Periodontist and Dental Implant Specialist
Common Questions

Questions Relating to Dental Implants

Questions Relating to Periodontal Disease

Questions Relating to Anesthesia/Sedation

General Questions

Questions Relating to Dental Implants

What are dental implants?

Implants are natural looking replacements for missing teeth. The implant itself is a post that attaches to your jawbone. This post provides an anchor for your general dentist to place crowns, bridges or other restorations.

We are experts in the placement of dental implant posts. Dental implants begin with an evaluation by your general dentist who will decide if you are a good candidate for this procedure.

For more detailed information, please see the section entitled "Dental Implants".

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Do implants work as well as natural teeth?

Dental implants function much better than removable teeth, (e.g. partials or dentures). Patients often comment that dental implants are so natural in appearance and function that it is like having their natural teeth back. Today's advancements make implants function within 90% of the efficiency of natural teeth in terms of both bite and feel.

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How much do dental implants cost?

The cost of implants varies from patient to patient, depending on the complexity of each case. As a general rule, however, the investment is comparable to that of fixed bridgework.

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How soon is it possible to eat after receiving dental implants?

As soon as the final restoration has been placed, you can resume normal eating again. A strict soft diet is necessary between placing the implant and placing the final restoration since stress prior to the final cementing of the restorative tooth could cause the implant to be weakened and fail.

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Questions Relating to Periodontal Disease

What is periodontal disease?

Periodontal disease (also known as periodontal infection, gum disease or pyorrhea) is an ongoing infection in the gums around your teeth. The cause of periodontal disease is infectious bacteria that gets deep into your gums and causes tissue inflammation.

This infection starts destroying the bone that supports your teeth. If left untreated, it can lead to tooth loss. For more information, please see the section entitled "Periodontal Disease".

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What are the symptoms of periodontal infection?

Because periodontal infection grows under your gums, you can have no symptoms at all. Patients with more advanced periodontal disease may experience some of the following symptoms:

  • Red, swollen or tender gums
  • Tooth sensitivity to heat/cold
  • Bad breath
  • Deep pockets around the teeth
  • Spaces between the teeth
  • Loose or shifting teeth
  • Missing teeth
  • Gums receding around the teeth (longer looking teeth)

For more information see the section entitled "Periodontal Disease".

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Why, all of a sudden, is my dentist sending me to a periodontist?

Periodontists have advanced training in the treatment of periodontal disease and the placement of dental implants.

Patients with periodontal infection have a lowered resistance to periodontal bacteria. This causes a continuing gum infection that can grow in bursts of activity. Some factors that can cause a dramatic increase in the severity of your periodontal disease are:

  • Poor oral hygiene
  • Dental plaque
  • Smoking
  • Genetic factors
  • Stress
  • Diet
  • Age
  • Illness

Two other important factors are:

  • Lack of regular dental checkups
  • Lack of regular dental cleanings

When your infection has a "burst" of growth, or when there are signs that this may occur, your dentist may recommend periodontal treatment.

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How is periodontal disease treated?

Periodontal disease is an infection in the gums and jawbone. The goal of treatment is to remove this infection and prevent it from coming back. The specific treatment required to do this will vary with each patients' individual needs. After your initial examination, we will completely explain your different options for treatment.

For more information see Periodontal Disease Treatment.

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Does periodontal treatment hurt?

One of our primary concerns is that you have a comfortable experience during treatment. Towards this end, we offer an extensive array of the latest techniques to minimize discomfort. Many of our patients are amazed at how little discomfort they experience.

For more information on the patient comfort techniques we use, see our Procedures page.

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Why must I start treatment right away?

Periodontal infection grows in "bursts of activity."


It is likely that you have been referred to us because your general dentist has noticed an increase in infection activity. This infection eats away at the bone that supports your teeth (leading to tooth loss). If not treated, there can be a number of consequences. Please see the Dental & Medical Consequences section for a list of these.

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Questions Relating to Anesthesia/Sedation

Is anesthesia safe?

Yes, sedation and anesthesia have been safely employed in dental practice for many years. 

