Frequently Asked Questions


How do you know if you need braces?

The goal of orthodontics is to align, level, and rotate teeth to correct their form and function. In general, braces can be placed on teeth at almost any age. Your orthodontist must determine the best course of treatment, dependent upon which will provide the best results in the quickest and most cost-effective way. First, Dr. Coughlin and his team at Ascent Dental Care must decide what the problem(s) is/are. These problems fall into three categories:

A)  The most common issue is misalignment of the teeth. The treatment goal is to straighten the teeth with either bands and brackets or aligners. In most cases, the treatment is completed in 12-18 months and the fees range from $2250.00-$6300.00. Misalignment can be corrected at almost any age.

B)  The next most common problem occurs when the upper and lower jaws are out of proportion. One or both jaws may be too narrow, too wide, too long, or too short. Because the jaws are not in proper position, the temporomandibular joint (TMJ) cannot function correctly, pulling the teeth out of alignment. In these cases, it is usually best to start orthodontic treatment at a younger age--just before puberty when the major growth spurt occurs.

The dual goals are to first redevelop the jaw’s shape and size, and then to address the position of the teeth. This type of treatment takes longer than conventional orthodontics and is approximately 30% more expensive. It also demands significant cooperation on the part of the patient and support from the family.

C)  Finally, there is a combination issue in which the patient has problems with both the jaw and the teeth. In these cases, the overriding problem is often genetics. There may be affiliated issues such as missing teeth, impacted teeth, habits such as thumb sucking, enlarged tonsils and adenoids, tongue tie, and others. These are generally the most complex orthodontic problems, taking the longest and costing the most to resolve. In some cases, the patient may require a surgical intervention known as orthognathic surgery, which is usually performed at around age 18.

How many appointments are needed to treat your orthodontic condition?

In most cases, you will see the doctor every 2-8 weeks, depending on the specific treatment selected. Many times, these appointments last  10-20 minutes and cause no discomfort.

Which is better: conventional bands and brackets or Invisalign-type orthodontics?

Let’s be clear. Most patients would prefer not to have braces placed on their teeth. But let's also be honest. Clear retainers have their limitations. Think about it… how can a clear retainer rotate a tooth or extrude a tooth or intrude a tooth? At Ascent Dental Care, we like to under-promise and over-deliver! That is accomplished by providing an accurate diagnosis and the correct treatment approach to solve each patient’s problems.

For clear aligners to properly move teeth, two main things must be accomplished. First, a light but constant force must be continually applied to the teeth. That means that removable aligners can only work if you are willing to wear them at least 18 hours per day.

Secondly, in order to put a force on a tooth, the aligner must be able to grab onto something. That means that we must place attachments on your teeth.

Lastly, in order to move teeth you need SPACE! The three main options to acquire space are as follows:

  • Extraction of teeth
  • ARS, or air rotor slenderizing, in which sandpaper-like discs are used to slightly narrow one or more teeth
  • Proclination, or pushing teeth forward to create more room in the arch

How many appointments are needed to treat your orthodontic condition?

In most cases, you will see the doctor every 2-8 weeks, depending on the specific treatment selected. Many times, these appointments last  10-20 minutes and cause no discomfort.

What are the advantages and disadvantages of conventional bands and brackets compared to aligner-based treatments?

When patients have only minor orthodontic issues and are very cooperative, I suggest aligner-based treatments. For more complex issues, I recommend bands and brackets. Another advantage of removable types of orthodontics is that they make it much easier to clean the teeth. This can dramatically reduce the risk of cavities, particularly in younger patients with less than ideal dental hygiene practices.

Dr. Coughlin and the Ascent Dental Care team have been providing orthodontic care and treatment since 1985. Dr. Coughlin is a certified instructor for the International Association of Orthodontics.

Gum Disease and Periodontal Issues

What is gum disease?

Any type of inflammation and or disease of the soft or hard tissues around the teeth is commonly referred to as gum disease.

What causes gum disease?

