Our Location
Brian Zwahlen, DDS

201 E Orangeburg Ave
Suite C

Modesto, CA 95350

Call Us

Dr. Brian Zwahlen
(209) 325-0905
Drs. Brady Marshall & Lynn Zwahlen
(209) 322-4331

General Dentistry

Preventive Care

Initial Oral Examination

Your first visit to our office is very important with regard to establishing your oral health baseline. We will begin by carefully reviewing your medical and dental histories and taking special note of all of your dental concerns, as well as any symptoms that you may be experiencing. This will be followed by a thorough clinical examination, including an oral cancer screening, periodontal evaluation, an analysis of your occlusion (bite) plus a thorough examination of your teeth, their supporting structures, and the complete orofacial area. Any needed diagnostic dental films will be taken at this time.

Deep Cleaning

By performing a deep cleaning, which is also known as a scaling and root planing, your dentist and dental hygienist can remove any excessive buildup of plaque and tartar that has accumulated around your teeth in the area below the gumline. The goal of this procedure is to treat periodontal disease by eliminating inflammation and reducing the size of pockets between the teeth and gums. While a dental scaling is intended to carefully eliminate any accumulated deposits on the surface of the tooth below the gumline, a root planing goes deeper to smooth the surface of the root so that the gums can properly reattach and heal.

The dentist will determine how many visits your scaling and root planing will require and how many sections of your mouth will be addressed at each appointment. Deep cleanings coupled with an excellent regimen of oral hygiene at home can be effective in restoring your periodontal health. If the tissues do not respond to this intervention, additional procedures including periodontal surgery will be considered.

Digital Radiography

Digital radiography utilizes computer technology and digital sensors for the acquisition, viewing, storage, and sharing of radiographic images. It offers several advantages over the older traditional film based methods of taking x-rays. The most significant of these advantages is that digital radiography reduces a patient’s exposure to radiation. Other benefits are that images can be viewed instantly after being taken, can be seen simultaneously as needed by multiple practitioners, and can be easily shared with other offices. Digital x-rays are also safer for the environment as they do not require any chemicals or paper to develop.

An electronic pad, known as a sensor is used instead of film to acquire a digital image. After the image is taken, it goes directly into the patient’s file on the computer. Once it is stored on the computer, it can be easily viewed on a screen, shared, or printed out.

Emergency Treatment

Dental emergencies can come about in any number of ways. Your discomfort may be due to an injury to the oral facial area, the acute flare up of a longstanding problem, or the result of the sudden onset of seemingly inexplicable pain. Whatever the case may be, urgent dental care is needed to provide you with relief and to avoid any further consequences to your oral health or function, as well as your overall well being.

There are many reasons to seek emergency dental care, including severe toothaches, chipped or fractured teeth, a dental abscess, impacted teeth, loose or broken fillings, lost or dislodged crowns, broken dentures and more. While the pain of a toothache is one of the more common reasons that patients come to our dental office for emergency dental care, we also promptly treat emergencies that are not necessarily painful like crowns that have been dislodged and broken dentures that leave embarrassing gaps in one’s smile.

Whether your dental emergency is painful, if it affects the appearance of your smile, or if you suspect that an infection is present, contact our office immediately for care. We will make every effort to see you as promptly as possible.

Extractions

Sometimes it is necessary to extract a tooth. This can happen for a variety of reasons. Extractions are commonly performed in cases where a deciduous “baby” tooth is reluctant to fall out, a severely broken down and non-restorable tooth is present, or “wisdom tooth” is poorly positioned and unable to fully erupt into place.

To reduce any anxiety and insure patient comfort whenever a tooth extraction is necessary, the procedure, the post surgical instructions, as well as any restorative follow-up care will be carefully and completely explained.

Pediatric Dental Care

At our office we take pride in creating and maintaining beautiful and healthy smiles for our younger patients in an environment that is lighthearted and fun. With an emphasis on establishing oral health habits that last a lifetime, our primary tools are education and a comprehensive preventive care program.

