Boise Family Dental Care

Centennial Dental Center welcomes families from Boise and surrounding areas. Our Family Dentistry services are designed to provide everyone in your home the dental care they need for a healthy smile.

Frequently Asked Questions About Family Dentistry

A family dentist is a general dentist who has established an office where patients of all ages can obtain the care they need. The fact that our dentist offers cleaning and preventive servicescosmetic treatmentsperiodontal care, and tooth replacement makes choosing a Centennial dentist an easy choice for the patient seeking convenient, personal care for their entire household. Centennial dentists provide exceptional and professional Boise dental services.

In the family dental office, patients find the care they need to prevent and treat common dental conditions. Routine hygiene visits involve checkups and cleanings that are tailored to the individual. If gum disease is an existing concern, routine visits may occur more frequently, and hygiene services more comprehensive.

Family dentistry prioritizes personal care for patients of all ages. This is a requirement in order to provide the high level of care every person deserves. We understand how to calm the fears that are natural to the young and the “older” alike. Our friendly staff shows concern for comfort and peace of mind, as well as familiarity with the various dental services that a patient may need as oral health changes from time to time.

Dental care can be somewhat challenging for any person, especially the person who has had an unpleasant experience with a dentist or dental office. One of the primary reasons to choose a family dentist is because it gives every one of your family members the opportunity to build a lifelong relationship with familiar faces. This means trust in the level of care and personal attention each person will receive.

Family dental offices are also convenient because children, teens, and adults can obtain the treatments they need in one location.

Choosing a dentist is a personal decision not to be taken lightly. Some patients value convenience above other attributes, such as cost. Some patients want to know that, when they visit their dental office, they will see the same dentist every time. When choosing the office that is right for your family, consider the attributes that matter most to you. You may ask about experience, training, the number of cases that have been conducted (cosmetic, restorative, or otherwise), and any special interests a dentist has.

We welcome your call and are happy to meet you personally to help you determine if our office is a good fit for your family!

Generally, we like to schedule exams and cleanings on a six-month recall schedule. This timing is the norm when there are no ongoing dental conditions to monitor, such as periodontal disease. When you visit Centennial Dental Center, we will discuss the routine care protocol that will best serve your needs. Of course, it is beneficial to visit your dentist anytime you experience something out of the ordinary, such as a toothache or an injury to a tooth.

Cosmetic concerns, as well, may be addressed at any time, not only during your routine appointments. If you want to learn how to brighten your smile, straighten teeth, or fix a chip or crack, we encourage you to give us a call for an evaluation and consultation. Many of the cosmetic concerns that our patients have can be corrected in a straightforward and affordable manner.

Looking for a family dentist in Meridian, Boise, Eagle, and surrounding areas? Contact our office to schedule an appointment.

Airway Dentist Boise

What is the field of Airway Dentistry?

Airway dentistry and sleep apnea probably aren’t what you think of immediately when you think of a dentist. However, airway dentistry is becoming an important part of many dental practices. What is airway dentistry and how can it help you? Airway dentistry is a new and growing field that’s focused on the structure of the mouth, jaw and nose and how that impacts your breathing. The dentist looks for sleep-disordered breathing by looking for signs of mouth breathing when you’re sleeping. Things like tooth wear, the position of your tongue, and the condition of the soft tissue in your mouth can speak to airway dentists. The goal is to prevent sleep apnea, as that leads to bigger health issues down the road.

What is the field of Airway Dentistry?

Airway dentistry is a new and growing field that’s focused on the structure of the mouth, jaw and nose and how that impacts your breathing. The dentist looks for sleep-disordered breathing by looking for signs of mouth breathing when you’re sleeping. Things like tooth wear, the position of your tongue, and the condition of the soft tissue in your mouth can speak to airway dentists. The goal is to prevent sleep apnea, as that leads to bigger health issues down the road.

Do I have signs of Sleep-Disordered Breathing or Sleep Apnea?

