PUHAK DENTAL CARE ... Dr George Puhak, General Dentistry



Maintaining good oral hygiene is one of the most important things you can do for your teeth and gums.  Healthy teeth not only enable you to look and feel good, they make it possible to eat and speak properly.  Good oral health is important to your overall well-being. Daily preventive care, including proper brushing and flossing, will help stop problems before they develop.

In between regular visits to the dentist, there are simple steps that each of us can take to greatly decrease the risk of developing tooth decay, gum disease and other dental problems. These include:

  • Brush thoroughly twice a day and floss daily
  • Eat a balanced diet and limit snacks between meals
  • Use dental products which contain fluoride, including toothpaste
  • Rinse with a flouride mouth rinse if advised to do so
  • Make sure children under 12 drink fluoridated water or take a fluoride supplement if they live in a non-fluoridated area
  • Visit your dentist regularly for professional cleanings and oral exams
  • Replace your toothbrush every 3-4 months

The following are indications of good oral hygiene:

  • Your teeth are clean and free of debris
  • Gums are pink and do not hurt or bleed when you brush or floss
  • Bad breath is not a constant problem
Back to top
A dental cleaning is a preventive, professional service you receive from a dentist or dental hygienist. It is performed to remove the bacteria that cause dental diseases.  Most general, routine, dental cleanings take approximately 30 minutes and are performed twice a year, however, Different levels of cleanings exist that involve more time and precision, depending on your diagnosis (patients who are diagnosed with gum disease generally need more time & visits, as do patients who have limited dexterity, or those patients who suffer from dry mouth).    Bacterial plaque left untreated can lead to unhealthy gums and tooth decay.   Back to top


Halitosis is sophisticated word for “bad breath”.  Depending on the cause, bad breath may strike on occasion or be a persistent condition. The most common cause of bad breath is bacteria.  Because the mouth is moist and warm, it creates perfect conditions for the millions of bacteria that live in the mouth.  In fact, approximately 80% of bad breath is caused by something in the mouth.

Some types of bad breath, such as "morning mouth," are considered fairly normal and are not usually health concerns. However, persistent bad breath may be a sign of more serious problems with the gums and teeth. Bad breath may be caused by the following:

  • Poor dental hygiene – poor oral hygiene can leave food particles to decay in the mouth
  • Infections in the mouth such as periodontal (gum) disease Respiratory-tract infections such as throat infections, sinus infections, lung infections
  • External agents including foods such as garlic, onions, and coffee, as well as cigarettes and chewing tobacco Dry mouth caused by salivary gland problems or by breathing through the mouth
  • Systemic illnesses such as gastric reflux disease, diabetes, liver disease, kidney disease, lung disease, sinus disease, and others

Call our office promptly if you have bad breath with painful, swollen gums that bleed easily or loose teeth.  We will perform a physical examination of your mouth to determine the cause.  If we discover that systematic problems are the cause, we may refer you to your family physician.  In severe cases of gum disease, we may recommend and refer you to a periodontist for treatment.  Back to top

Sealants are used to fill narrow grooves in a tooth that cannot be adequately cleaned by brushing.  In some cases, the tooth structure has fine grooves or pits which accumulate plaque, not because the person doesn't brush, but because they're too narrow to allow even one bristle into them.  To avoid cavities developing over time, the dentist will brush on a coating that seals the grooves and pits, making it possible to brush off all the plaque and keep your teeth healthy.  Back to top

Bonding has become a general term that defines tooth restorations-materials that are literally glued to teeth with modern adhesives.  Generally, most white fillings or porcelain utilizes bonding procedures.  Some metal restorations can also be bonded to teeth.  Orthodontists use bonding to apply braces to teeth. Bonding is performed to repair the damage caused by decay, to alter the alignment of a tooth or teeth, to change the bite or occlusion of teeth, to close gaps between the teeth, to whiten teeth, or for other cosmetic purposes. 

First the surface of the tooth is roughened in order to accept the bonding.  A gel is applied so the resin will adhere to the surface of the tooth.  The composite is then placed on the tooth and the bonding agent hardens with intense light. The last step is shaping and polishing to give a lustrous finish.  Back to top

A filling is a way to restore a tooth damaged by decay back to its normal function and shape.  If you have a tooth that requires a filling, the dentist will first remove the decayed tooth material, clean the affected area, and then fill the cleaned out cavity with a filling material.  A filling helps prevent further decay by closing off any cracks or spaces where bacteria can enter.

