The Center for Cosmetic Dentistry at Feiler Dental Associates provides a facility in Northern New Jersey, just outside New York City, for patients to pursue treatment at a comprehensive center for dental esthetics that treats the most difficult cases in cosmetically motivated dentistry.
Our Team
Dr. Kenneth N. Feiler, an American Academy of Cosmetic Dentistry-accredited cosmetic dentist, lecturer, and teacher, directs the Center and still provides much of the most complex treatment for the most difficult cases, and, if not the primary practitioner, is always available to consult on every treatment case provided by the Center. He is joined by a team that consists of:
Dr. Paula Gencarelli, a cosmetic dentist, performs restorative and family dentistry. Having been part of the Center for over five years, Dr. Gencarelli provides a wide range of cosmetic treatment including the newest zirconium crowns, veneers and onlays and is the Centers primary provider of in-office whitening procedures, which include both Brite Smile and Zoom 2.
Dr. Tracy Lipson, performs restorative and family dentistry, cosmetic bridgework and crowns, and Zoom 2 whitening procedures.Dr. Tracy Lip
Dr. Michael Reshad, our periodontist, provides surgical placement of implants, periodontal consultations, cosmetic plastic surgeries, and corrective surgery;
Marissa E. Rizkalla, B.A., R.D.H., our dental hygiene coordinator runs our hygiene department of eight dental hygienists. She specializes in the maintenance of cosmetically treated dentition. June Solari, R.D.H., is our assistant dental hygiene coordinator.
Our administrative and clinical staff consists of several individuals with extensive experience and training in the clinical treatment and administrative planning and financing involved in performing cosmetic dentistry.
A number of specialty dental laboratories work closely with us to provide the latest, most creatively beautiful dental restorations available in the world today.
Our Special Cosmetic Dental Services
Comprehensive Cosmetic Dental Examination, Diagnosis, Smile Design
This process takes at least an hour to an hour-and-a-half spent with one or more of our practitioners in the Center to conduct an oral examination, take a dental history, perform facial and smile analysis, take digital x-rays and photographs, and create before-and-after simulations of a patient’s potential treatment, using computer imaging analysis. Patients are encouraged to bring with them written questions, pictures of themselves or of others they wish us to use for design ideas, previous treatment materials, and supportive or interested family members or friends.
Treatment Planning and Financial Coordination Consultation
This may follow the comprehensive cosmetic dental examination and diagnosis the same day or require an additional visit in special cases. This consists of a visit with a treatment planning coordinator in conjunction with the primary cosmetic dentist coordinating the treatment. Educational material (both printed and video) is presented and viewed by the patient, explained, the patient’s options presented, and a computer printout of the recommended treatment options and financial options given to the patient after full explanation and discussion.
Computer Imaging Smile Analysis (Before and After Simulations)
As one of the earliest dental offices in the country to combine photography and computers to provide computer simulations to patients of their proposed treatment, Feiler Dental Associates has been using computer imaging since the late 1980s.
This consists of the patient having a photo session in our photography consultation room to acquire a large variety of photographic images of the patient’s smile. These are shown on a large screen computer monitor and manipulated digitally to provide simulations of how the teeth, smile, and face can look after different treatment modalities. Before-and-after simulation photographs are then given the patient to take home.
Cosmetic Mockups of Potential Cosmetic Dental Treatment
There are two types of physical mockups used to help patients see how they might look after cosmetic dental treatment.
The most desirable mockup is one performed directly on the patient’s teeth using composite material that is not bonded to the teeth, but placed temporarily. This is sculpted to show the teeth in a more desirable shape, correcting chipped or short teeth, out of position teeth, and discolored teeth. The composite material can then be viewed in the mirror and even photographed for the patient to see the potential change. After the procedure, the material is easily wiped off the teeth. The entire procedure can take as little as ten to fifteen minutes.
The second option is to take impressions of the patient’s teeth, make models, and, on the models, make the changes necessary to show the patient a new smile. This method is normally used to show large changes that cannot be shown quickly or irreversibly using the direct method.