Signs and symptoms of these conditions can be obvious to you once they’re pointed out. They include:

  • Feeling tired even after getting eight hours of sleep
  • Grogginess during the day
  • Headaches upon waking up
  • Sore throat in the morning
  • Being unable to focus
  • Snoring
  • Waking up in the night while gasping for air
  • Not dreaming or unable to remember dreams
  • Teeth grinding
  • Acid reflux causing acid erosion on your teeth
an infographic showing common symptoms of airway and sleep disorders

In addition to suffering from all of the symptoms of sleep deprivation that we listed above, sleep apnea patients are also subject to a higher risk of heart attack, stroke, and diabetes. If you notice that you’re having these symptoms in your day to day life, it’s time to talk to someone about airway dentistry. If your partner tells you you’ve been snoring loudly and waking them up during the night, that’s a red flag as well. Armed with a proper diagnosis, we can begin treatment that can benefit your overall health.

Schedule an appointment with
Centennial Dental Center

What Can I Expect From Airway Dentistry?

Even if you don’t go to the dentist specifically because of airway dentistry, symptoms may be noticed during a general dentistry exam. At Centennial Dental, we strive to practice comprehensive dentistry. Our team will look for the oral signs of sleep-disordered breathing at every dental exam you have, just to keep on top of things. If you bring up symptoms or our team finds them, we’ll assess the patterns of your breathing. Usually, sleep-disordered breathing is caused by the relaxation of the muscles in the throat. With sleep apnea, breathing is completely stopped by these muscles. However, there are conditions like Upper Airway Resistance Syndrome (UARS) that don’t stop breathing, but can significantly disrupt sleep, causing sleep fragmentation. Both conditions affect Rapid Eye Movement (REM) sleep. This is one of the most important parts of the sleep cycle. REM sleep is used for your brain to rejuvenate itself from the day. If this is disrupted nightly, it can lead to serious issues with your alertness during the day.

Airway Dentistry at Centennial Dental

Dr. Koeltl offers a personalized approach to airway dentistry. Sometimes, an oral device that people wear while sleeping can fix the problem by adjusting the mouth so the airway stays open. However, there are more advanced therapies and treatments available if this doesn’t work for you. Dr. Koeltl is dedicated to making sure he can get you the solution you need. Call us today or request an appointment online to get started!

Pediatric Airway Dentistry

Sleep Disordered Breathing

Airway Health and Sleep Disordered Breathing in children is a much more critical and common problem than what has previously been thought. SDB can manifest itself in a variety of symptoms that can be easily overlooked, misdiagnosed, and most unfortunately often left untreated. The symptoms associated with SDB can include mouth breathing, loud snoring and fatigue can point to serious underlying health issues and the need for treatment. Twenty years of research has identified an association between Sleep Disordered Breathing and crowded or crooked teeth or other dental concerns. SDB can have a lasting impact on your child’s growth and development and even create behavior challenges similar to ADD/ADHD or bedwetting.

The central issue for many children suffering from the effects of Sleep Disordered Breathing (SDB) or Obstructive Sleep Apnea (OSA) is a compromised airway. When a child’s airway is narrow, underdeveloped or obstructed in any way, the child will struggle to receive enough oxygen during the night, wake-up or change position to breathe, causing fragmented and interrupted sleep.

Snoring and apnea decrease oxygen supply to the body and brain, interrupt sleep and prevent the child from obtaining the vitally important stages of deep and REM sleep. Sleep Disordered Breathing, that can range from Snoring to Obstructive Sleep Apnea, is a vicious cycle and leads to symptoms such as:

  • Swollen tonsils and adenoids
  • Frequent ear and upper respiratory infections
  • Bed wetting
  • More severe allergies, asthma
  • Digestive issues
  • Disrupted sleep patterns
  • Delayed growth
  • Depression
  • Headaches
  • ADD/ADHD like behavior
  • Cognitive and learning issues
  • Poor memory and ability to focus
  • Aggression and socialization issues

Dr. Koeltl is a proponent of catching airway issues early in children, so that the issues can be addressed and corrected with airway focused orthodontic treatment. Proper orthodontic treatment can open up and develop the airway of a growing child by expanding the upper palate, bringing the upper and lower jaws forward and allowing the airway to widen. Airway focused orthodontic treatment offers a CURE for children suffering from SDB or OSA or PREVENTS it in children who might be at risk.

It is vital to not only address the underlying causes of both SDB and dental malocclusion but to also ensure that the causative issues do not reoccur. By incorporating myofunctional therapy with orthodontic care, we can help your child eliminate damaging habits like mouth breathing, improper swallowing and tongue thrusting. We have some superb myofunctional therapists in the Treasure Valley that we can refer you to.