The most common cause is bacteria and their byproducts that accumulate on and around the teeth. They create a film known as plaque, and when the plaque calcifies, it is referred to as calculus or tartar. Your body attempts to rid itself of plaque and tartar, but in the process, it destroys good, healthy bone and tissue. This is the leading cause of tooth loss.

How is gum disease treated?

Dr. Coughlin and the Ascent Dental Care team have been treating all types of periodontal issues (gum disease) for over 3 decades, and have received postdoctoral training in periodontics at the University of Connecticut. Our treatment options include:

  • Mechanical removal of plaque and tartar with hand instruments, cavitron instruments, piezo instrumentation, and lasers. At Ascent Dental Care, the cost ranges from $90.00-$385.00.

  • Chemical treatment in which we use pharmaceuticals to kill and remove the bacteria. At Ascent Dental Care, we refer to the 3 P’s:

    • Periostat (doxycycline), a low dose antibiotic that comes in a pill form. Patients take two 20 mg  pills a day for 3-6 months.
    • Periogard (chlorhexidine), a mouth rinse with which patients gargle for 1-2 minutes twice a day.
    • Prevident, a gel type fluoride that is brushed on the teeth twice a day.

  • Surgical treatment: When the patient does not fully respond to the first two methods, hard and soft tissue can be manipulated to remove the pocketing that allows bacteria to become trapped. Surgical fees vary dramatically, depending on the type of surgery and the needed materials, but typically range between $1850.00-$6300.00. You can expect 3-5 days of postoperative discomfort, similar to having a tooth removed.

  • At Ascent Dental Care, we believe the best treatment for our patients with periodontal or gum disease is to never let it begin. Ascent Dental Care has the best dental hygiene department anywhere, bar none. The team is exceptionally well-trained, caring, and understanding. If anyone can solve your problems, they can.

Oral Surgery

What happens when a tooth is removed?

Teeth are most often removed due to failed treatments, trauma, or orthodontic needs. The procedure typically takes 10-30 minutes, with minor to moderate discomfort for 2-4 days. The cost depends on whether the tooth is impacted, whether it is a primary or permanent tooth, and whether we need to section the tissue and bone. Extractions range from $115.00- $650.00.

Do you need to replace a missing tooth?

After a tooth is removed, one of the first things that will occur is bone loss in the jaws. This can cause the remaining teeth to shift and drift. To combat bone loss, we can place bone grafts in the extraction site. We can also prevent teeth from drifting by replacing missing teeth with either a removable partial denture, a fixed bridge, or a dental implant. Each solution has its own pros and cons. At Ascent Dental Care, we have been replacing teeth since 1983. We don’t have just one tool but many, so we offer all options and guide you toward what we feel is the best long-term solution for your problems.

What is a biopsy?

Roughly 60,000 people in the US are diagnosed with oral cancer each year. A biopsy is performed when we suspect that a lesion is cancerous or could become cancerous. An excisional biopsy occurs when we remove the entire lesion. If the lesion is large, we may perform an incisional biopsy, in which we take just a portion of the lesion. In some cases, we will instead perform a brush biopsy, in which we remove some loose cells through rubbing.We will then evaluate the removed tissue to determine if it is malignant or benign. The fee is generally between $250.00 and $650.00.

Should I remove my wisdom teeth?

Most adults do not have enough room in their mouth for the four wisdom teeth to erupt, because evolution is making the average jaw smaller. The wisdom teeth usually are the last teeth to erupt, typically emerging at around age 16-18. At Ascent Dental Care, we will carefully assess the wisdom teeth. If they are likely to develop problems, we recommend having them removed between the ages of 16-22. Younger patients heal faster with fewer complications.

If the wisdom teeth are not removed and become impacted, cysts, granulomas and tumors can develop around them. They may also cause damage to the second molars, which sit just in front of the wisdom teeth. If you elect not to remove them, we suggest specialized radiographs every 3-5 years to see if anything is developing. If you do choose to have your wisdom teeth removed, at Ascent Dental Care, we offer piezo options. These specialized instruments cut hard tissue but not soft tissue, reducing post-operative complications.