Composite Bonding, Enameloplasty and Gingivoplasty for Minor Anterior Cosmetic Changes
These services usually require only one office visit to reshape smiles. It may use enameloplasty (the reshaping and polishing of teeth using dental handpieces), gingivoplasty (the reshaping of the gum tissue using a soft tissue laser), and/or the application of composite materials bonded to the teeth to change the appearance of the teeth in shape, position, and possibly color.
Teeth Whitening
Are you unhappy with the color of your current smile? Are your teeth stained and discolored due to aging, smoking, tetracycline staining, food stains or just genetically darker than you would like? Feiler Dental Associates has good news for you! We can put that "SPARKLE" back in your smile. At The Center for Cosmetic Dentistry we provide a wide variety of bleaching procedures to whiten a patient’s natural teeth. All these "bleaching" procedures utilize a hydrogen peroxide or carbamide peroxide gel which releases oxygen upon contact with your teeth, thus removing the stain from the outer surface of the teeth.
These include the following options:
Power Bleaching – Zoom 2 or Brite Smile: In-office power bleaching uses the highest concentrated form of hydrogen peroxide to treat severe discolorations and is for those patients who want immediate results or cannot tolerate trays in their mouth.Our newest in office whitening system ZOOM 2 will allow you to see immediate results in about one hour right here in our office while you relax and enjoy your favorite T.V. shows. This new system will whiten your teeth up to eight shades whiter and is safe, effective, fast, simple and painless. After a short preparation period of isolating your lips and gums, a whitening gel is applied and is activated by a specially designed light. Typically your teeth will become 6 - 10 shades whiter after only 1 hour and, in the days to follow after this procedure, your smile may even whiten some more. (We encourage patients to enhance and maintain this procedure with take home trays for the best long term results.)- Custom Bleaching Trays: This at–home option requires two initial trips to our office. At the first visit, we take impressions of your teeth from which we fabricate your custom bleaching with reservoirs to hold the bleaching gel. At your second visit, we fit your appliance and instruct you on how to administer the whitening gel. The gels come in various concentrations which we can dispense to patients according to their particular needs. The trays can last for years and are a long term cost effective method of maintaining teeth whitening, requiring only the purchase of additional tubes of bleaching gel.
- Tres Whites (Prefabricated Bleaching Trays): These prefabricated trays come in a package of ten sets of trays for both upper and lower teeth. They are an innovative system that you as a patient can fit to your teeth at home, thus eliminating the need for impressions of your teeth and are a less expensive alternative to custom bleaching trays. (This is an ideal alternative for patients who have difficulty taking impressions.)
- Professional Strength Crest Strips: This is the least expensive bleaching option for patients. It is only for the front six teeth and is difficult for some patients to keep the strips on their teeth. The results vary greatly, being quite successful for some patients while others see little or not results. These professional stirps are a higher concentration of the “Over The Counter” Crest Strips that a patient can purchase at a pharmacy.
- Internal Bleaching (For dark endodontically treated teeth): Many patients that have had root canal treatments have often had their teeth darken dramatically. This ranges from a tooth that is a darker yellow color to some that are purplish or even approaching a black color. Fortunately at The Center for Cosmetic Dentistry we have been extremely successful bleaching these discolored teeth back to their natural shade. In this method the root canal filling is removed from the back of the tooth and bleach is inserted into the tooth and sealed in for a period of time. This is repeated as many times as is necessary to totally clean the stain from the internal tooth structure till the tooth has returned to the natural shade of the adjacent teeth. At the end of treatment the access in the back of the tooth is restored with a new tooth colored filling.
- Not only is bleaching safe, but it is the most natural solution to whitening in comparison to bonding, veneers or other restorations. However, bleaching cannot change the color of an existing restoration. In situations where a patient has some existing restorations next to natural teeth, we can use a combination technique to whiten the teeth naturally and adjust or replace the existing restorations to match the natural whitened teeth. These whitening options allow us to customize a program of whitening for your specific situation.
