Thursday, July 12, 2018

Protect Your Infant’s Dental Health in 7 Simple Steps

Protect Your Infant’s Dental Health in 7 Simple Steps
Give your child the best possible advantage by starting their dental care early and instilling healthy habits from the outset. Proper oral hygiene isn’t just about brushing and flossing, especially when it comes to babies and toddlers.

Today, Bertagnolli Dental discusses everything you need to know about how to protect your infant’s dental health in 7 simple steps. While some of these tips might seem like common sense, you’d be surprised what we see here at our dental practice in Westminster.

By following these steps and taking our professional advice to heart, you’ll get a jump start on protecting your child from all kinds of issues, including cavities and decay.

You’re also welcome to get in touch with our team to schedule a first appointment for your baby. We can provide a full examination and make sure you’re on the right path.

So, let’s get to what it takes to protect your infant’s dental health.

1. Avoid giving your baby a bottle at bedtime

Putting a baby down to sleep with a bottle of milk can quickly become part of your standard nightly ritual, but this is actually a not so great habit to form.

Here’s the problem. The sugars in milk will fuel bacteria in your infant’s mouth all night long which can lead to tooth decay. It’s best to clean your infant’s teeth and gums at bedtime, and if necessary, provide a bottle filled with warm water to help them drift off to sleep.

We know that it’s easier said than done, but when it comes to your infant’s dental health, putting the effort into creating new habits is well worth it.

2. Don't get too dependent on a sippy cup

For older babies and toddlers, this is yet another easy to form and tough to break habit.

The sippy cup, which is great for preventing spills, allows toddlers to transition from bottles to and cups. They’re designed to slow the ingestion of liquids to prevent choking, however, this also gives liquids ample time to sit in your child’s mouth.

For milk and juice, this often means a high exposure to sugar and an increased risk of tooth decay. Try to only give your child the sippy cup at mealtimes and avoid using it continuously throughout the day. For more leisurely sippy cup drinkers, you can fill it with water and let the child wander around as needed.

3. Be aware of high sugar content in medicines

Medications designed for babies and children can have extremely high sugar levels. This is intended to make them more palatable for children and easier to take. Makes sense, right?

While occasional use for colds and other temporary conditions are not usually a cause for concern, you should consult with our dentists if your child has a condition requiring a daily oral medication that has high sugar content. They can advise on the best ways to protect your infant’s dental health. 

4. Keep juice intake in check

After milk, fruit juice is the go-to beverage of choice for young children. While they are full of vitamins and nutrients, what many parents don't realize is that juices often contain a lot of sugar. They can be as harmful as soda to your child's developing teeth.

To protect your infant’s dental health, look for pure fruit juices with no added sugar and limit the consumption of sweet drinks to mealtimes. If it doesn’t lead to an all-out meltdown, you can also try watering down juices.

In fact, it’s best to accustom your child to drinking water throughout the day.

5. Ditch the pacifier

Many parents dread the day when they have to take away the pacifier. We understand and know it can be a very frustrating battle for both you and your child.

However, children over the age of 2 and 3 should not be using a pacifier. They should also stop sucking thumbs and fingers!

Prolonged pacifier use can affect the growth of your child's milk teeth, permanently altering their arrangement and causing abnormal mouth growth. By helping your child become independent of pacifiers at a young age, you can avoid the risk of dental malformation.

You can also avoid the costs associated with fixing related dental issues down the road. As you can imagine, proper care for pacifier-related problems can be complex and expensive.

6. Cultivate healthy dental hygiene habits

Taking the time to practice good oral hygiene with your infant from the very start will set them up for a future of better dental and oral health.  

You can start early by cleaning their gums with a soft cloth and water twice a day. Once their milk teeth start to appear, use a soft-bristled toothbrush and baby-safe toothpaste to gently clean all surfaces. Make it a game, have fun and keep going until dental care is fully incorporated into everyone’s daily routine.

This is the most impactful way to protect your infant’s dental health, and the earlier you start the easier it will be to create healthy habits that last a lifetime.

