Kuzma Advanced Dentistry

General dentistry is dentistry focused on protecting and maintaining your oral health. Your oral health is about more than just your smile, it’s the foundation of your general health, and we strive to ensure that you remain healthy in mouth and body. Preventive care is vital, and detailed exams help us identify problems as they arise. We offer a full range of treatments, so no matter what issues arise, we can give you not just one but several options to preserve your oral health.

Cosmetic dentistry has developed techniques and technologies for dealing with many of the most common complaints people have about their smiles, such as:

Discolored teeth
Chipped or cracked teeth
Small or poorly shaped teeth
Gaps in your smile
Crowded or crooked teeth
Missing teeth

With advances in cosmetic dentistry, you typically have not just one, but several options for improving the appearance of your teeth. We can talk to you about the benefits and limitations of each so that you can get the best treatment possible.

If you have lost one or more teeth or are facing the loss of teeth, you might be wishing you could start over. If only you could have your teeth back again and care for them properly this time, you would. The good news is that you can: dental implants are a tooth replacement option that is just like your natural teeth. They replace your lost teeth perfectly: you can smile with confidence, speak clearly, and eat all your favorite foods. Dental implants require the same care as your natural teeth, no special rinses or soaks. And dental implants are a great investment: they can last a lifetime.

Just having TMJ symptoms is not proof that you have TMJ, but if you have several of the following symptoms, you should be evaluated for TMJ:
Jaw pain
Popping or clicking of the jaw
Irregular jaw motion
Headaches
Clenching or grinding teeth
Heavy tooth wear
Chipped or cracked teeth
Neck pain
Ringing in the ears (tinnitus)
Dizziness or vertigo
Back pain
Tingling or numbness in the fingers
Some people experience all these symptoms as well as less common ones (such as hearing loss) . Others experience only one or a few. No matter how many symptoms you have, though, successful TMJ treatment can reduce or eliminate them all.

You can’t definitely diagnose whether you have TMJ-related headaches, but if you have other symptoms related to TMJ, you should suspect that TMJ is at least partly to blame for your headaches. Common symptoms associated with TMJ are jaw pain, neck pain, and back pain.

If you have these symptoms as well as headaches, TMJ may indeed be the problem. Here are the ways that TMJ could be causing your headaches.

TMJ and Tension Headaches
Dr. Kuzma can help you find relief from headaches
The most common type of headache, and the one most commonly associated with TMJ. In tension headaches, your muscles are pulling on your head, constricting it. This type can be caused by TMJ because muscle tension in your jaw muscles is being passed on to muscles in the head, which partner with those in the jaw.

We can demonstrate just how excessive is the force in your bite and how that translates into tension in your jaw muscles. The T-Scan digital bite sensor records just how much force each tooth is experiencing when you bite down. We can show you how imbalanced these forces are, and where your teeth are being subjected to the most force. Then we can use the electromyograph in the K-7 to measure how much tension is being carried in your jaw muscles, tension that can translate into tension headaches.

This type of headache is generally mild or moderate in intensity, but it can recur frequently, becoming very disruptive.

Jaw pain is one of the most common symptoms of TMJ. Because TMJ is a disorder of the jaw, it makes sense that jaw pain would be a natural consequence, but this doesn’t mean that TMJ-related jaw pain is simple or easy to fix. Jaw pain from TMJ can take many forms. You may experience several different types of jaw pain, and TMJ treatment to alleviate them all may require several steps.

Who Benefits from Sedation Dentistry?
People who experience any type of emotional or physical discomfort associated with dental visits can benefit from sedation dentistry, including:
Fear of dental visits
Anxious response to sights, sounds, or smells at dentist office
Sensitive gag reflex
Discomfort from holding mouth open
Difficulty sitting still for visits
Difficulty getting numb
Excess pain during or after dental visit
Inability to sleep the night before a dental visit
Most of these are related to anxiety to some degree or another. A sensitive gag reflex, for example, is dental fear that expresses as heightened sensitivity to dental tools inserted in the mouth. Fidgeting, tensing muscles, and focusing on the dental procedure can all make your dental visit more uncomfortable and lead to increased discomfort and difficulty getting numb.

To help you relax for your dental visit, we offer three types of sedation dentistry: oral sedation, nitrous oxide, and NuCalm.

Many people think it is not a serious issue, but it is. There are many risks associated with it, including hardened arteries, car accidents, and marital problems.

Snoring causes vibrations in the airway. These vibrations do more than make sound, they can cause trauma to your body, including the large arteries leading from your heart to your brain. This trauma causes tiny injuries to the arteries, resulting in the formation of scars. The scars cause the arteries to harden and can collect cholesterol from the blood, resulting in arterial plaque. This narrows the airways, raises blood pressure, and can lead to strokes.

