Our Services

From cosmetic dentistry to full-mouth rehabilitation, our practice is equipped to handle all of your dental needs. To help you understand more about our office, we have included brief descriptions of some of our most common services on this page.

Initial Visit and Comprehensive Examination

Your first visit, with us, at our office is very important in establishing your oral health baseline. We will perform a comprehensive (complete) oral examination which includes an oral cancer screening, periodontal evaluation, an analysis of your occlusion (bite) and a thorough examination of your teeth, their supporting structures and of the oral anatomy.

At Merrimack Smiles we are very progressive and thorough in our approach to diagnosing, treating and preventing dental problems. We use the latest technology to minimize radiation exposure when taking radiographs (x-rays) and we have an intra-oral camera that can take high-resolution pictures of your teeth and tissue.

Education is very important to the team of Merrimack Smiles. All members of the team are “life-long-learners” and take many continuing education courses to continue to stay current and improve ourselves as a group. We also like to educate our patients and provide detailed verbal and visual information so the patient better understands the processes that are occurring in their mouth. By educating our patients, we are able to give them the opportunity to make educated decisions about any treatment that may be required and to ultimately help prevent problems from occurring in the future.

We treat our patients how we would like to be treated, by providing detailed, complete, educational information in a warm, friendly, inviting and professional environment.

Preventive Programs

At Merrimack Smiles, we are focused on prevention through education. Both natural teeth and teeth with restorations (fillings) survive best in an oral environment that is clean and where proper oral hygiene is maintained.

Our dental hygiene program is designed to help prevent new cavities, preserve teeth that have been restored and manage periodontal disease. At the initial visit with our hygienist, oral hygiene instructions are reviewed and reinforced at subsequent recall visits. We custom tailor our preventive program to the patient and their individual needs. To help prevent the most common cavities, which occur on the chewing surfaces of our teeth, sealants are frequently placed on permanent teeth of kids and adults that have deep grooves.

We have found that by educating our patients we create a team approach, between the patients and us, to better prevent problems from occurring.

Dental Restorations (Fillings), Inlays and Onlays

Traditional dental restoratives (fillings) include amalgam and composite resin. Traditional restorations are also known as direct restorations and are placed the day the cavity is removed to fill the space left after drilling to remove the cavity.

Newer, more advanced, dental “fillings” include inlays and onlays composed of ceramic and composite resin compounds that mimic the appearance contours and strength of natural teeth. Inlays and onlays are also known as indirect restorations. Indirect restorations are completed similar to the process of a crown, only more conservative, with a better, more accurate, long-term result than direct restorations (fillings). We use only high-quality dental labs, located in the U.S.A. to provide our patients with the best treatment available.

Depending on the extent of decay and the tooth's location, we will go over the different options with the patient and recommend the specific type of restoration that is the most conservative and best for the given problem and unique situation of the patient.

Periodontal (Gum) Treatments

Periodontal treatment methods depend upon the type and severity of the disease. Periodontal disease, aka periodontitis, progresses as the sulcus (pocket or space) between the tooth and gums gets filled with bacteria, plaque and tartar, causing an infection and irritation to the surrounding tissues. When bacterial irritants remain in the pocket space, they can cause damage to the gingiva (gums) and eventually the bone that supports the teeth. If the disease is caught in the early stages of gingivitis, and no permanent damage has been done, one to two regular cleanings per year will be recommended. You will also be given instructions on improving your daily oral hygiene habits and having regular dental cleanings, specific to your individual needs.

If the disease has progressed to more advanced stages, a special periodontal cleaning called scaling and root planing (deep cleaning) will be recommended. A more frequent interval of regular maintenance cleanings will be recommended, depending on the patients individual needs. If the pockets do not heal after scaling and root planing, periodontal surgery may be needed to reduce pocket depths.

As with all of our treatments, we will educate you on what is happening, why we are doing certain treatments and what can be done to prevent and address problems.

