Patient Services


At Keith Grote, DDS, we perform a wide variety of services to help you get the smile you deserve. By leveraging today's advanced techniques and technology, your Davis, CA dentist Dr. Grote can restore your beautiful smile to help you maintain your youthful appearance. Whether you need to get a tooth filled, have crooked teeth, or need a complete smile makeover, we can offer a treatment plan that's right for you. Click the links below to learn more about some of the procedures we offer.

General Dental Procedures
Oral Hygiene
Professional cleanings, exams and regular x-rays performed by Dr. Keith Grote or one of our hygienists are just as important to your dental health as daily brushing and flossing. But we know that the success of professional dental care hinges very much on the care that you continue with at home.

Proper Brushing Techniques
Brushing should occur at least two times a day — or after any meal. It's important to remember to wait about 30 minutes after eating or drinking acidic foods, as the acid combined with brushing can sometimes damage the enamel on your teeth. Waiting for at least 30 minutes and making sure you have had some water to drink helps ensure that your saliva and the water you drink will rinse the acids off the teeth.

When you brush, set a timer or use a mobile app to make sure that you are brushing the full 2 minutes that are recommended.

Don't Forget That Floss!
Flossing is just as important as daily brushing. When we eat, food gets lodged between the teeth and brushing won't be able to get it out. Flossing is the only way to remove those food particles, and ensure that the food doesn't remain between the teeth, breaking down enamel and causing decay. There are several great tools to use in flossing; there is traditional string floss, and there are handled flossers that can make it easier — especially if you are on the go.

Preventive Dentistry
Preventive care involves more than professional cleanings, exams and regular x-rays — it includes whole oral health wellness. Dr. Grote is committed to each individual's oral health, from the oral cancer screening at each exam, to thorough disease evaluation.

Professional Cleanings
Every person gets one set of permanent teeth by the age of 12 or 13 and with proper care and attention, they can last 80 or 90 years. And yet, many people end up losing teeth or suffering from preventable dental disease. This to me, is tragic. In our office, we take pride in translating our extensive knowledge of the science of dentistry and maintaining health into terms that you can understand so that you can make your own decisions about how to attain a lifetime of optimal oral health. For too long, the dental profession has, in my opinion, done a poor job of helping people understand the disease process and too many times treated people like they were somehow flawed if they didn't floss properly or angle their toothbrush just right. The scolding and shaming that have long been a part of "home care instructions" do not help people understand and take ownership of their own health. In our office, we feel we can teach anyone who is willing how to prevent most dental problems with minimal effort. Knowledge is power!
Professional cleanings performed by a certified dentist or hygienist are just as important to your dental health as daily brushing and flossing. Using specialized tools and training, your hygienist will:
•  Remove plaque build-up from the surfaces of teeth. Bacteria in the mouth form plaque, which collects on teeth and causes decay, gum disease and gingivitis
•  Remove tartar from teeth surfaces. Tartar, or calculus, is plaque that has become so hardened on the teeth that its removal requires special procedures. Tartar below the gum line is also an indicator of gum disease
•  Remove surface stains from teeth through polishing

Examinations
Regular examinations help detect and prevent health issues before they become serious. Consistent dental check-ups help catch problems when they are small and easier to treat. Left unattended, small treatable problems become worse and may require more extensive, expensive procedures to repair. Dental examinations generally include the following:
•  Gum disease screening
•  Oral cancer screening
•  Visual tooth decay evaluation
•  Visual gum disease examination
•  Gum pocket measurement and tracking
•  X-ray examination to detect: tooth decay, cysts, tumors, problems below the gums and other hidden issues

X-rays (Radiographs)
X-rays are a primary tool for early identification of dental problems. Detecting issues with x-rays before they become problems can save you money in the long run. Early detection can help prevent the need for more extensive, expensive procedures or surgeries. X-rays are primarily used to detect:
•  Internal tooth decay
•  Cysts (fluid filled sacks at the base of your teeth)
•  Tumors, both cancerous and non-cancerous
•  Impacted teeth
•  Teeth that are still coming in

At Keith Grote, DDS, our dental team uses digital x-rays, which have several advantages over traditional film based x-rays. They emit up to 90% less radiation, are ready for viewing almost instantaneously, and do not require harmful chemicals to process.