7. Don't put off their first visit to the dentist

The American Academy of Pediatric Dentistry recommends that every child should see a dentist by the time they are a one-year-old.

It has been proven time and again that early intervention by a professional will lower your child's risk of developing issues in the future. Your dentist can demonstrate correct oral hygiene practices and analyze your child’s potential for tooth decay.

For more information, you’re welcome to contact the team here at Bertagnolli Dental in Westminster
to discuss how to protect your infant’s dental health. Now is a great time to make the changes and instill the habits that will positively impact their oral hygiene.

We hope these simple guidelines will make your life easier, too! We are always available to make your dental visits and home dental care a better experience at Bertagnolli Dental. Get in touch today to set up your child’s next appointment.


Monday, June 18, 2018

What's in Your Toothpaste?

The Truth about Toothpaste
Go to any supermarket or big box discount store across Denver, and you'll be presented with shelves full of toothpaste options. 

Some even have entire aisles dedicated to oral hygiene. 

How do you decide on which toothpaste is right for you and your family? 

Today, Bertagnolli Dental in Westminster is here to tell you the truth about toothpaste, its ingredients, and the adverse effects you should know.

Which toothpaste is right for me?

Toothpaste is separated into subcategories. In most stores, you’ll find whitening toothpaste, tartar control toothpaste, fluoride-free toothpaste, kids toothpaste and toothpaste for sensitive teeth. 

Some people will base their toothpaste choice on their individual needs. This can mean buying a different toothpaste for each member of the family. Others will choose their toothpaste based on the flavor and even price.

Does it pay to be loyal to one brand of toothpaste, or should you just buy whatever happens to be on special that day? 

The harsh reality is that toothpaste is mainly a cosmetic product. Despite the boasts in toothpaste commercials, the truth about toothpaste is that it does not contribute significantly to oral hygiene.

What toothpaste does is create foam and gives your mouth a fresh feeling. We associate a lather or foamy sensation with soap and cleanliness. The strong minty flavor incorporated into most toothpaste gives the whole mouth a crisp, clean, and fresh taste, temporarily at least. 

While toothpaste certainly has a pleasing psychological effect, it does not necessarily impact how clean your teeth are after using it.

In a clinical study to measure the properties of whitening toothpaste, researchers at the University of Bristol Dental School found that there was no difference between the whitening toothpaste, generic toothpaste and plain water at inhibiting stains

The whitening toothpaste produced slightly better results than generic toothpaste and plain water at removing stains, however, it was not deemed capable enough to be clinically relevant.

What is in toothpaste?

Your typical toothpaste will typically contain the following ingredients:


Detergents - These create the foamy lather we mentioned earlier. This does not technically help to remove plaque from your teeth, but it does create a pleasing sensation.

Abrasives - Calcium carbonate and dehydrated silica gel help to physically scrub the surface of the teeth and remove food particles. Brushing too hard and fast without using the correct technique can wear down your teeth and remove some of the enamel.

Fluoride - This remineralizes the enamel of your teeth, making them stronger and more resistant to decay. This is one of the most important ingredients of toothpaste, and sometimes the only true active ingredient. Some people are wary of fluoride's effects and try to avoid it, even though it is effective in preventing cavities.

Flavorings - Usually menthol based flavors and sweeteners such as saccharin are used to make toothpaste palatable. Toothpaste does not usually contain sugar, even though you can find sweet bubblegum and fruit-flavored tubes of toothpaste marketed towards children.

Specially formulated tartar control toothpaste is designed to prevent the buildup of hardened mineral plaques or 'tartar' sometimes found on the inner surfaces of the teeth. 

They usually contain ingredients called pyrophosphates – tetrasodium or tetrapotassium pyrophosphates are the compounds added to toothpaste to fight the formation of tartar or calculus plaques.

Unfortunately, according to the Houston Health Science Center Dental Branch, this type of toothpaste can cause irritation in some users. Pyrophosphates create higher than usual levels of alkalinity in the mouth, to which some people can be sensitive. 

