
Setter Periodontics has provided personalized dental care to thousands of patients from the Portland area. Our patients come from near and far to experience the warm, individualized care we provide. We pride ourselves in utilizing the most modern equipment and methods available.
In order to provide nothing but the best to our patients, our office uses state-of-the-art technologies in all our procedures. These new technologies allow us to detect dental concerns at early stages, treat your dental issues with precision, and provide stunning and customized restorations. Our premium dental software system maximizes your time and our office efficiency. When you visit our office you can be confident that you are receiving the finest and most advanced in dental care.
Click the Services below for more information on each subject.
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TOOTH REPLACEMENT
There are three basic ways to replace missing teeth, which include:
- Removable partial dentures
- Tooth supported bridges
- Implant supported teeth
Removable partial dentures have metal clasps that clip onto teeth to hold the device in the mouth. Patients need to take these in and out for cleaning after eating and do not replace or preserve all of the hard and soft tissues of the mouth.
Tooth supported bridges are supported by the neighboring teeth and have a “fake tooth” in the middle to fill the space. The neighboring teeth are ground down and the bridge is cemented onto them. This type of replacement does not come in and out but can be difficult to clean and often needs to be replaced throughout your life.
Dental implants are quickly becoming the gold standard for tooth replacement. They act as an artificial tooth root and a crown will be made by your general dentist after healing. They are not taken in and out and do not rely on the neighboring teeth for support. In addition, dental implants help preserve the bone and gum tissue for a long time.
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ORAL HYGIENE CARE
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 that contain fluoride, including toothpaste
- Rinse with a fluoride mouth rinse if your dentist advises you to
- Make sure that your children under 12 drink fluoridated water or take a fluoride supplement if they live in a non-fluoridated area
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TOOTH EXTRACTIONS
The goal of our office is to help patients maintain a healthy mouth and keep their teeth. In many cases, we are able to perform specialized treatments to save or repair your teeth. However, sometimes it may be recommended that a tooth be extracted because it has a poor long-term prognosis or life expectancy. Some reasons why a tooth may need to be extracted include:
- Severe decay
- Advanced periodontal disease
- Infection or abscess
- Orthodontic correction
- Malpositioned teeth
- Fractured teeth or roots
- Impacted teeth
Before a tooth is extracted, we perform a complete examination and generate a custom treatment plan for each patient which includes options to replace missing teeth. This plan is also discussed with your general dentist to make your treatment as seamless as possible. Dr. Setter has been trained in "Minimally Invasive Surgery" so that your tooth is removed in a gentle manner that preserves the gum tissue and bone for future replacement.
If you have a question about the prognosis of a tooth or minimally invasive extractions, please contact the office for a consultation.
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NIGHTGUARDS / MOUTH ADJUSTMENT
Treating periodontal disease often goes beyond just the gums. In addition to bacteria, an improper bite can also contribute the the worsening periodontal condition. Dr. Setter may recommend a bite adjustment to relieve pressure on certain teeth and more evenly distribute the bite forces around the mouth. This is done over a sequence of short appointments and can be done without anesthetic.
Moreover, many patients may require a night guard, which is a custom-fabricated appliance that can be worn at night. Most patients we see in the office have some form of clenching or grinding habit and of those, most are unaware of the condition unless they develop symptoms. A night guard goes over the edges of the teeth and provides almost an "ice skating rink" for your teeth to slide around while you sleep. The goal is to provide rest in your jaw joint, jaw muscles, and teeth. Additionally, it helps you protect your teeth, crowns, and fillings from strong bite forces which can lead to cracked teeth or restorations.
Common symptoms of bite problems may include loose teeth, cracked teeth/fillings, soreness in the jaw joint or muscles, morning headaches, uneven bite pressures, an inability to fit your teeth together properly, and changes in the tissues surrounding your teeth. If any of these raise questions about your bite, please give our office a call to schedule a consultation.
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DEEP CLEANING SCALING and ROOT PLANING
The first line of defense against the spread of gum disease is a unique type of cleaning called “scaling and root planing.” In this procedure, an ultrasonic cleaning device is used to remove plaque and tartar from your teeth where regular cleaning devices can't reach: under the gum line on the tooth and the root. This procedure is performed by the hygienist under local anesthesia and is usually done over two visits. The goal is to leave a healthy, clean tooth and root surface that makes it easier for the gum tissue to reattach to the tooth.