Root Canals or Endodontics

What is a root canal?

A root canal is the removal of nerve tissue inside a tooth. It is normally completed in 1-3 visits, and the cost ranges from $850.00-$1850.00 per tooth, depending on the number of major canals in the tooth and the location of the tooth in the mouth. Approximately 92% of all root canals are successful, and experts agree that in most cases, saving a tooth is better and less expensive than removing it.

What is needed after a root canal?

After a root canal, your tooth has been hollowed out and filled with a soft rubber material called gutta percha. In many cases, this weakens the tooth. To decrease the risk of fracture, we may recommend a buildup and crown. A buildup is a tough material that is placed on the tooth to strengthen it and give the crown more structure to grab onto. The cost of a buildup ranges from $250.00- $700.00, depending on materials and techniques.

After the buildup is placed, we recommend a crown (sometimes called a cap) for aesthetics and durability. The fee for a crown is $950.00-1950.00 per tooth, depending on the materials used as well as the dentist’s experience and artistic skills. At Ascent Dental Care, our team only uses to best materials and techniques in the field. We have successfully placed more than 10,000 of these restorations. Ascent Dental Care has the expertise to guide you on whether a buildup and crown are necessary after your root canal.

Dental Anxiety and Sedation

What do you do if you’re too frightened to have dental care?

Dental anxiety is extremely common, from slight nervousness to the complete inability to sit in the dental chair for treatment. Fortunately, medicine and dentistry provide many different options to help you deal with these issues.

  • Inhalation is the mildest form of sedation. You will breathe a carefully calibrated blend of nitrous oxide (20%-60% nitrogen mixed with oxygen) through a mask over your nose. Within 5 to 10 minutes of removing the mask, the sedation is completely out of your system and you can resume normal activities including driving. Fees range from $0 to $550.00, depending on the length of treatment.
  • Oral sedation requires you to take a pill (typically, though not always, triazolam) the night before your appointment and again one hour before your procedure. Safe and effective in most cases, oral sedation does require you to bring someone to drive you home and stay with you for at least five hours after your procedure. We recommend allowing the pill to dissolve under your tongue instead of swallowing it. The cost ranges from $0 to $550.00.
  • Intravenous (IV) sedation uses a drug (typically, though not always, Versit) that is relatively short-acting and injected into a blood vessel. We recommend fasting after midnight the night before your appointment and drinking only clear fluids. You will need someone to drive you home and stay with you for at least 5 hours after your treatment. The fee ranges from $250.00 to $850.00 depending on the length of sedation.
  • General anesthesia is the deepest form of sedation. It is normally done in a hospital setting with an intubation tube in your nose or mouth.

Keep in mind that no matter what type of sedation you choose, it is very important that monitoring equipment be available to measure your heart rate, blood pressure, pulse rate, EKG, oxygen, and CO2 saturation. At Ascent Dental Care, your safety is our top priority. Our job is to guide you to the safest and most cost-effective solution.

Cosmetic Dentistry

What is cosmetic dentistry?

Cosmetic dentistry focuses on getting form and function to work in harmony. Your face, gums, and teeth, should all be in balance as far as size, shape, color, and position. At Ascent Dental Care, it does not make sense to us for you to have teeth that are a nice color but poorly shaped, or to have nicely shaped teeth with poor color. It also does not make sense to us if you have nicely colored and shaped teeth, but unhealthy gum structure. We want you to have the entire package.

If all areas are not addressed the outcome will be less than ideal, so cosmetic dentistry can include a variety of procedures, including veneers, crowns, orthodontics, and gum treatment.  At Ascent Dental Care, we also offer our patients fillers and neuromodulators such as Botox and or Dysport for fine lines and wrinkles.

We can even take your makeover to the next level with HydraFacials, Kybella, PDO sutures, body re-contouring, tattoo removal, hair removal, scar and sun damage removal, and a complete med spa experience. Ascent Dental Care has the best and most up-to-date lasers, Intense Pulse Light, and RF (radiofrequency) techniques available on the market. Although a beautiful smile is a primary goal, it is only part of the services you can expect from Ascent Dental Care.