Another problem is that when you snore you just don’t get enough oxygen. Lack of oxygen and the sound of snoring disrupt your sleep, resulting in daytime sleepiness. Snorers are about 50% more likely to report falling asleep at the wheel.

Finally, it can lead to serious marital problems. In couples where one person is a snorer, fights are more likely because neither person is capable of being rational. Many people resort to violence as a way to deal with a snoring partner.

But the most serious risk of snoring is sleep apnea.

What Causes Snoring and Sleep Apnea

When you are awake and standing or sitting upright, your airways are wide open and air flows freely through. But when you lie down, gravity pulls on your airway, especially your tongue and throat. When you fall asleep and muscles relax, causing the airway to narrow.

A narrow airway can’t let air through as smoothly, leading to a turbulent airflow. This turbulent airflow causes the tissues of your airway to vibrate, which creates the sound of snoring.

In sleep apnea, the airways completely collapse, cutting off air to the lungs and brain. The brain responds to the oxygen shortage by waking slightly, just enough to resume breathing.

Sleep apnea is a cornerstone condition that can lead to many life-threatening effects. People with severe sleep apnea can be up to 10 times more likely to die young. Overall, people with moderate to severe sleep apnea are 4-6 times more likely to die. Dangers associated with sleep apnea that contribute to this risk include:
Heart disease
Heart failure
Stroke
High blood pressure
Kidney damage
Type 2 diabetes
Obesity
Depression and other mood disorders
Suicide
Car accidents
Workplace accidents
Many people with sleep apnea die before their condition is ever diagnosed, but many more have been diagnosed and prescribed treatment but just aren’t using it. If your sleep apnea is treated, your risks are reduced significantly. If your apnea is not treated, your risks remain.

Most dentures aren’t really designed to be attractive. With a plastic teeth and flat plastic base, they are barely distinguishable from a pair of chattering toy dentures. But Denture Fountain of Youth® are designed to look more natural than your average dentures.

Denture Fountain of Youth® have ceramic teeth made out of a material similar to the one used to make porcelain veneers. This material closely mimics tooth enamel. The teeth are also designed using the latest principles in cosmetic dentistry. Your smile will be carefully customized to your desire. It can be made to look like your natural smile, or like the smile you’ve always dreamed of. It can be perfect or it can have some of the small imperfections that give character and individuality.

The denture base for Denture Fountain of Youth® is also designed to look very natural. The plastic is carefully layered to give it the translucency and texture of natural gum tissue. Like the teeth, the gum line can be individualized to meet your desires.

Dental crowns are used in a variety of ways to repair or improve your smile. Here are some of the most common ways we use dental crowns:
Cover decayed tooth
Protect a tooth after a root canal
Restore strength to weakened tooth
Improve the appearance of a tooth
Build up small or worn teeth
Support a dental bridge
Sit atop a dental implant
Provide support as part of TMJ treatment

Porcelain veneers are one of the most powerful and flexible treatments in cosmetic dentistry. They can be used to correct:
Discolored teeth
Small teeth
Chipped teeth
Gaps in smile
Crooked or crowded teeth
Dental veneers can correct all of these at the same time, too, so that in one procedure you can have a completely new smile.

They are work better for these cosmetic complaints than other options. They can be used to whiten teeth that teeth whitening can’t affect. They last longer than other options for reshaping small or chipped teeth. They can correct gaps and crooked teeth faster than orthodontics.

CEREC technology continues to grow in popularity both with patients and with dentists because it offers many benefits:
Convenience
Predictability
No need for temporary crowns
Precise color and shape control
Highly attractive all-ceramic crowns
Very durable restorations
Design is stored in the computer for future use
The traditional two-visit structure was inconvenient in part because of having to make a second visit to the dentist, but also because of what happened between the visits. While waiting for a permanent crown, you would have to wear a temporary crown which often would come off before the next appointment.

CEREC restorations precisely match the color and appearance of your natural teeth. They are bonded to your tooth and polished to give you a perfectly natural look and feel so that you can chew, eat and speak normally. The color of the crown can be adjusted in our office to make sure the match is precise. In addition, the bonded porcelain ensures an extremely long life for your tooth. But if you do have a problem with your crown due to trauma, the pattern is saved in the computer and a new crown can be made quickly.

Gum disease is a serious health problem. As a chronic infection, it can significantly impact your entire health. Inflammation in your gums is mirrored by inflammation elsewhere in the body, including the heart, joints, kidneys, and prostate. Gum disease bacteria can spread throughout the body. They are commonly a part of deposits that clog the arteries, contributing to heart disease and high blood pressure. Oral bacteria can also spread to the lungs, leading to pneumonia. Gum disease also contributes to pregnancy risks and can make diabetes harder to manage.