As part of an effort to guard against childhood dental decay we recommend periodic fluoride treatments and dental sealants placed on the biting surfaces of the back teeth.

Night Guards

Chronic jaw clenching and grinding one’s teeth is called bruxism. While it can happen any time of day, it often occurs at night causing an individual to wake up with any number of symptoms including jaw pain, headaches, and sore teeth that may feel loose. Although, stress and anxiety are the most common causes of bruxism there may be other contributing factors such as a sleep disorder, an abnormal bite, as well as teeth that are missing or poorly aligned.

To alleviate the symptoms of bruxism, wearing a night guard while sleeping is frequently recommended. This appliance is designed to fit over the teeth and to keep the jaws slightly apart. Wearing a night guard prevents a number of damaging events including muscle strain, excessive pressure on the jaw joint (the TMJ), and such dental damage as chipped or cracked teeth resulting from the teeth grinding against each other.

In addition to preventing damage to the soft and hard tissues surrounding the orofacial cavity, a custom night guard fabricated at the dental office can help curb a bruxism habit and give the wearer a better night’s sleep.

Sleep Apnea

Sleep apnea is a serious and potentially life threatening disorder involving repeated pauses in breathing while asleep. The most common form of this condition is obstructive sleep apnea. This occurs when there is an obstruction of an individual’s airway that interferes with the flow of oxygen through the nose or mouth during sleep. In someone afflicted with obstructive sleep apnea, the muscles of the throat and mouth relax during sleep to the point where they fall back into the upper airway and create a blockage that restricts breathing.

The signs and symptoms of this disorder during sleeping hours may include, loud snoring, episodes of breathing cessation, abrupt awakenings, episodes of gasping for air, along with difficulties getting a good night’s sleep. An individual with sleep apnea will exhibit problems during the day as well. Sleep apnea can lead to a morning headache, excessive daytime sleepiness, difficulty concentrating, and irritability.

A sleep study is typically conducted to determine the severity of the disorder. The results of this study along with other medical findings will play a role in determining the recommended therapy. The most common form of therapy is a CPAP machine that is worn when sleeping. This device provides a steady stream of pressurized air into the respiratory system through a mask.

In situations of mild to moderate sleep apnea, a dental appliance may be deemed the appropriate treatment. Worn in a similar fashion to a mouthguard or an orthodontic retainer, it is designed to help keep the tongue and soft tissues in the back of the throat from collapsing, thereby enabling the airway to stay open during sleep. An oral appliance is easy to wear, easy to care for, comfortable, and portable. Oral appliances are individually fabricated, and customized for both maximum effectiveness and comfort.

Snoring Appliances

Getting a full night of sleep is essential to your overall health. Being well rested helps you to feel good and to function at your best. One of the most common problems that can affect the quality of your sleep is snoring. According to statistics about 90 million individuals in the United States snore while they sleep. While for about half of these people the problem is simply snoring, the others may be afflicted with a serious disorder known as sleep apnea. Therefore, before any type of treatment can be prescribed, it must be determined whether the problem is sleep apnea or “simple” snoring.

If it is determined that your problem is simply snoring, and you are what is known as a primary snorer, then an oral appliance can help you as well as any of your roommates enjoy a quieter and more comfortable sleep. A custom fabricated oral appliance to address snoring fits somewhat like a sports mouthguard or orthodontic retainer and is only worn while you sleep. As a removable and non-invasive treatment for snoring, your appliance slightly repositions your jaw to allow for a less restricted airflow to promote a quieter and more restful sleep.

Sports Mouthguards

Every year millions of cases of dental and facial injuries occur as the result of sport-related trauma. While all sports have some risk of oral injury, it is especially prevalent in recreational activities that involve frequent body contact with other players or the ground, as well as the possibility of being struck by other objects such as, balls, bats, or sticks.

