Les L. Holmes, DDS, PC
Accepting New Patients
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Our Services
We proudly offer these services for the entire family.
Cleaning and Prevention: 
A preventive program is designed to preserve the health of the patients gum tissue and teeth. Dr. Holmes and his staff will custom design a program specific to individuals needs. Our common goal is to preserve the natural dentition and supporting structures, and to maintain optimum oral health.

Our program includes oral home care instructions, regular dental exams, cleanings, and x-rays. Only in this way can we assure a healthy and beautiful smile.
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Dental Exams and Cleaning:
For new patients our concern for their dental care must begin with the initial interview, including a thorough medical history and a comprehensive dental exam, all necessary x-rays, cleaning, bite analysis and diagnostic impressions if they are indicated. Only in this way can we direct our patients toward complete oral health.

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Professional Dental Cleaning:
Dr. Holmes usually performs the professional dental cleaning. He feels this is a great way to spend time with the patient and really gets to know their complete dental needs. At your cleaning appointment he will remove the plaque, tartar (calculus) and polish your teeth.

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Dental X-rays:
Dental x-rays are very essential in that they provide diagnostic information about the bone structure around the teeth and allow a thorough evaluation of the health of the tooth structure. 

Dental x-rays are recommended based on each individuals dental health needs. Bite-wing x-rays are taken at the re-care visit either on a 6 month or yearly basis. New patients are encouraged to have a panoramic x-ray taken every 3- 4 years. Panoramic x-rays require 82% less radiation than a standard intra-oral full mouth survey, and reveals the presence of many diseases affecting the oral cavity. It can show disease even when it may not be evident to the patient and at an early stage, when most problems can be successfully treated. The staff of this dental office feels that you do not want us to make guesses concerning you oral health. For this reason, we recommend bite-wing x-rays and a panoramic x-ray.

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Home Care:
Your personal home care plays an important role in keeping your smile beautiful and functioning to the highest degree. We recommend the following.

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Plaue is a sticky white fiilm that contains harmful bacteria that can be a major cause of both tooth decay and gum disease. Regularly proper brushing can remove this type of placque.

1). Hold your brush at a 45 degree angle while brushing all surfaces with a
small circular motion.

2). The most important area to brush is where your teeth meet your gums.

3). If you have any other situations please consult with Dr. Holmes for special
instructions for the brushing care of your teeth.

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Daily flossing to remove plaque that the brush may not reach. Effective flossing is done in this manner: 

1). Cut off 18" of floss and wrap it around your middle finger, leaving about
1 inch to work with. 

2). Avoid "snapping" the floss against the gums. Just ease it between teeth,
up to the gum line. Gently position the floss under the gum and gently scrape
the sides of each tooth away from the gum line.

3). Use a fluoride rinse like ACT for important extra protection. Once a day after
brushing. Rinse for one minute with ACT dental rinse. A 0.05% fluoride rinse has
been proven in extensive clinical studies to reduce cavities an extra 40% when compared to the use of a fluoride toothpaste alone.

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Cosmetic Dentistry:
Your smile says more about you than any other physical feature. A beautiful, white smile is one of the best ways to leave a great impression. In the past few years there has been a tremendous interest in modern cosmetic dentistry.

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Composite Fillings:

A composite (tooth colored) filling is used to repair chipped teeth, fill spaces between the teeth and repair teeth affected by decay and fractures. Composite fillings and silver fillings are the most commonly used filling material used in dentistry.

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Porcelain Crowns (Caps):

A crown may be recommended for a tooth that has been weakened by decay,
fracture( 1) or failure of a large, previous restoration. The advantages of a crown
(C) are derived from its more desirable physical properties. A crown can provide
the strength necessary to withstand chewing forces. A crown can return the
tooth to its original and more natural size and shape. 

The construction of a crown is very precise and generally requires at least two
visits. During the first visit, the damaged tooth is prepared (2) to accept the
crown (C). An impression is taken and a temporary crown is put in place. At
the second visit, the temporary crown is removed. The permanent crown is then cemented onto the prepared tooth.(3). If cosmetics are of a concern, white porcelain is baked onto the crown surface. 

All ceramic crowns give people the superior cosmetic results they desire. Because all ceramic crowns contain no metal under structure, they are able to transmit the color of adjacent teeth and tooth structure. This enables them to blend more completely with the surrounding natural teeth.