By evaluating and screening your child for Lip-Ties or Tongue-Ties (tight maxillary and lingual frenum attachments) and offering procedures when appropriate, we can treat the anatomical barriers to good airway growth and health.

In summary, proper oxygenation through correct breathing, a healthy airway and a full night’s sleep in turn lead to an improved immune and hormonal system, better school and sports performance and an overall healthier and happier child.

Teeth & Airway Health

The position of the teeth, even as early as 2 years old, can indicate insufficient jaw size, poor airway development and be a symptom of poor myofunctional habits that can lead to Sleep Disordered Breathing and Obstructive Sleep Apnea. The earlier the signs are recognized and treated, the healthier your child will be.

No Spacing OR Crowding Between Baby Teeth

A normal and healthy bite with all the primary teeth present will appear to have SPACES between all the baby teeth. This is a good indication that the tongue is correctly placed on the roof of the mouth and is acting like a “scaffold” for proper tooth position and palate size development. Permanent teeth that come in after the baby teeth fall out are much bigger and wider than the baby teeth they replace and need the extra room spacing provides. No spaces between your child’s baby teeth usually indicate not only that the adult teeth are going to be crowed or even “crowed out completely”, but also indicate that the dental arches are too narrow and can lead to poor facial growth and unhealthy airway development. Early intervention and treatment can not only prevent the need for braces which will likely be inevitable, but can also prevent poor airway development that can lead to poor heath and sleep.

Tooth Wear and Chipping

When the teeth look “flattened, ” worn-down, short or chipped, it can indicate tooth grinding or bruxism and point to a potential airway problem. If a child is having a hard time getting enough oxygen while sleeping, the body will unconsciously respond to try and make breathing easier. One way the body accomplishes this is by moving the lower jaw forward (like the “jaw thrust” in CPR) to automatically open the airway. With repeated movement of the lower jaw coming forward, not only will you hear “tooth grinding” sounds, you will see damage to the teeth. Hearing or seeing evidence of tooth grinding means that your child is likely struggling to get enough oxygen while sleeping and treatment should begin as early as possible to cure this serious problem.

Over-Closed OR “Deep” Bite

When a child bites down and the lower incisors are hardly visible, this means there is an over closed or “deep bite” bite and a vertical discrepancy, which has serious future consequences for airway size and growth and development if not treated early.

An “Open” Bite

Front top and bottom teeth that do not overlap at all when the back teeth are touching and have a large gap or space between them (for example you could stick the tongue “through” the gap) are usually the result of a habit such pacifier or thumb sucking. Often it appears that the canine teeth are “longer”, when in fact the upper front 4 teeth are actually pushed “up” higher than the rest of the teeth. Unfortunately, this “open bite” leads to poor myofunctional issues like an open mouth posture and low tongue position, a tongue thrust, mouth breathing and further constriction of the palate leading to poor jaw growth and airway development compromised. Even though sucking and soothing habits are “normal” for babies and infants, the sooner they are addressed and stopped, the better. Early corrective and conservative treatment should be the goal in order to put the growth pattern of the face, jaws and teeth back on track and the correct any poor myofunctional habits that often coexist.

Front Crossbite

A cross-bite involving the front teeth: if the lower teeth are biting in front of the upper teeth, it is a situation that demands immediate intervention. The condition will prevent the upper jaw from growing forward and as the teeth grow longer with time, it will be harder to reverse the cross-bite.

Side Crossbite

A cross-bite involving the side primary molars means that the top jaw is smaller than it should be and is an indication of a constricted palate which is a risk factor for poor airway development and should receive immediate intervention.

Around age 8, as the baby upper lateral incisors are shed, if the palate is constricted, there will be very little space or no for the permanent laterals to erupt. These teeth need at least 7 mm of room to come into the mouth properly. Unless the palate is expanded and room is made, the loss of space will not be regained. In addition to severe tooth crowding, a constricted palate is a sign of unhealthy air way development and improper jaw growth. Early treatment around age 7 or 8 is vital.

Extreme “Overjet” and “Overbite”

Although the top teeth may look like they are way too forward and should be “pulled back”, its actually the opposite. The top teeth may look “buck”, but they are actually positioned in the maxillary arch correctly and the trouble lays with the underdevelopment of the lower jaw. This lower jaw “protrusion” is also known as a “retrognathic mandible.”