Toothpaste for sensitive teeth also contains an added ingredient, potassium nitrate. This compound desensitizes teeth and reduces the feeling of discomfort caused by hot and cold temperatures or sugary foods. Unfortunately, by using this additive, you may be just masking the pain of a cavity or serious issue requiring proper dental care and treatments.


So, what's best for my teeth?

While this information does not give you the green light to skip daily brushings, we also recommend a flossing regimen and seeing our dentists here at Bertagnolli Dental regularly.

Get in touch today, and let us take fantastic care of your teeth. 


Monday, June 4, 2018

Understanding Tooth Wearing as We Age

Understanding Tooth Wearing as We Age
Bertagnolli Dental provides our clients with high-quality dental care at every stage of life, along with vital information such as understanding tooth wearing as we age. Everyone experiences gradual tooth wear. Usually, it is only addressed during the later years when problems associated with tooth wearing begin to appear. Fortunately, early intervention by your dentist can often prevent the most common issues. Keep reading to get a better understanding of how to keep your teeth healthy.

One common misconception is that tooth wearing is only a problem in older people. Tooth wear is more commonly seen in older people because they simply have had more time to wear down their teeth from general, everyday use. Many younger people also experience issues related to tooth wearing as opposed to tooth decay. Depending on your diet, oral hygiene and tooth grinding habits, wear and tear on your teeth can occur at different rates.

At least three times a day we use our teeth to tear apart and break up food in our mouth. The biting surfaces of all your teeth and the molars especially are put under a lot of pressure when grinding down tough meat, crunchy vegetables, and chewy bread. As your teeth grind against each other, they gradually wear down the hard enamel surface. Once this enamel is lost, it cannot be replaced by the body, making tooth wear a continuous and inevitable phenomenon. 

The best approach to avoiding problems related to tooth wear is to slow down the rate of attrition experienced by your teeth. Bad dental hygiene habits can weaken the enamel on your teeth and make the surfaces more susceptible to wear from regular use. Brushing twice a day, flossing, and avoiding a highly sugary or acidic diet will set you up for strong teeth in the long run. A diet rich in calcium and exposure to fluoride through your drinking water or toothpaste will ensure your teeth are rich in the minerals needed to maintain resistant enamel.

Tooth wearing is often accelerated in certain people who have the habit of nail biting, pencil chewing, or teeth grinding. These can be unconscious mechanisms to relieve stress or tension. Often teeth grinding or clenching happens while the person is sleeping, without them even realizing it. Dentists can create a special dental mouth guard for night time use to prevent grinding damage during sleep. Always avoid biting non-food items like fingernails, pens, and pencils. Never use your teeth as tools to open bottles, cut string or tear packaging.

Keeping your teeth healthy and functional for your entire lifetime is possible. Understanding tooth wearing as we age will help you to avoid bad habits and care for your teeth today. Remember to consult regularly with your dentist and to continue getting annual dental check-ups. At Bertagnolli Dental, we can offer more information and advice on preventing tooth wearing throughout life. Do not hesitate to contact us if you think you may be grinding your teeth at night or are due for a general check-up.

Wednesday, April 25, 2018

Basics of Dental Insurance

Today, Bertagnolli Dental in Westminster has the basics of dental insurance. We get a lot of questions from our clients about how their dental insurance works. So, we have laid out some helpful points to guide you through the process of using your dental insurance with Bertagnolli Dental.

Deductibles
Your dental insurance plan is going to have a deductible. This means that you will first pay out of pocket for dental procedures, such as a crown or filling, before the insurance coverage and co-pays come into play. Fortunately, insurance rarely applies a deductible to appointments for cleanings or exams.

Annual Maximum Benefit
Based on the calendar year, your Annual Maximum Benefit is generally around $1,000-$1,500, which is how much total dental work your insurance will pay. Once you’ve reached this amount in services, you must wait until the next calendar year to receive additional coverage, unless you pay out of pocket.

Your annual maximum benefit is “spent” on different levels of procedures and typically by a certain percentage. Here’s a quick example:

·         Type 1 Services, Preventative Dental Care: Insurance provides 100% coverage for x-rays, exams, cleanings, fluoride treatments, and sealants.

