Why Dr. Meltzer?
1. Dr. Meltzer is one of only a handful of dental surgical specialists who is not only a Board-certified periodontist, but also a Fellow of the Academy of Osseointegration. These are some of the highest honors available and represent a true commitment to an exceptional level of care.

2. Dr. Meltzer has over twenty years of experience placing dental implants. He has performed over 10,000 implant procedures, many requiring sinus grafts and/or guided bone regeneration.

3. Dr. Meltzer was trained by P. I. Branemark, the father of osseointegrated implants in Sweden at the prestigious Branemark Clinic.

4. Dr. Meltzer not only performs these procedures, but he also teaches them on six continents. His work has appeared in magazines and on television.

I see ads in the paper for discount implants costing between $495 and $995. What is that about?

• If it seems too good to be true, it probably is.
• We place some implants (mini implants) in the $500 range, but these implants should not be placed in the same category as standard osseointegrated implants.
• A dentist can buy implants manufactured out of the USA at less expense and pass some of the savings onto the patient. In light of recent problems with implant quality of imported products, this practice could lead to less-than-desired outcomes. All our implants are designed, manufactured, packed, sterilized and shipped from the USA. This provides you with the best value.
• Some offices use a “bait and switch” approach, discounting the implant and up-charging the follow-up treatment or charging for each x-ray and each office visit. All our fees include: implant placement, follow-up care, 24-hour emergency treatment if required, and a lifetime guarantee on the implants.*
• Some offices offering discounted implants place more implants than are required. There is virtually never a need to place more than 4-6 implants in the lower jaw or 4-8 implants in the upper jaw to replace a full arch of teeth. More is not generally better. We have seen offices place as many as 14 implants when 4-6 will suffice.
• Decide who is best equipped to manage an implant complication should it occur. Do your homework. Ask your dentist whom he would see if he required an implant or periodontal treatment.

Do I need x-rays?

Dental x-rays are a very important tool that helps us to assess the condition of your teeth, its roots and the supporting tissues of your mouth (bone). X-rays are instrumental in determining the presence or degree of periodontal disease, abscesses and many abnormal growths, such as cysts and tumors. X-rays can show the exact location of impacted and unerupted teeth. They can also pinpoint the location of cavities and other signs of disease that may not be possible to detect through a visual examination. Without x-rays, the ability to diagnose many issues in the mouth is severely compromised. Dr. Meltzer utilizes digital x-rays to maximize diagnostic quality and minimize radiation exposure.

How often do I need x-rays?

The frequency of having dental x-rays taken often depends on your medical and dental history and current condition. Some people may need dental x-rays as often as every six months. Others, who have no recent dental or gum disease and who visit their dentist regularly, may need dental x-rays only every few years. If you are a new patient, Dr. Meltzer may take x-rays as part of the initial examination to establish a baseline record from which to compare changes that may occur over time. In our practice we take digital dental x-rays, greatly reducing the amount of radiation exposure compared to conventional dental x-rays. Special CT scans may also be required for some patients. Your specific needs will be discussed at your initial visit.

What will it cost?

Since all patients are different, Dr. Meltzer will personally complete your examination before establishing your treatment plan and the fee for care. The fee for periodontal and implant treatment can vary considerably depending on the type of problems and the complexity and length of treatment. An approximate fee can usually be determined at the initial visit. On occasion, however, some initial treatment or further diagnostics must be completed before the final treatment plan can be established. Our philosophy of practice is to treat as conservatively as possible to attain treatment goals. Surgery will be avoided whenever possible.

Will my insurance cover the cost?

Dental insurance policies often cover periodontal treatment and some are starting to cover implant treatment. Please bring all dental and medical benefit information and cards to your examination appointment. Upon request, we will submit a claim to predetermine your insurance benefits as required.

Will I need surgery?

Not everyone needs periodontal surgery. If treated early, gum disease can be controlled without surgery. We will make recommendations based on your individual situation. The philosophy of our practice is to treat as conservatively as possible to attain treatment goals.

Can my teeth be saved?

The recent advances in periodontal treatment allow us to successfully treat most teeth.

Will I go back to my dentist?

Our office and your dentist, if you have one, will work closely together. If crowns and fillings are needed, your dentist can provide them. Regular visits to your dentist can be an important part of periodontal maintenance.

What if I decide not to have periodontal treatment?

