Family Dentistry

LVI Dentist Boulder Colorado | Dr. Michael Adler Brings Top LVI Fellowship Credentials to Area

The Las Vegas Institute of Advanced Dental Studies (LVI) Fellowship recently awarded to Boulder Colorado dentist Dr. Michael Adler ensures the availability of the most advanced dental treatments for area residents.

Boulder, Colorado, September 27, 2009 – Boulder, Colorado-based dentist Dr. Michael Adler today released additional information concerning his recent designation as a Las Vegas Institute for Advanced Dental Studies (LVI) Fellowship recipient. The LVI Fellowship distinction is significant for area residents and dental patients of Adler Cosmetic and Family Dentistry as it ensures the availability of the most advanced dental care and treatment. Current and prospective patients are invited to contact Dr. Adler’s office for additional information concerning available services or to schedule an appointment or consultation.

The requirements for receiving the LVI Fellowship are extensive and confirm Dr. Adler’s completion of a series of studies on the clinical skills and knowledge necessary to provide comprehensive aesthetic treatment for dental patients. The Fellowship distinction is awarded only to select doctors who successfully complete studies and a comprehensive exam covering the skills and techniques taught at LVI.

In attaining this level of distinction Dr. Adler has made a commitment to offering a high level of Aesthetic Neuromuscular Dentistry. Neuromuscular dentistry is evaluation/diagnosis, and healing of the relationship between teeth, jaw joints, jaw posture, head muscles, neck muscles, back muscles, head posture, and body posture. These factors combine to impact a person’s bite and can cause a variety of symptoms affecting long term health and well being.

Adler Cosmetic and Family Dentistry is open weekdays by appointment. Additional information about the practice and services offered is available at

About Adler Cosmetic and Family Dentistry
The cosmetic and family dental practice of Dr. Michael Adler is based in the Colorado community of Boulder, a convenient and scenic drive from most locations in the Denver and Front Range areas. Boulder, Colorado is also an inviting destination location for visiting out-of-state patients seeking Dr. Adler’s specialized attention. Dr. Adler is nationally recognized for his work and is committed to providing his patients with the highest level of care in both cosmetic and family dentistry. The practice maintains a website at and regularly publishes information on its blog at  

Name:  Heather Ramsey
Email:  [email protected]
Phone:  (303) 449-1119

Adler Cosmetic and Family Dentistry
1810 30th Street
Boulder, CO 80301

Repairing Broken Tooth | Fractured Tooth

Katie after the accident

Katie after the accident

With just a slip of the foot, Katie’s appearance was instantly changed.  After slipping on ice and falling face first, Katie was left with at least two of her upper front teeth broken.  A large portion of her upper left middle tooth was fractured off and her upper right tooth next to the middle was also chipped.  She immediately sought treatment from Dr. Adler of Adler Cosmetic & Family Dentistry.  Dr. Adler examined the damaged area using the aid of both x-rays and an interoral camera to help diagnose the multiple fractures that were not apparent to the naked eye and to determine the extent of the damage.  Teeth #7 and 9 were visibly broken so Dr. Adler placed composite bond on the teeth as a temporary solution to restore the aesthetic look of the teeth until permanent restorations could be completed.  Tooth #8 did not appear visibly damaged but the interoral camera did reveal that the tooth was fractured.  Dr. Adler suspected that the tooth was more heavily damaged than it appeared since the teeth on both sided had visible damage due to the impact.  A week after the fall, a portion of tooth #8 broke off due to the trauma it sustained during the accident.  Dr. Adler determined that porcelain veneers should be placed on teeth #7-10 to restore the patient’s smile to its original brilliance.

Katie after the accident

Tooth #10 (upper left tooth, second from the middle) did not have any visible fractures but needed to be restored partly as a precaution since not all damage from a fall is immediately apparent and mostly for aesthetics.  It is recommended that front teeth especially should be restored in sets of two to insure that the patient’s smile remains symmetrical.  Tooth #10 was already shorter than its counter part #7, so if Dr. Adler was to only restore the teeth that had visible fractures (# 7-9), then tooth #10 would appear short and out of place, giving the patient an uneven smile.

A veneer is a thin shell of porcelain that is bonded to a tooth to improve its color or shape.  A veneer generally covers only the front and top of a tooth.  Veneers can be used to close spaces between teeth, lengthen small or misshapen teeth, or whiten stained or dark teeth.  When teeth are chipped, as in Katie’s case, or beginning to wear, veneers can protect them from damage and restore their original appearance.