Dental Implants

What is implant dentistry?

Implant dentistry replaces a single tooth or multiple teeth in one to several visits, depending on objectives. Costs vary from $800.00 to several thousand dollars. Why such a wide range of fees? Review the following…

How long have dental implants been in use?

Archeological records show that the Egyptians were placing dental implants a thousand years ago! FDA approval started in United States in the early 1980s, and Dr. Coughlin and his team placed our first dental implant in 1983! We have placed thousands of successful dental implants since that time.

What is a dental implant?

A dental implant is a cylinder of biocompatible titanium that replaces the tooth root and provides a strong, stable foundation for a replacement tooth. There are three classes of dental implants: cylinders, blades, and frames. The advantage of multiple options is that it allows us to accommodate different patients’ individual quality and quantity of bone structure. Most implant dentist focus purely on the cylinder type of dental implants, which is why we sometimes hear patients state that they were told they were not a candidate for dental implants. Not all dentists have the training and/or surgical equipment to provide every option, but Dr. Coughlin and his team have been trained to provide all different types of dental implants.

Who is a candidate for receiving a dental implant?

Really, almost anyone who is missing teeth can be a candidate. Patients who are heavy smokers or have uncontrolled health conditions such as diabetes or AIDS typically need special precautions.

If I have poor bone, can I still have a dental implant?

Bone quality falls into four types, conveniently called type 1,2,3, and 4. Type one is the densest and type 4 is the most porous. The denser and harder the bone, the better the prognosis. In most cases, this type of bone is best for patients who want or need new teeth in a single visit. Dr. Coughlin and his team have some of the most advanced technology available to determine the quality and quantity of bone. This allows us to predict the likelihood of success before you commit to treatment. We also use state of the art computers and software for virtual treatment planning to ensure the highest level of success.

What are mini dental implants?

Mini dental implants are a subcategory of cylinder implants that are generally less than 3mm in diameter. Conventional cylinder dental implants are 3mm to 7mm in diameter. The goal is to choose the best dental implant for the individual patient’s clinical condition. In most cases, the more surface area of dental implant that is in contact with the jawbone, the better the results. However, this can be accomplished with a variety of implants in various lengths, widths, and even surface textures.

You may have heard that mini implants are a non-surgical treatment, but we feel that this is highly inaccurate. Any time soft tissue or bone is cut, we consider it surgery. Dr. Coughlin and his team have many different implant systems and sizes to correct your unique dental issues.

What is the cost of having a dental implant?

Let’s review the steps and give you a range of fees for each step.

  • Step one is your diagnosis and treatment plan. Depending on your needs, you might require an exam, intra and extraoral photos, radiographs, CT Scans, impressions, and dental models. Fees can range from $115-$650.00.
  • Step two is the surgical placement of dental implants, and the fee is for each implant varies from $850.00-$2850.00, depending on whether you need extra procedures such as bone grafting, a sinus lift, or nerve re-positioning.
  • Step three is abutment stage. The abutment connects the final restoration to the dental implant. The fee ranges from $450-$900.00 per abutment, depending on whether it is stock or custom, and how it attaches to the implant.
  • Step four is the placement of the crown, bridge, or denture on the abutment. The fee for a single implant crown ranges from $800.00-$1850.00, while an overdenture costs $2250.00-$6300.00.
  • Step five is maintenance. This includes follow-up and hygiene appointments, along with radiographs and exams. Though you cannot get cavities or tooth decay on implants, you could develop periodontal (gum) disease, which can cause the implant to fail.

Dr. Coughlin has been placing dental implants of all kinds since 1983. His team at Ascent Dental Care has the knowledge, training, and experience to select the best option for your dental issues. Dr. Coughlin and the Ascent Team provide not only surgical treatments, but prosthetic restorations as well. The buck stops here, and we will take charge of the entire treatment process.