704.861.1208
1725 South New Hope Road
Gastonia, North Carolina 28054

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Kelly Family Dentistry

Dr. Will Kelly's sons

A few events that happened this week brought joy to my life and gave me some perspective that is worth sharing. Every February is designated as dental health month and children learn about teeth, cavities, nutrition, and oral hygiene. I have enjoyed visiting in schools for years now. This year was no exception. I had a blast visiting the weekday school my children attend and pulling out my giant toothbrush and telling a few stories about “sugar bugs” and the “tooth fairy”. Later in the week, it was a warm feeling when I received feedback from several parents about how responsible their kids had become when it came to bedtime with their toothbrushes.

My trip to the preschool was the highlight of a very busy week. In fact, it was a tough week with challenging procedures. In the middle of everything going on was a special person that kept showing up over and over and over. Ann. She is a cute 7 year old girl that loves coming to the dentist so much that she came to her little sisters appointment on Monday. She was bouncing off the walls with excitement. She came to her hygiene appointment on Wednesday and was back again for her mom’s cleaning the next day! I have never seen someone so excited about coming to the dentist. She really stood out among the hundred other people I encountered this week and left me thinking; I sure do enjoy it when kids have a good experience in the office.

When I was growing up my dad, Bill Kelly, presented his practice as R. William Kelly: Family Dentistry. This was a common designation a few decades ago. As cosmetic dentistry became more desired and dental offices became more specialized family dentistry came off of most of the shingles hanging from dentists doors (whether that was what the dentist actually did or not.). On the official letterhead my practice is William Kelly Dentistry: Comprehensive – Restorative- Cosmetic. These are the best description of the type of dentistry that I have had extensive training in and feel blessed to be talented in these ares. True, my office does not have a dinosaur sliding board in the reception area, but occasionally I hear an acquaintance say, “you don’t do kid dentistry do you?” . . . where did they get that idea? Maybe I need to put family dentistry on my sign?

We enjoy seeing the children of our adult patients. When you have the opportunity to meet someone’s family it gives you a richer understanding of who they are. My adult patients also enjoy the convenience of scheduling their children together and we try very hard to designate blocks in our schedule for days in hours when school is out. Kids enjoy seeing other kids that are excited to be in the office and it does keep a level of serenity the rest of the time for adults that need a calm visit.

We seem to be very blessed that most of the children visiting our office are in our hygiene program and rarely make it back to my suite in the office. In fact, with what we know today if children are getting cavities something is “off”. I’ll be the first to admit, it can be a pretty anxious time for a kid to have an injection and a tooth filled, but with such a focus on prevention, we just don’t see it much. When we do, we do not do sedate children, just a big dose of patience and TLC.

One of the most rewarding parts of treating families is watching growth and development, literally and figuratively. It is fun to see a child off to college that was two feet shorter and missing all of their front teeth when you meet them. It is rewarding to see a child that comes in at ten years old with a blue tongue from a lollipop and moss-like plaque on their teeth mature, take ownership of their health and have a bright, clean and healthy smile as an adolescent. I enjoy the areas of our profession that are concerned with how things are designed and function. Nothing is more fascinating than growth and development. Much of my involvement in children’s dental care is concerned with monitoring and advising as children mature and pass from primary to permanent teeth and have orthodontic and occlusal needs.

Sure kids some kids get cavities, some are going to kick and scream and bite and the pediatric dental practice is very appropriate for them. I am an advocate of getting adolescents into a general dentistry office that understands comprehensive dentistry when they get permanent teeth, not when they sign their selective service card and graduate from high school.

I probably will not repaint my sign or reprint my business card anytime soon --- but I had to acknowledge the blessing of children in my practice and tell the world that they are always welcome.

Technology Update: The Big New Thing

Indirect Composite and Porcelain Fillings

Providing white fillings is a rewarding part of my dental practice. Evolving for several decades, they went from being novel and cutting edge to the norm for treatment of small to moderate cavities throughout the mouth. Despite all the advantages of tooth-colored composite fillings they have their limitations. For years dentistry has used an alternative method of making white fillings, called an indirect inlay, with a great deal of success. Our practice has the ability to utilize this premium treatment choice conveniently and affordably, with our CEREC computerized milling system.

Before and After CEREC Inlays

The traditional method for restoring large cavities is a silver-mercury alloy filling. The advantages of these fillings were durability, ease of use, and that they have proved reliable for more than a century. Unlike white fillings, they can be condensed into the tooth preparation to create a very anatomical tooth form and contact with neighboring teeth very easily. Many general dentists still stand by these metal fillings as a “go to” for larger fillings in the back of the mouth. Unfortunately, the disadvantages of the metal fillings are wide. Those apparent to patients are that they are ugly and containmercury. The disadvantage to the integrity of the tooth is that metal fillings are vary greatly in physical properties from natural tooth structure. They do not bond to teeth, they wear very differently from enamel, and they expand and contract with temperature at a different rate than natural teeth. This point is important because it explains the cracks associated with metal fillings that lead  at best to a less conservative solution such as a crown and at worse tooth failure. It is not uncommon to find a metal filling that has lasted more than fifty years with the natural tooth around it fractured away.