This connection has been verified not just by science, but by economics. People who get their gum disease treated can save thousands of dollars a year in medical costs for treating other conditions like heart disease, stroke, diabetes, and pregnancy complications.

Tooth-colored fillings are better than the traditional metal amalgam fillings for many reasons:
More attractive appearance
Creates a seal with natural teeth
Require removal of less natural tooth material
Can strengthen weakened teeth
Provide better insulation against heat and cold
Can last longer than metal amalgam fillings
Don’t contain toxic mercury
The most recognizable benefit of tooth-colored fillings is that they don’t stand out the way metal amalgam or gold fillings do. Metal amalgam fillings start out silver, but they can rapidly turn black, resulting in an appearance that may be even worse than the cavity they are filling.

Another problem with metal amalgam fillings is that they are just pressed into the hole in your tooth. They aren’t actually bonded to the tooth, which means they won’t create a good seal. Tooth-colored fillings are bonded to your natural teeth, creating a tight seal.

Tooth-colored fillings are made of plastic and/or ceramic, so they provide about the same level of insulation against heat and cold as your natural tooth. Metal amalgam fillings are metal and conduct heat or cold into the tooth. The metal amalgam also shrinks faster in response to cold, which means it becomes smaller than the hole in the tooth, and allows liquid in around the filling. When the temperature returns to normal, the liquid is forced back out of the hole. This is described as percolation, and it can lead to damage to the tooth.

Another problem occurs when the filling is exposed to heat. It expands faster than the tooth, pushing against the tooth enamel, causing cracking. It may also push into the tooth and cause pressure sensitivity.

Despite these problems, metal amalgam fillings can be durable. But tooth-colored fillings can last even longer.

One concern many people have about metal amalgam fillings is that they contain mercury, which is known to be toxic. Dentists are being urged to add special filters to their practices to prevent mercury from reaching water supplies because it contaminates the ecosystem and makes fishes toxic to eat. Although the FDA and the American Dental Association claim that metal amalgam fillings are safe, many people do not like the thought that they will have this toxic substance in their teeth.

Your gums are an essential part of your smile. Your gums are supposed to be in balance with your teeth to create an attractive smile, and when they recede, they can make your smile look off. The tooth root, for example, isn’t supposed to be seen. It’s a dull color and can look unhealthy. And when you have an uneven gum line due to receding gums, it looks like your teeth aren’t lined up properly. Another alternative to correct the appearance of black triangles around the gum line is BioClear, which is especially good if you have other cosmetic complaints about your tooth or teeth.

But there are also practical reasons to fix receding gums. Gums are supposed to cover and protect your tooth roots and your jawbone. When your gums have receded, there’s not as much protection. That’s why your teeth feel sensitive to hot and cold — the tooth root is not as well insulated as the crown.

The root also isn’t as hard and resistant to tooth decay. Once your roots begin to decay, it can be harder to preserve a damaged tooth. Tooth loss can occur because of decay or because gum disease is allowed to advance and attack your jawbone.

In a dental bridge, one or more dental crowns are attached to one or more false teeth. The dental crowns go over surviving natural teeth and provide support for the false teeth. The most common size of dental bridge has three units: two dental crowns on either side of a single false tooth. This type of dental bridge provides good support and doesn’t result in too much excess force on the supporting teeth.

One type of bridge that is being used less often these days is a cantilevered bridge, which just has one dental crown that supports the false tooth. These are sometimes used at the back of a dental arch where the tooth that is lost only has a neighbor on one side.

Orthodontics, whether it’s traditional braces or a newer approach, uses the same basic principle. Your bones may seem solid and fixed, but the truth is that your body is constantly remaking them. Your body is trying to respond to the demands you put on bones and reshaping them to match. This includes the jawbone, where pressure on teeth can cause the bone around the teeth to reshape. Bone is removed from one side of the tooth where pressure is unfavorable and built up on the other side. As a result, our teeth can move slowly through our jaw.

In traditional braces, the force to move teeth is provided by a guiding wire that is trying to return to its optimal curve. This wire is run through small brackets that are bonded to your teeth. The amount of force can be controlled by changing the wire or by altering how tightly each bracket is linked to the guiding wire.

Invisalign works on the same basic principles as traditional braces. By applying force to the teeth, Invisalign encourages the body to reshape the bone around the teeth, allowing the teeth to move into the desired position. The difference with Invisalign is that instead of metal brackets and wires, clear plastic aligners are used to apply this force.

