July 26, 2016
Making endodontics less frightening for patients and dentists
Some patients are afraid of endo … so are some dentists. Neither should be. If a patient says, “That wasn’t bad at all” after treatment and the tooth is comfortable for many years, the patient is happy and the staff is rewarded. If done well, endo can be one of the most rewarding, predictable, and profitable treatments a dentist can do.
Root canal therapy has made great strides in ease, efficiency, and predictability during the last few years, with increasing levels of patient acceptance. Advances in anesthetic materials and techniques, digital radiography, apex locator accuracy when teeth aren’t perfectly dry or filling-free, rotary files that take most of the physical finger work out of the procedure, and obturation materials that are simple and effective mean there is no reason endo shouldn’t be routine in most dental offices. Certainly, it is not something to loathe.
1. Methodical diagnosis
It’s really satisfying to do great endo, and it’s a real bonus if you do it on the correct tooth! Working on the wrong tooth is no practice builder. Therefore, it is imperative to our patients’ well-being, our practice reputations, and the practitioners’ peace of mind that we diagnose accurately and have confidence in our decisions.
Often the diseased tooth is obvious, but other times our evaluation must involve a series of tests that are challenged and scrutinized by our own skepticism. Endodontic teacher Dr. Steven Buchanan calls the search for the correct tooth “Methodical Skepticism.” It means being sure about something that is not easily seen. One must have a system of repeatable diagnostic tests that allows checking of all teeth in a suspect quadrant, and then be diligently thorough.
The patient interview and history is the place to start. We repeat the same questions on every patient: “What makes it hurt?” “How long have you had the pain?” “Is it sharp or throbbing pain?” “Does it hurt or feel better to hot or cold?” “Do you feel pain radiating to other places?” These start the evaluation to help differentiate between pulp pathology, periodontal issues, tooth fractures, or restoration failure.
[caption id="attachment_712" align="alignright" width="300"] Fig. 1: Digital X-rays on this 20-inch monitor provide a much greater ability to diagnose than from a 3-inch film. Constrast is adjustable.[/caption]
Quality digital X-rays cannot be overstated. Periapical radiolucencies and opacities are still the best indicators of a diseased tooth. Poor X-ray developing, improper angles, and faulty exposure settings all contribute to incomplete and unreliable diagnosis. Digital X-rays can help remove these errors, can be manipulated in the software to increase their diagnostic contribution, and the images have almost zero wait time. Perhaps the greatest advantage of all is that the digital image is usually seen on a 15 by 20 inch monitor instead of a 2 by 3 inch film on a view box (Fig. 1). It is certainly easier to diagnose from an image that is seven times larger with sharp detail.
Cold testing with lingering pain is one of the classic signs of irreversible pulpitis. The use of a freezing spray on a cotton swab can be less messy, more precise, and less uncomfortable for the patient than dripping ice. For about $7, a can of Radio Shack component cooler can be sprayed on a cotton tip, touched on the buccal of a tooth, and patient reaction can be monitored. Once the patient feels cold on the tooth, the swab can be removed, and since no cold water lingers in the area, the sensation should quickly disappear. Lingering or intense pain can often identify the culprit.
Tooth loading is a great way to determine if biting sensitivity is from a fracture. Since people are keeping teeth longer than ever, fractures are a growing problem. Patients who complain of pain upon biting with no other symptoms can have their problem cusps identified by loading each tooth in the quadrant with a ToothSlooth II and reproducing the pain. For patients who have symptoms consistent with irreversible pulpitis, loading the central fossa of each tooth can reveal the ones with periapical inflammation.
Of course, there are many other tests that can be done, such as percussion, heat, and vitality. Find the testing methods that are most reliable for you and stick with them on every case to develop a comfort level.
