Paul Covell, DDS

Products And Services

• Cosmetic Dentistry

  Cosmetic dentistry encompasses not only the health of the teeth, but also their aesthetic value. Various products and procedures exist within cosmetic dentistry with the goal of improving both the well-being and visual beauty of the teeth, giving the individual a higher level of self-confidence. Tooth Whitening Tooth bleaching, also known as tooth whitening, has become so advanced and widespread that certain dental companies have marketed their own form of at-home tooth whitening products. While there is some merit to these home bleaching kits, there is nothing that compares to having a professional, nationally board-certified dentist perform this procedure on your teeth. When performed by a professional, the entire whitening process is abbreviated and can be completed in only a few short visits, compared to weeks of at-home treatment. Veneers Porcelain and composite veneers are effective aesthetic cover-ups for damaged or stained teeth. Although some veneers are designed to be removable, most are permanent and are bonded very tightly to the teeth they are protecting. Advancements in technology have improved the bonding agents to the extent that it is quite common for veneers to remain functional for 10 years or more. Fillings Cavities are painful and unsightly holes in the teeth that must be filled with inert material. Contemporary fillings, called dental composite resin, are much closer in hue to the natural color of teeth. This allows the tooth to be protected but still look untouched. Dental Implants A dental implant is an artificial tooth replacement designed to fill the void created by a missing tooth. There are many types of dental implants, ranging from individual crowns to large scale dentures. A cosmetic dentist can ensure that not only will the most comfortable replacement be found, but it will be implanted in the most accurate and aesthetic manner possible. There are numerous options available to improve the overall health and appearance of the teeth and smile. Patients should consult with their Dr. Covell to decide which option best suits their specific needs and will most effectively meet their expectations.

  Link: Cosmetic Dentistry

• Restorative Dentistry

  What is restorative dentistry? A patient who has teeth that are damaged or missing, whether from disease, injury or other causes, is a candidate for restorative dentistry, which will restore overall mouth health and make teeth look aesthetically pleasing. Receiving proper treatment for damaged or missing teeth is essential in order to prevent further problems and eliminate difficulties with eating or speaking. There are several restorative options available, and which ones are used depend upon the patient’s overall health and personal preference, and the doctor’s recommendation. Available restorative dental treatments include: Full and partial dentures Crowns and bridges Dental implants Mini dental implants Full-mouth reconstruction Inlays and onlays Each type of dental restoration has its own benefits. To complete a full-mouth restoration, several treatments may be combined.

  Link: Restorative Dentistry

• BIOLASE® Dental Lasers

  Lasers are replacing traditional tools in many areas of medicine, and dentistry is no exception. BIOLASE® dental lasers allow most procedures to be performed with minimal drilling, and often without anesthetic. Using a patented process called hydrokinetics, the laser energizes a stream of water capable of removing both hard and soft tissue, and eliminates the need for a needle, drill or scalpel. Types Of BIOLASE Dental Lasers BIOLASE water lasers provide minimally invasive dental procedures. Its three main systems are the WaterLase iPlus, the Waterlase MDX and the Waterlase MD. The WaterLase iPlus is the most powerful of the three systems, and has the greatest number of features. According to the manufacturer’s website, the dual-wavelength WaterLase iPlus is the world’s most advanced all-tissue laser; the WaterLase MDX is the ideal system for pedodontists, periodontists, and endodontists; and the WaterLase MD is the world’s most widely used all-tissue laser system. BIOLASE water lasers are used to perform the following procedures: Decay removal Cavity preparation Root canal Etching Bone and soft-tissue procedures Benefits Of BIOLASE Dental Lasers Benefits of using BIOLASE dental lasers rather than traditional methods include: Reduced heat and vibration High precision Little-or-no need for anesthetic Little-or-no bleeding Less post-operative swelling Fewer medications/antibiotics required BIOLASE laser technology means that several procedures can be performed during a single appointment. Patients can often be treated without needing to be referred to a specialist.

