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Dr Nick DDS

Frequently Asked Questions (FAQs)

How can we help you?

At Dr. Nick, D.D.S., we believe that knowledge is the first step in maintaining a great smile and we welcome all of your questions. Here are a few common questions we hear from patients. Please call us at (479) 876-8000 if you don't find the answer you're looking for here.

CEREC® CAD/CAM

CEREC CAD/CAM technology allows Dr. Nick to 3D image prepared teeth, which pulls the very accurate data into software whereby the patients teeth are instantly imported into hi-tech software.  Dr. Nick then creates a virtual crown, onlay, or veneer within the CEREC software which is then sent to a very accurate CAD/CAM milling unit.  The restoration is then very accurately milled out of ISO controlled ceramic blocks in minutes.  The restoration is then tried in the mouth, and then custom stained and glazed at high temperatures to strengthen a beautify the restoration in a ceramic oven.  20 minutes later, the “cooked” restoration which perfectly mimics the natural situation is then prepared, and subsequently bonded on to the tooth or teeth, all customized onsite within the practice.  No mold, no temporaries, less tooth structure taken way; no wait.  Done in a day!

Same Day Porcelain Veneers

Every 3-4 months, Dr. Nick flies in a lab technician who has specialized in working with CEREC ceramics for decades.  Every case is carefully planned virtually and on 3-D printed models of the patient’s teeth well in advance of the day that the veneers are prepared, created, and inserted, after (of course) Dr. Nick vets the patients TMJs and their bite, minimally, with digital occlusal/bite technology and maximally with TMJ CBCT and TMJ MRI to ensure efficacy and longevity.  On the day of treatment, Dr. Nick prepares the teeth for cosmetic veneers for that patient and then hands the software design off to Eddie who creates the 6-10 veneers in the software and based upon the diagnostic workup that was done previously, mills it out, tries them in on the patients a few hours later, and then “cooks” them after customizing the shape and look of the smile.  Remember, the patient has already had a virtual diagnostic “mock-up” prior to that day, so they know what things will look like.  If any changes need to happen midstream, the technician and Dr. Nick changes things to the patient’s satisfaction on the fly.  Four hours later, Dr. Nick bonds the cosmetic veneers in place.  Customized, minimally invasive little “Ferrari’s”, these veneers, the shade, the shape; the whole case is completely created in the patients’ presence, allowing for personal input to ensure that the patient extremely happy with the final result! 

Patients eagerly fly in from all over the country for CADSMILES, knowing that they will:

  • Look amazing
  • Be created in a single day
  • Have less tooth removal accomplished by Dr. Nick due to the lack of need for temporaries
  • Not have to wear temporaries for weeks or months on end
  • Get to meet the talented lab technician in the flesh and have input into the final restorations

Dr. Nick also accomplishes many cosmetic front cases on his own, without the technician, though her prefers to have the patient who wants more than 4 anterior veneers to come in on a CADSMILES day.  Dr. Nick has accomplished more than 10,000 CEREC restorations since the year 2007 when he first incorporated CEREC technology into his practice.  He is one of the most experienced and talented CEREC providers in the nation!

 Contact Dr. Nick’s office for a CADSMILES same-day veneer consultation if you are interested in the ultimate expression of cosmetic ceramic dentistry, accomplished on the SAME DAY!

Mercury-Free and Mercury-Safe Dentistry

The mercury-free dentist does not place amalgam, period. Instead, they rely on gold, zirconia (a white, powdered metal oxide), composite (white filling), or ceramic (porcelain) alternatives. Some even go as far as to completely eliminate all metal-containing alternatives when possible.

Are the metal alternatives safe? In general, yes, especially in regards to the gold-containing alloys. Gold is hard to beat in regards to biocompatibility and lifespan. It goes downhill from there though, as the non-gold-containing metal alloys can cause allergies in some patients.

Using these metal alternatives, one can restore a tooth in a variety of ways. From least invasive to most invasive, they are inlays, onlays, and finally crowns. Many times dentists have their outsourced laboratory fabricate metal crowns with porcelain overlays.

Have you ever seen someone with a white crown smile and you can see a dark ring around the gumline? Chances are excellent that you were observing a porcelain fused to metal crown. But what kind of metal? Be sure to ask. The dentist may not be using gold alloy-based metals, but the cheaper, more allergenic base metals containing materials such as nickel instead.

The biggest problem that I see with the metal variety though, is that they are simply not minimally invasive, meaning that more tooth structure was removed than was necessary in contrast to other viable alternatives.

Dr. Nick Yiannios is a mercury-safe and mercury-free dentist in Rogers, AR.

