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Family Care at Dentistry with Smiles


Healthy smiles for healthy families start with professional family dentistry. At Dentistry with Smiles, your bright, healthy smile is our top priority. Of course, you'll only smile if you're as happy with our service as you are with our dental treatment. That's why we take the time to listen to your needs and concerns. Not only do we listen to your concerns, but we use gentle, efficient cleaning techniques. We also hire caring, highly trained professionals. Our experienced team of specialists is invested in meeting all of your dental needs; from calming anxieties to teaching good habits, from regular check-ups to sophisticated dental surgery.

At Dentistry with Smiles, we take exceptional care of your oral health. Below are some of the family dental services that our practice provides.

Children's Dentistry


Pediatric dentistry is more than bright, healthy smiles; it's also about making the trip to the dentist a calm, pleasant experience so there's no fear of "next time." As pediatric dentists, we take pride in seeing our patients grow into their adult teeth, so we're committed to earning the trust of everyone who visits our clinic—both children and parents. Read More About Children's Dentistry

Dental Checkups


Professional cleanings performed by a hygienist are important to your dental health, as are daily brushing and flossing. Twice yearly dental check-ups and cleanings help catch problems when they are small and easier to treat. Left unattended, small treatable problems become worse and may require more extensive, expensive procedures to repair. Read More About Dental Checkups

Fillings
Fillings are used to restore areas of your tooth affected by decay. Kelsey Ullsmith, DMD uses both amalgam (silver) and composite (tooth-colored) materials to "fill in" the surface of the tooth after all decay has been removed. Read More About Fillings

Dental Crowns
Crowns are used to restore teeth severely damaged by fracture or decay. After the tooth surface is cleaned and prepared, the crown is placed to cover the remainder of the tooth. Read More About Dental Crowns

Root Canal Therapy
A "root canal," or endodontic therapy, is a procedure available to save a tooth that is infected and would otherwise require extraction. There are many reasons that teeth can become infected, including: cavities, previous large fillings, crowns, cracks and trauma. Read More About Root Canals

Extractions
A tooth extraction is the procedure done to remove a tooth that is damaged beyond repair from its socket in the jawbone. Extractions are also done to remove wisdom teeth that may be impacted or create future problems. Read More About Extractions


Gum Disease Treatments
Gum disease occurs in stages and more than half of adults over the age of 30 have some form of it. If you feel you are at risk, you should talk to us right away. If you catch gum disease in the early, gingivitis stage, it could be reversed with proper care from your dentist. Read More About Gum Disease and its Treatments
Healthy smiles for healthy families start with professional family dentistry. At Dentistry with Smiles, your bright, healthy smile is our top priority. Of course, you'll only smile if you're as happy with our service as you are with our dental treatment. That's why we take the time to listen to your needs and concerns. Not only do we listen to your concerns, but we use gentle, efficient cleaning techniques. We also hire caring, highly trained professionals. Our experienced team of specialists is invested in meeting all of your dental needs; from calming anxieties to teaching good habits, from regular check-ups to sophisticated dental surgery.

At Dentistry with Smiles, we take exceptional care of your oral health. Tap the links below to read about some of the family dental services that our practice provides. (Tap again to close.)

► Children's Dentistry
Happy Child with Healthy Teeth

Your child shines with every smile. Let's keep it that way.


A lifetime of healthy teeth starts with good brushing habits, good nutritional choices, and trust in the dentist. By teaming up with you, we can ensure that your child has a vibrant smile all the way into adulthood.

Dr. Ullsmith is not a Pediatric Dentist, but we have served families in Bellingham since 2000. At Dentistry with Smiles, children's dentistry is more than bright, healthy smiles; it's also about making the trip to the dentist a calm, pleasant experience so there's no fear of "next time." We take pride in seeing our patients grow into their adult teeth, so we're committed to earning the trust of everyone who visits our clinic—both children and parents. That's why we take extra time to build rapport and earn confidence; it makes the experience easier for everyone. As a part of our care, we use pleasant, simple explanations to answer your child's questions and calm any anxieties. Of course, we're also happy to address any concerns or questions you might have as a parent.

Kid's teeth need dental care, just like grown-up teeth. Regular exams by a Dentist can help to identify any abnormalities in your child's oral development, and can minimize the impact of decay on your child's health by catching cavities early. Coming in for professional cleanings are not just about helping your child have shiny clean teeth, they are also very important in educating your child on proper brushing and flossing techniques.