In past years, if teeth were lost due to the periodontal disease process, one type of treatment was to replace the missing tooth/teeth with a bridge or a partial/full denture. Unfortunately, dentures are never as effective or desirable as your own teeth. The standard of care today is to replace missing teeth with (an) implant(s) which can act, look and feel as natural as your very own. Please understand that our primary goals are to conservatively maintain your dentition, to restore the supportive tissues to optimal health and to save your teeth whenever possible.

Periodontal disease is a progressive, painless infection. Delay can cause you further bone loss and more expense. If your teeth are lost, dentures are never as effective as your own teeth.

BEFORE SURGERY

When I had my wisdom teeth out, I was told not to eat anything before the appointment. What about for this operation?

You will be given a local, not general, anesthetic unless discussed differently at your consultation – so eating is OK. If you have been prescribed sedative medicines, a light meal shortly before the appointment is still OK. If you happen to be diabetic, then it is essential that you have normal meals.

My normal meal includes several cups of coffee followed by a cigarette. Is that OK, too?

Sorry, but that is not a good idea! Coffee will only make you more nervous and uncomfortable, especially because “bathroom breaks” will be very inconvenient. Tobacco in any form should not be used at all on the day of surgery and for as long afterward as possible! Nicotine is a potent constrictor of blood vessels, shutting off blood supply that is critical for wound healing. If you cannot resist the cravings, then use a dermal patch (not nicotine gum!) to sustain your addiction.

When do I start using the prescription mouthwash?

Use the mouthwash an hour or so before your appointment, when you take your first dose of antibiotic and any other prescribed medicines. Thoroughly clean your teeth, then measure about ½ ounce (or 15 cc) of the mouthwash into the cap or medicine cup. Swish it vigorously around all of your teeth for a half minute, then spit out (“expectorate”) the excess. This greatly reduces the number of germs in your mouth so your wound will be less contaminated during the operation. There is a medicine aftertaste to the mouthwash that some find objectionable. . .but the germs don’t like it either!

Can I use the mouthwash more than twice a day?

Not a good idea. The active ingredient in the rinse stays in your mouth for 12-14 hours, so “twice a day” means just that. Using the mouthwash more often does not increase its effectiveness, but it does increase the side-effects of staining sometimes “canker sore-like” ulcerations.

Why not just wait until after the surgery to start taking the antibiotics?

Antibiotics do the most good if they are already in your system “just waiting for the germs!” It is especially important for the success of any graft for your blood to be “full of antibiotic.” Once sutured and clotted, antibiotics cannot get to the wound until new blood vessels form a few days later.

I don’t like taking pills, so can I stop taking the antibiotic if I feel OK?

Not a good idea. Antibiotics kill the susceptible bacteria (the “weak bugs”) quickly, but some (the “strong bugs”) will be somewhat resistant and won’t be killed for several days. If you stop taking the antibiotic early, the resistant bacteria will multiply uncontested and the resulting infection will be more difficult to treat.

Why can’t I just take my sedative pills and then quickly drive to my appointment?

Though it will be a while before you feel the effect of the sedative, absorption can occur quickly if your stomach is empty. You could hurt yourself or others or get a DUI! Besides, you should be relaxing, not stressing over the drive here. Also, since you will not be driving home (right?!!), you won’t have to worry about getting your car back.

Can’t I just take the bus or call a cab for the ride home?

Sorry, but even just walking down the steps outside the office you could fall and hurt yourself. You must be accompanied by a responsible adult. (No offense intended to cab drivers!)

AFTER SURGERY

When the numbness wears off, what do I do?

It is easier to prevent pain than to relieve it. You will feel pain after the surgery, so start taking the prescription pain reliever before the numbness is gone. After review of your medical history, we may suggest that you start taking ibuprofen before your appointment. You will then be well on your way to a comfortable recovery. Remember: “Don’t wait for it to get bad” and “Stay ahead of the pain.” Also, take it easy and treat yourself as if you have just had an operation.

I was feeling better a few days after my surgery, but now my teeth feel high and tender when I bite, my jaws ache and even my ear hurts. What’s happening?

A normal part of wound healing is swelling, so when the tissues around your teeth swell, it will move the teeth slightly out of position. This usually starts two or three days after the surgery and last for a week or two.

I have had codeine, Vicodin, Percocet and Demerol before and they all make me sick to my stomach. What else can I take to relieve the pain?