In order to administer anesthesia, Dr. Hollander has had advanced training in intravenous medication. He is also trained to handle emergency situations, and have the necessary safety equipment and medication on hand in the unlikely event of an emergency.

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What medications do you use?

Local anesthesia (Lidocain) is used in many of our dental and surgical procedures. Lidocain does not affect your state of awareness, but blocks the pain sensation in a particular area of the mouth.

For procedures requiring more sedation, we use sedative drugs such as Valium. Just enough sedation is administered to allow you to be completely relaxed while still being aware of your surroundings.

Medications such as Demoral, Valium & Versed may be used as a deeper sedative that actually puts you to sleep during the procedure.

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How am I monitored during treatment?

The periodontist along with a highly qualified staff member will be with you throughout your procedure.

Depending on the form of sedation required we may use one or several mechanical monitors as well:

  • Automatic blood pressure cuff
  • Blood oxygen sensors
  • EKG

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How is the medication administered?

These medications are administered intravenously. You periodontist administers just enough medication to make you relaxed and comfortable. You are carefully monitored, and additional medication can be easily administered throughout the procedure to ensure your sustained comfort.

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General Questions

What is going to happen on my first visit?

On your first visit to our office, you will receive a periodontal examination. You should experience little, if any, discomfort during this examination. If necessary, x-rays will be taken to further evaluate any loss of bone around your teeth.


Afterwards, our findings and your options for treatment will be thoroughly explained. At that time, the doctor will answer any questions you may have.

Our goal is that you leave with a complete understanding of your condition and the treatment needed to restore you to optimum oral health.

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How much will treatment cost and will my insurance cover it?

Everyone deserves to keep their natural teeth for a lifetime. While periodontal treatment is not as costly as replacing natural teeth due to tooth loss, its cost can vary greatly depending upon your needs.

If you have dental insurance, this may provide full or partial coverage. Our office will contact your insurance company to learn what they will cover. We do accept assignment of most insurance benefits and your responsibility will only be to cover the remainder.

We feel that finances should never be an obstacle to treatment. For your convenience, we offer several payment options. We also have payment plans to suit your individual needs. Our office manager will be happy to answer any of your financial or insurance questions.

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What are the medical consequences if I delay treatment?

When periodontal infection gets into the bone around your teeth, it can then enter your blood stream. From there it travels to other parts of the body and can contribute to medical problems.


Recent research has found that patients with periodontal disease are more than twice as likely to suffer heart disease and stroke.  Please read the section entitled "Dental & Medical Consequences" to see an overview of recent research correlating periodontal disease with serious medical problems.

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Do you use the latest equipment and techniques?

We keep ourselves up to date regarding equipment and periodontal procedures. You can be certain you will receive state-of-the-art care in our office.

Regarding sterilization, we believe that all procedures should be safe as well as comfortable. We use only the latest sterilization techniques. For more information on treatment techniques and sterilization see the section entitled "Procedures".

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What other treatments do you provide?

Besides periodontal treatment and dental implants, we can perform a number of procedures, including:

Prescriptive Periodontal Procedures:

  • Crown lengthening
  • Antibiotic treatment
  • Aesthetic Ridge augmentation
  • Connective tissue grafting


Cosmetic Procedures:

  • Gingival (gum) contouring
  • Aesthetic crown lengthening
  • Soft tissue grafting

For more information on these procedures, please see the section entitled "Procedures".

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How is my general dentist important in my overall care?

Your general dentist knows your entire dental history, the condition of your teeth, and your future dental needs. He is in charge of your overall dental care. We work closely with him or her to ensure you receive the best possible dental care.

In many cases, your general dentist may do your preliminary periodontal treatment and a portion of your periodontal maintenance.

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Brian N. Hollander, DDS, MS
Diplomate, American Board of Periodontology
1615 Hill Road, Suite 4, Novato, CA 94947
Tel: (415) 898-6660 • Get DirectionsContact Us

A key to dental implant safety and success is advanced radiography. A CT scan we can be sure that every precaution has been taken.

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Dr. Hollander is a periodontist in Novato, CA who specializes in dental implants and in treating periodontal disease.
He also services the surrounding areas of San Francisco, San Raphael and San Anselmo.
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