  Link: BIOLASE® Dental Lasers

• Bruxism

  Bruxism is a disorder in which the patient grinds, gnashes or clenches their teeth. Although some individuals may experience bruxism during the day, it most frequently occurs during sleep. Occasional teeth grinding is not harmful but when bruxism occurs often, the teeth can be damaged and other oral complications may occur. What Are The Risks Of Bruxism? Individuals who have bruxism are more likely to suffer from other sleep-related disorders, such as snoring or sleep apnea. Sleep partners may notice bruxism in one another and dentists can often diagnose the disorder based on evidence of damage to teeth or crowns they discover during routine examinations. Who is at risk for bruxism? There is no specific known cause for bruxism, and for unknown reasons it is common in young children, often disappearing in adolescence. Individuals are more at risk for the disorder if they: Have certain abnormalities of the jaw Are stressed or anxious Have other sleep disorders Have missing, crooked, or misaligned teeth Drink alcohol to excess Are highly competitive or aggressive Smoke or drink caffeinated beverages Take illegal stimulants Because stress, smoking, and consumption of alcohol, caffeine and recreational drugs can play a part in bruxism, healthy life changes and relaxation exercises, especially those involving the jaw and mouth, may help to resolve the problem. What are the symptoms of bruxism? Over time bruxism can wear down enamel, chip, and even fracture or loosen teeth. Bruxism can also cause damage to the inner cheek or tongue. During a dental examination, the dentist may discover early signs of the disorder, which is one of the reasons that regular dental check-ups are vital. Apart from a sleep partner reporting the sound of teeth grinding or clenching, the patient may become aware of the condition because they experience one or more of the following symptoms: Facial or jaw pain Tight or fatigued jaw muscles Feeling that the jaw won’t open or close completely Earache Headache at the temples Difficulty sleeping through the night Increased tooth sensitivity A clicking sound as the jaw is opened or closed, typical of patients with TMJ, is often indicative of bruxism. How is bruxism treated? In addition to lifestyle changes that may diminish symptoms of bruxism, treatment options may include the use of a custom mouth guard to protect teeth from grinding at night. In some cases, a muscle relaxant may be prescribed to relax the jaw muscles. In severe cases where the patient’s bruxism has not responded to treatment, orthodontic adjustment or surgery may be considered. In cases where bruxism has damaged teeth, a dentist should be consulted for any teeth restoration that may need to be performed. When bruxism is noticed in young children, it should be reported to the dentist promptly. Although, in all probability, the problem in children will resolve on its own over time, it is important that the dentist be aware and keep a careful watch for possible complications.

  Link: Bruxism

• Laser Dentistry

  In laser dentistry, dental procedures are performed using lasers. The use of lasers allows many dental procedures to be performed with great precision, few complications, and very little pain. Lasers are versatile tools that can be used in the following dental procedures: Cavity detection Tartar removal Dental fillings Gum surgery Dental implants Teeth whitening Removal of benign tumors Lasers started to make their way into the dental world in 1994. The word “laser” is actually an acronym standing for “light amplification by stimulated emission of radiation.” As technology has advanced and the benefits for patients have expanded, Dr. Covell added BIOLASE® dental lasers to his practice. Dr. Covell uses lasers in combination with traditional practices to improve the treatment of various hard- and soft-tissue problems. When used for soft-tissue procedures, such as gum contouring, the BIOLASE® diode laser has a wavelength that is absorbable by water and hemoglobin (the oxygenating protein in the blood). This gives the diode laser the ability to precisely cut, coagulate, ablate, or vaporize targeted soft tissue. For hard-tissue procedures, Dr. Covell now uses the BIOLASE® WaterLase iPlus for removal of tooth decay, preparation of the cavity before filling, tooth preparation before applying sealants, to activate tooth whitening products, and other procedures. Laser Dentistry Is Not Painful Lasers are powerful, and this can intimidate patients. But it’s the very power of the laser energy that makes laser dentistry with Dr. Covell more comfortable than traditional methods for many procedures. Because the laser wavelengths are absorbable by water and hemoglobin, the laser energy can instantly vaporize infected gum tissue without the need for a scalpel. And because the energy instantly coagulates the blood vessels and seals nerve endings, there is dramatically less pain and usually the incisions don’t require sutures. For hard tissues, no one cares for the dental drill, even if simply because the sound. When applicable, Dr Covell uses the BIOLASE® laser to remove decay and etch the teeth for procedures such as placing porcelain veneers and dental sealants. Types Of Lasers Used In Laser Dentistry Different types of lasers are used for different dental treatments. The two most common types of lasers used by dentists are: Hard-Tissue Lasers Hard-tissue lasers are used to cut into teeth and bone with great accuracy. They are often used to shape teeth for composite bonding, remove small amounts of tooth material, and repair dental fillings. Soft-Tissue Lasers Soft-tissue lasers are able to kill bacteria and activate the regrowth of tissues. They are commonly used by periodontists in procedures for treatment of the gums. Other types of lasers are used to view the insides of teeth to detect cavities and other internal teeth-related issues. How Dr. Covell Uses Lasers Dr. Covell continues to expand the uses of the BIOLASE® WaterLase iPlus. Here are some areas he is using this exciting technology for the benefit of our patients. Periodontal disease — When cleaning periodontal pockets, the laser vaporizes infected tissue, disinfecting the area and triggering tissue re-growth at the same time. As the laser energy penetrates the gum tissue, it instantly seals blood vessels and nerve endings. This dramatically reduces post-procedure pain, and encourages faster healing. Here are areas Dr. Covell uses the laser for periodontal disease: – Root planing and scaling – Removal of bacteria and infected tissue from periodontal pockets – Surgical reshaping of the gums to reduce periodontal pockets – To enhance reattachment of the gums back to the tooth root Gum contouring — Lasers are excellent for addressing gummy smiles, creating a more symmetrical gumline, and for preparing the gumline when readying a tooth for a crown. Other soft tissue uses — From exposing unerupted permanent teeth in children to freeing the tongue in a frenectomy, from removing tissue from partially exposed wisdom teeth to treating canker sores and other lesions, we keep expanding our soft-tissue laser uses. Hard tissue uses — We use our lasers to remove tooth decay without needing to drill. We also use the laser to prepare the surrounding enamel for the composite resin filling of the cavity. Lasers are very effective for excavating deep pits and fissures in the molars prior to filling them with sealants. Laser energy effectively etches the tooth enamel, making it a better surface when bonding or applying sealants.