If gum disease treatment is initiated before it becomes severe, scaling and root planing may be the only treatment you need. However, as with any dental procedure, your home care is essential to maintaining a healthy mouth and ensuring that our treatments are successful. In order to maintain a healthy mouth and resist future occurrences of gum disease, you must brush and floss daily, eat a healthy diet, avoid tobacco use, and have regular dental checkups.
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PERIODONTAL CLEANING/MAINTENANCE
A periodontal cleaning is a professional cleaning you receive from a periodontist or periodontal hygienist. These go beyond a "regular cleaning" that you may receive at your general dentist because we specialize in the long-term treatment of "deep pockets" and patients susceptible to periodontal disease. Most periodontal maintenance visits take between 45-60 minutes and are usually performed every 3-4 months to prevent the recurrence or spread of gum disease. These visits include a review of your medical history, dental history, x-rays, and an update of your current dental condition.
Dental hygienists traditionally perform most treatment by hand. However, new and advanced technology has led to more modern methods such as electric scalers. This sophisticated tool allows us to access bacteria below the gumline more efficiently and in less time. To achieve best results, we often use both electric and manual instrumentation in order to create the healthiest periodontal environment when you leave.
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TMJ TREATMENTS
TMJ stands for temporal-mandibular joint. Temporal, as in temple area of skull; mandibular as in mandible, or lower jaw; joint as in it's where the head and jaw meet. Problems in this joint may be caused by a misalignment of the teeth, trauma, or excess muscle tension. Aside from the two bones that meet there, cartilage buffers them and five muscles are involved in the area. If something goes wrong a good deal of trouble can result.
Problems in this area can cause:
- Headaches
- Earaches
- Trouble/soreness in opening and closing the mouth
- Clicking or popping of the jaw
- Pain in the jaw muscles
- Soreness in the area, sometimes extending to the face
Dental treatments for the condition can include replacing missing teeth, moving teeth, adjusting the bite, filling gaps between teeth, etc. There is no one solution that is right for all cases. Sometimes a plastic mouthpiece is used to prevent clenching or grinding that is contributing to the problem. If untreated and taken to extremes, surgery may be required to repair a badly damaged joint.
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HALITOSIS/BAD BREATH TREATMENT
Halitosis is the sophisticated word for "bad breath". Depending on the cause, bad breath may strike on occasion or may be a more 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.
Bad breath caused by bacteria in the mouth can easily be treated. Brushing your teeth, tongue and gums after meals as well as flossing and rinsing with mouthwash will usually take care of the problem. Regular visits to the dentist should be made for dental examinations and for professional teeth and gum cleaning.
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 diabetes, liver disease, kidney disease, lung disease, sinus disease, reflux disease and others
If you have questions about bad breath or notice bad breath in combination with painful, swollen gums or loose teeth, please contact our office for an evaluation.
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PATIENT COMFORT AND SEDATION DENTISTRY
Dental sedation is a service that can be used when a patient suffers from dental anxiety or dental phobia. We are happy to offer a number of solutions for our patients to make their dental visit as comfortable as possible. Sedation dentistry enables patients, who might otherwise avoid the dentist, to receive dental treatment necessary for a healthy smile.
Depending on the extent of the anxiety or phobia, varying degrees of dental sedation can be utilized as described below.
Oral Sedatives
Oral sedation is used to "take the edge off" and provide relaxation to patients in the form of prescription pills. This medication can be given to a patient the night before a dental procedure or 30-60 minutes prior to the dental appointment, depending on the patient and procedure. Oral sedatives do not provide pain relief, so local anesthetic will also be administered.
Intravenous (IV) Sedation
IV sedation provides relaxation medication through a small IV inserted in your hand or arm. Since IV sedation does not provide pain relief, a local anesthetic will also be administered. Intravenous sedation allows patients to still be awake but in an extreme state of relaxation, feeling little or no pain. Dr. Setter is trained and licensed to provide IV sedation to patients in the office in order to make you as comfortable as possible while you’re with us.
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PERIODONTAL (GUM) TREATMENT

The gums, ligaments, and bone around the teeth form the foundation for one's 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. Any of these may be a sign of a problem. With proper gum treatments, however, 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. If the gum disease gets too severe it may need to be treated through surgery or extraction. This is why it is important to have it treated at the first sign of a problem.