This is a problem. All oral narcotics will cause some nausea, especially if taken on an empty stomach. So always take prescription pain relievers with plenty of liquid and/or some food. Also, the larger the dose of narcotic the more nausea, so try smaller doses more frequently. You can even grind up the pill (two spoons work very well) and put it in yogurt or applesauce, then eat this mix slowly over a period of half an hour. This problem is also why you should be taking ibuprofen as your “basic” pain reliever. It is very good at relieving dental pain and can be taken at the same time as your prescription pain reliever.

I really don’t like taking antibiotics. . .can I stop in a few days?

This is not a good idea. Antibiotics kill the susceptible bacteria (the “weak bugs”) quickly, but some (the “nasty bugs”) will be somewhat resistant and won’t be killed for several days. If you stop taking the antibiotic early, the resistant bacteria will multiply uncontested. The resulting infection will have to be treated with still another antibiotic, often one that is more costly and/or with more side effects.

I had a gum graft and thought all of the recession would be gone. What happened?

The main purpose of the graft is to thicken and widen the gum to protect the underlying bone. Getting new soft tissue to survive on a tooth root, where there is no blood supply, can be difficult. The major objective of any graft is to provide a barrier to prevent further gum recession and bone loss. In cases of root sensitivity or areas where the recession has produced aesthetic compromise, specialized root coverage procedures can be undertaken. Dr. Meltzer had advanced training in microsurgery and performs these procedures using a microsurgical approach.

I had surgery to get rid of my gum pockets. Will my gums grow back?

If gum tissue were to grow all the way back to its original position where gum pockets were present, the pockets would be back. So, we do not want the gums to “grow back” that far. In aesthetic areas of your mouth, specialized techniques are used to preserve aesthetics as much as possible.

After the dressing came off, my teeth were sensitive to cold. Why?

Tooth roots are normally sensitive to cold, somewhat like an unfilled cavity would be sensitive. The dressing was placed to assure the gums did not reform pockets, so with the loss of insulation you will feel anything cold. Also, any injury to a tooth results in a nerve that is extra-sensitive. This sensitivity, if it occurs, will decrease quickly. You can speed your recovery by keeping the teeth plaque free and applying the concentrated fluoride gel provided if required. Apply a small amount to the sensitive spot (your tooth root at the gumline) with a finger or Q-tip every hour or two for a few weeks. You can rinse or eat immediately afterwards. You will be given the necessary materials and instructions if and as required.

How can we get rid of the black line around my crowns?

The black line is the metal that seals the crown to the tooth and provides a core which is then covered with porcelain. Only a new crown will alter this appearance. Attempting to cover it with a filling is not a good idea. New crowns can be made without a metal core.

Why is my tongue black

This is an occasional side effect of disinfectant mouthwash or rinsing with peroxide. It will go away when you are able to perform normal oral hygiene and discontinue use of the agent. It is not an infection and does not require treatment.

QUESTIONS AND ANSWERS ABOUT DENTAL IMPLANTS

Why dental implants?

Once you learn about dental implants, you finally realize there is a way to improve your life. When you lose several teeth – whether it is a new situation or something you have lived with for years – dental implants can be your doorway to renewed self-confidence and peace of mind.

Dr. Per-Ingvar Branemark, developed this concept for oral rehabilitation more than 35 years ago. With his pioneering research, Dr. Branemark opened the door to a lifetime of renewed comfort and self-confidence for millions of individuals facing the frustration and embarrassment of tooth loss. Dr. Meltzer was personally trained by Dr. Branemark in his clinic in Sweden over 20 years ago.

Why would you select dental implants over more traditional types of restorations?

There are several reasons. Why sacrifice the structure of surrounding good teeth to bridge a space? In addition, removing a denture or a partial at night may be inconvenient, not to mention that dentures that slip can be uncomfortable and rather embarrassing.

Are you a candidate for dental implants?

If you are considering implants, your mouth must be examined thoroughly and your medical and dental history reviewed. If your mouth is not ideal for implants, ways of improving outcome, such as bone grafting, may be recommended.

What type of anesthesia is used?

The majority of dental implants and bone grafts can be performed in the office under local anesthesia, with or without oral or intravenous sedation. General anesthesia is available at a Surgi-center, where Dr. Meltzer maintains hospital privileges.
Do dental implants need special care?

Once the implants are in place, they will serve you well for many years if you take care of them and keep your mouth healthy. This means taking the time for good oral hygiene (brushing and flossing) and keeping regular appointments with our dental specialists.