Same Day Crowns

CEREC CAD/CAM technology allows Dr. Nick to 3D image prepared teeth, which pulls the very accurate data into software whereby the patients teeth are instantly imported into hi-tech software.  Dr. Nick then creates a virtual crown, onlay, or veneer within the CEREC software which is then sent to a very accurate CAD/CAM milling unit.  The restoration is then very accurately milled out of ISO controlled ceramic blocks in minutes.  The restoration is then tried in the mouth, and then custom stained and glazed at high temperatures to strengthen a beautify the restoration in a ceramic oven.  20 minutes later, the “cooked” restoration which perfectly mimics the natural situation is then prepared, and subsequently bonded on to the tooth or teeth, all customized onsite within the practice.  No mold, no temporaries, less tooth structure taken way; no wait.  Done in a day!

Tooth-Colored Fillings

All composites and sealants used at Dr. Nick’s do not contain Bisphenol A, a chemical often used to create resins which have been implicated in adverse health effects.

 

Family Dentistry

In regards to children, we typically treat children from the age of 5 and older, suggesting that the parents bring their child along during the adult's checkup appointment to observe how easily and comfortably a dental cleaning and examination are accomplished in our practice so that at their own subsequent appointment, that child will not be apprehensive.

Many children under the age of 5 are generally best treated at a specialty pediatric dental practice geared up for toddlers. Our primary goal for the young new patient is to not have them experience a negative dental visit which they may psychologically carry on with them for the rest of their life!

Headaches and Dental Medicine

Dr. Nick Yiannios is the founder of the teaching institution known as the Center for Neural Occlusion (CNO). He teaches doctors from all over the world novel and objective ways to screen, diagnose and treat patients with bite and TMJ problems.

What could headaches possibly have to do with your mouth or your jaws for that matter?

An increasing amount of data suggests that certain types of headaches are related to malocclusion (a bad bite) and Temporomandibular Disorder (TMD or commonly referred to as “TMJ”). 

Despite the fact that mainstream scientific evidence does not definitively corroborate this, an experienced clinician that treats these types of cases knows that an apparent connection exists. Dr. Nick is just that sort of clinician.

For years he has been treating patients with amazingly accurate instrumentation that allows him to track the forces generated between opposing teeth (upper teeth to lower teeth), the timing involved with how long those opposing teeth frictionally “rub” and interact with one another, and the resultant muscular responses from the aforementioned force and timing interactions.

Schedule an evaluation with Dr. Nick today to learn more about solutions for headaches. Contact our Rogers dental office at (479) 876-8000.

Root Canals

A properly cleaned root canal system removes the vast majority of the dead tissue and infection within the canal system.  That is the goal.  Some authorities rightly worry about residual tissue, bacteria, and the corresponding pathologic byproducts that are left following root canal therapy.  This is why Dr. Nick has added the combination of erbium laser PIPs (to create a cavitation effect with expansion and successive implosion of fluid chemistry used to clean the root canals) with ozonated water (to neutralize bacteria via destroying the bacterial cell walls) to improve the other steps of a well-performed root canal therapy. 

Exactly how much of what’s left can promote chronic problems systemically, and is this tolerance the same for all patients?  At what point does one sacrifice the tooth and proceed to implant therapy?  What other factors need to be considered?  There is often a lot to consider. Firstly, if a tooth, its roots and the ligaments connecting root to bone are removed, there no longer remains a neurological connection to the Central Nervous System (think brain) which coordinates chewing/muscular function (the main purpose for our teeth).  If you remove the tooth, you  lose the connection. Additionally, if you remove the tooth, the bone will melt away, often disallowing the chance of future implant placement for full subsequent restoration.  Only roots and implants stimulate bone to remain.  This is very important because there are times that the positives (keeping neurological connection and keeping bone around) out way the negatives (dealing with a not quite sterile and clean root canal system). 

Every case is different.  In Dr. Nick’s practice, if an effective root canal can be accomplished all the way to the root tips, his experience and confidence with the combination of laser and ozone usage coupled w/ state-of-the-art nickel titanium mechanical cleaning and shaping (with the associated chemistry to aid in cleaning) leans him towards retaining that “ neurological connection”, IF the tooth sits in a crucial place within the dental arch.  In cases where the anatomy is too complex for an effective root canal or the tooth is not as important to retain, he recommends removal.  Implants are great, but often times it’s better to have a well done root canal therapy than it is to remove it. 

Conversely, there are times to remove rather to perform root canal therapy.  Every single case is different. At the end of the day, the decision to retain or remove relies on the patient after proper and thorough informed consent is delivered from Dr. Nick.