Gum Recession and Treatments
Many patients are concerned with gingival recession, or "gum loss". Aggressive tooth brushing and gum disease are two of the many reasons why gum tissue recedes and roots become exposed. This recession does not necessarily mean that the tooth is being lost. However, exposed roots may be sensitive to temperature change, vulnerable to decay, and associated with loss of supporting bone. Gum recession and exposed roots can lead to the following problems:
- Compromised esthetics
- Increase in root sensitivity
- Loss of supporting bone
- Increase in plaque build-up and inflammation
- Risk of future recession and root cavities

The solution to this situation is a soft-tissue graft, also known as a gum graft. During this procedure, tissue is transplanted to the gum area, covering the roots and restoring the gum line to its original, healthy location. A soft-tissue graft is aimed to thicken the tissue, thus protecting your roots from decay and helping prevent additional gum recession.
Gum Indentations
When a tooth falls out or is removed, an indentation can appear in the gums and jawbone just above the spot where the tooth used to be. This occurs because the jawbone slowly dissolves in response to the empty space and loss of function. In combination with replacing your missing tooth, we can provide ridge augmentation, a procedure in which we smooth out the indentation to recreate the original curvature of your gums and jaw. This procedure generally includes bone and/or soft tissue grafting to restore the missing tissues, and in some cases must be performed prior to the placement of implants to ensure that sufficient bone is available to securely retain the implant.
Gummy or Crooked Smile
If you have too much gum showing when you smile, causing your teeth to look short, we call this a “gummy smile.” If your gum line is uneven, causing some teeth to look shorter than others, we call this a crooked smile. Both situations can be easily remedied with a procedure referred to as a gum lift or crown lengthening. During this procedure, we reshape the gum tissues to provide a natural-looking smile and gum line.
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Click the Technologies below for more information on each subject.
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IV SEDATION DENTISTRY
Dental sedation is a service that can be used when a patient suffers from dental anxiety or dental phobia. We are happy to offer a number of solutions for our patients to make their dental visit as comfortable as possible. Sedation dentistry enables patients, who might otherwise avoid the dentist, to receive dental treatment necessary for a healthy smile.
Intravenous (IV) Sedation
IV sedation provides relaxation medication through a small IV inserted in your hand or arm. Since IV sedation does not provide pain relief, a local anesthetic will also be administered. Intravenous sedation allows patients to still be awake but in an extreme state of relaxation, feeling little or no pain. Dr. Setter is trained and licensed to provide IV sedation to patients in the office in order to make you as comfortable as possible while you’re with us.
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X-RAYS AND DIGITAL X-RAYS
X-rays are a focused beam of x-ray particles passed through bone which produce an image on special film, showing the structure through which it passed. This provides the familiar black and white images doctors and dentists use to diagnose problems and disease. Without an x-ray of the whole tooth and supporting bone and gum tissues, there would be no way to detect infection or pathology that requires attention.
In our office we use digital radiography which allows us to take x-rays using up to 90% less radiation than conventional film x-rays. Using this technology, we are able to take an x-ray of your mouth by using a small sensor which records the image of your teeth and sends it to a computer. The result is a highly detailed image of your mouth that can easily be enhanced to better diagnose dental concerns and determine the very best treatment for each case.
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DIGITAL IMAGING
We use digital imaging software in our office, which allows us to take a digital picture of you and use our imaging system to predict how a particular treatment or cosmetic procedure would change the appearance of your teeth. This software is beneficial for patients who are considering cosmetic procedures but are not sure if they're ready for dramatic changes. Digital imaging also allows us to document your dental case and procedures very well. We take digital images of your face, teeth and smile to provide us with a permanent dental record and to provide a visual documentation of treatment.
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ELECTRONIC CLAIMS
Our office utilizes electronic claims processing. This means that rather than sending your dental claim through the mail, it is sent electronically to your insurance company with the click of the button. By filing your claim electronically, information is submitted more efficiently and with fewer errors. This benefits our patients because the turn around time on claims is faster and fewer claims are returned or denied. We are happy to submit your dental claims to your insurance company on your behalf.
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INTRAORAL CAMERA
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 advanced technology we can zoom in on small diseased areas, cracks, chips and worn metal fillings with extreme precision. The full-color images taken with the intraoral camera are sent to a computer screen so we can clearly see and diagnose dental problems much earlier than with traditional dental technology. Because images are displayed on our screens, patients will also be able to see areas being worked on and are able to gain a better understanding of dental procedures being performed.