Our friendly and experienced staff love working with kids of all ages. We look forward to meeting your child and helping them learn how fun dentistry can be.


► Dental Checkups

Professional Cleanings


Professional cleanings performed by a certified hygienist are just as important to your dental health as daily brushing and flossing. Using specialized tools and training, your hygienist or dentist will:
•  Remove plaque build-up from the surfaces of teeth. Bacteria in the mouth form plaque, which collects on teeth and causes decay, gum disease and gingivitis
•  Remove tartar from teeth surfaces. Tartar, or calculus, is plaque that has become so hardened on the teeth that its removal requires special procedures. Tartar below the gum line is also an indicator of gum disease
•  Remove surface stains from teeth through polishing

Examinations


Regular examinations help detect and prevent health issues before they become serious. Consistent dental check-ups help catch problems when they are small and easier to treat. Left unattended, small treatable problems become worse and may require more extensive, expensive procedures to repair. Dental examinations generally include the following:
•  Gum disease screening
•  Oral cancer screening
•  Visual tooth decay evaluation
•  Visual gum disease examination
•  Gum pocket measurement and tracking
•  X-ray examination to detect: tooth decay, cysts, tumors, problems below the gums and other hidden issues

Regular examinations are very important for your health. Remember, "An ounce of prevention is worth a pound of cure." –Benjamin Franklin

X-rays (Radiographs)


X-rays are a primary tool for early identification of dental problems. Detecting issues with x-rays before they become problems can save you money in the long run by preventing the need for more extensive, expensive procedures or surgeries. X-rays are primarily used to detect:
•  Internal tooth decay
•  Cysts (fluid filled sacks at the base of your teeth)
•  Tumors, both cancerous and non-cancerous
•  Impacted teeth
•  Teeth that are still coming in

Digital X-rays Advantages


Digital x-rays have several advantages over traditional film based x-rays:
•  They emit up to 90% less radiation
•  They are ready for examination nearly instantly
•  They can be viewed on a computer screen
•  Their image can be refined and enlarged
•  They are greener; no chemicals are needed for processing


► Fillings
When it comes to your oral health, we at Dentistry with Smiles take things seriously! Helping you to maintain your smile in the safest and healthiest way possible is our goal every single day. We try to stress the importance of a rigorous at-home oral hygiene routine but every now and then something slips through the cracks. Even the most intensive brushing and flossing can’t always reach every nook and cranny of your mouth, and that is usually where cavities form. We are highly skilled in detecting and treating cavities even at their most preliminary stages. Let us bring your teeth back to health.

Preventing Cavities is Our Goal


The first step is detecting a cavity. We have a number of cavity detection methods that we use, the most notable of which are X-rays and examinations. Remember, we always advise that you come in to be seen for a regular cleaning and examination at least every six months. We will X-ray your mouth at least once a year. We use these X-rays to see issues that would otherwise be very difficult to detect – one of those issues being the beginning stages of a cavity.

During a professional examination Dr. Ullsmith will closely examine your teeth for signs of cavities. Both X-rays and exams can help us to alert you to the beginning stages of a cavity so that you can keep it from fully forming with proper brushing and flossing.

The Filling Process


If we find a cavity that must be filled, we will begin the procedure by ensuring your comfort. We will numb your gums with a topical numbing agent before administering the injection of Novocain to ensure you don’t feel a thing. We will wait for the local anesthetic to take full effect before starting the procedure.

Dental fillings are a simple, routine procedure that don’t take too much time and doesn’t pose any risks. All we have to do is remove the decayed portion of the tooth, sterilize the tooth to ensure no microbes or bacteria are hanging around and fill the portion of the tooth that was drilled away.

Filling Materials


When many people think of fillings, they think of the large, silver fillings that are called amalgam fillings. These are still used, although less frequently and typically only to deal with large cavities. The much more popular option today is that of the tooth colored or “composite” filling.

This composite filling is a mixture of plastic, glass and a resin medium that we mix in our office to match the color of your tooth precisely. Once mixed the composite is moldable, much like a piece of clay. We insert the mixture into your tooth, mold it to the proper shape, and set it in place permanently with a special UV light. These filling are strong, and long lasting but the best part is they do nothing to detract from your smile because no one will be able to tell that they are there.

Please call us today at (360) 312-3187 to schedule an appointment.