During your first consultation, we will take a digital image of your teeth. This image will be used to determine the ideal set of movements for your teeth to get from their current position to their desired position. The instructions are then used by Invisalign to manufacture your set of clear plastic aligners. Each of these aligners will try to move your teeth a small amount. After you wear an aligner for two weeks, you switch to the next aligner.

At first we may want to see you between each aligner, but soon we will give you several aligners so you can visit our office only every four to six weeks or go even longer between visits. And visits will be quick checks on your progress followed by giving you a new set of aligners.

After you finish all the aligners, your teeth will be in their desired final position. It is important that you wear a retainer to help ensure your teeth stabilize in their new place.

Six Month Smiles is an exciting new approach to orthodontics that has many benefits over both traditional braces and new orthodontic approaches like Invisalign, including:
Shorter treatment time
Reliable, consistent results
Comfortable treatment
Barely noticeable
Reduced cost
Of course, what most people know about Six Month Smiles is that you can get your straight smile in less time. The name is literally true for many patients: treatment time averages about six months!

And the use of traditional braces has advantages, too. With more than a century of scholarship, we know how your teeth will respond to braces, so you can reliably get the results you desire, which isn’t always true for newer orthodontic technologies. Braces can apply more consistent forces, which are less because of the efficient design of Six Month Smiles, making your treatment more comfortable.

Six Month Smiles is also designed using advanced materials, including tooth-colored wires and clear brackets, making your braces barely noticeable — most people won’t know you’re wearing braces.

With less treatment time comes a reduced cost. Six Month Smiles saves you money over aligner treatments and traditional braces.

Teeth whitening works by breaking down and removing the staining molecules from your teeth. Peroxide penetrates your tooth enamel and attacks the staining molecules. They break down and are removed. We offer two kinds of teeth whitening in our office.

With Zoom! teeth whitening, we apply a very strong whitening compound in our office. It aggressively attacks the stains. We also use a catalyzing light that helps the peroxide reactivate after it’s attached to a stain molecule so that it can remove more stains. In less than an hour with Zoom! teeth whitening, you can have significantly whiter teeth.

We also offer take-home teeth whitening. In this teeth whitening approach, we custom-craft special trays that you wear at your convenience on a daily basis. You put whitening gel in the trays and gradually whiten your teeth over time. The results aren’t as immediate, but your teeth will ultimately get whiter, and you can maintain these results forever.

The outside of your tooth is hard, mineralized tissue, but inside your tooth there is a vital, living part called the pulp or nerve. When bacteria penetrate the tooth they infect the pulp chamber. Since the pulp is the part of the tooth that experiences pain, when it gets infected the pain can be quite intense.

In root canal therapy, the infected pulp is removed from your tooth, including the tunnels or canals that run through the roots of the tooth. The tooth is then filled with inert material that helps support your tooth but can’t be infected. Finally, a dental crown is placed over the treated tooth.

Once your teeth have been fully cleaned, we will perform a thorough exam of your teeth. This allows us to identify where decay is occurring and treat it with the least invasive treatment possible. The more of your natural tooth material we can preserve, the better.

It’s better to get a tooth-colored filling rather than a dental crown, and it’s better to get a dental crown before you need a root canal, and a root canal is better than having to replace a lost tooth with dentures, bridges, or implants.

During your exam, we will take digital x-rays as well. Digital x-rays provide good resolution, and are easy for you to see, too. They allow us to look inside your tooth to see how much decay is really there. It also lets us see whether receding gums are being accompanied by bone loss around your teeth.

We also utilize the DiagnoDent cavity detection system, which uses light to look for decay that is hiding just under the surface.

These two procedures are basically the same thing. Both terms describe the use of a combination of different cosmetic dentistry procedures to transform a person’s smile. A full mouth reconstruction is the term we tend to use more often, but many people prefer smile makeover. Sometimes people will use both terms to mean different things. In this case, full mouth reconstruction often refers to a combination of procedures that is addressing structural problems, such as missing teeth or bite problems like TMJ. Smile makeover, on the other hand, refers to the use of a combination of procedures to address primarily cosmetic problems. Sometimes people even refer to the use of just porcelain veneers, which can radically transform your smile, as a smile makeover.

Dr. Kuzma began his practice with a very strong foundation as a general dentist, which is the best start when growing into cosmetic dentistry. He received his BA in Biology from Lafayette College. He then got his Doctorate of Dental Surgery (DDS) from the University of North Carolina at Chapel Hill.
After his DDS was complete, Dr. Kuzma began his career of service with a one-year Advanced Education in General Dentistry Residency in the US Army. Upon completion of this residency, Dr. Kuzma served as a General Dentistry Officer at Fort Bragg, NC for three years.