Sealants
Sealants are generally used to help prevent tooth decay on the biting surfaces of back teeth (molars). The natural grooves of these teeth can trap food that can resist casual brushing and rinsing. If left in place, the trapped food allows bacteria to multiply, eventually causing tooth decay and requiring costly attention.

Sealants are painted directly onto the tooth where they seal the natural grooves to help prevent tooth decay. While sealants are durable, they are not permanent. They can last up to 5 years of normal wear before needing replacement.

Sealants offer a cost-effective, preventative step to reduce the chances of tooth decay on the chewing surfaces of molars. However, they do not replace the need for regular brushing and flossing.

Gum Disease (Periodontal Disease)
Gum disease accounts for approximately 70% of all tooth loss in adults. Early signs of gum disease include bleeding gums when flossing or brushing and gums that are red, inflamed, or swollen.

Gum disease and tooth decay are two different diseases. Gum disease starts to deteriorate the bone, and if deterioration is allowed to continue, "pockets" form in between the teeth and the gums. Pockets deeper than 3mm may require special treatment to remove the bacteria and plaque. Without treatment and continuous maintenance, gum disease will eventually decrease the bone levels and can lead to bone loss.

Gum disease is not curable, however, it can be kept under control with proper personal hygiene and regular visits to a trained dentist or hygienist.

Oral Cancer Screening
Your mouth is part of the oral cavity, which also includes your lips, cheek lining, gums, front part of your tongue, floor of the mouth and the hard palate (roof of your mouth). The throat (pharynx) starts at the soft part of the roof of your mouth and continues back into your throat. It includes the back section of your tongue as well as the base where the tongue attaches to the floor of your mouth.

During your dental visit, Dr. Grote can talk to you about your health history and examine these areas for signs of mouth and/or throat cancer. Regular visits to our office can improve the chances that any suspicious changes in your oral health will be caught early, at a time when cancer can be treated more easily.

Symptoms of Mouth or Throat Cancer
•  Sores that bleed easily or do not heal
•  Thick or hard spot or lump
•  Roughened or crusted area
•  Numbness, pain or tenderness
•  Change in the way your teeth fit together when you bite down

Make sure to alert us about any problems you have when chewing, swallowing, speaking or moving your tongue or jaw.


Restorative Dentistry
Fillings
Fillings are used to restore areas of your tooth destroyed by decay, or dental caries. When bacteria is left undisturbed on a tooth, it secretes acid that dissolves tooth enamel. Dentists use both amalgam (silver) and composite (tooth-colored) materials to replace the missing tooth structure and restore the form and function of the tooth.

Reasons for Fillings
•  Restoring small to medium sized cavities
•  Restoring a chipped anterior (front) tooth

What Does a Filling Involve?
First, Dr. Grote will explain the procedure and answer any questions you have before beginning. If necessary, he will numb the area requiring the filling. He will ensure you are as comfortable as possible at all times. Then Dr. Grote will thoroughly remove the decay and prepare the tooth for either the restoration. These days, he often uses tooth colored materials that mimic the appearance of natural teeth.

What Are Composite "Tooth Colored" Fillings?
Composite fillings are tooth-colored to blend in with the remaining natural part of the tooth. The term composite refers to the actual filling material, which is a mixture of glass or quartz filler in a resin medium.

Composite fillings provide good durability and resistance to fracture in small-to-mid size restorations that need to withstand moderate chewing pressure. In addition to being more aesthetically pleasing, composite fillings are "bonded" or attached with adhesive directly to the tooth surface. This allows for a more conservative repair than traditional fillings with their inability to bond to the tooth structure. Since traditional fillings do not bond to the tooth, amalgam is packed into the tooth, and may loosen over time. Amalgam fillings require that more tooth structure be removed to create a space that will hold the filling in place.