One way to significantly reduce the risk of damage to your teeth, cheeks, lips, tongue, face, or jaw as the result of a sports-related injury is to wear a mouthguard. A mouthguard is a removable appliance made of a sturdy plastic that sits comfortably over your teeth. Typically, mouthguards are designed to cover just the top teeth but may also be fabricated to include the lower teeth as well depending on your particular situation. Individuals who wear braces or have some types of dental work may require a specific type of mouthguard that provides more coverage.

There are three types of sports mouthguards on the market, including pre-formed and ready to wear stock mouthguards, boil and bite mouthguards, and custom mouthguards fabricated by your dentist. Our office will help you to select just the right sports mouthguard to protect your smile. While the first two choices offer some level of protection, the best and most comfortable mouthguards to safeguard your smile are the ones individually designed and customized by your dentist.

Tooth Restoration

Implant Dentistry

Losing a tooth due to injury, dental decay, or gum disease can happen. However, in order to avoid causing problems for the adjacent teeth and your overall dental health, it is important to replace the tooth that has been lost. This can be done a number of ways including fixed bridges, removable partial or full dentures as well as a more recent procedure known as dental implants.

One of the most significant dental innovations in recent times, an implant is a small surgical fixture made of biocompatible metal or ceramic materials that is placed into the jawbone and functions in the same manner as the root of a tooth. In the same way that natural root supports the natural crown of your tooth, an implant once it fully integrates with the surrounding bone, provides a stable and durable foundation for a replacement tooth. Implants often support a crown for an individual tooth, but can also be used as abutment teeth for a dental bridge, or strategically placed to help stabilize a denture.

Out of all of the restorative choices available today an implant comes the closest to replicating the look, feel and function of a natural tooth. Furthermore, it is the only method of tooth replacement that does not require the involvement or preparation of the adjacent teeth. A dental implant also stimulates bone remodeling to prevent shrinkage in areas where teeth are missing and helps to restore facial contours in areas where significant bone loss has occurred.

Dental Fillings

Dental Fillings are the most common type of dental restoration used to replace sections of teeth that are missing, damaged or decayed. While traditional dental materials like gold, amalgam, porcelain, and composite successfully restore teeth; recent advances in dental technology have made a wider and improved selection of restorative choices available. Some of the newest state-of-the-art filling materials including ceramic and the latest composite materials, are not only strong and durable, they offer the most aesthetically pleasing and natural looking results.

Crowns & Caps

The terms dental crowns and caps are synonymous. If dental decay, cracked fillings, root canals, clenching or grinding the teeth have caused extensive damage to the underlying tooth structure a dental filling may not be a sufficient restoration. The only way to completely restore the cosmetic appearance and function of this tooth is often full coverage with a dental crown. The good news is that a completed dental crown looks and feels like a natural tooth.

In addition to restoring a single natural tooth, crowns can be used in other situations including being the supporting ends of dental bridge, covering dental implants, or as coverage for a cracked tooth to prevent further breakdown. A crown may also be indicated when a discolored or stained tooth needs to be restored to its natural appearance. Crowns can be made of either porcelain baked onto a metal substrate, all-porcelain, or many of the new ceramic materials that have been developed.

Bridges

When teeth are missing a series of changes that can impact your overall dental health and jaw function may be initiated. The adjacent teeth may start to drift or tilt into the space, and teeth in the opposing jaw may start to shift toward the area of the missing tooth. It is therefore important to replace the single tooth or multiple teeth that have been lost. One of the best options to prevent the consequences of shifting teeth and to restore full function to a small edentulous section in the mouth is a dental bridge.

A dental bridge replaces the missing teeth with artificial teeth called “pontics,” and is supported on the ends by prepared natural teeth. Once fabricated and fitted a dental bridge will be permanently “fixed,” or cemented into place. Like crowns, bridges can be made of either porcelain baked on to a metal substrate or many of the new ceramic materials that have been developed.

Root Canals

Endodontics, or root canal therapy, is employed when the nerve supply to a tooth has been irreversibly affected by damage or decay. It is a way to prevent or help resolve a dental infection and save a natural tooth from extraction. A root canal is performed when there is enough sound root and crown structure remaining to eventually restore form and function to the involved tooth.