► Dental Crowns
000051707346A lot of different things can happen to our teeth so at Dentistry with Smiles we prepare for everything. When a tooth becomes damaged either by trauma or decay or if there is not enough of it left for it to be structurally sound we can often save the tooth with a dental crown. Dental crowns are essentially caps that look and feel like a real tooth that we place over the top of your natural tooth. This crown simultaneously protects your teeth from further damage and gives you the form and function of your full tooth back.

Reasons You May Need a Dental Crown


There is a variety of reason people end up needing dental crowns, some of the more common reasons are:
•  Fractured and broken teeth due to blunt force trauma
•  Teeth that have suffered extensive decay
•  Teeth that are no longer aesthetically pleasing
•  Failed amalgam fillings
•  To protect a tooth that has undergone a root canal

Most of those reasons are self-explanatory. Some extra explanation may be required to describe why a crown would be needed following the failure of an amalgam filling. Amalgam (silver) fillings are common in the molars. They are notable because of how large they must be to be successful. As with any restoration, amalgam fillings will eventually fail given enough time and when they do they leave a very large hole in the tooth. Sometimes we can fill that tooth back in with confidence that the tooth will maintain its structural integrity. Other times we will recommend that a crown be placed over a tooth to ensure that it remains viable.

What Crowns Are Made Of


Crowns can be crafted from a wide variety of materials to achieve some different goals. The material that we choose to make your crown out of will depend upon a few factors. The most important factor is which tooth will have the crown and what it’s function is.

Front (Anterior) Teeth


If we need to place a crown on one of the teeth that are a big part of your smile, we will usually consider using a material that is aesthetically very similar to the look of a natural tooth. Porcelain is a more fragile material used for making crowns, but the front teeth don’t see the same stressed as the molars. Because porcelain looks so similar to a natural tooth, we might use it to restore an anterior tooth that needs a crown.

Rear (Posterior) Teeth


Molars see most of the action when it comes to chewing things. The molars are subjected to tremendous pressure when we bite down on foods or clench out teeth. The materials that we use for crowns that will be placed on molars must be able to stand up to these pressures for many years. Ceramic and Zirconia crowns have very high durability and can match the look of teeth accurately. Gold is also a great option for those who enjoy the aesthetic appeal of gold and want a long-lasting crown.

Call us today at (360) 312-3187 to schedule an appointment.


► Root Canal Therapy
An infection inside one of your teeth is not just painful; it is also dangerous. Untreated infections can spread from the inside of your tooth into the jawbone and into the bloodstream, which can lead to serious health issues. At Dentistry with Smiles, we can remove the infection, protecting both your oral and your overall health, with a root canal.

What is a Root Canal?


A root canal is a procedure that is meant to restore the health of your mouth, avoiding the need for extracting an infected tooth. With a root canal, the pulp of your tooth (which contains nerves and blood vessels) is removed, along with the bacteria that are hiding inside of the tooth’s canals. At the end of your procedure, the tooth is provided with a crown, which helps to provide it strength while protecting it from new infections.

A root canal becomes necessary after bacteria have managed to find their way inside the structure of your tooth. This can happen in a variety of different ways, including cracks, chips, tooth decay, or gum disease. Once inside, the bacteria begin to attack the pulp of the tooth and take up residence inside the hollow canals that lead down to the root. They multiply quickly, filling the tooth and irritating the pulp, which can lead to serious pain and put your health at risk. The only way to remove the infection is with a root canal.

Signs of an Infection in Your Tooth


There are several signs and symptoms that could point toward an infection inside the tooth, and therefore a need for a root canal:
•  A severe toothache.
•  Facial swelling.
•  Lingering pain and sensitivity.
•  Your jaw may lose bone mass.
•  Dental abscesses. This is, quite possibly, the biggest indicator of an infection. Abscesses form when bacteria spill out of the root of the infected tooth. They are the bodys way of attempting to contain the bacteria and prevent their spread. They continue to grow as they go untreated, and can sometimes rupture, allowing bacteria to spill out.

Diagnosing and Treating the Infection


To diagnose, and treat, an infection in your tooth, we need to perform a thorough oral exam. We visually inspect the inside of your mouth, checking for damage to your teeth, as well as swelling in the gums. We will also take X-rays, which will allow us to see the parts of your teeth hidden below the gum line as well as your jawbone. X-rays also allow us to detect abscesses.