Prostheses: Crowns (Caps), Bridges and Dentures (Fixed, Removable, Full and/or Partial)

There are two basic types of prostheses, each with their own subcategory depending on the patient and their needs. One type of prostheses is a fixed prostheses, which remains in your mouth at all times, and is supported by either your natural tooth, teeth or dental implants. Common fixed prostheses are crowns and bridges. The other type of prostheses is a removable prostheses, which can be removed from your mouth for cleaning, and is supported by either your natural teeth, resting on your gums where teeth are missing or dental implants. Common removable prostheses are complete dentures and partial dentures. Each of the various prostheses are fabricated in dental laboratories. We use only high-quality dental labs, located in the U.S.A. to provide our patients with the best treatment available. Both fixed and removable prostheses can be used to replace one missing tooth, multiple missing teeth or all teeth.

Prostheses are used to replace a/an missing tooth/teeth to help maintain the shape of your face, provide good chewing efficiency, alleviate the stress on your bite and provide great esthetics.

Crown

The terms dental crowns and caps are synonymous. Crowns are used to restore a tooth's function and appearance when the structural integrity of a tooth is compromised such that a restoration (filling) is not an adequate long-term solution.

Common problems that require a crown are broken or fractured teeth, very large cavities, very large existing fillings and teeth that have had root canal therapy. When decay in a tooth has become so advanced that large portions of the tooth must be removed, crowns are often used to restore the tooth. Crowns are also used to attach bridges, cover implants, or to prevent a cracked tooth from becoming worse. Crowns also serve an aesthetic use, and are applied when a discolored or stained tooth needs to be restored to its natural appearance.

Bridge

A fixed, partial, prosthesis is often called a “bridge”. A bridge is used to replaces missing teeth with artificial teeth by literally bridging the gap where one or more teeth may have been lost. Your bridge often is made from ceramic or a combination of other strong materials to provide a result that looks natural and esthetic. The bridge is permanently anchored to surrounding teeth or implants for support.

Full and Partial Dentures

A prosthesis that can be taken in and out by the patient (removable) and replaces some or all of a patients teeth, is often referred to as a denture. However, a denture can be used to describe a prosthesis that is either removable or fixed. A removable denture is a more cost-effective way to replace teeth while a fixed denture is a more stable way to replace teeth. Dentures are called full dentures when they replace all missing teeth on the top and/or lower jaws, and partial dentures when they replace some of the teeth on the top and/or lower jaws. Full dentures are supported by the gums and/or dental implants while partial dentures can be supported by teeth, gums and/or dental implants.

Merrimack Smiles provides many options to help restore and replace teeth to better suit the specific, unique needs of each and every one of our patients. Merrimack Smiles also has added Dr. Suranyi to its team to help treat patients with prosthetic needs. Dr. Suranyi is a Prosthodontist, which is a dental specialist who receives extensive training after dental school to address those with simple to complex prosthetic needs.

To find the best fit for you, we will find out what is important to you, the patient and find the solution that best fits your needs and desires.

Dental Implants and Restoration

If a tooth/teeth is/are extracted or missing for some reason, it is now possible to replace it using a/an dental implant(s). An implant for a single tooth, is like a new tooth made of titanium and ceramic that looks just like your natural tooth. A complete dental implant is composed of three main parts: One part is the titanium implant body that takes the place of the missing root, the second part is the tooth-colored crown that is permanently secure on top of the implant and the third part is the abutment that connects to the implant body to the crown.

In addition to tooth replacement, implants may be used to anchor prostheses (dentures), both fixed and removable. The most common use of dental implants with a removable denture is the stabilization and support of lower, complete dentures that tend to be unstable and shift when you talk or chew without implant support. For patients missing teeth, dental implants can replace a few or many missing teeth so that you have a more natural-looking smile. For descriptions of the various types of prostheses, please refer to our prostheses tab.

Dental implants play a big role in modern dentistry and provide patients with fantastic options that were not available previously. With the addition of Dr. Suranyi, a Prosthodontic specialist, to the practice, we are continually working to provide our patients with the best possible options and treatments available.

Extractions and Surgery

When tooth removal is necessary, we do simple and complex (surgical) extractions with local anesthesia and if needed, we offer oral sedation or nitrous oxide. We also remove wisdom teeth on and place dental implants in a number of patients. In situations where the patient needs to be heavily sedated or “knocked-out” so they do not remember anything, we will refer them to an Oral Surgeon.

Information regarding post oral surgery can be found here.

