Here are some comments from our recent e-mail survey:

Thank you! You are awesome! – Gina

I wouldn’t go anywhere else and couldn't be happier with your office and its people. Many thanks. - Michael

The staff are all beautiful, the Doctors are very handsome; however, the qualifiers are the state-of-the art equipment, professional care, and concern of the patient. I'll never change. Do I win something? Susan

Going to the dentist is not something I usually look forward to but Boise Downtown Dental has made the whole experience much more pleasant - Thanks to all. - Charlette

I have enjoyed my long relationship with this office. Junie, Tammy and Dr. Bruce are great. I almost look forward to my dentist appointments, just to be able to see their friendly faces and catch up on the goings on in their lives. And Tammy is very kind to my sensitive mouth! - Carol

You make it easy to 'go to the dentist'... something I haven't experience before! You make me glad I was there and you make me feel you were glad I came for a visit! - Susan

Thanks for a great first visit. I feel very comfortable and confident that Dr. Dan is the dentist for me here in Boise. - Rick

I have only been patient for couple of years but everyone has treated me very well. Big thanks to all at Boise Downtown Dental. - Thomas

I have complete confidence in my dentist, dental assistant, and dental hygienist. Really. - Brenda

Love you guys! Thanks for being the reason I still have all my teeth way past the time they were supposed to be gone! – Marylee

You are all wonderful, especially June. – Nick

I have referred friends to your practice based on the high-quality care I received. Also, your downtown office is very convenient for those of us who work here. – Derek

I was seated quickly but had to wait a while to be seen by the dentist. I appreciate the willingness of the office to work me into their schedule on short notice. Billing with my insurance has always gone smoothly but I will continue to monitor the costs and review alternative practices should they offer better prices for the same care. – Kody

Great place, great staff, great dentist. Can't say anything more than that. – David

Dr. Dan, Junie, Tammy and Amanda are awesome. Junie is the reason I started with the practice and Dan is the reason I stay. Only met the senior Dr. Bruce once and he was very polite, kind and professional. Haven't had the pleasure of meeting Dr. Ririe but figure he must be pretty cool since he hangs out with the Bruce boys! – Elizabeth

Thank you... Going to Dr. Dan Bruce takes the edge off of "going to the dentist" – Matt

I really appreciate Tammy's patience in getting x-rays on my son. I know it is difficult and she always does a great job with him. – Rebecca

I have been a patient at this office for over 10 years, and I am so thankful that Dr. B. even ALLOWS me to be a patient. I have had lots of trouble with my crowns, caps, you name it, and I don't think any other dentist would EVER give me the type of service and attention that he has. I also have to say that Junie is one of the nicest, most caring people I will ever meet, and I hope that she is paid well enough to stay for as long as I need a dentist (and will be coming to this office). – Amanda

Junie is the reason I started with the practice. I just moved to Boise and had a dental emergency, Junie listened to me weeping on the phone, soothed my fears and offered me several options for an appointment. She explained that the junior Dr. Bruce would be who I would be seeing. Since I didn't know any of the dentists I really didn't care...all I wanted was my tooth fixed. Dr. Dan is awesome. He and Junie are the reason I tell everyone about the wonderful dentist's office I was fortunate to find - Elizabeth

I enjoy the convenient location and friendly staff at the downtown office. Thank you. – Ryan

Beverly Hartford I have already referred three or four patients to you.  You guys are great.  I dreaded going to the dentist but you have changed that all for me.  Keep up the great work. – Bev

Have always been pleased with the service and care I receive at Dr. Bruce's office. Wish all God's best for this new year. Happy New Year!!!! - Gordon

I can and do refer friends--in many years of using the services of this practice I have had nothing but professional and caring treatment. - Cheryl

Very friendly and welcoming staff! Kim

I love you guys! I tell everyone to come here - the staff is so nice and nothing really hurts. Believe me, that's a compliment. – Jillian

