tmj & tmd

The “Temporomandibular Joint,” more commonly referred to as the “jaw joint,” assists in the basic opening and closing movements of the jaw. Unfortunately, this joint is a common area for recurring pain. Although conventional wisdom suggests that “popping” sounds in the jaw indicates a TMJ dysfunction, this is not always true. Many times, your jaw is functioning properly even if a “popping” sound is present when chewing or talking.

We offer a TMJ exam that evaluates the joint tissue in the “hinge” of the jaw. Possible problems include swelling, deterioration of the joint tissue or damaged joint tissue (which cushions the jaw bones during the opening and closing movement of the mouth). Common pain relievers and cold compresses can provide temporary relief for most cases of TMJ.

For more serious cases of TMJ, we will recommend alternate treatments. Often, we will suggest using a mouth guard to relieve teeth grinding. In some cases, we will instruct you to use orthodontic appliances or retainers to alleviate discomfort or redirect positioning of the TMJ joint. For the most severe cases of TMJ, we may recommend certain invasive procedures.

endodontics

An endodontist is a specialist in the area of soft tissue inside the tooth. Endodontists, who perform root canals, receive advanced education after graduating from dental school and typically only deal with endodontic-related problems.

A common misconception is that a root canal is a painful procedure. Actually, root canals are similar to having a cavity filled, producing minimal pain.

Common causes for the need of endodontic treatment:

• Inflamed/infected tooth pulp
• Severe sensitivity to hot and cold elements
• Tooth decay
• Chipped or broken tooth
• Blow to the tooth
• Swelling or tenderness near the infected tooth
• Repeated dental procedures on a tooth

general treatment

A BEAUTIFUL SMILE IS PRICELESS!

• Show the world your smile with confidence!
• Show the world who you are!
• Show the world how proud you are!
• Show the world your confidence!

Don’t hold back that beautiful smile. Don’t wish for a smile to be proud of. Do you often get embarrassed of your smile due to:

• Faded, chipped or cracked teeth?
• Crooked or crowded teeth?
• Stained or worn teeth?
• Uneven spaces in your teeth?

Davinci veneers

Generically known as laminate veneers, these thin shells (i.e. veneers) of porcelain, pressed ceramic or composite are cemented over the teeth to modify the color, shape or alignment or restore chipped teeth.

To avoid any confusion, it must be noted that there is a dental lab with the name DaVinci Studios that makes the laminate veneers that have been used on makeover shows on television. That is why the procedure is labeled DaVinci Veneers.

The shows on television and DaVinci Studios deserve a lot of credit for highlighting the great contribution dentistry can make to both a person's appearance and self-esteem. Although everyone does not meet the criteria for placement of porcelain veneers, the fundamental knowledge that there are options out there for people who want to change their smile is welcome.

When properly done, laminate veneers are very hard to discern from beautiful, natural teeth and can improve a patient’s smile significantly, or bring their smile back to life.

Porcelain veneers are a fantastic way to repair or enhance the appearance of front teeth. They can be used to whiten teeth, close spaces and create a great smile. Using veneers, we can even perform "instant orthodontics" to straighten crooked teeth and give patients the bright smile they always wanted. Many Hollywood actors have porcelain veneers. That is how many of them got the "Hollywood Smile."

fIRST vISIT

When you arrive for your first visit, please be prepared to complete all insurance and health information forms that will allow us to begin your dental treatment. We will ask you to fill out several forms that will get you acquainted with our office.

Your initial exam will last approximately one hour. Oral hygiene instructions will be provided along with suggestions to help you care for your teeth. In most cases, we will also clean your teeth on this visit and provide an evaluation that will outline your existing dental problems and proposed treatment.

early dental care

Teething: Normally the first tooth erupts between ages 6 to 12 months. Gums are sore, tender and sometimes irritable until the age of 3. Rubbing sore gums gently with a clean finger, the back of a cold spoon or a cold, wet cloth helps soothe the gums. Teething rings work well, but avoid teething biscuits-they contain sugar that is not good for baby teeth.

