little more expensive initially, it is still more cost effective in the long run. Porcelain will look nicer, last longer and it doesn’t stain.
While composite veneers are slightly less expensive initially, they do not last as long and they will stain over time. Therefore, they usually have to be replaced much sooner adding to the long-term cost.
BACK TO TOP
CROWNS
A crown or cap has multiple indications. A crown is recommended when fifty percent or more of a tooth is decayed or missing. Frequently in this situation a “core build-up” may also be indicated to rebuild the base of the tooth providing a solid foundation for the crown. A crown fits over the tooth holding the tooth together, restoring the original shape, function and appearance of the tooth.
Crowns are also recommended for teeth that are cracked or broken helping patients avoid the need for root canals. One of the most common dental problems faced by patients over the age of thirty-five is broken teeth. It is not uncommon to find fractures in virtually healthy appearing teeth with no fillings. More common are cracked or broken teeth that have large fillings. While some cracks in the enamel surface of our teeth may be very superficial many times they extend much deeper than they appear. Often the tooth may not be sensitive and patients may not understand the need for crowning a tooth that doesn’t hurt. The problem is that the enamel on our teeth is almost identical to glass. When a tooth begins to crack it will act much like a crack in a car windshield. In time the crack will begin to grow or spread.
If a patient waits until the tooth begins to ache they are much more likely to need a root canal in addition to a crown. This procrastination can be very costly more than doubling the expense of saving the tooth. Delaying treatment also greatly increases the risk of losing the tooth all together.
Another recommendation for crowning a tooth is following root canal therapy. When a root canal is performed on a tooth the nerve and blood supply is removed from the roots and crown of the tooth. This causes the tooth to become dehydrated and brittle leaving the tooth very susceptible to breaking. Crowning the tooth is done to prevent the tooth from breaking off and having to be extracted after a root canal has been performed. Having a root canal without a crown can be very wasteful if the tooth breaks and has to be extracted. The expense of the root canal is wasted. The tooth usually has to be surgically extracted. Any appliance used to replace the tooth will likely be much more expensive than the cost of a single crown. Therefore a crown can be a very cost effective method of restoring teeth.
Crowns are also indicated in rebuilding a patient’s bite. Many patients grind their teeth to the point that their bite collapses causing very significant dental problems such as TMJ syndrome. Crowns can be used to restore the patient’s bite allowing them to avoid these problems.
Crowns can be used to reshape teeth as a fast and cost effective means of avoiding orthodontic treatment. Crowns offer beautiful results in a matter of a few weeks as opposed to months or even years of orthodontic treatment.
BACK TO TOP
BRIDGES
A bridge is a natural looking way to replace a missing tooth or teeth. It is more comfortable for patients since it stays in place. The teeth on both sides of the space are prepared for a crown, and the bridge is made as on piece, but looks and functions like a row of natural teeth.
BACK TO TOP
WHITENING
Take Home Whitening
Today many patients are more aware of their smile and how white their teeth are. Realizing the emotional and psychological benefits of a pleasant smile many patients are choosing to whiten their teeth. While there are many products being sold over the counter at supermarkets and drug stores their results can be very inconsistent. Some of these products can also be harmful if misused.
Having teeth whitened by a dentist will afford patients a much safer and more predictable result. The systems we use are tried and proven to be very safe and effective. Patients can choose to do take home whitening, or have their teeth whitened in the office. The take home method is as simple as having an impression made and returning the next day to receive your whitening trays, whitening materials and instructions.
In as little as a couple of day’s patients will see their teeth becoming whiter. The time required to use the whitening system will depend on the patients tooth shade before whitening and how white the patient wants their teeth to be. Desired results are usually achieved in two weeks. Touch up whitening will need to be done periodically and will vary with each patient.
In Office Whitening
The advantage of having your teeth whitened in the office is that the process is complete in two hours, rather than two weeks. At this appointment we take impressions for take home trays as well, so patients can do touch up whitening at home as needed. The procedure is simple. The lips and gums are covered leaving only teeth exposed. Whitening gel is then applied, and a special light is used. This process takes a little over an hour. You will notice results immediately. With proper care, you will have a whiter, sparkling smile for years.
BACK TO TOP
FILLINGS
A filling is used to restore a tooth to its original shape and function. Fillings are only recommended when less than half of the tooth is decayed or missing. If more than half of the tooth is decayed or missing, a build-up and crown is recommended.
There are two basic types of fillings, amalgam fillings and composite resin fillings. Amalgam fillings are the old black fillings used in the past and contain mercury, silver and a host of other metals. While they hold up well, they do contribute to tooth fractures and breaks, due to thermal expansion and contraction caused by hot and cold foods and liquids. These fillings are slightly less expensive, however, they do create a higher risk of tooth fracture or breakage, therefore increasing the need for crowns.
Dr. Cornish prefers composite resin fillings. These fillings not only look nice, they actually bond to the tooth and are not subject to thermal expansion and contraction like amalgam fillings. These characteristics reduce the chance of tooth fracture and breakage, helping patients avoid or delay the need for crowns in the future.