Thanks for the referral to Dr. Bruce Newcomb. I was well-treated there also. – Elaine

You have all done a wonderful job. Dr Bruce, Tammy and Junie have taken excellent care of all my dental needs. You have gone the extra mile and more. I appreciate and thank you. Patti

It's a pleasure dealing with Dr. Dan and his staff. – Jo

I had a great experience, I will definitely be back! And the downtown office is very beautiful and convenient! = ) - Jason

I feel very fortunate to have Dr. Bruce and his team for my dental care. – Connie

Very impressed. – Dana

I LUV you all – Esther

Having the option of a downtown office has been very convienent. As always, Tammy and Dr. Bruce were awesome! Thank you, as it is great to have such good dental care. – Frank

Thanks!!! – Joe

Boise Downtown Dental is outstanding. From the time I walk in the door and am greeted by Junie to the time I walk out it is a positive experience. The staff is sincere, friendly, and personally interested in me. Dr. Bruce is an excellent dentist whom I have complete trust in. He is very skilled and has appropriate interpersonal skills and good Popeye forearms. I particularly appreciated the follow-up check on my comfort level after my last procedure. You guys are a class act. – Jeff

Well, I don't typically score highest marks on surveys for any reason, but your office has consistently earned it. Always professional, finest care, and very pleasant. Special kudos to Junie and Tammy; Thanks! -Randy

Here is another cosmetic veneer case from start to finish.  We replaced 6 porcelain veneers to provide a more feminine and youthful smile.  I apologize to those of you who do not like to see teeth up too close.  A full-face smile would show much more, but our patient prefers to remain anonymous (which I totally understand!). 

Here is the before photo.  The patient was concerned about the exposed margins of the old veneers that were stained.  The later incisor (first arrow on the second photo) was especially dark and visible when she smiled.  She also wanted to whiten her smile, create a more natural tranlucency on the teeth and round the edges for a more feminine appearance.  The flash in the photo kind of whitens the old veneers, they actually had a much "grayer" appearance.  This was a tough case, because we were starting with a pretty good situation.  Our patient just wanted it to look perfect.


Exposed natural teeth.


These are the temporaries.  You can see we added a little bit of length to match the lower lip line. 



The final veneers one week after seating.  Our patient was very happy with the final esthetics, color and fit.



This photo shows the natural translucency that was added to the edges of the teeth.  The edges have a much softer feel and the teeth look very natural coming out of the gums (see the close up photo below).  Again, the teeth are much whiter in this photo than the first, but the flash of the camera hides that a little.


Close-up showing very healthy and natural looking teeth and gums.

For this patient, we used 3 porcelain veneers and 1 porcelain crown to correct spacing, length, and color concerns (I apologize for the poor quality in the first photo).

 

I had a conversation with a friend the other day regarding the public view of dentistry as a commodity.  There is an idea that every dentist has been to dental school, has a license to practice dentistry and can drill and fill the needed cavities.  Therefore, he reasoned, it makes sense to choose on price.  I would compare that to buying a box of Cheerios at either Walmart or Albertson's--you get the same product, you just pay more at Albertson's.

But there are a lot of differences in dentists.  Here are a few instances:

• Continuing education - After dental school, there a many courses for dentists in various subjects
• Areas of interest  - Every dentist has certain aspects of dentistry that they enjoy.  The focus may be on cosmetics, pediatrics, dentures or any other area.  For example, we offer sedation dentistry.
• Equipment and Technology - Digital cameras, digital x-rays, and many other technological advances can, in my opinion, improve the quality and esthetics of care.
• Personality - The personality and treatment philosophies of the patient and doctor should be aligned.
• Location - Being close to work or home can save time and money.
• Communications - E-mail reminders for appointments are a new advance we have used to help patients.
• Insurance - Being on your insurance plan can save money.  But it may not and seeing a dentist not on your plan because they feel a good job is worth looking into your coverage and finding out what it really costs to see any particular practice.