Inside every tooth is either a single central chamber or multiple ones that contain connective tissue, a nerve supply, and blood vessels. These core tissues, known as the dental pulp, help your tooth to grow and mature before it emerges into the mouth. A root canal procedure is required when this dental pulp is irreversibly damaged or has died.

Root canal therapy involves cleaning and shaping each canal, and then filling them with a special inert material. Following this they are sealed to prevent any subsequent infection. Once root canal therapy has been completed, the tooth should be fully restored as recommended.

Dental Prosthetics

Dentures

Whether from disease, malnutrition, genetic disorders, or an accident sometimes it is necessary for an individual to have some or all of their teeth extracted. While this can be devastating, partial or full dentures can be fabricated to restore an attractive smile, provide needed support for normal facial contours and reestablish a highly functional occlusion.

A denture consists of natural looking artificial teeth set in a supportive base. It may be fabricated to replace either a small group of teeth, an entire upper arch, an entire lower arch, or used to restore both dental arches.

A complete denture refers to the replacement all of the teeth in a dental arch. It can be inserted either of two ways. It can be inserted some weeks after the extraction sites and all of the surgical procedures have had a chance to heal, or as an “immediate” denture placed the same day the last remaining teeth are extracted. Although an immediate denture offers the advantage of not having to go without teeth for any period of time, it can require multiple adjustments as the tissues remodel and heal following dental extractions or other surgical procedures.

In situations where some sturdy teeth remain, partial dentures can be fabricated. Partial dentures can achieve adequate retention and stability by having clasps on the teeth surrounding the edentulous areas.

In some cases added stability for the dentures can be provided by strategically placed implants.

Treating Gum Diseases

Periodontal Treatment

Periodontal disease damages the surrounding soft tissues and bone that support the teeth. It is predominantly caused by the accumulation of bacteria, mucus and other particles in the form of plaque or tartar that sit between the teeth and the gums. Periodontal disease can range in severity from a simple gum inflammation, known as gingivitis, to a more serious inflammation of the periodontal tissues. Left untreated periodontal disease can result in significant tissue damage and eventual tooth loss.

The problem with periodontal disease is that often the progression is painless. As a result the affected individual may not be aware of an ongoing disease process. This is why it is so important to recognize the signs of the earliest stage of periodontal disease, which is gingivitis. The symptoms of gingivitis typically include red, swollen and bleeding gums. Treatment instituted at this point is often sufficient to reverse the course of the disease and to avoid any permanent damage to the periodontal tissues. A series of deep dental cleanings, an improved home care regimen, and a commitment to regular maintenance may be all that is required to prevent this stage of periodontal disease from progressing.

Left untreated, gingivitis can escalate into periodontitis. However, there are other factors that can contribute to the escalation of periodontal disease, including smoking, genetic tendencies, and unchecked diabetes. In either case, when periodontal disease has progressed to a more advanced stage there is usually clinical and radiographic evidence of damage to the bone and soft tissues supporting the teeth. Periodontal treatment in this phase is designed to halt the progression of the disease and to restore tooth support as possible. This may involve medications to control the bacteria and reduce the size of the pockets between the teeth and gums, gum surgery, as well as bone and tissue grafts.

Cosmetic

Veneers

If your teeth suffer from gaps, chips, stains, or discolorations you may be a candidate for porcelain veneers, a highly effective and minimally invasive cosmetic procedure that can achieve beautiful results.

Porcelain veneers are thin facings custom-made of the highest quality ceramic materials that are designed to fit perfectly over the front of your teeth. One of the most conservative cosmetic treatments available, veneers can mask a host of dental imperfections to give you the smile that you have always wanted. Porcelain veneers not only enhance and improve the shape of your teeth, they are able to create an overall whiter and brighter smile.

One of the most appealing aspects of the process of fabricating porcelain veneers is that they involve minimal tooth preparation and take just a few visits. Porcelain veneers, once they are fabricated and fitted, are permanently bonded to the underlying teeth. The result is a naturally pleasing smile that is both strong and durable.