  Link: Laser Dentistry

• Mouth Guards

  Mouth guards are customized devices worn over the teeth to protect them from injury. Unlike dental splints, which are orthodontic devices used to treat conditions such as teeth-grinding (bruxism), snoring or sleep apnea, mouth guards are used primarily to protect the teeth and braces during athletic or recreational activities. Effective mouth guards should be comfortable, durable, easy to clean, and allow the wearer to breathe and speak normally. Reasons For Mouth Guards Any individual, child or adult, who engages in contact sports, such as football, hockey, boxing or lacrosse, or participates in any activity in which the mouth is vulnerable to injury, such as bicycling or skateboarding, is advised to wear a mouth guard. The reason for wearing a mouth guard during such activities is to diminish the risk to the teeth, tongue, jaw, gums, and nerves of the area. Without a mouth guard, anyone who is physically active runs increased risk of chipping, breaking or losing a tooth, injuring the soft tissue of the mouth, and damaging or even fracturing the jaw. Mouth guards are especially helpful in protecting dental or orthodontic appliances. Braces and fixed bridge work can be damaged during sports encounters and require expensive repair or replacement. Even worse, a setback in treatment can occur as injuries heal and equipment is repaired or refitted. Although it may seem contradictory, patients are advised to remove orthodontic retainers or headgear during sports. Benefits Of Custom-Made Mouth Guards While over-the-counter mouth guards are available, they are no substitute for individually designed, custom-made mouth guards manufactured in a dental office or professional laboratory. Personalized mouth guards, produced to protect the patient’s particular bite, though more expensive than those that are mass-produced, are well worth the extra cost. Because they fit the patient precisely, they leave less room for damage to teeth or hardware, and provide greater patient comfort. Also, because they have been specially prepared for the individual, they are unobtrusive during speech and never interfere with normal breathing. Construction Of Mouth Guards There are several steps involved in the manufacture of a custom-made mouth guard. First, the dentist uses a malleable material to make an impression of the patient’s teeth. Then a mouth guard is molded over the impression. In most cases, mouth guards cover only the upper teeth, but, when necessary, particularly when the patient wears braces or other dental appliances on the lower jaw, a mouth guard will be fashioned for the lower teeth as well. Caring For Mouth Guards Mouth guards, like other dental equipment, should be cared for properly to increase their longevity. Patients should always rinse their mouth guards with mouthwash or cold water and clean them with a toothbrush and toothpaste before and after each use. The devices should also be washed on occasion in cool soapy water, rinsed and dried thoroughly. Mouth guards should be stored in containers with air holes to permit circulation and should be kept away from heat. The mouth guard should periodically be examined for wear and should be brought to all regular dental visits so that it can be evaluated to see if replacement is necessary.