While your baby is teething, it is important to monitor the teeth for signs of baby bottle decay. Examine the teeth, especially on the inside or the tongue side, every two weeks for dull spots (whiter than the tooth surface) or lines. A bottle containing anything other than water and left in an infant's mouth while sleeping can cause decay. This happens because sugar in the liquid mixes with bacteria in dental plaque, forming acids that attack the tooth enamel. Each time a child drinks liquids containing sugar, acids attack the teeth for about 20 minutes. When awake, saliva carries away the liquid. During sleep, the saliva flow significantly decreases and liquids pool around the child's teeth for long periods, covering the teeth in acids.

Infant's New Teeth: The primary, or "baby," teeth play a crucial role in dental development. Without them, a child cannot chew food properly and has difficulty speaking clearly. Primary teeth are vital to development of the jaws and for guiding the permanent (secondary) teeth into place when they replace the primary teeth around age 6.

Since primary teeth guide the permanent teeth into place, infants with missing primary teeth or infants who prematurely lose primary teeth may require a space maintainer, a device used to hold the natural space open. Without a maintainer, the teeth can tilt toward the empty space and cause permanent teeth to come in crooked. Missing teeth should always be mentioned to your family dentist. The way your child cares for his/her primary teeth plays a critical role in how he/she treats the permanent teeth. Children and adults are equally susceptible to plaque and gum problems-hence, the need for regular care and dental checkups.

A Child's First Dental Visit: A child's first dental visit should be scheduled around his/her first birthday. The most important part of the visit is getting to know and becoming comfortable with a doctor and his staff. A pleasant, comfortable first visit builds trust and helps put the child at ease during future dental visits. If possible, allow the child to sit in a parent's lap in the exam room. Children should be encouraged to discuss any fears or anxiety they feel.

Why Primary Teeth Are Important: Primary teeth are important for several reasons. Foremost, good teeth allow a child to eat and maintain good nutrition. Healthy teeth allow for clear pronunciation and speech habits. The self-image that healthy teeth give a child is immeasurable. Primary teeth also guide eruption of the permanent teeth.

Good Diet and Healthy Teeth: The teeth, bones and soft tissue of the mouth require a healthy, well-balanced diet. A variety of foods from the five food groups helps minimize (and avoid) cavities and other dental problems. Most snacks that children eat cause cavities, so children should only receive healthy foods like vegetables, low-fat yogurt and cheeses, which promote strong teeth.

Infant Tooth Eruption
A child's teeth actually start forming before birth. As early as 4 months of age, the primary or "baby" teeth push through the gums-the lower central incisors are first, then the upper central incisors. The remainder of the 20 primary teeth typically erupt by age 3, but the place and order varies.

Permanent teeth begin eruption around age 6, starting with the first molars and lower central incisors. This process continues until around age 21. Adults have 28 secondary (permanent) teeth-32 including the third molars (wisdom teeth).

Preventing Baby Bottle Tooth Decay: Tooth decay in infants can be minimized or totally prevented by not allowing sleeping infants to breast or bottle-feed. Infants that need a bottle to comfortably fall asleep should be given a water-filled bottle or a pacifier. Our office is dedicated to fighting baby bottle tooth decay. Let us know if you notice any signs of decay or anything unusual in your child’s mouth.

financial & insurance

Down payments are required at the time of the treatment. Visa, MasterCard, Discover and American Express are accepted.

Please ask a member of our staff about our cash and senior discounts.

Additionally, we will electronically submit all insurance claims for you.

Our office hours are:

Mondays, Thursdays and Fridays: 8 a.m. to 5 p.m.
Tuesday and Wednesday: 8 a.m. to 7 p.m.

dental health

Bad Breath: What you eat affects the air you exhale. Certain foods, such as garlic and onions, contribute to objectionable breath odor. Once food is absorbed into the bloodstream, it is transferred into the lungs, where it is expelled. Brushing, flossing and mouthwash will only mask the odor temporarily. Odors continue until the body eliminates the food. Dieters may develop unpleasant breath from infrequent eating.

If you don’t brush and floss daily, particles of food remain in the mouth, collecting bacteria, which can cause bad breath. Food that collects between the teeth, on the tongue and around the gums can rot, leaving an unpleasant odor. Dentures that are not cleaned properly can also harbor odor-causing bacteria and food particles.