2. Gentle treatment presentation
“No offense, Doc, but I hate dentists!” is often heard in our office, to which we respond, “It’s OK, we don’t like patients.” It kind of makes things even. The second most popular phrase we hear is, “I don’t want a root canal, they hurt!” Just telling patients, “Trust me, I’m a doctor!” doesn’t always work; it’s about being confident that we can fix the problem and explain it in a way that is informational but not scary.
We should be careful how we describe things so we don’t stir up unnecessary fear. This isn’t deception, it’s using words and phrases that reduce patient stress. Usually, “root canal” to the patient means pain - real or imagined - multiple appointments, and even torture. Just as we don’t ask the assistant for “the needle” when doing an injection, we also want to avoid words that conjure up fearful images about endo. Careful wording can increase a patient’s acceptance and ease apprehension.
When we suspect endo is needed, we describe the procedure like this: “We will remove decay and the diseased part of the tooth, clean out infected debris, disinfect the inside, and then fill it with a sterile filling material.” We call it tooth disinfection, nerve work, or endodontic therapy, but never a “root canal” unless the patient asks, “Isn’t that like a root canal?”
3. Efficient, organized setup
[caption id="attachment_713" align="alignright" width="300"] Fig. 2: Endodontic materials kept in a 12-inch basket aids office efficiency by being ready at a moment's notice for the "surprise endo."[/caption]
The materials used in endo are seldom used for anything else, and lend themselves well to being “packaged” together in a single basket or drawer for easy retrieval (Fig. 2). This makes it very efficient to have everything ready when the “surprise endo” happens. The files, measuring device, apex locator, irrigant, paper points, sealer, and obturation materials are all kept in a small, inexpensive basket that is quickly pulled out and unloaded in seconds for endo at any time.
Endo baskets can be kept in each treatment room close to the assistant’s position, or in a central location that is quickly accessed. Often the assistant can have all instruments ready in about the same time it takes the doctor to explain the treatment to the patient. This concentration of endo paraphernalia makes the setup much faster and relieves your staff of considerable stress.
4. Effective numbing
After correct tooth diagnosis, the lack of profound anesthesia may be the greatest cause of staff and patient stress in endo. As we drill toward the pulp, will the patient squirm, scream, jump, or run out the door? Pain control is critical for patient comfort, staff peace, and practice enhancement. Anesthetic choice and delivery method are crucial.
A systematic approach to local anesthesia is important to achieve consistent, profound pulpal numbing: 30 seconds of topical anesthetic followed by a half carpule of prilocaine (Citanest) to achieve initial soft tissue anesthesia, followed by one to two carpules of articaine (Septocaine) to provide great deadening in almost all cases. For maxillary teeth, anesthesia must be delivered deep enough into the tissue to reach all the way to the end of the roots. An anesthetic working time of five to eight minutes is sufficient to achieve sensation control.
On mandibular teeth, the cannula is placed into the tissue just inferior to the maxillary second molar, and the prilocaine is injected slowly as the cannula is advanced toward the ear and along the ramus of the mandible. The remainder of the carpule is emptied at the suspected mandibular nerve location and followed by two carpules of articaine to the same location, with one minute between each carpule.
Most dentists who use these anesthetics report significantly greater anesthesia success. Keep in mind that some reports show an increase in the risk of paresthesia than with other 2 percent strength anesthetics. Since both of these anesthetics are 4 percent in strength, they should be injected slowly after aspiration to decrease chances of neurotoxicity and longer-than-desired paresthesia.
With these 4 percent anesthetics, the need for intrapulpal, intraligamental, or transosseous injections is much less. However, in those rare times of difficulty in numbing, the transosseous method is extremely effective. Stabident (Fairfax Dental) provides reliable anesthesia in almost any situation. Using a small osseous perforator on a slow-speed hand piece, a small amount of anesthetic is delivered through the cortical plate between adjacent tooth roots. Anesthesia is almost always reliably achieved in even the hardest-to-numb situations.