There are a variety of filling materials available including gold, silver, plastic and porcelain. The dentist will work with you to determine which material is best, depending on the extent of repair, where in the filling is needed, and cost.  Each filling material is briefly explained below:

· Gold fillings are generally custom made in a laboratory and then cemented or bonded into place.  While gold fillings are often the most expensive choice, and since they are metal and not considered "cosmetic", their use has been surpassed by the newer composites and porcelains.  However, most dentists and researchers agree that it is the best, longest-lasting, dental materials (It is still the "gold" standard!).  Gold inlays are well-tolerated by gum tissues and may last more than 20 years.

· Amalgam (silver) fillings are still a workhorse material in dentistry, however they are falling by the wayside to the increaisng use of white composites.   They are a more inexpensive choice and are more tolerant to wear.  However, due to their dark color, they are more noticeable than porcelain or composite restorations and are not recommended for fillings in very visible areas such as front teeth.

· Composite resin is a modern, white-colored,  special plastic that is bonded to the tooth.  Its use continues to increase, and, the material continues to be improved as years go by.   Composite Resin can be matched to the exact color of your natural teeth, creating a more natural appearance. White composite fillings are generally less noticeable than other materials.  They usually last between 3 and 5 years and may not be ideal for large fillings as they may chip,wear and deteriorate over time.  They can also become stained from coffee, tea or tobacco.  Lately, evidence is showing that large composites tend to deteriorate faster than large metal fillings.  Many times though, composites enable dentists to perform "miracle" dental work that results in a beautiful restoration and rejuvenation.  Much can be done with composites. They provide good, basic value for all patients.

· Porcelain fillings are another level of white dental material that are generally harder and more durable than composite fillings.  They are custom created in a lab and then bonded to the tooth. They work best on back teeth.  Many people do not want metal fillings on their back teeth ---white inlays and onlays can help.   They can be matched to the color of the tooth, resist staining, and are about the same cost as gold fillings.  A porcelain restoration generally covers most of the tooth, making the filling nearly undetectable.

If decay or a fracture has damaged a large portion of the tooth, a crown (or "cap") may be recommended.  Decay that has reached the nerve may be treated through root canal therapy or through a procedure called pulp capping.  Back to top

The gums, ligaments, and bone around the teeth form the foundation for  teeth. All structures are also referred to as the periodontium. When the periodontium is not healthy, it jeopardizes the teeth just as a bad foundation would threaten the stability of a house.  Signs of unhealthy periodontium include: gums that are red and bleed easily, persistent bad breath, gums that are pulled away from the tooth, loose teeth, and changes in the position or bite of the teeth.  With proper gum treatments,  it may be possible to return gum tissue to a healthy state.  If you're having a problem, come in and see us so we may treat it right away. The treatment usually involves a deep cleaning or root planing done under a local anesthetic, along with local antibiotic agents.  It is important to have gum problems checked promptly, as gum disease left alone may eventually need treatment through surgery or extraction.  Back to top

Crowns and bridges are used to restore and enhance teeth that are damaged or to take the place of missing teeth. A crown (also referred to as a cap) is used to entirely cover a damaged tooth.  A crown not only strengthens a tooth, but it can dramatically improve a tooth’s appearance, shape and alignment.

Crowns are constrcucted of metal, metal-porcelain, or all porcelain.  All-porcelain or all-ceramic crowns are slightly more costly, however, they offer the best shade match when esthetics are a concern.

Crowns replace a large filling when there is little tooth structure remaining.  They also 

                • Protect a weak tooth from fracturing
                • Restore a fractured tooth
                • Attach a bridge
                • Cover a dental implant
                • Cover a discolored or poorly shaped tooth
                • Cover a tooth that has had root canal treatment

A bridge is an ideal method to fill the space created by missing teeth. A bridge is one or more artificial teeth cemented into place using the teeth on either side for support. This is an option for filling the space created by a missing tooth.  Bridge work is as much an art as it is an exact science since it replaces a missing tooth both functionally and cosmetically. The materials used may be gold alloys, porcelain bonded to metal alloy, or all ceramic material made to match your natural tooth color.  The choice of material depends on requirements for strength, wear, and esthetics.