Katie's Teeth After

Katie’s four upper front teeth were first shaped and roughened to prepare them for the veneers.  Impressions were then taken of the teeth and sent to Aurum Ceramic Dental Laboratory, where the veneers were artistically custom crafted.  Once the veneers had returned from the lab, they were cemented onto Katie’s teeth using a durable adhesive bond.  The bond was then cured with a harmless high-intensity light.  The pain Katie initial experienced from the accident was relieved after the veneers were placed.  The final results were a beautiful and natural looking smile.

Hidden Decay and Crown in One Day

Hannah's Teeth Before
Hannah’s Teeth Before

Hannah, a college student in Boulder, Colorado, first came to Adler Cosmetic & Family Dentistry because she was experiencing cold sensitivity and pain while chewing on one of her lower left teeth.  During the emergency exam, we took a digital x-ray of the area and used the Diagnodent, a painless laser that helps detect decay beneath the hard enamel layer.  Tooth #19 (first front molar on the lower left) was determined to be the cause of the pain.  Hannah had a stainless steel crown on tooth #19.  She had worn holes in the top surface.  Stainless steel crowns are commonly placed on young children’s teeth but they do not last permanently.  It was also noted that tooth #18 had a dark stain on the top back surface and the Diagnodent got a reading that indicated the presence of decay.  It was determined that the old stainless steel crown on #19 needed to be replaced with an all porcelain Cerec crown and that tooth #18 needed a composite resin (white) filling.

Decay Exposed Once Crown Was Removed

Decay Exposed Once Crown Was Removed

 Only when the old stainless steel crown had been removed to prepare the tooth for the crown was the extent of the decay apparent.  Decay underneath the crown had destroyed most of the tooth structure.  Dr. Adler removed the visible decay and used decay indicator, a liquid dye that indicates areas of decay, to insure that all the remaining decay was then removed.  Tooth #19 was then prepared for the crown by shaping the remaining tooth into the best shape for supporting the crown.  In Hannah’s case, some of the tissue around the tooth needed to be cleaned with a laser due to the inflammation caused by the stainless steel crown.  Optical impressions were taken using the high-tech Cerec camera which then allowed Dr. Adler to custom shape the crown to fix Hannah’s tooth and bite.  The Cerec machine then fabricated the crown from a solid block of porcelain while Dr. Adler did Hannah’s filling on tooth #18. 

 The decay was similarly removed from the top back surface of tooth #18.  Once the area was disinfected and cleaned the composite resin was then chemically bonded to the tooth.  The filling was then adjusted to Hannah’s bite.  The composite is matched to the color of the tooth so once the filling is done it is hard to spot.  By the time the doctor was finished with the filling, the Cerec

  Hannah's New Crown

Hannah’s New Crown and Filling

machine was done milling the crown for tooth #19.  The crown was fitted on the tooth before any cement was added to insure a proper fit.  The tooth was then disinfected and cleaned.  Using very strong clear cement, the crown was then chemically bonded to the tooth.  In just one appointment, Hannah was able to leave with two much healthier and better looking teeth.

Cracked Tooth Syndrome | The Hidden Fracture

You are having frequent but sometimes intermittent pain, discomfort, and sensitivity in your tooth.  The cause of the pain is not visible to the naked eye and does not show up on the dental x-rays.  You are beginning to wonder if the pain is all in your head until the doctor tells you that you have cracked tooth syndrome.   

fractured-tooth-illustration-smCracked tooth syndrome describes the recurring pain, discomfort, and/or sensitivity that is caused by an incomplete fracture or crack in a tooth.  The fracture involved is often difficult to detect and may be completely invisible to the naked eye and may not appear on dental x-rays.  A cracked tooth can be caused several different ways.  Clenching and grinding can weaken teeth causing them to fracture.  Root canalled teeth that are not restored after treatment and large fillings can cause your teeth to loose strength, making them brittle.  Every day your teeth endure a tremendous amount of pressure from biting and chewing, so if you bite down on something hard like a popcorn kernel, the force can cause the tooth to fracture, especially if it is weakened. 