Porcelain Veneers
What Are Veneers?
Veneers are thin, custom-made moldings that cover the fronts of unsightly teeth. They are crafted from tooth-colored porcelain to present a natural, bright smile. Veneers are often referred to as porcelain laminates.
Should You Consider Veneers?
Veneers provide an alternative to traditional crowns. They cover unattractive gaps, and can mask stained, misshapen, or crooked teeth. If these conditions apply to your mouth, veneers may be your best option.
How Long Will Veneers Last?
Veneers are intended to last many years. Unlike most bonding materials, veneers will not change color over time. You should consult with your dentist to find out exactly how long veneers will last in your mouth.
How Are Veneers Applied?
The tooth is first reshaped to allow for the added thickness of the veneer. A molded image is then taken from the tooth and sent to a dental laboratory where the veneer is custom-fitted to your tooth. When the veneer is ready, we apply it to the tooth with water or glycerin to make sure the color and size match the original. If it is a match, the veneer is applied with a special adhesive that bonds it to the tooth. A special light is used to cure the adhesive and ensure a permanent bond.
Porcelain vs. Direct Composite
The advantages of porcelain veneers over direct composite bonding include:
- Tooth-like Appearance: Since veneers are individually sculpted for each patient, it is nearly impossible to tell the difference between the veneer and the natural tooth.
- Stain-resistant: While direct composite bonding resins have a reputation for staining or discoloring over time, porcelain veneers resist staining by coffee, tea, and cigarette smoke.
- Longer Lasting: Porcelain veneers are made of stronger and more durable materials than their resin counterparts.
Benefits of Porcelain Veneers
- A minimal amount of the natural tooth must be altered to fit the veneer.
- Veneers can be matched to make even the darkest teeth appear to be bright white.
- Few problems and fewer return visits to the dentist arise from veneers because they do not stain and are strongly attached to the teeth.
Porcelain Crowns (No Metal)
Today, we have a wonderful selection of crowns without any metal in them. There are several types, each with its own benefits.
- All-ceramic porcelain crowns are very lustrous, and can be very translucent to pick up the natural color of the teeth beneath them. They are essentially like porcelain veneers that cover the entire tooth. They must have a good base of natural tooth structure under them; otherwise, they do not have the strength of a metal crown or a porcelain crown with a metal base inside.
- Zirconium porcelain crowns are the newest type of porcelain crowns. They have a very strong internal base of zirconium that comes in different tooth shades, upon which lustrous cosmetic porcelains are placed. These provide the strength of metal crowns with the beautiful, non-metallic cosmetics of natural teeth. In the past several years, these crowns have improved to the point of being the state-of-the-art in restorative and cosmetic dentistry.
- Porcelain-to-metal crowns are still quite necessary when long span bridgework is required in cases of several missing teeth, although zirconium crowns are increasingly competing in this area with the latest improvements.
Today there is no reason to have a crown that does not live up to your standards of cosmetic desire in the hands of an experienced cosmetic dentist.
Periodontal Plastic Surgery (Gum Repositioning)
In treating a smile cosmetically, the gums must be considered as the framing of that smile. Not only must they be treated for health and function, but also for their cosmetic architecture. There are a number of cosmetic gum problems that we treat with periodontal plastic surgery:
- gummy smiles that show a large band of gums with normal sized teeth;
- gummy smiles that cover the teeth, artificially reducing the size of all the teeth;
- selective teeth covered by too much gum tissue, resulting in an uneven smile, with some teeth appearing small and short while adjacent teeth are longer, often resulting in a very unsymmetrical smile;
- gum tissue that creates gaps between teeth;
- gum defects that result in long root surfaces showing and require grafting of tissue to cover the exposed root surfaces
Today we can treat these problems with a variety of techniques including:
- traditional surgical removal of tissue;
- surgical flaps to reposition the tissue;
- laser removal of excess gum tissue;
- laser reshaping of gum tissue;
- grafting tissue from one part of the mouth to another to add tissue where needed.