Composite fillings require that the tooth be kept clean and dry during the entire filling process, and they are subject to stain and discoloration over time. The life expectancy of a white filling can depend greatly on where it is in your mouth and how heavily your teeth come together when you bite.

Composite filling material is also commonly used to repair front teeth that have chipped or worn. Where possible, aesthetic bonding of composite material to front teeth is generally much less expensive than veneers or crowns. However, bonding typically does not last as long as veneers or crowns.

If your tooth is sensitive for a week or more it is important to call our office so we can examine the tooth and determine if additional treatment is needed.

Bonding
Bonding is a procedure in which we apply a tooth-colored composite material to a tooth, shape it, allow it to harden and polish it. It can be used in certain situations where a tooth has been damaged or become stained. These are generally minor repairs, ones that can be resolved through this relatively inexpensive means rather than through a more costly dental procedure.

Here's How it Works
The dentist prepares the tooth surface so that the bonding material will adhere. Once that's been applied, the dentist will shape it so that it has a natural appearance. Then the material is allowed to harden, usually with the help of a light. Finally, the composite is polished and buffed so that the surface is smooth.

This is not a process that is recommended if you are a smoker as smoke causes staining. Also, the material is not as durable as porcelain veneers and crowns so it chips more easily; eventually it may require replacing.

Bonding is a perfectly adequate and more affordable solution to certain dental problems. Dental bonding can take less time to accomplish and may not even require anesthesia. Depending upon the issue, insurance may cover it.

Please don't procrastinate if you have a dental problem but are worried about the time, cost, or pain involved. Perhaps dental bonding can offer you a solution. Give us a call so we can discuss options with you.

Crowns
A crown (or cap) is a covering that encases the entire tooth surface, restoring it to its original shape and size. A crown protects and strengthens the tooth structure giving the tooth a longer life than it would have if restored by fillings or other types of restorations.

There are three common types of crowns: all porcelain (tooth colored), porcelain fused to metal, and gold. All porcelain crowns are very aesthetically pleasing, but usually recommended for front teeth only. Porcelain fused to metal (PFM) crowns are a metal-based crown with porcelain baked to the outside for a cosmetically appealing look.

Gold crowns are often recommended for back teeth where the crown cannot be seen. Gold crowns are most like your natural teeth and your tissue adapts best to this material.

If a crown is diagnosed for the extent of decay present, Dr. Grote will discuss what type of crown would be best for you.

Reasons for Crowns
•  Broken or fractured teeth
•  Cosmetic enhancement
•  Decayed teeth
•  Fractured fillings
•  Large fillings
•  Tooth has had a root canal

What Does Dental Crown Treatment Involve?
A crown procedure usually requires two appointments. Your first appointment will include numbing and preparing the tooth by removing any decay and shaping the surface to fit the crown. After the preparation, the dentist will take impressions that will be used to create your custom crown at the dental lab. After the impression is taken, a temporary crown will be placed and you will wear this for approximately two weeks.

At your second appointment your temporary crown will be removed, the tooth will be cleaned, and your new crown will be carefully placed to ensure the spacing and bite are accurate.

You will be given care instructions and encouraged to have regular dental visits to check your crown. As always, proper oral hygiene will help extend the life of your new crown.

Bridges
A dental bridge is a fixed (non-removable) appliance and is an excellent way to replace missing teeth.

There are several types of bridges. We will discuss the best options for your particular case. The "traditional bridge" is the most popular type and is usually made of porcelain fused to metal. This type of bridge consists of two crowns that go over two anchoring teeth (abutment teeth) and are attached on either side of the artificial teeth (pontics), filling the gap created by one or more missing teeth.

Bridges are highly durable and will last many years with proper homecare; however, they may need to be replaced or re-cemented due to normal wear.