 

Today tooth colored fillings are made of composite resin materials that are essentially plastic precisely filled with particles of glass-like material that mimics enamel. The method for placing tooth colored fillings includes removing decay, cracks, and failing tooth structure and preparing the surface with adhesives. The filling is then placed in a soft putty-like state and hardened with a curing light. We have had great success in our practice with tooth colored fillings. Studies show that resin fillings are as good and even better than metal fillings in most applications. White fillings do have limitations though. Resin that is cured in the mouth does not have the quality of the same material made in the lab (or factory) under more controlled conditions. Also, resin shrinks when it is cured, in large restorations is does not adapt as well to the adhesive surface of the tooth as a smaller filling that shrinks less. When the defect in a tooth is very large, more often a restoration such as a crown is a more appropriate choice. With some very large composite fillings patients can expect the filling to fail before the tooth does (unlike a metal filling in which the tooth seems to crack).

A filling option that blends the advantages of both a metal filling (strength, good contact, and tooth contour) and that of a composite tooth colored filling (esthetics, wears like enamel, flexes like a tooth, etc.) is an inlay that is fabricated outside of the mouth.  Inlays can be made of composite or ceramic/porcelain and are bonded into place with a thin layer of resin adhesive. These types of restorations have been made by dentists for years with success rates higher than traditional direct fillings, but are not widely used because the process was inconvenient. They required two appointments and a temporary, much like a traditional crown. This also made these restorations costly. Today in our practice we are able to provide both ceramic and composite inlays in the place of white fillings in the same day with no temporization period. We make these inlays with our CEREC computerized milling system. The materials we use are made with a high level of quality control. Because the composite restorations are milled from a dense fully pre-cured block, the issue of shrinking and complete polymerization in the curing of the material is eliminated. This leads to a more precise fit and less sensitivity. If appropriate, the same porcelain that crowns are made of can also be used in this process. The contours of both types of inlays are more precise than direct fillings because they are designed in a computer and refined outside the mouth before cementation.

 

In our practice, indirect inlays are becoming a commonly used and valued asset in our treatment mix. They help provide a service gap between placing fillings that are slightly beyond their engineered size limit and crowns that are a more aggressive preparation of the tooth structure.  Much of the tooth structure can be preserved with these more conservative preparations reducing sensitivity, lessening the need for root canal therapy, and respecting keeping the intergrity and form of the healthy remaining natural tooth. Our patients are enjoying the esthetic outcome when faced with the need to replace older fillings that might be leaking or beginning to crack. We always strive to offer the best quality available to our patients and are happy to present CEREC inlays, both ceramic and composite, as a treatment option that is conservative, and durable. It doesn’t hurt that they are beautiful too :)

Great New Book about Breast Cancer

Dr. Will Kelly with Sheri Kay

Our practice has been blessed for several years to know Sheri Kay. Sheri began her career as a dental hygienist and is now the lead practice coach at ACT Dental Coaching. Our practice established a relationship with ACT in 2007. Sheri, ACT Dental, and it's community of dentists have been an amazing resource that has benefited our practice life, our dentistry, and relationships with our patients greatly. Sheri is a great friend who has one of the most positive attitudes I have ever seen. She teaches dental practices to think, work, and live by a code that focuses on being fully engaged, fully present, and goal oriented in order to enjoy the best life has to offer. In 2010, Sheri was diagnosed with breast cancer. Like many who begin the dreaded journey into this disease, she started blogging and corresponding with friends through a Caring Bridge webpage. Her entries proved to inspire me every time I read them as she dealt with her circumstances in the same way she encouraged us to face dental practice: focused and looking positively at possibilities.

She has recently released a book of her journaling her journey titled Hineni: Here I Am. I encourage anyone with a friend or family member that has faced or is facing breast cancer to enjoy reading her book. I purchased five copies with the thought that I might have the opportunity to share them and found myself giving one away to someone (unplanned) the day they arrived in the mail. It was very touching for that person.

Hineni can be purchased online at www.sherikay.comHineni by Sheri Kay

 

New Years Dental Resolution 2012

Bobbie, Kelly Dentistry ReceptionOur practice has been hustling! In fact, no matter how busy the year is, the month of December brings a welcome homecoming of college students and a bunch of folks that realize that dental benefits are expiring. It is honestly a fun time! With the new year on the way we know that we will see another busy month in January. Just as dental benefits expire, they renew and we see an interesting trend . . . dental resolutions!

Just like diets, exercise plans, and other promises to achieve great things, we see folks who have been away from the dentist for a while find their way to us. Some patients that have put off care seem to have renewed attitudes. Perhaps some folks even find their way to us to try something different. The thing that we love best about people who make commitments to a resolution for their dental health is that promises seem to stick. We see a real interesting trend in our practice: when people become aware of their teeth and overall oral health, its hard for them to give up. Whether the commitment is made in January or June, we get super-excited to see that look in people's eyes that tells us they are ready to have a bright smile and enjoy the health benefits that come along with it!

Our part in getting folks started in their resolution is simple. We love to facilitate learning about the condition they are in and know that this understanding is the barrier that must be broken to create a commitment to a lifetime of oral health. Our process is focused on assessment, not treatment planning, and we invite you to consider the possibilities we might discover together as a resolution to oral health in 2012!

Please contact William Kelly Dentistry's Patient Coordinator, Bobbie, at 704/ 861.1208 or use the contact links on our website to send us a message. Again, thanks you so much for a great 2011 and we look forward to serving you in the years to come.

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American Dental Association           American Academy of Cosmetic Dentistry            Pankey Institute Alumni