We offer computer imaging for patients to view what their smile would look like before performing any procedure to change their level of the gum tissue.
Traditional Orthodontics (Fixed Braces and Traditional Removable Appliances)
We have a large traditional orthodontic practice at Feiler Dental Associates, performing all levels of orthodontics. However, at our Center for Cosmetic Dentistry, our orthodontist works with the other doctors in the group to coordinate cosmetic changes as well as functional changes for both children and adults.
We may use orthodontic techniques before doing crowns, bridgework, veneers, periodontal surgery, or even implants, to improve the result and create a more natural, beautiful, and healthier smile.
In addition, our restorative team will work with the orthodontic treatment to coordinate cosmetic results that will be required after orthodontic treatment (that orthodontics alone cannot provide) including:
- congenitally missing teeth;
- undersized teeth, such as peg lateral incisors, that must be bonded, veneered, or crowned;
- discolored teeth, chipped teeth, decayed teeth;
- gum changes that may be required before, during, or after orthodontic treatment.
Invisalign®, Thin, Nearly Invisible, Removable Orthodontic Aligners
We use Invisalign® for adults and teenagers to provide a comfortable method to realign malpositioned teeth. (Click here to see our separate page under Invisalign®.)
Implants (Teeth Replacements)
We have an implant team that works together to provide the best use of implants, not just to replace missing teeth, but to make sure we can do so with the best final cosmetic result, as well as making sure the patient has an excellent cosmetic appearance during treatment, which can often last several months.
Our periodontal surgeons who perform the surgical placement of the implants, and our prosthodontist who performs the restorations on the implants, plan treatment together and often do the surgery together, to assure not only the most successful implant placement for strength and longevity, but also to allow the best cosmetic result for the restorative phase.
Follow-up, Maintenance, and Repair
So very important to having dental treatment to create a beautiful smile, and so often either not mentioned or overlooked, is the long-term follow-up, maintenance, and repair of this treatment!
Follow-up: All cosmetic treatment should have a proper follow-up to
re-evaluate how the teeth and soft tissues have reacted to the treatment, how the patient’s phonetics may be affected, how the patient feels about the new appearance of the smile, how the patient is caring for the new smile at home, and any additional help or direction they may need, and to take "after" photos for both the dentist and patient to keep. This follow-up is critical to the long-term success and patient happiness with the new smile!
Maintenance: Maintenance may be required for certain dental procedures. For example, bonding requires the hygienist to clean the teeth carefully, so as not to ditch the composites and accelerate staining, the patient must be checked for occlusal (bite) changes requiring a night guard or adjustment of the occlusion, and soft tissue must be cleaned and maintained both in the dental office and at home. Many of the observations required during immediate follow-up and mentioned above must be performed on a long term regular basis at regular dental hygiene and exam appointments to ensure the best long term success of cosmetic improvements.
Repair: Often patients may require repair of cosmetic improvements due either to the nature of the treatment (such as certain bonding situations that can chip or stain over time), or to accidents that patients may have, be they small or large. Some repairs are simple and others more complex. We pride ourselves on being able to provide the most up-to-date techniques and equipment to allow us to repair patients’ cosmetic improvements easily and efficiently, thus avoiding major re-treatment over the years, after already making a major investment on a smile improvement.
At the Center for Cosmetic Dentistry at Feiler Dental Associates, we are proud to have one of the most advanced and comprehensive centers to provide patients with a place to seek advice, opinions, initial treatment, or repair treatment. We always advise patients that, in our effort to be comprehensive and provide the best treatment available, we take our time in all phases of care, thus often requiring longer visits from initial examinations to maintenance and follow-up visits. This is done with the patient’s best interests in mind.
Our goal is to provide the most advanced treatment available in a manner that is tailored appropriately for you, with all factors considered.
Please feel free to contact us any time with questions you may have. We will answer them as quickly and comprehensively as possible.