  Link: Mouth Guards

• Oral Cancer

  Oral cancer often appears in the mouth as a white, or red, spot or sore that is so small it goes unnoticed. Because many people do not realize they have oral cancer, a diagnosis may not be made until the cancer has become more advanced, making treatment more difficult. Early detection of cancer and precancerous conditions increases the likelihood of a cure. Regular dental examinations are an invaluable part of early cancer detection and treatment. Oral cancer can be caused or exacerbated by heavy alcohol and tobacco use, and sun exposure. It may appear on the lips, gums, inner cheeks or tongue, or on the hard or soft palate. Symptoms Of Oral Cancer Symptoms of oral cancer may include: A sore that bleeds easily or does not heal Red or white patches in the mouth A change in color of any parts of the mouth A lump, thickened tissue, rough spot, or crusted or eroded area Pain, tenderness or numbness anywhere in the mouth or on the lips Difficulty chewing, swallowing or speaking, or moving the jaw or tongue Sore throat or hoarseness A change in the way the teeth fit together

  Link: Oral Cancer

• Radiograph Technology

  A radiograph is a digital image created by an X-ray. Dentists follow careful guidelines as to when radiographs should be taken. Radiographs are a valuable diagnostic tool, giving dentists the ability to view internal structures of the mouth that are not visible in a physical examination. Radiographs assist dentists with the following: Viewing cavities Measuring bone levels Assessing the health of bone Examining the dental pulp and roots of the teeth Inspecting and evaluating cysts or tumors in the mouth Calculating the extent of any damage caused by trauma Dental radiographs provide essential information to dentists as they work to diagnose, treat and maintain the oral health of their patients. The amount of radiation exposure is too small to pose any major risk. Compared to traditional radiographs, digital imaging reduces exposure time by more than 50 percent. State-of-the-art digital imaging is also faster, safer and clearer than traditional radiographs, making them the preferred type of imaging test. Because they are stored digitally, the images can be viewed on a computer, which makes an exact comparison of older and newer images possible. In addition, if needed, images can be delivered electronically to any specialists or insurance companies.

  Link: Radiograph Technology

• TMD Treatment

  What is TMJ/TMD? You think of your bite as your teeth, but a balanced bite actually requires the temporomandibular joint, the teeth, and the masseter muscles to all work together in harmony. When all is properly aligned, chewing is quiet and you don’t have pain in the jaw or lower face. But if one or more of the three components of your bite force the jaw into misalignment, you now have problems with every movement of the jaw. This can lead to pain across the jaw and face, and it can radiate down into the neck and shoulders. You are suffering from temporomandibular joint disorder (TMD). You may have seen this denoted at TMJ, but that acronym refers to the temporomandibular joint itself. Proper identification of this group of related disorders that results from problems with the temporomandibular joint, the teeth, and the masseter muscles is a temporomandibular joint disorder or TMD. Doctors or dentists who do not have specialized training with the temporomandibular joint and the corresponding disorder often misdiagnose the pain associated with TMD. Dr. Covell has pursued continuing education at the renowned Las Vegas Institute for Advanced Dental Studies to expand his ability to successfully treat TMD in his patients. How does Dr. Covell treat TMD? In the majority of cases, TMD is treated with non-surgical methods. Dr. Covell usually seeks to ensure the patient’s jaw is in proper alignment before deciding on the course of treatment. His treatment approaches can involve everything from using anti-inflammatory medications to giving the patient exercises to do at home to help relieve stress on the TMJ. Here are some of the methods Dr. Covell uses to treat TMD: Cosmetic dentistry — To correct alignment, we can replace missing teeth with dental implants or bridges, crown overly worn teeth, or move the teeth with orthodontics. This can involve widening constricted arches. Splints or night guards — Night grinding and clenching is often the main factor in TMD. To combat this, it’s important to put the jaw in the correct position at night. To do this, we fabricate plastic mouthpieces that fit over the upper and lower teeth. These are usually worn at night. Exercises — Tightening the jaw muscles and clenching the teeth is a common cause of TMD problems. We have various jaw exercises that stimulate and relax the jaw muscles. Medication — Muscle relaxants and anti-inflammatory medication can be effective. Lifestyle changes — Stress and anxiety are often root causes; stress reduction techniques are important. Transcutaneous electrical nerve stimulation (TENS) — Small electrical pulses are delivered to the jaw muscles through a small wand. These pulses stimulate the nerves, encouraging the muscles to relax and the jaw to fall into alignment. Botox injections — While Botox is known for its ability to erase wrinkles on the upper third of the face, it can also be used for TMD patients. The FDA has approved Botox for TMD treatment, and it is very effective for relaxing the overused muscles that lead to TMD pain. Can TMD affect other areas of the body? The pain from TMD often spreads away from the jaw. Pain can encompass the entire face. From there it can affect the neck, shoulders, and even the arms. The ears can become tender. Headaches are typical. Tinnitus, or ringing in the ears, is common. Will my dental insurance cover the diagnosis & treatment of TMD? Awareness of TMD is increasing and insurance companies are finally recognizing the condition. Still, coverage varies depending on your carrier and your plan. Our team works with insurance companies to attain the most coverage, but it’s a good idea to do a little research with your provider beforehand to see what is or isn’t covered. Why should I see Dr. Covell for my TMD? Because TMD pain does spread out beyond the jaw, the source of the pain is often misunderstood, and more importantly, misdiagnosed by many dentists and doctors. Dr. Covell is very familiar with TMD and the operation of the temporomandibular joint. He has pursued extensive continuing education in this area of dentistry at the prestigious Las Vegas Institute for Advanced Dental Studies. He has a long history of treating patients in Pasadena and the surrounding areas and has reviews and testimonials from the patients he has helped get through their TMD.