Treatment of a fractured tooth usually depends on the location of the fracture as well as the extent of the damage.  If only the outer enamel is cracked then we remove the affected portion and restore the tooth with a crown or onlay to stabilize it and protect it from further damage.  If the crack extends into the underlying dentin or pulp layers then more extensive treatment may be required, such as a root canal, before a final restoration can be placed to stabilize the tooth.  In some rare instances, a crack will extend all the way through the tooth and under the bone.  In these extreme cases, there is no way to restore the tooth and we have no other option but to extract it.  Fortunately, most cracked teeth can be saved.  The key is early detection and appropriate treatment.  Since diagnosis is often based on patient symptoms, it is very important to tell your dentist of any pain or discomfort you have been experiencing as soon as you have it.

  Fractured tooth as it is uncovered

Dr. Beyer’s Fractured Tooth As It Is Revealed

Dr. Craig Beyer of Beyer Laser Center is a good example of a those rare cases where a fracture extends through the tooth.  Dr. Beyer came to Dr. Adler complaining of that he was having pain when he was biting down.   Based upon the symptoms Dr. Beyer described, photographs, and x-rays, Dr. Adler determined that Dr. Beyer had a fractured tooth and recommended a crown.  The tooth was prepped and fitted with an all porcelain Cerec crown.  The fracture became even more apparent once the tooth had been prepped for the crown and had decay indicator placed on the tooth.  Decay indicator is a dye that helps make decay more visible, it can also be used to see tooth fractures because the dye will run along the crack.  Interoral pictures allow the doctor to get an up-close look at the teeth allowing him to see cracks that might otherwise be missed.  If the fracture had been an oblique fracture, extending into the enamel or dentin but not the pulp layers, as was first assumed then the crown would have solved the problem.  Unfortunately, Dr. Beyer continued to have symptoms of pain.  Dr. Adler then performed a root canal believing that the fracture extended into the pulp of the tooth.  During the root canal procedure, Dr. Adler saw that fractured propagated through the tooth and that the root canal would not be sufficient treatment to save the tooth.  Since the fracture extended through the tooth splitting it, the tooth could not be saved and had to be extracted and replaced with a titanium implant.

Bill's uncovered tooth fracture

Bill’s Uncovered Fractured Tooth

Bill is a common example of cracked tooth syndrome.  Bill had been having sensitivity with a tooth on his upper left side for about one year whenever he would bite down but didn’t think much of it since it only hurt when he bit down and wasn’t a constant pain.  After mentioning to the hygienist at his cleaning that he was having this continuous problem, the doctor diagnosed a fracture in the tooth.  An old filling was removed from the tooth and a decay indicator was placed on the tooth in order to see the extent of the fracture.  The decay indicator along with the interoral pictures allowed Dr. Adler to see that the fracture, an oblique fracture, extended across and into the tooth but had probably not yet entered the pulp chamber.  Dr. Adler placed an all porcelain Cerec crown on the tooth to stabilize and to help prevent the fracture from propagating further through the tooth.  The crown also kept the fracture from expanding and contracting which can increase the pain or sensitivity that a patient experiences.  Since the crown was placed, Bill has been symptom free.

Full Mouth Reconstruction Getting the Bite Right Part 2

peter after 279x300 1
Peter after.

Phase 2 of treatment was reconstructing Peter’s teeth to his ideal bite so that the use of the orthotic would no longer be necessary. Every tooth was prepared for a ceramic crown, removing any decay or fractures that were present, and fitted with temporary crowns while the impressions of Peter’s teeth and bite were sent to the prestigious Aurum Dental Laboratory which is known for their quality and excellence. The ceramic crowns were individually crafted to not only look great but to also be functional and in the correct bite.

Once the lab finished fabrication of the crowns, Dr. Adler removed the temporaries and cemented on the permanent crowns. Peter’s treatment was conducted under the supervision of the esteemed Las Vegas Institute (LVI) where Dr. Adler was trained in the most advanced techniques of neuromuscular and cosmetic dentistry. Peter’s results are amazing and he is thrilled with how he looks and feels. His smile is now balanced, teeth look great, and his jaw is comfortable. He said that he is more confident and the look of his entire face has changed. He looks more youthful now that the atrophy on one side of his face is gone. Another change that Peter noticed was that he stopped biting his nails since his treatment started. Peter was a habitual nail biter most of his life, since treatment Peter has completely stopped chewing on his nails and cuticles. He believed it is because his bite changed and so it is no longer as easy to bite on his nails and also because he was using his figures as a subconscious crutch for his jaw that is no longer needed with his new bite. There is no question that Peter’s smile looks great and has greatly improved his life.

after retracted 300x111 1
After retracted view.

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