This type of “bite” and jaw position puts a child at extremely high risk for developing a constricted airway and Obstructive Sleep Apnea. Treatment to help guide the lower jaw forward should begin as young as possible knowing that the jaw basically stops growing around the time all the permanent teeth come in, usually around age 12. The earlier treatment for this condition begins, the more conservative and effective it can be. Waiting too long can result in unfavorable treatment options, including jaw surgery and if not addressed at all, will likely lead to OSA and poor health.

Flared Lateral Incisors

If lateral incisors are fully erupted around age 9, and they look like they are flared sideways, this is a warning that there is impending crowding. Due to a lack of space, the underlying canines are pushing against the roots of these laterals and shifting their position. This can be detected with early screening and good imaging, preventing potential damage to the permanent lateral tooth roots as well as creating room for the permanent canines to erupt in a more normal path.

Displaced Canines

Around age 11, the upper canines will appear. Among all the permanent teeth, these travel the longest path before they emerge. They start their journey from the space right next to the nose, almost under the eye, and travel down over many years. If there is insufficient space due to a constricted palate, they will emerge “ectopically,” or sideways, or they will be impacted within the palate. Complications and lengthy treatment time can be avoided with early treatment.

Frenums – “Tongue and Lip Ties”

If the tongue is restricted and unable to touch and rest on the upper palate, a simple Frenectomy procedure may be necessary to improve your child’s health and dental issues.