RELATED A Step-By-Step Guide To Root Canal Treatment
5. You can’t fix what you can’t see
Since the assistant gets tired holding a magnifying glass over the tooth during long procedures, loupes with magnification are used in many dental offices. Loupes are fairly inexpensive and comfortable. Surgical microscopes would be nice in every operatory; however, most of us don’t have them.
Finding canals, locating fractures, and excavating decay are exponentially easier with 2.5 to 4.0 magnification loupes. If they have fiberoptic lighting, it’s even better. Once a classic endo access is made, even those “fourth” canals in upper molars are seen more easily. In those cases where a canal is hard to find, a caries indicator helps locate them. After removing all soft tissue from the pulp chamber, dry it thoroughly and apply a liberal amount of caries indicator. After rinsing and drying well, the missed pulp canal can often be seen.
6. Tooth preparation
[caption id="attachment_714" align="alignright" width="300"] Fig. 3: Removing all chamber soft tissues and taking a 15 file down each canal usually controls bleeding. Because full coverage is planned for this case, the cusps were shortened to aid in rapid canal location.[/caption]
Visibility is often the limiting factor for chamber and canal identification. Rubber dam use and classic endo prep are critical. Because the general dentist is usually the professional in charge of the final restoration, it is occasionally advantageous to do the definitive restoration prep prior to doing the endo. Doing the prep first can remove tooth structure that would otherwise be in the way, and decrease the time needed to locate wayward pulp tissue (Fig. 3).
Rotary files are now the standard in many offices. They are made of metals that flex easily and make canal preparation much faster than with hand files. They also are particularly safe to use with the newer electric handpiece engines with automatic reverse feature, should too much torque be placed on the file.
7. Finding the canal lengths
Electronic apex locators are terrific these days and, like digital X-rays, have reduced the amount of radiation exposure in many offices. These length-finding devices work best if the pulp chamber is devoid of soft tissue and blood, which is often present when the tooth is opened (see Fig. 3).
Once the pulp chamber is cleaned out, the electronic probe is placed on the file and taken toward the apex. Results are extremely accurate, within .5mm of the apical constriction. The Root ZX (J. Morita) works best when:
- The filling material is removed first
- The pulp chamber is rinsed well with water
- A small file is quickly taken down the canal to remove excessive tissue
- The canal is dried with air before using irrigants.
The electronic apex locator can remove the aggravation caused by waiting for poorly composed X-rays to be developed.
8. Single-appointment obturation
Single-visit endo is widely accepted in the industry. Not only is it more efficient for the office, it is a benefit for the patient in that there is no second appointment or anesthesia. You also have the opportunity to complete the procedure while the tooth morphology is fresh in your mind. In most cases, the long-term results are the same as multiple-visit endo.
Lateral and vertical condensation with master and auxiliary points has been the standard in endodontic therapy for many years. However, newer materials can simplify treatment and may provide a better bacterial seal, resulting in better long-term results. ThermaFil (DENTSPLY Maillefer) has been around for nearly two decades, and has proven to be quite effective with much research behind it. Most studies show the bacterial leakage to be at least as good as vertical condensation as long as a sealer is used. With accurate length determination, thorough canal preparation, and effective disinfection, these obturators make it almost as easy as making a hole and stuffing something into it.
Newer epoxy-resin sealers and obturation materials such as Resilon and Epiphany may provide the best antibacterial sealing yet while being kind to tissues. These materials can decrease postop concerns by allowing less microbe proliferation, which can decrease future patient problems and stress for the dentist.
9. Definitive restorations help prevent failure
Definitive, nonleaking restorations may be as important to endo success as filing and obturation. The sooner the definitive restoration is placed, the greater the likelihood of treatment success: studies show it only takes 30 days for bacteria to migrate down the root and contaminate the apex from a faulty coronal seal. We have all seen patients with a grossly decayed molar that had previous endo who say, “I never had it finished.” It’s a shame so many patients leave the office with an endo temporary, experience no pain, and then return after the tooth is too far gone to restore it.