As fillings age the margins or edges will begin to break down from the wear created by chewing and grinding forces exerted on the teeth. Studies have shown that half of the fillings over ten years old will have decay around them. Therefore it is recommended to replace old worn fillings before they break or fall out. This will often allow the patient to avoid or at least delay the need for crowning a tooth. We all know that fillings are much less expensive than crowns. As a cost effective preventive measure, Dr. Cornish will recommend that old worn fillings be replaced.
BACK TO TOP
PERIODONTAL (GUM) EXAMINATIONS
Four out of five patients in America have some degree of gum disease. Since many of these patients have gums that appear relatively healthy a visual examination is not an adequate means of diagnosing gum disease. Therefore a gum examination should be performed periodically depending on the patient’s age, oral hygiene, frequency of dental visits, etc.
A small measuring device called a periodontal probe is gently inserted between the tooth and gum at six points on each tooth. The examiner is looking for bleeding and for the “pocket” depth. Bleeding points and all six measurements for each tooth is marked on the periodontal examination form. Bleeding points are the primary indicator for active gum disease. Pocket depths are used to determine the extent or stage of gum disease present. Once the examination is completed the results are used in conjunction with the x-rays to determine the stage of disease if any is present.
BACK TO TOP
PERIODIC EXAMINATIONS
Depending on the patient’s oral hygiene along with the frequency and extent of decay a periodic examination may be performed every six months or every year. This will include necessary dental x-rays, examination of the head, neck and jaw joint, an oral cancer examination, evaluation of the gums and soft tissue, and a visual examination of the teeth. Dr. Cornish will look for existing as well as potential problems that need to be addressed.
BACK TO TOP
CLEANINGS
A cleaning or ” prophylaxis ” is defined by the American Dental Association and by dental insurance companies as the removal of soft and hard plaque from the teeth that exists above the gum line. A cleaning is performed to prevent gum disease. If a patient has gum disease, just a cleaning will not help cure the disease.
Legally, only a licensed dentist or a licensed Registered Dental Hygienist can perform a cleaning. If you are unsure about the qualifications of the person cleaning your teeth please ask. Cleanings are usually recommended every six months. Depending on the patient they may be performed every three months or once a year. Routine cleanings, where indicated, are a very inexpensive measure that will help patients avoid a multitude of dental problems.
BACK TO TOP
DENTAL RADIOGRAPHS (X-RAYS)
There are two types of x-rays commonly used by the general dentist. These are intra-oral x-rays and panoramic x-rays.
Intra-oral x-rays are the small x-rays placed inside the mouth. They are used to detect decay, evaluate bone levels around the teeth, detect cysts or tumors associated with the teeth and jawbone, identify defective restorations or crowns and evaluate root shapes.
Intra-oral x-rays may be referred to as bite-wings or periapicals. Bite-wing x-rays show the crowns of several upper and lower teeth in one view. This allows us to look for decay between the teeth in only two or four x-rays. Bite wing x-rays are recommended once a year for most people. Periapical x-rays show the crown and roots of several upper or lower teeth. These are used to evaluate the presence of cysts that may form at the root tip, determine root shape prior to extracting a tooth, identify root fractures in trauma cases, etc.
Periapical x-rays are usually taken during dental emergencies to evaluate one or more teeth. They are also taken in conjunction with bite wing x-rays when a full mouth series of x-rays is indicated. Full mouth series of x-rays are usually recommended at least every three years in conjunction with panoramic x-rays.
Panoramic x-rays show the entire upper and lower jaw and jaw joints, the maxillary sinuses, nasal septum, nasal passages and other facial bony structures. These x-rays are not used to diagnose decay and other problems that intra-oral x-rays are used for. Panoramic x-rays are used to evaluate third molars for their removal, jaw or facial bone fractures, cysts, tumors or other pathology, jaw joints for trauma or disease, etc. These are recommended every three years for most people in conjunction with full mouth x-rays.
BACK TO TOP
FLUORIDE
It has been proven that fluoride is one of the safest and most effective means of preventing tooth decay and sensitivity. We offer fluoride treatments to all patients especially children. We can provide fluoride treatment in the office and we prescribe fluoride for use at home on a daily basis where indicated. If you, your spouse or children seem to have a problem with tooth decay or sensitivity you will probably greatly benefit from the use of fluoride.
BACK TO TOP
SCALING AND ROOT PLANING
Gum disease is a bacterial infection that occurs below the gum line eventually causing gum recession and bone loss. Bleeding is the primary indicator of the presence of gum disease. If your gums bleed during a gum examination you probably have some degree of gum disease. The treatment indicated for gum disease is scaling and root planing. This procedure can only legally be performed by a licensed dentist or licensed Registered Dental Hygienist. If you are having scaling and root planing and you are unsure of the qualifications of the person providing this care please ask. A cleaning is not indicated or beneficial to the patient with gum disease and in fact is a waste of the patient’s money.
An important fact to remember is that meticulous home care and regular visits to the dentist for maintenance care is critical in preventing the recurrence of gum disease. Special home care instruments such as the Braun Oral B mechanical toothbrush will be very helpful and cost effective in preventing recurrence. Patients should return to their dentist every three months for maintenance care. It has been proven that the bacteria that cause gum disease can repopulate below the gum line in a period of three months once again becoming destructive. Therefore, if a patient only returns every six months for maintenance care by their dentist or hygienist they are much more likely to have the gum disease recur.
BACK TO TOP