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Fixed Bridge: 

When a tooth or teeth are lost and not replaced, your teeth can drift from their
proper position. This drifting can cause many undesirable consequences such
as jaw pain and headaches from malocclusion ( a bad bite alignment). Drifting
of teeth can make certain areas more susceptible to decay. Problems with the
supporting structures of your teeth (gum and bone) can arise from shifting of
teeth as they try to fill a vacant area. In order to prevent the drifting of teeth, a
fixed bridge may be recommended. This will return your masticator (chewing)
system to a full complement of teeth. The teeth can then support each other
and function beautifully together.

The teeth (1) on either side of the space (2) are prepared, as shown, to accept the bridge. A laboratory then fabricates the bridge (3) very precisely. At a subsequent visit, the bridge is cemented into place over the prepared teeth. Bridges can be fabricated from a variety of materials including gold, other metals and porcelain. 

All porcelain bridges resemble your natural teeth. They do not have any metal understructure and they have a chameleon-like quality of disappearing in the month. They do not have any metal understructure.

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Porcelain Veneers:

Porcelain veneers are very thin pieces of tooth shaped porcelain that are bonded to your front teeth to create a beautiful smile. We place porcelain veneers on crooked teeth, misshaped teeth and severely discolored or stained teeth.

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Tooth Whitening:
We use the opalescence bleach system. It is a whitening procedure to
counteract years of exposure to coffee, tea, cola and smoking. Tooth whitening
is a chemical process where the peroxide in the whitening agent breaks down
into tiny molecules that are able to move inside the tooth structure, where they
break down any molecules that cause discoloration, However, the structure of
the tooth is not altered. Enamel, dentin, and current fillings and cements are
not affected or harmed by the peroxide.

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Implant Crowns:
Dental implants are a new development in the field of dentistry. They provide
fixed replacements for missing teeth. Dental implants solve many of the
problems associated with removable dentures. Implants help a person gain
self-confidence by knowing that they are fixed in place. Fixed implants help to
eliminate the gag reflex (a choking feeling associated with some dentures).
They make food taste better and speech easier. Implants result in less tissue
irritation within the mouth. 
The procedure begins with the insertion of an implant (1) into the bone (2) of
the upper or lower jaw. The implant is allowed to fuse to the bone for several
months. This process is called "osseointegration". The patient’s old removable denture is modified for use during the waiting period. The top of the implant is exposed after the waiting period. A single tooth (3) , fixed bridge (4), or full denture (5) can then be made to fit onto the implant (s). The number and type of implants and the method of implantation can vary with each individual case.

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Partial Dentures:
A removable partial denture replaces multiple missing teeth in either the upper
or lower jaw. This replacement of missing teeth is necessary in order to restore
your mouth to its original functioning condition and maintain normal facial
contour. If a condition of missing teeth is left untreated, the remaining teeth
may drift. Drifting teeth can lead to a bad occlusion (bite), additional decay and
possible gum and bone problems.

Each partial denture is precisely made to fit an individual’s unique situation. It
is designed to be removable. The partial denture (1) is held in place with clasps
(2) that are comfortably fit around a select few of your remaining teeth.(3). A partial denture is cosmetically designed to hide all metal whenever possible (4). The artificial teeth and gums are colored to match an individual’s natural teeth and gums. A beautiful alternative to a metal free partial is a Valplast. Valplast is an advanced solution for the replacement of missing teeth. Unlike metal, Valplast blends naturally with your teeth and gums, enhancing the appeal of your smile. With a Valplast partial you will not show any unsightly metal clasping.

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Complete Upper and Lower Dentures: 
We fabricate custom dentures that are characterized to each individual patient for esthetics and function. The dentures are placed in wax so that each patient can see what the finished product will look like before they are processed. The patient can approve or make changes at this point to meet their satisfaction.

We also fabricate immediate dentures where the denture is placed the same day as the teeth are removed. This is a very nice transition for patients who want to avoid the annoyance of being without teeth, even for a short period of time.

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Denture Repairs and Relines (same day):
Dentures are very durable but they need to be relined about every 5 years due to changes in the bone structure of the jaws. 

Repairs and relines can be made on the same day if the office is notified in advance, usually before 10:00 am.

