Our typical first appointment is a complete exam, with as few x-rays as possible that would still allow for a thorough examination, and a cleaning.

Some patients bring or email us x-rays that were taken in another office, and that is great, because we like to reduce radiation as much as possible, so we are always happy to look at other x-rays rather than take our own. Even if you think your x-rays are old, we may be able to still use them and just take a couple on each side to check for any issues between teeth. 

During the complete exam, we review the health history, evaluate the teeth and gums, and make a recommendation about anything we see in the mouth and on x-rays. We also make recommendations about ways to reduce cavity risk and to strengthen the outer layer of the enamel.
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When it is time for the cleaning (also called prophy or prophylaxis), if possible, we use hand scalers rather than the ultrasonic machine, to carefully remove any calculus that is around the teeth (usually on the inside of the lower front teeth). If the calculus is tenacious and difficult to remove, an ultrasonic machine is used with warm freshly-ozonated water to minimize any root sensitivity to cold. If there are root areas that are sensitive, we have a hydroxyapatite based desensitizer that can help to desensitize the exposed roots after the cleaning. We do the coronal polish part with a hydroxyapatite toothpaste, so that it can remineralize any areas of the tooth that are weak.
Sometimes, a first appointment is a limited / emergency exam, an x-ray of the problem area, and treatment of the problem area if treatment can be done and there is adequate time for it. We would need to know in advance if there is a large cavity that you would like addressed, or an infected tooth, so that we can plan adequate time to hopefully take care of it during the first appointment. 
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Occasionally, people who are well overdue for a cleaning may need two cleanings to remove all of the calculus from their teeth, as the calculus can get more and more tenacious and difficult to remove. If there is bone loss (also known as periodontal disease), a person would need Scaling and Root Planing instead, which is done per quadrant and usually needs to be preauthorized with insurance. 
In the case of periodontal disease, a cleaning would not be done on the first appointment, because it would not be helpful, but if a patient did not have insurance to preauthorize, we may be able to start with the first quadrant of the Scaling and Root Planing, also commonly referred to as “deep cleaning” or “root cleaning” with the use of anesthetic to numb the gums and teeth, because in areas of bone loss, the calculus is deeper and we would want the patient to have a comfortable experience.
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We recommend a checkup and cleaning every 6 months. This helps to keep gums healthy by keeping teeth free of calculus. A frequent checkup helps ensure that if there is a small cavity starting to develop through the process of demineralization, actions are taken to remineralize the area to avoid the progression of the area into an actual cavity. Regular checkups and cleanings help to maintain healthy teeth and gums for life. 
For adults, our new patient exam is $135, and a cleaning is $180. If you have your own recent x-rays from another office, the new patient exam and cleaning appointment will come to $315.

If you have older x-rays and just need 4 bitewings (to check for the health of the tooth and bone between back teeth), the bitewings are $80, for a total first appointment cost of $395. 

If you have no x-rays and have extensive dental needs that require more x-rays, the full mouth series of x-rays is $160 … so with the exam and cleaning, this would come to $475.

For children, our new patient exams are $100, and cleanings are $110. Unless a child has x-rays from another office, it is recommended to take at least 1 bitewing on each side, as the enamel in children’s teeth is weaker and thinner, and cavities can progress very quickly. In total, 2 x-rays with the exam and cleaning come to $270.

A limited, problem focused exam is $120, and if an x-ray is needed, that is $50. If the tooth in question needs a filling, fillings range from $250 to $400, for a total appointment cost of $420 to $570.

If the tooth in question needs an extraction, extractions range from $250 for a non-surgical extraction to $400 for a surgical extraction, for a total appointment cost of $420 to $570 as well.

If you suspect that there might be other cavities or areas of concern, it is more cost effective to have a complete exam rather than a limited exam, to have a full treatment plan at the first time, so as not to pay for a limited exam, and then come back at a later time and pay for the complete exam.

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