Pediatric Dental Care

We take pride in creating and maintaining beautiful and healthy smiles for our younger patients in an environment that is lighthearted and fun. We focus on establishing oral health habits that last a lifetime, with education and prevention as our primary tools. A number of our reviews are associated with parents who state how much their kids enjoy coming to see us at Merrimack Smiles.

Esthetic (Cosmetic) and Reconstructive Services

Esthetic (Cosmetic) Dentist in Merrimack NH

Dr. Mark S. Morris and Dr. Thomas P. Suranyi understand that there are numerous people who want to achieve a smile that looks just as great as it feels. Helping our patients achieve and maintain great oral health is an important priority of our team at Merrimack Smiles. Unfortunately, there are all kinds of esthetic flaws which can affect even healthy teeth over time, such as cracks, gaps, discoloration, crowding, rotations and more. Here at Merrimack Smiles, we are happy to offer several cosmetic dentistry services that can seamlessly erase all of these problems, leaving you with a look you’ll be proud to show off to those around you. Dr. Suranyi is trained and skilled as a Prosthodontic specialist, which makes him highly trained and qualified to handle a variety of situations from minor fixes to very complex, full-mouth-rehabilitation situations. Not only will you have a great esthetic result, you will have something that feels natural and functional with longevity.

Esthetic (Cosmetic) and Reconstructive Services Include:

- In-Practice & At-Home Whitening – Are you struggling with teeth that are stained, darkened, or simply lackluster? Our team provides both advanced whitening care in-office that creates fast, stunning results and customized take-home kits that can be worn on your own schedule and in the comfort of your own home. Before you know it, you can be enjoying a smile that’s much whiter, brighter and more confident.

- Tooth-Colored Fillings – Amalgam fillings are silver in color and therefore more noticeable, which some people do not like. For those who are concerned with fillings that are noticeable, we offer tooth-colored or white fillings. Our practice utilizes the most reliable technology to provide fillings made from high-quality composite resin that closely resembles the look of your natural teeth. White fillings offer patients more esthetic value with improved longevity that they can feel confident about.


- Porcelain Veneers – If you feel overwhelmed with the appearance of your front teeth and wish you could just start over to create the shape and level of whiteness you see in other smiles you admire than veneers may be the right treatment option for you. Veneers are precisely crafted tooth coverings composed of dental porcelain that are designed to fit over your existing teeth in a natural-looking way. Veneers give your teeth a new, polished, natural and esthetic appearance that movie stars and models strive to emulate. The quality and durability of the veneers are very strong and far more resistant against staining than natural teeth.

- All-Ceramic Restorations – When dealing with badly damaged teeth, it is important to have restorations placed as soon as possible so that their structure and health can be preserved. We know that for all patients, it is also important to maintain a smile that looks complete and esthetically natural. At Merrimack Smiles, we provide patients with both of these important qualities in our all-ceramic crowns, bridges, inlays, and onlays. We work closely with a lab technician that handles each case carefully to ensure that the final result is as seamless as possible.

Root Canal Therapy (Root Canal)

Root canal therapy is needed when the pulp (nerve and blood supply of a tooth) gets infected, which is often caused by a large, deep cavity. Root canal therapy is a simple treatment that can save your natural teeth and prevent the need for dental implants or bridges, if address promptly. The bad stories you have heard about root canals often is the result of people getting them when they are severly infected and their face is swollen. Severly infected patients are far more sensitive so the therapy can be painful. Symptoms of the infection are generally acute (quick onset) dental pain or extreme sensitivity to hot, cold or biting pressure, sometimes with swelling and/or a bump on the gum. If you experience any of these symptoms, we will test your teeth to determine if the tooth needs root canal therapy or if something else is causing the tooth pain.

Root canal therapy involves the removal of the infected pulp and disinfection of the tooth structure followed by sealing of the canals inside the root where the pulp was removed. Root canal therapy is done with local anesthesia and often is completed in one appointment but certain situations may require more than one appointment. Success for this type of treatment is very high but the degree of success varies with each situation.

We take the time to assess and listen to the patient to ensure they are receiving the right kind of care. We take the time to assess each situation completely because we often find people think they need root canal therapy, but in fact it is another, easily fixed issue causing the problem.

Information regarding post root canal treatment can be found here.

