General and Family Dentistry in Miami

General dentistry is the everyday care that keeps a mouth healthy: examinations, cleanings, X-rays, fillings, gum treatment, root canals, extractions, night guards and mouthguards, and prevention. At Vizcaya Dental Arts it is done by the same doctors who do the implants, the veneers and the orthodontics, for adults and for children from about age ten.

Who we care for

• Adults of every age, for everything from a cleaning to a full reconstruction.
• Teenagers, many of whom start with us through orthodontics.
• Families, who often come as a household.

We are not a pediatric dental office. Children are usually ready for us at about age ten, when most of the permanent teeth are in. Younger children are better served by a pediatric dentist, and we can recommend one. The exception is orthodontics: Dr. Hong, our board-certified orthodontist, sees children from around six or seven for a first orthodontic evaluation, which is often a matter of watching growth rather than starting treatment.

Care that changes with age

• The risk of cavities tends to fall with age, and the risk of gum disease rises.
• Medications cause dry mouth, and dry mouth brings decay in places that were never a problem before.
• Teeth wear.
• Old fillings reach the end of their life.
• Gums recede and expose roots, which are more sensitive and softer than enamel.

So the plan changes. The same small crack in a molar might call for a crown in a patient who grinds, because the tooth is likely to break, and for watching, or a filling, in an older patient with a light bite. We look at your history of cavities and gum disease, your bite, your habits and your health before recommending anything.

The hygiene visit

Most patients have a cleaning and an examination every six months. Patients with gum disease, or who find it hard to keep the teeth clean at home, do better at three or four months, and we set the interval for your mouth. A new patient has the cleaning at the first visit, with the comprehensive examination and a full set of X-rays, in about ninety minutes.

At every visit Dr. Kottar screens the soft tissues of the mouth for oral cancer, examines each tooth, measures the gums, checks the bite, and goes through the X-rays with you. Our exams and cleanings page describes the visit in detail, and the gum disease page explains what changes when the gums need more than a cleaning.

Prevention

Prevention is the cheapest and least invasive part of dentistry.

• Fluoride for adults as well as children, when the risk of decay calls for it.
• A custom night guard for patients who grind, because grinding is what cracks teeth and breaks fillings.
• An athletic mouthguard for anyone who plays a sport where a blow to the face is possible.
• An oral cancer screening at every examination.
• Home care that fits your hands and your habits, because what you do every day matters more than what we do a few times a year.

How we work

We recommend what is needed and nothing more. A problem that can safely be watched is rechecked at the next visit rather than treated. Patients regularly come to us for a second opinion after being offered a longer plan elsewhere.

Fillings are placed under a rubber dam, which keeps the tooth dry while the filling bonds. Crowns and bridges are cemented when the fit, the contact points and the margins are right. The doctors do most of the work in the chair themselves.

We see one patient at a time, with enough time scheduled for each procedure, and your questions get answered. Everything is explained before it happens, including the cost. Our coordinator goes through the estimate, what your insurance is likely to contribute and how payment works before anything is scheduled.

Coming back after a long gap

If it has been years, the first visit works the same way as for anyone: a full examination, a clear picture of where things stand, and a plan sorted into what is urgent, what matters next and what can wait. The order is set by what would get worse if left. If the visit itself is the hard part, our anxiety and comfort options page explains the help available.

The treatments

Each service under this heading has its own page.

• Anxiety and Comfort Options

  Comfort options for anxious patients, including nitrous oxide and oral sedation.

• Athletic Mouthguards

  Custom mouthguards made from a scan of your teeth and sized to your sport.

• Diagnostics and Testing

  How we find the cause of tooth pain when the answer is not obvious.

• Emergency Dental Care

  Urgent visits for pain, swelling, broken teeth and injuries, and what to do in the meantime.

• Exams and Cleanings

  A comprehensive examination, digital X-rays and a cleaning, usually at the same visit.

• Gum Disease Treatment

  Treatment and maintenance for gum disease, from deep cleaning to three-month visits.

• Night Guards

  A custom night guard for grinding and clenching, made from a digital scan.

• Root Canal Treatment

  Treating a tooth whose nerve is inflamed, infected or injured, so the tooth can be kept.

• Snoring Appliances

  An adjustable oral appliance for snoring, after a sleep physician has ruled out apnea.

• Tooth Extractions

  Removing a tooth that cannot be saved, and planning what replaces it before it comes out.

• Tooth-Colored Fillings

  Composite fillings for cavities, chips and small breaks, placed under a rubber dam.

• Wisdom Teeth

  When wisdom teeth should come out, when they can stay, and how removal works here.

When we refer

Nearly everything on this list is done in our office, including root canals, extractions, wisdom teeth and gum treatment. A few things are better done elsewhere:

• Jaw surgery
• Sleep medicine evaluation
• Occasionally, a case that is unusually complex

In those cases we refer you to someone we trust and coordinate the rest of your care.

Frequently asked questions

Do you see children?

We are not a pediatric dental office. Children are usually ready for us at about age ten, once most of the permanent teeth are in; younger children are better served by a pediatric dentist, and we can point you to one. The exception is orthodontics: Dr. Hong sees children from around six or seven for a first orthodontic evaluation.

How often should I come in?

For most people, every six months. Patients with gum disease, or who find it hard to keep the teeth clean at home, do better at three or four month intervals. We set the interval for you, not from a schedule.

Will I have a cleaning at my first visit?

Usually, yes. A new-patient visit is about ninety minutes: a comprehensive examination by Dr. Kottar, a full set of X-rays and a cleaning. If your gums need a deeper form of treatment instead, we explain why and schedule it.

Does the doctor do the examination?

Yes. Dr. Kottar examines every tooth and the gums, screens for oral cancer, checks the bite, reads the X-rays with you and goes through what he finds. Enough time is set aside for your questions.

Do you do root canals and extractions, or refer them out?

Nearly all of it is done here, including root canals, extractions, wisdom teeth and gum treatment. Once in a while a case is unusually complex and is better in a specialist's hands; when that is so, we say so and arrange it.

What makes this a family practice?

Many of our patients come as households: parents, teenagers, grandparents. The dentist and the orthodontist are a husband and wife who plan cases together, so a teenager's braces and a parent's crown are handled by people who talk every day.

Sources

Professional guidelines and peer-reviewed reviews this page draws on.

1. Eke PI, Thornton-Evans GO, Wei L, Borgnakke WS, Dye BA, Genco RJ. Periodontitis in US adults: National Health and Nutrition Examination Survey 2009-2014. Journal of the American Dental Association. 2018;149(7):576-588. DOI
2. Weyant RJ, Tracy SL, Anselmo TT, et al. Topical fluoride for caries prevention: executive summary of the updated clinical recommendations and supporting systematic review. Journal of the American Dental Association. 2013;144(11):1279-1291. PubMed
3. American Association of Orthodontists. Orthodontics for children: developing a healthy smile. Recommends a first orthodontic check-up no later than age 7. AAO