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Periodontal Disease Diagnosis

Healthy Gum Tissue


Moderate Periodontal Disease

Severe Periodontal Disease

The word periodontal means "around the tooth". Periodontal diseases are infections that affect the gum tissues and bone that support teeth. Where the gum line meets the tooth, it forms a slight v-shaped crevice called a sulcus . In healthy teeth, this space is usually three millimeters or less. As the tissues are damaged, the sulcus develops into a pocket that is greater than three mm. Left untreated, periodontal disease may eventually lead to tooth loss.

Periodontal disease is diagnosed by Dr. Holmes using a periodontal probe which is gently placed in the sulcus (pocket or space) between the tooth and gums. This information is used along with amount of bleeding, inflammation and tooth mobility to make an accurate diagnosis.

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Periodontal Disease Treatment: 
It is possible to have periodontal disease without apparent symptoms. That’s why regular dental checkups and periodontal examinations are very important.

If the disease is caught in its early stages of gingivitis, 2 cleaning’s a year is recommended along with oral home care of flossing daily and brushing 2-3 times per day.

If the disease advances to early stages of periodontal disease, (pockets of 3 m.m. or more) we recommend a process called periodontal scale and root plane ( deep cleaning). We meticulously clean and smooth the roots of all bacterial toxins. This allows the gum tissue to heal and pockets to shrink. Medications and an electric toothbrush ( oral B Braun) will help the gum tissue heal and bond to the root structures. A vast majority of the gum pockets are taken care of in this way.

If the pockets get to deep, they may require periodontal surgery to allow for proper healing and to make the gum tissue and teeth easier to clean.
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Periodontal Disease Maintenance:
It is very important to remove the plaque that forms on teeth every day. If plaque is not removed by brushing and flossing it can build up and infect the gums, teeth and supporting bone.

Dr. Holmes and his staff will recommend brushing 3 times a day and flossing 1 time a day. In addition once periodontal treatment has been completed, it is recommended that regular periodontal cleaning’s, usually three or four times a year. At these regular maintenance appointments, we will clean and polish your teeth to remove difficult plaque and calculus (tartar) forming above and below the gum line. The pocket depths are checked around each tooth to ensure healthy gum tissue.

Finally, necessary x-rays are recommended for detection of decay between the teeth and bone loss. All fillings and crowns will be evaluated for healthy sound tooth structure.
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Root Canal: 
Root canal therapy (endodontics) treats disorders of the nerve (pulp) of the
tooth. It used to be that a tooth with a diseased or infected nerve had to be
removed. However, today in 95% of these cases this is no longer true. We
believe in saving teeth (instead of removing them) and we will make every effort
to save yours!

There are several reasons why teeth die and need a root canal. This includes:

Trauma- (a physical blow to a tooth that traumatize’s the tooth) and physical
irritation (deep decay or a very large filling).

Regardless of the initial cause, the tooth pulp becomes irritated and an abscess (infection) occurs. In some cases the face may swell.

Once It has been determined (with x-rays and clinical examination) that root canal treatment is necessary, you will be scheduled for an appointment. In many cases, root canal treatment is less costly than replacement with an artificial tooth.
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Oral Surgery:
Baby and permanent tooth removal

Anxiety Free Dental Services
Happy gas and headphones are used to reduce anxiety and bring the patient comfort. Everyone on our team is dedicated to providing you excellent care and services to make your visits as pleasant as possible.
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Pediatric Dentistry:
Includes exam, cleaning’s, fillings, crowns, fluoride treatments, sealants and appliances.

T.M. J. Nightguard:

Dr. Holmes will take impressions of the upper and lower teeth. Next a
custom nightguard is fabricated over the lower teeth. It's an appliance that is
adjusted to the mouth to help relieve pain, pressure, joint clicking and
popping, ear pain and to calm sensitive teeth.

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Silent Night Appliance:
Dr. Holmes will take impressions of the upper and lower teeth, Next a
custom silent night appliance is fabricated to aid in the dissolution of snoring
for a more restful nights sleep.

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Emergency Dental Services:
We make every effort to see you the same day.

$350 Value from Dr. Les Holmes
After New Patient Exam, Cleaning,
Bitwings & Panoramic X-rays.
Not valid with any other offer.  Expires  7-1-18
Les L. Holmes, DDS, PC
General Family & Cosmetic Dentistry
Creating Beautiful Natural Smiles

Les Holmes, DDS
7 NW 72nd Street
Gladstone, MO 64118

$75 OFF
Any Future
Dental Work After
After New Patient Exam, Cleaning, Bitwings & Panoramic X-rays.  

Expires 7-1-18