TMJ, DTR, and Neural Occlusion

These are treatments for muscular TMD issues that DO NOT rely upon traditional splints and acrylic appliances. These treatments are a new, more definitive way of addressing TMD issues by creating a permanent physiological change in patients with confirmed stable and adapted joints (via digital metrics such as JVA and 3-D imaging), rather than the temporary change that splint appliances create. Dr. Nick Yiannios rarely makes acrylic splints that the vast majority of dentists do, but rather relies on the following protocols when indicated for muscular-based TMD issues, in a patient with a pair of objectively confirmed stable and adapted TMJ’s.

DTR stands for Disclusion Time Reduction. This is the process whereby “interferences” or “speed bumps” in the way the back teeth from the top jaw interact with the opposing teeth from the lower jaw, during function, are precisely removed with data gleaned from the T-Scan/EMG link. This process decreases muscular output, relaxing the muscles of mastication (via instantaneous confirmation with EMG), which typically alleviates many TMD symptoms. Years ago, Dr. Nick Yiannios was personally trained by the creator of this new process, researcher Dr. Robert Kerstein of Tufts University, and is considered an expert in this process. Dr. Nick Yiannios is also a beta tester for Tekscan, the company that created the T-Scan technology.

ICAGD stands for Immediate Complete Anterior Guidance Development. Basically, the human chewing system is more efficient the faster the back teeth separate when chewing side to side, as we all naturally do. Hence our front teeth should cause a separation QUICKLY (via measurement w/ the T-Scan or T-Scan/EMG link) of our back teeth based on known values. Sometimes bonding materials are added to front teeth to help assist in a more “immediate” separation than the patient can base on the shape, condition, or position of their natural dentition.

This creates huge advantages for TMD sufferers because the muscles of mastication are made more efficient and do not produce excess lactic acid as a result of being overworked and chronically fatigued. It is this excess lactic acid buildup that at least partially creates many TMD symptoms, such as tension headaches, painful and stiff jaw muscles, neck tension, clenching and grinding of teeth, etc.

ICAGD is not a mainstream treatment as of 2015, so this is not something that you can find in just any dental practice. In just the past year, there are a growing number of TMD experts who are beginning to see the advantages and effectiveness of this process. Dr. Nick Yiannios expects that over the next 20 years this novel protocol will become more practiced and available, but presently, his practice is one of the only places where a patient can have this therapy done. From his experience with this process dating back to 2008, it simply changes the lives of muscular TMD sufferers almost every time!

So what is Neural Occlusion?  Neural Occlusion is a novel TMD screening protocol that Dr. Nick Yiannios created to help him decide whether or not a particular TMD patient might predictably benefit from ICAGD Occlusal Adjustment to accomplish DTR. It involves a combination of numerous technologies (CT, JVA, EMG, T-Scan®, and sometimes MRI) combined with a thorough history, examination, and FDH screening.  As of 2015, there is no other place that a TMD patient might go for this particular type of screening.

Contact our Rogers dental office today for more information about our advanced treatments for TMD.

Microscope Dentistry

Simply put, many of the things that we are evaluating and treating are small, so small, that many times we must visualize with a high-output, high-magnification LED-powered surgical microscope to affect the most effective treatment for our valued patients.

ENT’s, neurosurgeons, and other medical specialists who routinely deal with minute surgeries have been using high-powered magnification for decades, though few dentists have followed suit, unfortunately, in Dr. Nick Yiannios’s opinion. The increased visualization and information gleaned from the usage of a microscope results in more precise, deliberate, and improved patient treatment outcomes.

Dr. Nick Yiannios routinely uses his Carl Zeiss microscope for endodontic (root canal) therapy, and at times pulls it out for restorative and esthetic dentistry in Rogers as well.  He even has a digital camera and video recorder integrated into the microscope in the event he needs to document the treatment. You will never see him not using magnification, whether it be through his hi-powered head loupes or the microscope.

T-Scan, JVA, and EMG Technologies

The importance of bite relation (occlusal analysis) cannot be over-emphasized in the dental practice setting. The placement of fillings, crowns, bridges, bite splints, implants, veneers, onlays, inlays, dentures; just about anything we do in dental medicine demands a proper spatial relationship between the temporomandibular joints (TMJ’s) and the oral cavity, not to mention a proper relationship between the maxilla and the mandible.

Ignorance to the occlusion, or bite, can create havoc for the patient, creating problems ranging from sensitive teeth, to root canal therapy, to temporomandibular disorder (TMD or “TMJ” as it’s known widely), and even certain types of chronic headaches.  Traditionally, a colored ribbon of paper known as articulating paper is used by the dentist to check the bite. The use of this thin paper is problematic though, as it only qualifies where the bite is “high”, doing nothing to quantify/show how much or how hard.

Learn more about our leading-edge treatment for TMD by calling our Rogers dental office at (479) 876-8000.

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