One of the warning signs of periodontal (gum) disease is persistent bad breath or a bad taste in the mouth. Periodontal disease is caused by plaque, the sticky colorless film of bacteria that constantly forms on teeth. The bacteria create toxins that irritate the gums. In the advanced stage of the disease, the gums, bone and other structures that support the teeth become damaged. With regular dental checkups, periodontal disease can be detected and treated early.

Tooth Care: Dr. Joel Gould strongly recommends the use of an electric toothbrush for home care. Proper home care after any dental treatment is necessary to maintain the results we have worked hard to accomplish and is as important as the treatment. Without proper home care, the likelihood of recurring dental problems rises exponentially.

Flossing, while not everyone’s favorite thing to do, is necessary for proper home care. The bacterium that causes gum disease does not like oxygen. By flossing, you are bringing oxygen down to the bacteria between your teeth and helping to kill those nasty bugs. You should be flossing twice a day.

Your gums will be sore when you start flossing because of the local areas of inflamed tissue. After a couple of weeks of regular use, you will notice the gum tissue heal and become less tender. Bleeding, which may be apparent at the start of a flossing regimen, will become minimal or disappear entirely.

Policies & Mission

Our goal is to help all of our patients become healthy by providing state-of-the-art care with minimal discomfort, and then showing them how to stay healthy.

We value heath-centered, wellness-focused and optimum care dentistry in a safe, comfortable, friendly environment.

In an effort to develop meaningful, long-term relationships with our patients, we have made a commitment to take the time to listen so that we may better understand each patient’s wants and needs, and help them to be as healthy as they choose to be.

Our office hours are:

Mondays, Thursdays and Fridays: 8 a.m. to 5 p.m.
Tuesday and Wednesday: 8 a.m. to 7 p.m.

About Teeth

Throughout your life, you will have two sets of teeth: primary (baby) teeth and secondary (permanent) teeth. At age 6-8 months, the primary teeth appear; all 20 are in place by age 3.

Permanent teeth will begin to grow around age 6, and except for wisdom teeth, are all present between ages 12 and 14. The next teeth to grow in are the 12-year molars and finally the wisdom teeth. Wisdom teeth typically begin breaking through from age 17 and on. The total number of permanent teeth is 32, though few people have room for all 32 teeth. This is why wisdom teeth are usually removed.

Your front teeth are called incisors. The sharp “fang-like” teeth are canines. The next side teeth are referred to as pre-molars or bicuspids, and the back teeth are molars. Your permanent teeth are the ones you keep for life, so it is vital that they are brushed and flossed regularly and that periodic check-ups by a dentist are followed.

cosmetic

Many patients notice that their teeth aren't "as white as they used to be." Over time teeth commonly turn a shade of yellow. This can be due to several factors including diet, smoking, coffee, tea, colas, wine, etc. Fortunately, there is an easy solution. "Home bleaching" is a very popular cosmetic procedure. It is a simple and effective method to whiten natural teeth. After two weeks of treatment, most patients will see dramatic results. Bleaching is an effective and economical way to achieve a remarkably improved smile. It should be noted that existing fillings, bondings or crowns will not change color and may need to be replaced to match your new, whiter teeth.

There are several ways to whiten teeth, all of which are effective, but to varying degrees. “Over the counter" products, such as strips and gels, use the same ingredients dentists use, but in a lower concentration and with a less effective delivery system. Tray bleaching is a procedure in which molds are taken of your teeth and custom trays are formed. A higher concentration of whitening gel is used. Depending on the gel’s concentration, trays are worn from one to eight hours. "Laser" bleaching is for patients who want immediate gratification. A protective barrier is placed and peroxide gel is applied to the teeth. A "laser" light source activates the solution, so that after about one hour, you walk out looking like a movie star with whiter teeth. Tooth whitening will improve the appearance of the teeth but will not change their overall contour. It will also not change the color of existing crowns or fillings.

Whitening prices are as follows:

brushing

STEP 1: Use a soft-bristled toothbrush and a small strip of fluoridated toothpaste. Holding the brush at a 45-degree angle, move the brush in small, circular motions across the teeth.

STEP 2: Carefully brush the chewing surfaces of your teeth, making sure to clean the back teeth and between the teeth.

STEP 3: Use the same circular motion to clean the inside of the upper and lower teeth.