Inlays or Onlays

In certain cases inlays and onlays are recommended as alternative restorations to amalgam or tooth colored fillings. Known as indirect fillings, since they are fabricated outside of the mouth, inlays or onlays can be made from either gold, porcelain or resin materials. The material selected depends upon the exact requirements of the individual case. Inlays/onlays are individually fabricated restorations that are designed to precisely fit the excavated and prepared area of a tooth that has been damaged by decay or other injury. While an inlay is used to restore the central portion of a back tooth, an onlay is a larger restoration that extends out over one or more cusps of the tooth. In certain cases an onlay can cover and support enough tooth structure to avert the need for a full coverage dental crown. Once the fit of the custom made inlay/onlay is checked, it is permanently cemented or bonded to the underlying prepared tooth structure.

Bonding

Dental bonding is procedure that is often used to restore teeth affected by decay as well as repair chipped or fractured teeth and mask a range of dental imperfections such as stains, discolorations, gaps, misshapen, or undersized teeth. A popular method for restoring and improving the appearance of a person’s smile, dental bonding qualifies as a cosmetic procedure by virtue of the fact that the composite resins used for the procedure are tooth-colored and come in a range of shades that blend seamlessly with natural tooth structure.

A dental bonding procedure, which is performed to fill a cavity or to cosmetically repair a chip, fracture, enamel defect or gap between teeth is known as a “direct composite restoration.” For a direct composite restoration, both artistry and precision are required as the dentist places the selected shade of composite resin and carefully sculpts it to rebuild or improve the appearance of a tooth.

In terms of the cosmetic repair of dental defects, the masking of discolorations or the closure of gaps between teeth, a dental bonding procedure is considered the most economical and quickest method of care out of all the cosmetic solutions available for these types of corrections. Unlike porcelain veneers or ceramic crowns, dental bonding is a minimally invasive, one-visit cosmetic procedure. Moreover, unless a cavity is being cleaned and prepared prior to a dental bonding procedure, no drilling of tooth structure and no anesthesia is required.

How is a dental bonding procedure performed?

When performing a bonding procedure, it is important to enable the composite resin to firmly adhere to the underlying tooth structure. To do this the surface of the tooth is etched and then painted with a liquid bonding agent just prior to the placement of the filling or cosmetic bonding. As the dentist places the composite resin, it is carefully sculpted to achieve the desired shape and then cured it with a special light or allowed to set. Once hardened, the newly bonded restoration is polished and buffed for a smooth finish. Some dentists may offer composite veneers as an alternative to porcelain veneers, artistically bonding and blending successive layers of composite resin to transform the appearance of a tooth.

Caring For Bonded Teeth

While a bonding procedure offers an excellent and cost-effective method of care for the treatment of minor cosmetic dental issues, there are a couple of considerations with this approach. Teeth that are restored or cosmetically enhanced with a dental bonding procedure are as a rule more susceptible to staining and chipping than with other types of cosmetic treatments. For this reason, highly pigmented foods and drinks are to be avoided along with tobacco products. As dental bonding can easily chip and break, it is also important not to bite into hard objects or foods and to avoid oral habits such as biting one’s nails or chewing on pens. However, with proper hygiene and care, a bonded restoration can last for many years.

Invisalign®

Invisalign®* is a form of orthodontic treatment that works to correct many different types of malocclusions through the use of a series of clear plastic trays called aligners. In many cases it provides an excellent treatment alternative to traditional orthodontic braces and metal wires.

Invisalign utilizes 3-D computer imaging technology to correct problematic bites or malocclusions by planning a complete sequence of custom-made clear aligners. This series of clear aligners, each of which is worn for a couple of weeks, incrementally move the teeth into place until the final desired corrections are reached.

The advantage and appeal of Invisalign appliances is that they are more cosmetic and more comfortable than most other orthodontic appliances With Invisalign appliances orthodontic treatment is practically “invisible.”

*Invisalign is a registered trademark of Align Technology, Inc.

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