The Nose is for Breathing, the Mouth is for Eating

  • Normal and healthy breathing is done through the nose, NOT the mouth. Each nostril functions independently and synergistically to filter, warm, moisturize, dehumidify and smell the air. Only by the act of breathing through your nose is the air being properly prepared to enter the lungs.
  • Babies are born obligatory nose breathers, but somewhere along the way nose breathing can change to mouth breathing, with dire consequences. Harmful effects of mouth breathing include drying out oral and pharyngeal tissues and not filtering the air entering our bodies from bacteria and irritants. This often leads to inflamed tonsils and adenoids, more frequent upper respiratory infections, dry cough, gingivitis and caries.
  • Additionally, mouth breathing causes the jaws to grow incorrectly, the tongue to hang lower in the mouth, the upper palate to constrict and narrow, in turn causing a restricted nasal cavity space, as well as crooked teeth. This is an example of “form following function” – poor bone structure and muscle formation will occur from poor breathing function (mouth breathing.)
  • Normal respiration follows a gentle wave pattern with 10 to 12 breaths per minute and is driven by the diaphragm. Mouth breathers take too many breaths, with rates from 12 to 20 breaths per minute or more and incorrectly use their chest muscles to breathe.
  • Breathing delivers oxygen to the cells of the body and removes excess carbon dioxide. Carbon dioxide is produced as a byproduct of exercise and digestion of food, but, carbon dioxide is not just a “waste product:” having the right amount of carbon dioxide in your body is critical to health.
  • Carbon dioxide plays a significant role in the release of oxygen from hemoglobin and how much oxygen your organs receive. It also triggers breathing, maintains blood pH and prevents smooth muscle spasms. All of these functions are reduced or impaired in mouth breathers.
  • Surprisingly, oxygen is absorbed on the exhale, not on the inhale. The back pressure created in the lungs with the slower exhale of nose breathing allows more time for the lungs to transfer oxygen to the blood. This exchange requires carbon dioxide. Exhaling through the mouth allows too much carbon dioxide to leaver the body, resulting in less oxygen being absorbed in the body.
  • An enzyme called nitric oxide is released in the nasal cavity ONLY WHEN NASAL BREATHING. Nitric Oxide is a vasodilator. It dilates blood vessels carrying oxygen increasing the efficiency of oxygen exchange in the body by 18 percent.
  • There is no Nitric Oxide inhaled with mouth breathing, therefore less oxygen is absorbed.
  • The reduced oxygen absorption leads to a cascade of poor sleep, poor stamina, low energy level and in kids can lead to ADHD symptoms. Children diagnosed with ADHD may in fact be mouth breathers who are simply sleep deprived.
  • With proper nasal breathing, the tongue rests against the palate without touching the teeth and the lips are closed.
  • In this position, the tongue provides passive pressure on that roof of the mouth that stimulates stem cells located in the palatal suture and within the periodontal ligaments around all the teeth, to direct normal palatal growth. The teeth erupt around the tongue which acts like a scaffold, producing a healthy arch form and straight teeth.
  • The lateral pressures from the tongue also counter inward forces from the buccinator (cheek) muscles which can “collapse” the arch and constrict the palate.
  • The low carbon dioxide levels associated with mouth breathing lead to over- breathing or hyperventilation (breathing too much, too deep and too fast) because the body is trying to keep the proper amount of carbon dioxide in the body for proper oxygen exchange and blood pH.
  • With less oxygen being delivered to the brain, muscles and all the cells of the body, the body functions less than optimally.
  • Sleep is often disturbed and of poor quality, leaving the mouth breather with fatigue, focus, behavior and cogitative issues during the day.
  • As the mouth dries out, the pH of saliva drops, leading to increased caries.
  • The lack of air filtration and humidification a result mouth breathing, irritates the tonsils and adenoids causing them to become inflamed and enlarged and increases the risk of upper respiratory tract infections.
  • Lower levels of carbon dioxide cause smooth muscle spasms associated with gastric reflux, asthma and bed wetting.
  • Smooth muscle is found throughout the body – in the respiratory system, digestive system and circulatory system, therefore mouth breathing can cause body-wide symptoms and problems.
  • When properly breathing through the nose, the lips are closed and the tongue is correctly positioned, “resting” on the top palate behind, but not touching, the front upper teeth. You can usually find correct position of the tongue or “the spot” by saying the word “banana” or pronouncing the letter “N.”
  • With mouth breathing, the tongue hangs in a down and low position, resting either in between the top and bottom teeth or behind the bottom teeth.
  • When the tongue is in the proper position and resting on “the spot,” it acts as a scaffold or support for the shape and form of the upper palate and the teeth.
  • When the tongue does not rest on “the spot,” the buccinator (cheek) muscles and orbicularis oris (lip muscles) are allowed to push “inward” unopposed, causing the upper arch to collapse.
  • Children who mouth breathe have an underdeveloped, narrow maxilla with a high vaulted palate. They develop a retrognathic (pushed back) mandible and generally have a long face. This is known as “long face syndrome.”
  • Some think the long face syndrome is actually dictated by genetics, rather than mouth breathing. Much anthropologic research has proven this false.
  • Modern man is not genetically programed to grow this way, it’s our lifestyle, diet and unhealthy habits, like mouth breathing, that is causing these skeletal changes to occur in “modern man.”
  • A study to demonstrate how mouth breathing alone could change jaw development and occlusion was conducted on monkeys by Dr. Egil Harvold and his team in the 1940’s.
  • In the study, Dr. Harvold artificially switched the naturally nose-breathing monkeys to mouth breathing by surgically blocking their noses with silicone plugs.
  • The monkeys were uncomfortable with the new mouth breathing, but eventually adapted to their new pattern of mouth breathing.
  • However, where they originally had normal jaw shapes and normal teeth, after being forced to breathe through their mouths, they all developed changes to their jaws and developed malocclusions (crooked teeth).
  • Breathing through the mouth creates changes in development of both the maxilla and mandible, and causes the airway to become constricted, predisposing the child sleep problems that result in poor health, growth and cognitive development and set children up for obstructive sleep apnea later in life.
  • It may seem logical that mouth breathing occurs because the nose is congested, but that is not always the case.
  • The brain of a mouth breather thinks TOO MUCH carbon dioxide is being lost too quickly from the body and makes adjustments in the body to stop the escape.
  • One way the brain directs the body to try and “stop” the release of too much carbon dioxide is to stimulate the goblet cells in the nose to produce mucous to slow the breathing.
  • This creates a vicious circle of mouth breathing, triggering mucous formation causing nasal passages to constrict and become blocked, leading to more mouth breathing. In fact, mouth breathing can cause nasal congestion leading to more mouth breathing.
  • Determining if someone is a mouth breather is not always easy. Some people admit they always breathe through their mouth. Others believe they are nose breathers, but if you watch them, their mouth is open most of the time.
  • Some may have their mouth closed while sitting still, but if they get up and walk across the room, their mouth is open.
  • Kids often have a “cute” or “angelic” look with their lips parted making their lips look “full” and plump.
  • You can usually observe or see the tongue resting behind the bottom teeth.
  • Often kids who mouth breathe chew with their mouth open allowing them to breathe while they eat. They often tend to eat very fast or messily.
  • An open mouth posture caused by chronic mouth breathing, leads to the lips becoming “weak” and unable to remain closed easily. This leads to drooling, both awake and asleep and can cause a rash around the mouth.
  • Chapped lips are also common because mouth-breathers tend to lick their lips frequently. Nasal breathing allows for proper mouth lip seal is efficient at keeping saliva in and air out.
  • Mouth breathing at night dries the tissues so the mouth, teeth, tissues and the throat are dry upon waking
  • This further inflames the tonsils or adenoids.
  • Always needing a glass or bottle of water at hand is a sign of mouth breathing
  • If someone wakes with a dry mouth or in a puddle of “drool,” they are likely a mouth breather at night, which means they are also likely mouth breathing during the day.