It is important that a missing tooth be replaced as soon as possible.  If not treated, the teeth surrounding the gap begin to shift inward. Since teeth use their neighbors for support, if one is missing they begin to "fall” and shift into the open spaces. This may worsen the bite because of the changes in pressure and can eventually result in problems with the jaw such as TMJ.

Bridges and crowns are made by first taking an impression of your mouth.  The impression is sent to a dental lab where your crown or bridge will be custom made to fit your mouth and match your natural tooth color.  A temporary crown or bridge will be placed into your mouth until your permanent crown or bridge is ready and cemented into place. 

Bridges and crowns are very durable and can last many years with extra care and good oral hygiene. Back to top

Good oral hygiene should always be practiced since the loss of a single tooth can have major impact upon your oral health and appearance.  Although dentists will use every measure to prevent tooth loss, there are still sometimes necessary occasions when a tooth may need to be extracted.  A tooth may need to be extracted for the following reasons:

                • Severe decay
                • Advanced periodontal disease
                • Infection or abcess
                • Orthodontic correction
                • Malpositioned teeth
                • Fractured teeth or roots
                • Impacted teeth

After careful examination and treatment, the dentist may advise to have a tooth extracted.  Before a tooth is removed, the dentist will take an x-ray in order to understand the shape and position of the tooth and surrounding bone.  Based on the degree of difficulty, we may refer you to a specialized oral surgeon.

For a simple extraction, we will first apply a local anesthetic to prevent pain and discomfort. The tooth will be loosened with a tool called an elevator and then removed with dental forceps. Once the procedure is complete, the area may be closed with one or two stitches.  We will then provide you with care instructions to alleviate discomfort and ensure proper healing.  Back to top


Root canal treatment (also referred to as  endodontic therapy) is necessary when an untreated cavity or fracture reaches all the way to a tooth's nerve & blood supply (the"pulp") in the hollow part of the tooth known as the "canal".   Treatment may also be needed when deep restorations or trauma to a tooth cause nerve damage.  Once the pulp becomes infected, it begins to destroy the surrounding bone (this is known as an abscess).  If the pulp is infected, not only is it painful but it will require treatment as it cannot heal on its own.   Symptoms that indicate the tooth has become infected  include sensitivity to hot/cold or sweets, pain, swelling, pain to biting or pressure, and a bad taste in the mouth.  However, sometimes no symptoms are apparent and you may be unaware of any problem until a checkup.

A root canal treatment involves removing the infected tooth pulp, disinfecting, then filling the canals of the tooth  (one, two or even three treatments may be necessary).  Alternate treatment would be to extract the tooth.  Usually a core build-up and crown is recommended for restoring a tooth that has undergone root canal therapy.  Most root canal-treated teeth need a crown restoration so you can chew.  Crowns have been shown to withstand chewing and biting forces, and, will increase the life of the tooth (rather than simply "patching " the tooth with numerous fillings).  Back to top




A dental implant is an ideal tooth restoration for people who are missing one or more teeth as a result of injury, periodontal disease, or any other reason.  Generally, a dental implant is a metal cylinder that is surgically positioned into the jaw.  (Other designs exist).  Once in place and bone surrounding the implant has had time to heal, a special post is attached to the implant, and finally a replacement tooth  is cemented or attached to the special post.  While implants are typically more expensive than other methods of tooth replacement, they provide superior benefits and are considered the most comfortable of all tooth/teeth replacements.   Implants are stronger than natural teeth and generally last 10-20+ years.  They are also a more favorable approach than bridgework since they do not depend on neighboring teeth for support. Studies are showing that,  in the long run (over 5 years)  they can be less expensive than  fixed bridges.  Another bonus ---that is truly amazing --- they never decay!

To receive implants, you need to be generally in good health, have healthy gums and have adequate bone to support the implant.  Many times a bone graft needs to be placed to ensure the implant has a strong foundation.  You must also be committed to excellent oral hygiene and regular dental visits as these are critical to the long-term success of dental implants. 

New, one-piece,mini-implants are now available for patients who suffer from loose dentures.  They work best for retaining lower dentures. Ask us how mini-implants can help you.