Anxiety Relief: Nitrous Oxide (Laughing Gas or Happy Gas) and Oral Sedation

For some, going to the dentist is a terrifying experience. Often a bad experience in the past is not forgotten and now all dental appointments are scary. We have a large number of patients who have come to us with severe dental anxiety and/or phobia that now are able to receive care comfortably. We have several ways of helping those with fear of the dentist, depending on the degree of their fear. The best way we have found to alleviate the fear of the dentist is to establish trust with our patients. We educate our patients verbally and visually so they fully understand any problems they have and how we will be addressing the problem. We go slowly when needed and reassure the patients as we go. Essentially we are very compassionate in our care for all patients. For those who need more than education and compassion we provide nitrous oxide or oral sedation (in situation where surgery is required we will often refer to an Oral Surgeon for deep sedation).

Nitrous oxide is simply a gas which you can breathe in, allowing you to enjoying a remarkable depth of relaxation. Nitrous oxide is colorless, sweet smelling, non-irritating and allows for safer, quicker and more comfortable dental care. The use of nitrous oxide virtually eliminates the fear, nervousness and tension associated with dental procedures. You remain in complete control, you are conscious and you can follow directions. The advantages of nitrous oxide are associated with the quick onset, adjustability and quick removal of it and its effects. Nitrous oxide works very rapidly, it reaches the brain within 20 seconds, and relaxation and painkilling properties develop after two to three minutes. With nitrous oxide, the depth of sedation can be altered from moment to moment, allowing us to increase or decrease the depth of sedation by incremental doses until the desired action is obtained, this is called titration. We have virtually absolute control over the action of the drug, preventing the possibility of accidental overdoses. Other sedation techniques don't allow for this titration or quick adjustment to the depth of sedation. Nitrous oxide acts as a painkiller; however, its pain-relieving effects may vary from person to person so we still will get the patient numb, for procedures that require local anesthesia, after the patient is comfortable on the nitrous oxide.

Oral sedation techniques have a fixed duration of action because the effects of pills that last for a specific span of time. For oral sedation we prescribe the patient a type of medication from the drug class of benzodiazepines. Benzodiazepines are medications commonly prescribed to people with anxiety and/or phobias. When oral sedation medications are used, the patient will take the medication prior to their dental appointment and will still feel the effects after their appointment. Therefore, anyone who has oral sedation MUST have someone drive them to their appointment and drive them home from their appointment.

We often will use nitrous oxide for most patients but we have options to accommodate your specific needs.

Sleep Apnea

Sleep apnea is characterized by brief interruptions of breathing during sleep and occur repeatedly throughout the night. The most common type of sleep apnea is obstructive sleep apnea (OSA), caused by relaxation of soft tissue in the back of the throat that blocks the passage of air. Central sleep apnea (CSA) is caused by irregularities in the brain's normal signals to breathe. Symptoms of sleep apnea include loud snoring, morning restlessness, morning headaches and irritability. Sleep apnea is more likely in people who are overweight and occurs much more frequently in men than in women.

Most treatments for sleep apnea begin with the patient avoiding alcohol, tobacco and medications that relax the central nervous system such as sedatives and muscle relaxants. Some people are helped by devices that keep them from sleeping on their backs, or oral appliances to keep the airway open during sleep. For more severe cases, doctors often recommend continuous positive airway pressure (CPAP), in which a face mask is attached to a tube and a machine that blows pressurized air into the mask to keep the airway patent (open). Also available are machines that offer variable positive airway pressure (VPAP) and automatic positive airway pressure (APAP). Occasionally surgical removal of excess tissue is performed to allow the airway to remain open. For patients with mild sleep apnea, hypopnea or problems with snoring, there is another, less invasive treatment available in the form of a oral appliance.

The Mandibular Advancement Device (MAD) is a simple, patient-friendly oral appliance created for noninvasive treatment of Sleep Apnea and Snoring. The primary treatment mechanism of opening the bite and gently moving the mandible forward, is achieved with the use of advancement devices that offer varying degrees of mandibular advancement specific to a patients needs.

We are now a Veterans Choice Participating Provider. This program offers Veterans more health and dental options in their local community, instead of waiting for a VA appointment or traveling to a VA facility. If you have any questions or would like to learn whether or not you are eligible, you can call the VA at 1-866-606-8198 to determine eligibility.