·         Type 2 Services, Basic Restorative Dental Care: Insurance pays 80% of the cost for fillings, root canals, periodontal scaling, root planning (deep cleanings), and extractions.

·         Type 3 Services, Major Restorative Dental Care: Insurance pays 50% of the cost for bridge work, dentures, crowns, posts, and buildups.

What About Exceptions?
Exceptions are one of the unavoidable basics of dental insurance, so read through you policy to better understand your dental care coverage. You can also call your insurance carrier for clarifications.

Waiting Period
If you are just getting new insurance, you may have to wait six months for coverage to begin on Type 2 Services. This is an industry standard, so set your calendars for any basic restorative dental care services including fillings, root canals, periodontal scaling, root planning (deep cleanings), or extractions.

Missing Tooth Clause
If you are looking to get a bridge or implant, hopefully, you still have the tooth or teeth needing help. If the tooth was already missing as you started your new dental insurance coverage, then your insurance will typically not cover the work.

Frequency
Your dental care group plan only allows services at certain intervals. This includes cleanings only every 6 months. If you schedule a cleaning before the 6 month period is up, your insurance will not cover it. At Bertagnolli Dental, we can advise and set up appointments so you’ll never have to worry!

Be sure that your dentist is contracted with your insurer to ensure coverage. You can also ask for a pre-treatment estimate to be sent over to your insurer. That way, you will see just what they will cover of your dental treatments, so there are no surprises in the bill.


At Bertagnolli Dental, we always work with our clients to get the absolute best benefits coverage and service. We appreciate our patients and want your experience with us to be a pleasant one. Now that you have the basics of dental insurance down, you are ready to schedule your visit with us.

Sunday, April 15, 2018

When to Worry About a Toothache

Know when to worry about a toothache with these tips from Bertagnolli Dental in Westminster. Toothache pain does not come from only one cause or symptom. There is a myriad of reasons you are experiencing it. Read on to get the facts on when to worry about a toothache and seek treatment.

If you’re experiencing a ton of pain with your toothache, it’s best to make an appointment immediately with your dentist. Remember, that you may have to wait a few days for a time to open up, so the sooner you call, the better.

In the meantime, take a written account of the pain you are experiencing. You can also take a painkiller, apply numbing gel, and a cold compress. Most importantly, keep your teeth clean. This will do the most good in this situation until you can meet with your dentist.

Schedule with your dentist immediately if:
·         Your toothache is causing you severe pain
·         Your toothache is lasting longer than 1-2 days
·         You have pain by simply opening your mouth
·         You have an earache as well

Additional Causes/Symptoms of a Toothache:
·         Chest pain
·         Jaw pain
·         Excessive pain
·         Dull or sharp pain around the tooth
·         Difficulty chewing or swallowing
·         Bleeding gums
·         Facial rash

Allergy and Sinus Problems
Believe it or not, you may have a sinus toothache. If you have recently gotten sick or have an infection, your mucus lining may swell up. This will lead to blockage of the nasal passages, clogging up your sinuses and trapping bacteria inside, leading to a toothache.

Trauma
Have you done any recent activities, such as playing sports, where you got hit in the face? You may be experiencing the effects of unintended trauma to your teeth. Your dentist can diagnose you and provide appropriate treatment.

Wisdom Teeth
The pain you are experiencing may also be from your wisdom teeth coming in. Make an appointment with your dentist as soon as possible for an accurate assessment. 

Abscessed Tooth
If you have had any issues with your mouth for a while and did not get treatment, you may have an abscessed tooth. The sooner that you can get to the dentist, the better. An abscess qualifies as when to worry about a toothache.

Tooth Decay and Cavities
If your cavity has gotten extreme, it will begin to expose nerve endings and start to hurt. Get to your dentist quickly to resolve the issue.

Cracked Tooth
Cracked teeth can happen for a number of reasons including less than perfect oral hygiene, a misaligned bite, or trauma to the mouth. Get to the dentist quickly if you have a cracked tooth.