Back to top

A denture is a removable replacement for missing teeth and surrounding tissues.  There are two types of dentures available, including partial and complete dentures.  Partial dentures are used when some natural teeth remain (Partials are anchored onto you remaining natural teeth), while complete dentures are used to completely replace all teeth.  Dentures are made to resemble your natural teeth so there should be no noticeable change to your appearance. In fact, dentures may even improve your smile!

 A superior improvement is noted by patients who choose dentures that are anchored with implants (especially for lower dentures).   If you have dentures that are loose, ask how modern, special, mini-dental implants can help. 

You can choose the shape and degree of whiteness of your replacement  teeth.  New dentures may feel awkward or loose for the first few weeks until the muscles of your cheek and tongue learn to keep them in place and you are comfortable eating and speaking.  Although this may require some practice you will adjust and enjoy the benefits a full mouth of teeth can provideBack to top

Custom designed mouthguards and nightguards are made of flexible plastic and molded to fit the shape of your teeth.

Mouthguards are recommended to protect the jaw and teeth during physical activity and sports such as boxing, football, basketball, or other activities where your mouth may be hit.  Guards also protect the soft tissues of your tongue, lips and cheek lining. 

Nightguards are recommended for patients who clench or grind their teeth at night as a way to protect their teeth and bite.

If you decide a guard is right for you, we will take an impression of your teeth which is sent to a lab to make a custom fit guard.  In most cases you can choose from a variety of colors and styles. On average, guards last between 3 and 5 years.  Back to top

Tooth whitening is the simplest and most cost-effective way to renew and improve smiles for many patients. It is a popular procedure to make teeth whiter and brighter, and more attractive.  Whitening works best on your intact, front teeth that have no fillings.  The active ingredient will not whiten porcelain or large fillings.  (In some cases, thanks to the miracle of modern dental materials and adhesives, old crowns with chipped or darker/off-color porcelain do not have to be re-made ---they can be rejuvenated and whitened at less expense with a porcelain or composite veneer ----ask us about this procedure).  The active ingredient in whiteners can be used to whiten stained and discolored teeth, or simply to enhance a dull smile.  Either way, tooth whitening is a safe and relatively painless procedure ithat is deal for most patients.  Our office offers two methods of whitening: in-office whitening and take-home tray whitening.

In-office whitening is an ideal for anyone wanting immediate results.  The entire process takes place in our office in about an hour (one or two visits) making it the perfect choice for busy individuals.  In this process, a protective gel is applied to your gums to protect the soft tissue.  A whitening gel is then applied to your teeth and a special light or laser may be used to enhance the action of the agent - making your teeth whiter and brighter.  As a final step, we take impressions of your teeth to create custom trays for you to use for home touch-ups, and we'll give you instructions for keeping your smile bright. The result is dramatically whiter teeth.  

Take-Home, Tray whitening is a less expensive, affordable whitening treatment you can use while in the comfort of your own home.  We take an impression of your mouth to create customized clear whitening trays for you to wear.  Within a day or so your trays will be ready to be picked up and we will show you how to apply the special bleaching material to the trays.  The whitening gel trays should be worn 30-60 minutes a day for a few weeks (Results may vary for some patients).  At the end of this period, you will see maximum whitening results.    To maintain your whiter teeth, you only need to undergo occasional tray treatment at your convenience. Back to top

The Invisalign treatment consists of a series of clear, snap-on, custom fit, removable mouth trays that apply a controlled amount of force to your teeth, forcing them to shift.  The system provides the same beautiful results as traditional braces, but since the trays are made of clear plastic, they are virtually invisible.  In addition, because Invisalign trays are removable, they can be taken out while eating, drinking, brushing and flossing.



The Invisalign System works by using a series of trays that move your teeth gradually until the end result is achieved.   Throughout the process, you visit your dentist every six weeks to ensure treatment is progressing.  Once treatment is complete, you will  wear a clear retainer to ensure your new smile stays in place.