  Link: TMD Treatment

• Sleep Apnea

  The Dangers of sleep apnea American society takes a somewhat perverse pride in working more and sleeping less. While this may seem like the ultimate productivity, it’s actually bad for us mentally and physically. It’s one thing to not get enough sleep as a choice, but it’s another to suffer from sleep apnea. Most people don’t even know they have sleep apnea, but it’s ruining their sleep, and can actually be killing them. Dr. Covell has extensive experience recognizing sleep apnea at his Pasadena, Texas practice. What is sleep apnea? Many people think that snoring is sleep apnea. While most people with sleep apnea have some degree of snoring, snoring only involves interference of the airway when sleeping. Sleep apnea involves partial or complete blockage of the airway dozens of times through the course of the night. This forces the person to wake up to regain muscle control in the throat to reopen the airway. Typically, the person doesn’t become fully conscious after these episodes, but this constant cycle of lack of oxygen and forced awakening results in poor sleep quality. This leads to fatigue, sleepiness, inability to concentrate, depression, and even greater health risks. How common is sleep apnea? Sleep apnea is the most underdiagnosed medical condition in the U.S. It affects 4 percent of middle-aged men and 2 percent of middle-aged women, yet only a fraction of those people receive sleep apnea treatment. What is obstructive sleep apnea? Obstructive sleep apnea (OSA) is the most common form of sleep apnea. OSA occurs when a person’s airway becomes partially or completely blocked while sleeping. In a frantic attempt to get the required oxygen, the brain wakes the person so that he or she engages the throat muscles to open the blocked airway. This can happen dozens, even hundreds, of times every night. What causes sleep apnea? Obstructive sleep apnea occurs when the muscles in the back of the throat relax. These muscles support all of the surrounding tissues, such as the tonsils and the side walls of the throat, so when they relax the airway narrows or closes. In some cases, the tongue falls back, blocking the upper airway. In others, the airway collapses on itself. When we’re awake, our brains make sure the tongue and muscles surrounding the airway are more rigid to enable airflow. Plus, we’re not lying down. But when we’re sleeping and the brain isn’t alert, the airway can collapse. Other contributing factors with sleep apnea are large tonsils and adenoids, a neck circumference over 17 inches, obesity, a small lower jaw with a deep overbite, and a family history of sleep apnea. What are the symptoms of sleep apnea? These are the common symptoms of sleep apnea: Loud snoring Abrupt awakenings from sleep Awakening with shortness of breath (central sleep apnea) Episodes of breathing cessation witnessed by another person Waking up with a headache in the morning Excessive daytime sleepiness Waking up with a dry mouth or sore throat Difficulty staying asleep Attention problems Irritability How is sleep apnea different from snoring? Snoring occurs when there is resistance to airflow when a person is sleeping, particularly when lying on his or her back. The noise results from the tissues in the back of the throat vibrating against one another when the person inhales. When a person has sleep apnea, the airflow is partially or completely blocked and the person stops breathing for a period of a few seconds or even minutes. While snorers can have sleep apnea, it is not a direct causal link. How is sleep apnea diagnosed? If you have some of those symptoms listed above, Dr. Covell can provide a self-assessment called the Eppworth Sleepiness Scale questionnaire. He also can provide what is called a “bed partner survey.” Answers provided could make it clear the person should be screened for obstructive sleep apnea. Waking up gasping and chronic snoring can be signs of sleep apnea, but they can sometimes simply be due to factors such as congestion or alcohol consumption. What negative health impacts can sleep apnea cause? Obstructive sleep apnea is a serious health concern. It’s way more than just some annoying snoring! People with OSA have a higher risk of stroke, heart disease (including hypertension), heart failure, and heart attack. OSA patients incidence of type 2 diabetes is higher. And, if all of that weren’t enough, OSA is linked to premature death. Treating Severe Sleep Apnea For patients with severe sleep apnea, the American Association of Sleep Medicine (AASM) recommends the use of a CPAP (Continuous Positive Airway Pressure) machine. This is a breathing system that uses air pressure to keep the upper airway passages open. The patient wears a mask over his or her nose during sleep.

  Link: Sleep Apnea