Reasons for a Fixed Bridge
•  Fill space of missing teeth
•  Maintain facial shape
•  Prevent remaining teeth from drifting out of position
•  Restore chewing and speaking ability
•  Restore your smile
•  Upgrade from a removable partial denture to a permanent dental appliance

What Does Getting a Fixed Bridge Involve?
Getting a bridge usually requires two or more visits. While the teeth are numb, the two anchoring teeth are prepared by removing a portion of enamel to allow for a crown. Next, a highly accurate impression (mold) is made which will be sent to a dental laboratory where the bridge will be fabricated. In addition, a temporary bridge will be made and worn for about two weeks until your next appointment.

At the second visit, the temporary bridge will be removed, and your new bridge will be carefully checked, adjusted, and cemented or bonded.

You will receive care instructions at the conclusion of your treatment. Proper brushing, flossing and regular dental visits will aid in the life of your new bridge.

Implants
A dental implant is a post made of metal that is designed to replace missing teeth. It is usually made out of titanium and is placed surgically into the jawbone where the tooth is missing. Unlike a bridge, an implant is a more permanent solution.

You have several options when replacing teeth; it isn't limited to crowns and conventional bridges or dentures. Dental implants are aesthetically pleasing and feel very natural. Implants are surgically placed below the gums over a series of appointments. With time, they fuse to the jawbone and serve as a base for individual replacement teeth, bridges or dentures.

Through a process called osseointegration, implants offer stability because they fuse to your bone. Integration of the implants into your jaw also helps your replacement teeth feel more natural. Some patients have reported that the secure fit is more comfortable than alternatives. Dental implant candidates must have healthy gums and bone to support the implant.

Reasons for Dental Implants
•  Keep the look and feel of a real tooth where one is missing
•  Maintain healthy bone levels
•  Help support overdentures

What Does a Dental Implant Involve?
•  Implant Site Preparation: To prepare the site, the gum tissue is opened to expose the bone area. If there is insufficient bone structure, bone grafting may be recommended. With healthy bone, a special drill is used to prepare the bone to receive the implant.

•  Placing the Implant: The implant is placed into the healthy bone and the tissue is sutured. The sutures are removed in seven to ten days. It is normal to expect three to six months to heal entirely. Osseointegration occurs over this time period allowing the implant to become part of the upper or lower jaw.

•  Attaching the Post: A special post is attached to the implant when the gum tissue is ready. This post is the support for the new porcelain crown. Zirconium abutments attached to the implant post assure that the new porcelain tooth has translucency properties similar to a natural tooth.

•  Placing the Crown: The new crown is made from impressions taken and shaded to match your existing teeth. The crown is cemented over the post. The final prosthetic crown appears as your natural tooth.

Smoking tends to lead to a high rate of failure in implants, so dental implants are not the best option for patients who are actively smoking. We will help you determine whether dental implants will be a good tooth replacement option for you. Proper brushing and flossing will maximize the longevity of your new dental implant.

Root Canal Therapy
A "root canal," or endodontic therapy, is a procedure available to save a tooth that is infected and would otherwise require extraction. There are many reasons that teeth can become infected including cavities, previous large fillings, crowns, cracks, trauma and extreme wear.

Root canal therapy is needed when the nerve of a tooth is affected by decay or infection. In order to save the tooth, the pulp (nerve and blood supply), bacteria, and any decay are removed and the resulting space is filled with an inert material called gutta percha. After the tooth is healed, getting a crown is recommended, because the tooth will become brittle.

Having a root canal done on a tooth is the treatment of choice to save a tooth that otherwise would die and have to be removed. Many patients believe that removing a problematic tooth is the best (and most economical) solution. Extracting, or pulling a tooth, could ultimately be more costly and cause significant problems for adjacent teeth, as well as causing loss of bone around the extraction site.

While root canal therapy has a high degree of success, it is not 100% guaranteed. It is very important to have a permanent restoration (usually a crown) placed within 30 days of the root canal. If a permanent restoration is not placed, the tooth can fracture or further decay to the point where the root canal must be re-done or, worse, the tooth must be removed.