The general dentist is in a great position to place the definitive restoration at the endodontic appointment. As long as the occlusion is properly adjusted, placing a more long-term restoration of composite, onlay, or even crown may be more important in endodontic success than filling to the apex. Provisional restorations have been shown to leak almost immediately. Placing at least a well-bonded build-up material or composite may increase your endodontic victories.
10. We have a support group
We have specialists who deal with endo complications and difficult teeth every day - we always have the option to refer when the case appears too difficult or when we have complications. Having the endodontist standing behind us is comforting; however, his or her support does not give us the right to consistently get in over our heads. Continuing education and reading the clinical literature are the best ways to increase our skills and comfort levels, as well as learn our limitations.
Doing endo routinely in general practice is both rewarding and one of the lowest-overhead procedures we can do. Endodontic therapy is rewarding as long as sound systems are used for diagnosis, treatment, and tooth restoration. The only fear with endo should be running out of supplies from doing so many.
Dr. Jack Griffin has maintained a full-time practice in St. Louis county, Mo., since 1988. In a busy practice, his office has consistently maintained a 50 to 55 percent overhead doing all phases of dentistry with an emphasis on cosmetics. The practice is focused on current technologies, materials, and procedures, and is the head of the Missouri MasterTrack AGD program and the St. Louis area CEREC study club. Dr. Griffin also speaks at many study groups and courses.
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Thank you personally and from the bottom of my heart for the kindness and consideration you showed my mom, Catherine the other day! ?
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I want to say that this office and the staff are by far the best professionals in dentistry in Hollywood!! they become family!! I want to thank you all for...
norma masoud
I had an amazing experience here. Lily the hygienist is the best she’s so nice and didn’t stop until my teeth were perfect. I love her I’ll be back soon...
Auto Sales
Outstanding customer and dental services. The Doctor is very professional and knowledgeable. Thank you . Alla S.
Vadim Broytman
I've been looking for a good dentist since So. FL lacks them. Not anymore, great professional services, and best of all, you will find a personal touch. You will truly...
ML GG (Aventura, FL)
I came to Dr. Gorbatov wanting a new smile. My front teeth were worn and tired at the young age of 43. I wanted something very natural, nothing too obvious...
Michelle Kawas
One of the best dental offices in my life. Very professional and cordial staff from the front desk to the dentistry team.
Вадик-Ванадик Vadik-Vanadik
it was the best experience ,dr. Gorbatov, is the best dentist in the world, special thanks to Lidice (assistant) . thank you all.
Alexey Evdokimov
Dr. Gorbatov is an excellent dentist. I went to several other dentist and they all wanted to do a root canal, but Dr. Gorbatov was able to save my tooth....
Arthur Rubinovich (Sunny Isles, FL)
I had a procedure done by Dr. Gorbatov, it was amazing, I didn't feel anything, he has very gentle hands and techniques and I didn't even feel the shot! I...
Jessica Y Montero (West Palm Beach, FL)
Dr. Gorbatov is one of the most wonderful professionals I’ve ever been to. His team is very kind, professional and caring. One of the best dentist’s experiences I’ve ever had.
Yana Dmitrieva
Thanks to Dr.Gorbatov and his team to save my teeth! They helped me to revise other dentist's mistake.Team very professiinal, attentive to my needs and details of case. Will continue...
Sergii Cherednyk
I had an amazing experience with Dr Gorbatov and his excellent staff. I went to him for a second opinion and he told me I did not need any work...
James Borelli
I absolutely LOVE the attentive and friendly customer service and quality of work they provide here at Dr.Gorbatov’s office!! I would highly recommend them to anyone looking for a touch...
Serena Morrisey
I just moved from California and immediately fell into the "trap" of Dr.Gorbatov. Was very pleasantly surprised. Firstly, a knowledgeable sociable Doctor with "golden hands". Secondly, the wonderful staff, especially...