Before we begin your root canal, we first administer a local anesthetic near the affected tooth. We clean and dry the tooth, and place a rubber dam around it to prevent any contamination while we perform your procedure. A small hole is drilled into the top of the tooth. Specialized tools are used to remove the pulp and shape the canals. The interior of the tooth is cleaned and disinfected. We then place a filling material inside the tooth and prepare it for a dental crown. Until your permanent crown is ready (which can take several weeks) a temporary crown is placed to protect the tooth. Once your crown is finished, it is cemented into place, restoring strength to the tooth and providing it with protection from new infections.

Root canals do more than just remove the infection from a compromised tooth; they help to protect the tooth from extraction. If you are experiencing severe tooth pain, or suspect you have an infection, call Dentistry with Smiles right away at (360) 312-3187!


► Extractions
Extractions are only performed out of necessity. Our staff at Dentistry with Smiles takes the removal of teeth very seriously. Extractions are used to improve a patient’s bite, to remove impacted teeth, or to remove an extremely decayed tooth that is beyond repair. Dr. Ullsmith understands how important your teeth are to your overall oral health. Working together, we can discuss your options and weigh the best course of action, which for some patients will include the extraction of a single or multiple teeth.

When should I have my tooth extracted?


Extractions are done when it is in the best interest of the patient for their oral health. Dr. Ullsmith will perform an examination, which may include digital x-rays, to review and diagnose your dental health. In most situations, there are three main categories that we may discuss the removal of a tooth. These categories include:

•  To improve a patient's bite:A bad bite can cause havoc on your teeth. This can be due to having an extra tooth, not having the space for all of your teeth, or not having the correct jaw shape for all of your teeth. The order for this type of extraction is often done under the control of an orthodontist. We can remove a tooth, creating space that will be closed in a controlled matter.
•  To remove a tooth that is impacted:An impacted tooth is a tooth that was unable to fully ascend for one reason or another. This is often the case for third molars, known as wisdom teeth. A tooth that is impacted can cause some negative effects, it can twist inside disrupting neighboring roots, and it can come in contact with bacteria leading to the development of a cavity or decay. Removing an impacted tooth is best for your oral health.
•  To remove a tooth that has decayed beyond repair:In most situations, we would hope to catch a decaying tooth before the problem has grown out of hand. This is not always the case. Alternatively, in some situations, the patient does not have the financial means to take the necessary steps to restore a severely decayed tooth. In this situation, it is best to remove the tooth. A decayed tooth is a source of infection that the body can not heal on its own. Infection remaining in your body can cause other damaging effects.


Extraction Procedure


A dental extraction can be performed as either a simple extraction or as a surgical extraction. A simple extraction can quickly turn into a surgical extraction.

A simple extraction means that the tooth is entirely intact and fully extended, it is not impacted. Once the patient is numbed, Dr. Ullsmith can loosen the ligaments that hold the tooth root in the socket using a dental tool called an elevator, or extraction forceps. Wiggling the ligaments from the root, Dr. Ullsmith can lift the tooth from the socket. The process is not known for being easy on the patient but should be fast.

A surgical extraction is done when the tooth is broken, severely decayed, or impacted. Surgical means that the tooth extraction will require some cuts to remove the entire tooth. In many cases, the tooth is removed piece by piece. This process can be uncomfortable but is done because it is best for the patient’s health.

If you have questions about an extraction, our front office staff is here to assist you. Contact us for more information. (360) 312-3187



► Gum Disease Treatments

What Is Periodontal Disease/Gum Disease?


Gum disease is an infection of the tissues that surround and support your teeth. Because gum disease is usually painless, you may not know you have it. Also referred to as periodontal disease, gum disease is caused by the bacteria that is constantly forming on our teeth.

Here Are Some Warning Signs That Can Signal a Problem


•  Gums that bleed easily
•  Red, swollen, tender gums
•  Gums that have pulled away from the teeth
•  Persistent bad breath or bad taste
•  Permanent teeth that are loose or separating
•  Any change in the way your teeth fit together when you bite
•  Any change in the fit of partial dentures

There are many factors that increase the risk of developing gum disease, including: smoking, pregnancy and diabetes. It is important to visit Dentistry with Smiles if you suspect you have gum disease, because the sooner you treat it the better.

The Early Stage of Gum Disease Is Called Gingivitis


If you have gingivitis, your gums may become red, swollen and bleed easily. At this stage, the disease is still reversible and can usually be eliminated by a professional cleaning at your dental office, followed by daily brushing and flossing.

Advanced Gum Disease Is Called Periodontitis


Chronic periodontitis can lead to the loss of tissue and bone that support the teeth and it may become more severe over time. If it does, your teeth will feel loose and start moving around in your mouth. It usually gets worse slowly, but there can be periods of rapid progression.