These and many other factors can influence your choice of a dentist.  I am of the opinion that trust is the most important factor.  If you like and trust the dentist and staff, you will be more likely to stay involved in your oral health care.

For this case, Dr. Dan Bruce replaced old porcelain veneers that had become discolored and chipped.  We also corrected tooth position to give the patient are more symmetric and natural smile. 

Before


After

Apparently snoring can be more than a nuisance, it can also be a health risk!  A new study has found that snorers are at a significantly higher risk for developing carotid artery atherosclerosis.  This can lead to an increased risk for stroke.  The study also shows an increase in the severity of the problem with an increase in snoring.  Why this is the case is yet to be discovered.

The good news is there are ways to treat snoring.  One way is with an oral appliance that advances the mandible forward and opens the airway.  This is the same treatment for sleep apnea, which is an even more severe disease.  Dr. Dan Bruce is a member of the American Academy of Dental Sleep Medicine and has experience in fabricating oral appliances and dealing with side effects.

Here is the study: http://www.sciencedaily.com/releases/2008/09/080901084842.htm

Boise Downtown Dental is located within minutes of the Boise State University campus on Front and 9th streets downtown.  We accept almost all insurances and will help with processing your insurance claim. 


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There are a couple different ways to look the situation that occurs when a second impression has to be taken for a crown, denture or some other appliance.  The patient may feel that the dentist is not skilled enough to get the impression the first time.  The fact is, on some occasions a second impression may be needed to get it right!  If this is the case you have a dentist who cares about quality and won't proceed with a second-rate product.  Of course it is best to get it perfect the first time, but sometimes a second is necessary to guarantee the best finished product.

I often get the question - what is the difference between an all-ceramic crown and a porcelain with metal-based crown.  First of all, crowns that are used in the posterior usually have a core material.  This is either a porcelain-type core of metal.  Then a more esthetic porcelain is placed over the top of the core material.  For many years, metal has been used as the core material.  This is for strength.  The porcelain is bonded to the metal.  The problem is that metal is dark and needs a layer of opaque porcelain to cover it.  Porcelain-fused to metal crowns are typically more opaque than all ceramic crowns.  The other problem some people have is that porcelain and metal crowns can show a dark line if the gum tissue recedes.  This can be fixed by placing what is called a porcelain butt shoulder in which the porcelain goes all the way to the tooth. 

All ceramic crowns can either be made without a core, which is called a porcelain jacket crown.  These crowns rely on the bond between the underlying tooth and porcelain for strength.  Other porcelain crowns have a ceramic core, such as alumina or zirconia.  These cores are incredibly strong, and do not need as much opaque porcelain to cover them. 

Porcelain/metal crowns still have their place in dentistry.  All-ceramic crowns provide great esthetics and show promise for long-term results, but we do not have the years of data associated with porcelain/metal crowns.  There are many factors associated with crown choice - biting force, area of the mouth, and surrounding colors of the other teeth are just a few. 

I use both all-ceramic and porcelain/metal crowns (And even gold crowns when indicated).  The most important thing to do when selecting a crown material is to ask your dentist what your situation is and let them know your concerns. 

After coming home from the American Academy of Dental Sleep Medicine annual meeting in Seattle I learned some new facts about sleep apnea in children.  Sleep apnea in children occurs in 1-3% of children.  Enlarged tonsils and adenoids are most commonly the reason for obstruction of the airway.  There are various signs and symptoms that may be associated with sleep apnea in children.  These include, but are not limited to: excessive tiredness, snoring, slow growth, inability to concentrate and focus, and poor performance in school.

The first line treatment for these kids is to remove the tonsils and adenoids.  This improves symptoms in many children.  After that, expanding the dental arch to make more airway space may be indicated.  The good news for sleep apnea in children is treatment is usually very successful and makes a big difference in the child's quality of life.