Naum Berdichevsky
Very professional office , sweet people. Love this place . I really recommend it . I went for an emergency dentist issue and I would hoped tolived in this city...
Ingry Rodriguez
Dr. Dmitry Gorbatov and his team provided an exceptional dental experience. Their attention to detail, gentle approach, and thorough explanations made me feel at ease throughout the procedure. Truly a...
LANA C
Well I’ve been going to Dr. Gorbatov since 1996.... Yes ! I’m a loyal. With all the dental issues I’ve had, he’s been able to resolve them and been keeping...
Burke Crump (Wellington, FL)
I want to thank Dr. Dmitry Gorbatov for giving me a beautiful smile. I want to thank his entire staff for their professionalism, friendly atmosphere and holding my hand when...
Alla Shvarts
I always have a good experience here with the Doctor. He is always helping me and is always assisting me with anything I may need. Thank you!
igor gorodetsky
I feel I have the best care possible under Dr. Gorbatov and his team. His work is top quality and because of him I know my teeth and the health...
Alex P. (Fort Lauderdale, FL)
Top-notch and high-quality services are provided at Dr. Gorbatov’s office. Since my last visit, I can't stop smiling ever after. I think I found the dentist for life. My highest...
Val Lovechild
Been going here forever and they do an excellent job with all your dental needs and even with cosmetic dentistry as well!
Lauren Harris (Lake Worth, FL)
I have been going to this office now for the past 3 years. From Jessica working the front, to having my teeth cleaned, and both Drs. working on my teeth,...
Joanne Purdy (Wellington, FL)
From the minute I walked in the dr Gorbatov office till the and of my treatment I was pleasantly surprised with professionalism and care of Dr and his staff. I...
Anna (Hollywood, FL)
I switched my dentist because i was dissatisfied with their service and decided to go to Dr.Gorbotov's office for my wisdom tooth extraction. I never thought I would see the...
Oleg Solovey (Sunny Isles, FL)
You are the best guys! You definitely make me smile more :) Thank you sooooo much! Olga Aksenova ❤️
Olga Axenova (Hallandale Beach, FL)
Friendly and the caring stuffOK gentle professional careComfortable and election dental experience
Albert Volchek
The dentist fit me in last minute when my normal dentist was unavailable I tried them on the recommendation of a friend after I broke a veneer and had 3...
Mark Krawiec (Hollywood, FL)
Most beautiful veneers ! Dr. Gorbatov is the most talented doctor ever !Air flow cleaning is the best in their clinic ❤️
Julia Zhguleva
I had a great experience with Dr. Dmitry Gorbatov. He was able to save my tooth from getting a root canal. All the staff was really nice, and attentive. I...
Arthur R. (North Miami Beach, FL)
I want to say that I never write reviews. However I have to say that this dentist center is amazing! From the moment you enter you feel like family. Everyone...
Lisa Jerkins (Wellington, FL)
What a great experience at the dentist!! I wish I had found these guys years ago, maybe I wouldn't be so afraid of the dentist. Thought I needed a root...
Craig Balsam (Wellington, FL)
I had a wonderful experience at the office of Dr Gorbatov , great attitude of all here , the work I have done was painless, I would highly recommend Dr...
Hans Werner
Dr. Gorbatov and the amazing team took amazing care of me during my extractions and had attended to me last minute. Very conveniently located!
Steven Kupchan
Absolutely the best doctor and staff. I was afraid of any and all oral procedure. Dr Gorbatov did all my oral surgery without any pain involved. I do not even...
Sharon Shields
One of my greatest experiences at the dentist, had Lidi as an asisstant very friendly and professional, for my cleaning i’ve had my hygienist Carolina was one of the best...
irina condrea
Let me start by saying Dr Gorbatov is amazing, a true credit to the art of dentistry. He is a perfectionist and his assistant Lidi is amazing also in her...
Keith Miller
Dr. Gorbatov's office equipment and services represent highest professional standards in the industry. All procedures and cost are explained in details in layperson language. The doctor and the assisting personnel...