Reasons for Root Canal Therapy
•  Decay has reached the tooth's pulp (the living tissue inside the tooth)
•  Infection or abscess has developed inside the tooth or at the root tip
•  Injury or trauma to the tooth
•  Extreme wear due to bruxism (grinding)

What Does Root Canal Therapy Involve?
A root canal procedure requires one or more appointments and can be performed by Dr. Grote. While the tooth is numb, a rubber dam (a sheet of rubber) will be placed around the tooth to keep it dry and isolated from the other teeth. Your Davis dentist will then create a hole at the top of the tooth, and clean the infected pulp from inside the tooth. Medicine will be applied to remove any bacteria, and a temporary filling will be placed. When the tooth has had time to heal from the root canal treatment, you will need to return to our offices to check the healing of the tooth. If the tooth has healed, then it will be ready to have a permanent crown placed to prevent any further decay or fracturing of the treated area.

At times the tooth requiring treatment has a complex root or the infection is such that it needs a specialist, called an endodontist, to examine and complete root canal therapy. Dr. Grote will work closely with our endodontic specialist to review your treatment case, send necessary records to their office, and place the crown after your root canal is completed. Our office staff will help coordinate your appointments, and help you understand your financial responsibility.


Cosmetic Services
Teeth Whitening
Teeth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel, and is an ideal way to enhance the beauty of your smile.

Because having whiter teeth has now become the number one aesthetic concern of most patients, there are several ways to whiten teeth. The most popular method is using an at-home teeth whitening system that will whiten teeth dramatically. Since teeth whitening only works on natural tooth enamel, it is important to evaluate replacement of any old fillings, crowns, etc. Replacement of any restorations will be done after bleaching so they will match the newly bleached teeth.

Teeth whitening is not permanent. A touch-up maybe needed once a year and more often if you smoke and/or drink coffee, tea or wine.

Reasons for Teeth Whitening
•  Fluorosis (excessive fluoridation during tooth development)
•  Normal wear of outer tooth layer
•  Stained teeth due to medications (tetracycline, etc.)
•  Yellow, brown stained teeth

What Does At-Home Teeth Whitening Involve?
Whitening systems provided by our dental office usually require two visits. At the first appointment, impressions (molds) will be made of your teeth to fabricate custom, clear, plastic trays.

At your second appointment, you will try on the trays for proper fit, and adjustments will be made if necessary. The trays are worn with special whitening solution either twice a day or overnight, depending on the degree of staining and desired level of whitening. It is normal to experience tooth sensitivity during the time you are whitening your teeth, but it will subside shortly after you have stopped bleaching.

You will receive care instructions for your teeth and trays, and be encouraged to visit our office regularly to help maintain a beautiful, healthy, white smile.

Cosmetic Bonding
Fillings are used to restore areas of your tooth destroyed by decay, or dental caries. When bacteria is left undisturbed on a tooth, it secretes acid that dissolves tooth enamel. Dentists use both amalgam (silver) and composite (tooth-colored) materials to replace the missing tooth structure and restore the form and function of the tooth.

Reasons for Fillings
•  Restoring small to medium sized cavities
•  Restoring a chipped anterior (front) tooth

What Does a Filling Involve?
First, Dr. Grote will explain the procedure and answer any questions you have before beginning. If necessary, he will numb the area requiring the filling. He will ensure you are as comfortable as possible at all times. Then Dr. Grote will thoroughly remove the decay and prepare the tooth for either the restoration. These days, he often uses tooth colored materials that mimic the appearance of natural teeth.

What Are Composite "Tooth Colored" Fillings?
Composite fillings are tooth-colored to blend in with the remaining natural part of the tooth. The term composite refers to the actual filling material, which is a mixture of glass or quartz filler in a resin medium.