STEP 4: Brush the inside of the top and bottom front teeth by angling the head of the toothbrush up-and-down, and brushing in a soft, circular motion.

STEP 5: Finish by brushing your tongue and the roof of your mouth before rinsing.

BRUSHING / FLOSSING / DIET CONTROL / DENTAL VISITS

flossing

STEP 1: Floss at least once a day. Pull a small length of floss from the dispenser and wrap the ends tightly around your middle fingers.

STEP 2: Gently guide the floss between all teeth to the gum line, including the back teeth, to remove any food particles or plaque.

STEP 3: Unwraw clean floss around your fingers as you go, so that you have used the floss from beginning to end.

BRUSHING / FLOSSING / DIET CONTROL / DENTAL VISITS

diet control

The teeth, bones, and soft tissue of the mouth require a healthy, well-balanced diet. A variety of foods from the five food groups help minimize and avoid cavities and other dental problems. Consumption of foods that contain sugars and starches should be decreased. These foods can include candies, cookies, chips, and crackers. Healthier foods, such as vegetables, low-fat yogurt and cheeses, help promote stronger teeth.

BRUSHING / FLOSSING / DIET CONTROL / DENTAL VISITS

dental visits

You should visit your general dentist twice a year (once every six months). In order to maintain a healthy smile, it is vital to have professional cleanings and regular checkups. Your dentist will examine your teeth and provide an evaluation of existing dental problems and proposed treatment. If you have a dental emergency, you should call your dentist immediately.

BRUSHING / FLOSSING / DIET CONTROL / DENTAL VISITS

directions & maps

Manhattan Beach Location

Santa Monica Location

appointment request

Our doctors

Dr. Joel Gould graduated from the University of Western Ontario with a Doctorate in Dental Surgery in 1991. He has been practicing dentistry for 17 years.

A native of Winnipeg, Manitoba, Dr. Gould has worked with the government of Ontario to provide on-site dental treatment for elementary school children in underserviced areas. While working in Ontario, he established a dental clinic in the town of Emo.

Before moving to southern California, Dr. Gould operated a private practice in Vancouver, British Columbia for ten years.

He is a member of the American Dental Association, the California Dental Association and the Canadian Dental Association.

Dr. Gould volunteers at the Children’s Dental Center in Inglewood, CA in his spare time.

He enjoys beach volleyball, running, cycling and snowboarding.

Dr. Nowell Gray strives for excellent treatment on a variety of patients, or is it that he strives for a variety of treatments on excellent patients. Either way, his goal is providing comprehensive cosmetic and general dental care while attempting to take the “dentist” out of dentistry.

Dr. Nowell Gray earned his doctorate of dental surgery from the University of Southern California in 2005. Prior to this he received a bachelor’s of science degree in biochemistry from La Sierra University. Before that his life was a whirlwind of pep rallies and prom dates.

While attending dental school, Dr. Gray worked with several dental aid organizations including, the Union Rescue Mission and the Mobile Children’s Clinic. Once graduated, he volunteered for the Children’s Dental Clinic as well as Homeless Not Toothless.

Nowell Gray was born and raised in Riverside, California. He enjoys surfing, snowboarding, and the occasional Wiffle® ball game. His turn-on’s include blond eyes and blue hair, and very short walks on the beach. His turn-off’s are tooth decay, gum disease, and malocclusion. He currently resides in Santa Monica.

He is a member of the American Dental Association and the California Dental Association.

Dr. Amy Ellett was born and raised in the Okanagan Valley of British Columbia, Canada. She received her Doctor of Dental Surgery degree from the University of Alberta in 2007 and went on to complete two years of specialized hospital dentistry training at UCLA. She has since been working in private practice in Calgary, Alberta.

Dr. Ellett is passionate about donating her time to dental aid organizations and has travelled for the past five years with Kindness in Action to provide dental care to children in rural Central and South America.

She is a member of the American Dental Association, California Dental Association, West LA Dental Association, and Canadian Dental Association.

In her spare time Dr. Ellett enjoys surfing, yoga, scuba diving, and cycling.

Dr. Ellett is also an endurance athlete who recently completed an Ironman triathlon. She will go the extra mile to make sure your visit to the dentist is second to none!