Elena Levitskaya
I'm very thankful with the doctor and the entire office staff. Very professional work and excellent treatment.
Guillermo Ricard
I've been looking for a good dentist since So. FL lacks them. Not anymore, great professional services, and best of all, you will find a personal touch. You will truly...
ML GG (Hollywood, FL)
Excellent job! Very professional and friendly ... that’s my personal experience and actually if I could, I would give 5+ stars. Will recommend it to everyone!
Janetta Smilowska Matyinko
Highly recommend this dental office. Dr. Gorbatov provides high quality, state of the art dental services. He has a very calming demeanor and the entire staff is professional, warm and...
Valerie
Staff was so kind from start to finish. Dr Gorbatov was so gentle I didn’t feel a thing. My teeth look beautiful! Would recommend to anyone
erika castro
I am grateful to reach the hands of Dr. Gorvatov,my dental surgery has been successful, he was very professional when deciding what to do with my tooth, thinking about the...
EP TECH USA
I am usually very scared of dentists and specially surgery but today Dr. Gorbatov and his wonderful team made the experience go seamless and they are very professional and knowledgeable...
Marlene Girard
I would like say that this office is at the TOP of my list. The staff is awesome, it is very clean and you made at home as soon as...
Jazlyne Jimenez (Lake Worth, FL)
I’ve been coming here for almost 10 years now and can surely say that the customer service provided is one of the best in town. Make sure to be nice...
Hype Kay (Royal Palm Beach, FL)
Great Dentist and Team. Fantastic experience and service. My husband had a dental emergency while on vacation and Anna got us in immediately. Dr. Gorbatov is very attentative and caring...
Giannotti Jessi
My experience here was absolutely great!. From Anna who I first spoke to about an appointment to Lida and Patricia who made me feel relaxed and comfortable during my procedure....
sean scott
Dr. Gorbatov is an outstanding dental surgeon and professional in every sense of the word. He and his entire staff are wonderful--- by far the most knowledgeable and compassionate of...
Salt&Light (West Palm Beach, FL)
Wonderful service! I recently had a dental cleaning for the first time at Dr. Gorvatov Dentistry. The whole process was smooth and relaxed. Their office environment is pleasant and the...
Karol Rodriguez
I take my 90yr great grandmother to this office and they are so kind and she feels so loved here. Every visit she receives excellent service and quality work. Thank...
Farron Ann (Wellington, FL)
Dr Gorbatov is an amazingly talented dentist. I had the porcelain veneers done in his office and have a feeling like I have never had such beautiful smile in my...
Julia Soldatova
Amazing doctor and very friendly and professional stuff! Definitely the best doctor in Miami!
Lily AA
I can report that I have had a positive experience at Dr. Gorbatov's office. I have had several procedures done there and all have gone well. The doctor is very...
Christine Stahl
I went to the doctor’s office today and the service was great, fast , proficient and very helpful for me. People was very friendly and nice
Natalia Smirnova
Amazing experience! Everyone in the office is so sweet and friendly! My husband was freaking out because he had a bad experience somewhere else but the whole team worked together...
Laura Painchault
One of a kind dentist. Always take the time and explain to you all the choices. He does have a smile for me every time I have to go to...
Liviomail
If you're looking for an Exceptional dentist then you should visit Dr. Gorbatov Dentistry. I've only been going to this dentist office a little over two months to obtain a...
S Jackson
Great experience! Really felt like Dr Gorbatov and his staff took time to explain and perform my procedures on a very short notice. Highly recommend!
Suzanne Ireland
The best Doctor and assistants, who really care about their patients and work professionally. They helped me to save a tooth, when other doctor refused to do so, and what...
A
I highly recommend Dr.Gorbatov dentistry . I tried so many doctors and finally I found people who knows what they do, I can trust my and my family to them....