As with all orthodontic appliances, the cost of Invisalign varies according to the complexity of the case, and, you must be a very committed patient for a successful outcome.  Patients who need conventional or Invisalign orthodontic treatment are generally referred to an orthodontist who can provide thorough, appropriate care, and who can provide more complete treatment thru the Invisalign and/ or other technologies.  To learn more, visit the Invisalign website by clicking hereBack to top

Veneers are a dental procedure in which a covering is placed over the outside (visible area) of the tooth. Veneers are usually only applied to the part of the tooth that is visible when talking or smiling. Veneers incorporate the now familiar dental technology term known as "bonding"

Veneers are an ideal treatment to renew your smile especially for patients who have stained, chipped, rotated or crooked front teeth.  Veneers can even be used to fill in gaps or spaces between teeth, within reason. (They can work especially well for patients who choose not to undergo orthodontic treatment for crooked teeth).  They improve the appearance of front teeth with receding gums, and those that have white fillings that have become stained or deteriorated.  As an added bonus, you can whiten teeth at the same time.   


Veneer procedures are termed "direct" or "indirect".  The direct method involves placing composite resin on the outside of the tooth.  This method relies on the dentist's artistic skills as much as his or her mechanical skills.  We use generally-accepted artisitic guidelines to help us design the veneer.  Composite veneers offer all the benefits mentioned above, but like enamel, they will stain over time.

The indirect technique usually involves two appointments because the veneers will be fabricated at a dental laboratory.  At the first appointment,  the teeth are prepared, impressions taken, and the teeth are given a temporary covering. In two to three weeks the veneers are back from the laboratory, the temporaries are removed and the veneers are bonded to the teeth. The laboratory fabricated veneers are usually made using porcelain or pressed ceramic and are very aesthetic. They virtually never stain.

The advantage of veneers versus crowns is that much less tooth material is removed (in some cases, no enamel needs to be removed),  and the procedure is generally less uncomfortable.  
Back to top

In order to provide the best to our patients, our office uses state-of-the-art technologies in all our procedures.  These new technologies allow us to treat dental cases with extreme precision, detect dental concerns at early stages, provide attractive cosmetic treatments, and ensure procedures are done more efficiently and comfortably. When you visit our office, you can be confident that you are receiving advanced dental care.  We offer and use the following equipment:


X-rays are a necessary tool that help the dentist diagnose problems and diseases.  They are a necessary standard of care.  X-Rays help dentists view teeth, surrounding tissue & bone. 


In our office we use digital radiography which allows us to take x-rays using up to 85% less radiation than conventional film x-rays.  A small sensor records the image of your teeth & bone.  The result is a highly-detailed image on a computer screen that can be used to determine the very best treatment for each case. Back to top





Our office uses  different computerized shade-matching technologies to make restorations that can match the color of your natural teeth.  Old methods of shade matching can be inaccurate and inconsistent.  Our office has special, true-light, fluorescent bulbs installed in all of the operatories.   A digital camera or hand-held device captures tooth hue, value and chroma to create precise color match may.  In addition, new computer and E-Mail programs can be used by thr dentist and dental lab to communicate shades and colors.  Digital cameras are revolutionizing treatment outcomes (in addition to their use as teaching tools or for "before-after" pictures).  With these technologies, you can be confident that your restorations will beautifully match your natural teeth. Back to top


Our office utilizes electronic claims processing. Your dental claim is sent electronically to your insurance company with the click of the button. By filing your claim electronically, information is submitted faster, more efficiently and with fewer errors.    Back to top

We use small cameras about the size of a pen, called intraoral cameras, to help clearly see the condition of your teeth and gums.  With this technology we can zoom-in with extreme precision on small diseased areas, cracks, chips and worn fillings.  The full-color images taken with this special camera are sent to a computer screen so we can clearly see and diagnose dental problems much earlier than with traditional dental technology.  Patients gain a better understanding of their needs and the dental procedures that are performed.  Back to top

INSTRUCTIONAL VIDEOS:  A picture speaks a thousand words!  We have invested in computer instructional videos that will help you understand proposed treatments, dental disease, & prevention services

TELESCOPIC LOUPES:  The dentist performs most dental procedures while wearing surgical telescopes. These powerful eyeglasses have magnifiers on them, allowing the dentist to see fine details that would go unnoticed to the naked eye.  Back to top

George I. Puhak, DMD

General Dentistry

1730 E. Broad St.  Hazleton, PA 18201


Fax. 570-459-5660