Composite fillings provide good durability and resistance to fracture in small-to-mid size restorations that need to withstand moderate chewing pressure. In addition to being more aesthetically pleasing, composite fillings are "bonded" or attached with adhesive directly to the tooth surface. This allows for a more conservative repair than traditional fillings with their inability to bond to the tooth structure. Since traditional fillings do not bond to the tooth, amalgam is packed into the tooth, and may loosen over time. Amalgam fillings require that more tooth structure be removed to create a space that will hold the filling in place.

Composite fillings require that the tooth be kept clean and dry during the entire filling process, and they are subject to stain and discoloration over time. The life expectancy of a white filling can depend greatly on where it is in your mouth and how heavily your teeth come together when you bite.

Composite filling material is also commonly used to repair front teeth that have chipped or worn. Where possible, aesthetic bonding of composite material to front teeth is generally much less expensive than veneers or crowns. However, bonding typically does not last as long as veneers or crowns.

If your tooth is sensitive for a week or more it is important to call our office so we can examine the tooth and determine if additional treatment is needed.

Cosmetic Crowns
A crown (or cap) is a covering that encases the entire tooth surface, restoring it to its original shape and size. A crown protects and strengthens the tooth structure giving the tooth a longer life than it would have if restored by fillings or other types of restorations.

There are three common types of crowns: all porcelain (tooth colored), porcelain fused to metal, and gold. All porcelain crowns are very aesthetically pleasing, but usually recommended for front teeth only. Porcelain fused to metal (PFM) crowns are a metal-based crown with porcelain baked to the outside for a cosmetically appealing look.

Gold crowns are often recommended for back teeth where the crown cannot be seen. Gold crowns are most like your natural teeth and your tissue adapts best to this material.

If a crown is diagnosed for the extent of decay present, Dr. Grote will discuss what type of crown would be best for you.

Reasons for Crowns
•  Broken or fractured teeth
•  Cosmetic enhancement
•  Decayed teeth
•  Fractured fillings
•  Large fillings
•  Tooth has had a root canal

What Does Dental Crown Treatment Involve?
A crown procedure usually requires two appointments. Your first appointment will include numbing and preparing the tooth by removing any decay and shaping the surface to fit the crown. After the preparation, the dentist will take impressions that will be used to create your custom crown at the dental lab. After the impression is taken, a temporary crown will be placed and you will wear this for approximately two weeks.

At your second appointment your temporary crown will be removed, the tooth will be cleaned, and your new crown will be carefully placed to ensure the spacing and bite are accurate.

You will be given care instructions and encouraged to have regular dental visits to check your crown. As always, proper oral hygiene will help extend the life of your new crown.

Porcelain Veneers
Veneers are very thin pieces of durable, tooth shaped porcelain that are custom-made (for shape and color) by a professional dental laboratory. They are bonded onto the front of teeth to create a beautiful and attractive smile.

Veneers can completely reshape your teeth and smile. They can often be alternatives to crowns and the ideal solution in treating many cosmetic dental conditions for the front teeth. As with most dental restorations, veneers may someday need replacement; however, they are still very durable and will last many years, giving you a long-lasting, beautiful smile.

Reasons for Porcelain Veneers
•  Crooked teeth
•  Misshapen teeth
•  Severely discolored or stained teeth
•  Teeth that are too small or large
•  Unwanted or uneven spaces
•  Worn or chipped teeth

What Does Porcelain Veneers Involve?
Receiving veneers usually requires two visits to complete the process. The teeth are prepared by lightly buffing and shaping the surface to allow for the thickness of the veneer. A mold or impression of the teeth is taken and a shade (color) will then be chosen by you and Dr. Grote.

On the second visit the teeth will be cleansed with special liquids to achieve a durable bond. Bonding cement is then placed between each tooth and veneer, and a special light is used to harden and set the bond.

After your visit you will receive care instructions for your veneers. Proper brushing, flossing and regular dental visits will aid in the life of your beautiful veneers.
Conveniently Located on
Anderson Road, Just North of UC Davis

Dr. Keith Grote
635 Anderson Road Suite 16
Davis, CA 95616-3505

Phone: 530-756-8800
Fax: (530)758-9418
email: drgrote@sbcglobal.net

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