Aggressive periodontitis is a highly destructive form of periodontal disease that occurs in patients who are otherwise healthy. Common features include rapid loss of tissue and bone, and may occur in localized areas or in the entire mouth. Periodontal disease cannot be cured, however, we have measures to help slow or stop the progression.

Research between systemic diseases and periodontal diseases is ongoing. While a link is not conclusive, some studies indicate that severe gum disease may be associated with several other health conditions such as diabetes or stroke.

Regular dental checkups and periodontal examinations are very important. The treatment methods that our dentist diagnoses will depend upon the type of disease and how far the condition has progressed. Good dental care at home is essential for helping to keep periodontal disease from becoming more serious.

Prophy (Regular Cleanings)


A prophy includes a series of procedures where plaque, calculus and stain are removed from all surfaces of the teeth above the gum line. This is done with hand instruments, ultrasonic scalers, and coronal polishing. Only a licensed dental professional is qualified to determine the need for oral prophylaxis. Only a dentist, dental hygienist or a trained dental assistant can perform the procedure.

Periodontal Maintenance
A periodontal maintenance procedure (PMP) is defined as a procedure that is recommended following periodontal treatment (such as scaling and root planing) and continues at varying intervals, determined by the clinical evaluation of the dentist.

These intervals can be as frequent as every two months and they can be extended as long as six months, depending on the patient. Keeping up your PMP interval is important because periodontal disease can recur without adequate follow-up.

PMP includes removal of plaque and tartar above and below the gums, scaling and root planing of specific areas, and polishing. PMP is always completed following active periodontal treatment such as scaling and root planing or more extensive gum surgery.

Scaling and Root Planing
Scaling and root planing is a special type of treatment that goes deeper BELOW the gum line to remove contaminated debris and bacteria, most often performed on patients with active periodontitis.

This seems to be a procedure that causes much confusion for patients trying to understand the difference between "just a cleaning" and scaling and root planing, and the need/reason for this procedure.

A professional polishing or prophy removes only the soft sticky plaque and hard crusty calculus that is ABOVE the gum line on the crown of the tooth. Scaling and root planing is done to remove soft sticky plaque and hard crusty calculus that is loaded with bacteria, around and BELOW the gum line on root surfaces. It is a method of treating gum disease when pockets formed around the teeth have a measurement of greater than 3mm and there is evidence of bleeding and tissue attachment loss.

Scaling
Scaling is a procedure that meticulously removes contaminated biofilm, plaque, calculus, microorganisms and toxins from around the gum line down to the bottom of each periodontal pocket, in order to obtain a healing response.

Root Planing
Root planing involves smoothing the root surfaces of your teeth with thin instruments so gum tissue can more firmly reattach to roots that are clean and smooth, to prevent tooth loss and sensitivity problems. This procedure makes it more difficult for plaque, calculus and bacteria to accumulate along these root surfaces.

Because this procedure goes deeper than a regular cleaning, your mouth may be numbed. The cleaning may take one to six visits to complete. Depending on the extent of the disease, you may need one or more quadrants of the mouth to be treated with scaling and root planing.

Some Reasons Why Root Planning May Be Necessary
•  To control the growth of harmful bacteria
•  Help the pocket wall reattach firmly to the clean root surface
•  Prevent further bleeding of the gums from disease
•  Reduce inflammation
•  Reduce discomfort
•  Prevent bone loss
•  Prevent gum disease related tooth loss
•  Reduce systemic disease

Home Care After Root Planing and Scaling
Rinse with warm salt water every few hours (1/2 tsp. salt in 8 oz. water) for the remainder of the day to encourage healing and sooth discomfort. Be careful not to bite or chew your lip, cheek or tongue while they are numb. Avoid chewing for 2 hours after this procedure or until numbness has worn off. Keep your fingers and tongue away from the areas that have been treated. Take Tylenol or ibuprofen according to directions on the manufacturer label for a couple of days to help with the discomfort; do NOT take aspirin because it may prolong bleeding.

Rinse your mouth with Closys or Chlorohexidine, if prescribed by your dentist, to reduce oral bacteria. Do not smoke or chew tobacco for 72 hours after the procedure to allow for healing. Gently brush and floss your teeth after each meal. How you care for your teeth and gums at home after treatment is critical to reducing the risk of recurring periodontal disease.
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1101 N Forest St, Suite 6
Bellingham, WA 98225
(360) 312-3187
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