Centennial Dentist Center of Boise, Idaho

A Dental Exam is the First Step to a Healthy Smile

People can be more diligent about changing the oil in their cars than keeping their regular bi-annual dental exam and professional cleanings.  That’s a shame because for most people good home hygiene coupled with a regular professional dental check up and cleanings could be all they’d really need. Good hygiene usually heads off issues such as

  • gum disease
  • teeth extractions
  • root canals

Why is this? Frequent check ups with the team at Centennial Dental Center allows us to spot issues such as decay. With early detection, we can help you long before anything more than a filling would be required. We can also see signs of gingivitis before it evolves into gum disease. If you need a dental exam, contact our Boise office, and our helpful staff is ready to help you today.

a close up of a woman's face as boise family dental care is performed

Why Visit the Dentist Twice a Year?

Patients sometimes wonder why they need to have their teeth checked and professionally cleaned twice each year. It’s not an arbitrary number. Six months is about the length of time it takes plaque to harden into tartar to a degree in your mouth that it should be removed. While brushing and flossing remove plaque every day, that same plaque hardens into tartar if you don’t brush enough and also in some places such as the inside of your lower teeth (where everyone builds up tartar). Tartar can only be removed by a professional hygienist using dental picks. When you get beyond six months, tartar can begin to creep under your gumline, and that spells the beginning of gum disease.

What's Involved

Your twice-yearly visit usually takes around one hour. Here’s what we do in this appointments at Centennial Dental Center:

a picture of a patient and dentist looking at an x ray of a mouth

We Take X-rays

We like to take digital x-rays once each year. These can reveal cavities between your teeth, the health of your jawbone, and the alignment of the teeth (particularly important for children). Our digital x-rays have very low radiation compared to film x-rays and they can be enlarged easily to look at areas of concern.

We’ll Check Your Mouth

Before Dr. Koeltl sees you, your hygienist examines your mouth. He or she will first look for signs of tooth decay and any areas of softening enamel. This is an early sign of decay. Next will come measurements of the pockets around your teeth. These measurements tell us if your gums are receding and whether gum disease is causing bone loss. Finally, your bite will be evaluated. Again, this check is important for children with rapidly developing teeth.

We’ll Screen for Oral Cancer

Both your hygienist and Dr. Koeltl will check for signs of oral cancer during your check up. We’ll examine your head, neck, and lips, along with your mouth tissues including your tongue. This is when we pull on your tongue, push on your glands below your jawline, all of that. The reason we do this is simple —oral cancer treatment is very successful IF it is caught early.

We’ll Scale and Clean Your Teeth

We’ll scale your teeth, which means we’ll use picks and other dental tools to remove all of the tartar that has formed on your teeth. We’ll then polish your teeth with a special gritty paste that removes stains and polishes the enamel. See our dental cleaning page to learn more.

woman smiling in dentist chair
child smiling in a dentist chair while the dentist prepares to perform a cleaning

We May Apply Fluoride

If we’re dealing with our younger patients, our final step during a exam will be to apply fluoride, long proven to effectively protect teeth. And if we haven’t done so already, we’ll apply a resin sealant to the molars to prevent bacteria and food debris from getting down into the deep cracks in the molars.

Fill out our contact form so we can answer any questions you may have about dental check ups in Eagle, Boise, Meridian, and surrounding areas of Idaho.

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