Nuriya Deberdeeva
Excellent professionals and Dr Gorbatov was the one in Miami who helped me with the toothache. Excellent Job!
A. El Dani
I was very fortunate to find Dr. Gorbatov right when I had a major issue with an old crown that fell off and led to a major infection just a...
Octavian Miron (Aventura, FL)
S u p e r b ...Immaculate dentistry! I was impressed with a GREAT attention to details! His work is truly an ART and priceless! Everyone in the office is...
Gordana Skracic (Aventura, FL)
The receptionist goes above and be on for the customers. Excellent service the doctor treats you with all his attention feels like I’m right at home and explain everything detailed....
Sophie Garcia (Royal Palm Beach, FL)
My experience, couldn’t ask for any better, great office, wonderful people. Professional in his field, with pleasant energy in his office Dr. Gorbatov, his assistant, Lidi, without whom all the...
Kirill Krassikov
Great service Knowledgeable doctor Friendly staff 5+ stars!! Someone hacked into my account and gave false review. Not me!!! Outstanding service @ Dr Gorbatov Dentistry!!!!
Ellen Zlobinskiy (Hallandale Beach, FL)
Had a great experience with Dr.Gorbatov, he is really professional and doing great his job always with a smile)) Definitely recommending him
Tanya Kusiumova (Sunny Isles Beach, FL)
Absolutely loved the staff and doctor! Right when you walk through the door they greet you with such a big smile and kindness. Thank you doctor I will never stop...
epasco12
The best confortable dental officeHighly recommendedVery nice and professional Doctor and assistant
62511aveful
Since me and my wife moved to Florida from Nj several years ago, we were looking for good dentist, the one we can trust. We tried a few but were...
Tatiana Lapushchik (Hollywood, FL)
Dr. Gorbatov is the best dentist in Florida. He is my dentist many years. He is very professional and honest. The best doctor in Florida. Great professional and very honest.
Polina Padva
I had an amazing visit and pleasure to meet Dr Gorbatov and his assistance were very pleasant. Ana is very sweet secretary upfront. I will definitely return as a new...
Gigi Borden
I really hate having to go to the dentist. And I was very nervous about having an amalgam removed to work on a tooth with bad cavities. I came specifically...
Heather Valmy
I've been going here for a few years now. I'm a periomaintenance case, so I'm in four times a year. The hygienists do a great job, provide me with excellent...
Devin Scheller
Thank You so much for great service, I’m very satisfied with the level of service I received can definitely recommend
Janina Grabska
I finally found a great dentist who does its all, root canals, caps, and implants. I needed major work on my mouth all at once, although it was expensive because...
Diane O’Brocki (Loxahatchee, FL)
The atmosphere in this office is beyond believe, I instantly felt comfortable with Dr Dimitiri and his assistant Yuri. They work great together. I had 6 veneers put in and...
Ruslan Gahramanov (Sunny Isles Beach, FL)
FIVE STARS! I left my pre you’d Hollywood dentist because she refused to do a simple noninvasive ADA recommended preventive treatment, and insisted I needed an implant. In addition her...
therese costa
Doctor always helps me with everything and the atmosphere is always amazing and welcoming. I would recommend this office to everybody!
Edgar Gorodetsky
Amazing experience! The office is beautiful, the staff is knowledgeable and super friendly.
Maria Slomka
My experience was great.Doctor is very professional.I really recommend.The best place to go for your dental.
Olga Meverden (Sunny Isles Beach, FL)
Dr. Gorbatov is a highly qualified, very skilled dentist. I came to Dr. Gorbatov to remove amalgam fillings and replace crowns.All the personnel that work in the office are very...
Irene Mandel
Dr. Gorbatov and his team are amazing! All were very kind and excellent professionals. 100% recommended!
Ylianne Vela
My experience, couldn’t ask for any better, great office, wonderful people. Professional in his field, with pleasant energy in his office Dr. Gorbatov and all his team members where AWESOME!!...