Gum Disease
A toothache can also stem from gingivitis. If your gums appear inflamed or bleed easily, it just might be showing up as a toothache. Seek help from your dentist immediately so that they can assist.


Now you have the facts on when to worry about a toothache, get help with your toothache today from Bertagnolli Dental. We are service-oriented, providing excellent dentistry to our clients. Don’t delay; call or schedule online today to get your toothache under control.

Wednesday, March 14, 2018

Baby's First Dental Visit

baby's first dental visit at Bertagnolli Dental in WestminsterThis week at Bertagnolli Dental in Westminster, we want to focus on your baby's first dental visit. As a practice specializing in family dentistry, we are well-equipped to help you with any queries related to dental care for your little ones. And of course, our entire team is gentle and friendly, to ensure all goes well when you come see us. Now, one of the most frequent questions we’re asked is, when should I bring my baby for their first dental check-up?  Let’s talk about what you need to know.

Scheduling the First Appointment
Your baby's first few teeth will probably appear when they are between six months and one year old. Schedule their first visit to a dentist once teeth start appearing and certainly by their first birthday. While some parents may be surprised at the advice to take their child to a dentist at such a young age, it's never too early. If you notice anything unusual about your baby's gums or mouth before the six-month mark, you can schedule an appointment with a dentist or pediatrician to have them checked.

Baby's first dental visit is crucial to a lifetime of dental care. Even with just a few teeth present, your dentist will be able to analyze their risk for cavities. The number of babies with tooth decay before they are two years old is rapidly increasing. By age four, at least one in four children in here in the United States will already have a cavity.

Baby teeth or milk teeth eventually fall out. It is, however, critical to take care of them for the five to seven years they are present. Not only does it set up a good routine for caring for the future adult teeth, but it also helps your child in this crucial stage of development. Healthy baby teeth are necessary for them to process food and receive the correct nutrition, as well as develop their speech skills.

How to Find a Pediatric Dentist
Finding a dentist that will cater to your child's needs and ensure they are comfortable is the top priority. While many dental practices will cater to children, not all of them are experienced and capable with infants. To get an idea of whether a practice is a good fit for your baby's first dental visit, call them up and ask what age they recommend for a first visit. If they respond by saying when the first tooth arrives or before their first birthday, you can be confident that they see babies on a regular basis.

Preparing for the First Appointment
Before taking your baby to their appointment, it's a good idea to think about any worries or concerns you have and write them down. This first visit aims to:

  • Start building a relationship with the dentist that will be taking care of your child's dental health
  • Have the dentist evaluate your child’s oral health
  • Receive advice on oral hygiene
  • Get answers to any specific questions or concerns

On the day of baby's first dental visit, it is a good idea to bring an extra diaper, snack, and toy for your child. This will hopefully keep them happy in the waiting room.

If possible, bring their other parent or an adult with whom your baby is comfortable with to the visit. They can hold the baby and keep them amused while you focus on talking to the dentist. Try to avoid bringing other children along so that you can give your undivided attention to the consultation. This appointment is a valuable opportunity to address your specific concerns with your dentist, so make the most of it.

At the Dental Office
Baby's first dental visit will begin with the dentist going over your child’s medical history. The dentist will probably ask about things related to their overall development, teething, diet, and sucking habits. They may ask about the dental health of any siblings and whether the siblings have cavities. This will give them an overall idea of your baby's health before they carry out the exam.

The dentist will then ask you to help them position the baby so that they can look at the teeth and gums. Usually, the parent will sit the child on their lap, and the dentist will sit opposite the parent. The parent can lay the baby back so that his or her head rests on the knees of the dentist and both can see clearly into their mouth. This is usually the most comfortable position, as they can still see the parent's face and don't have to be on the unfamiliar surface of a dentist's chair or table.

The dentist will examine the inside of your child’s mouth, checking each tooth. They will demonstrate how to clean the teeth and gums correctly. At this stage, they should let you practice the suggested technique for cleaning and correct any mistakes. They will also tell you what to expect in the following months as your child continues to develop.

After the examination, the dentist will discuss any irregularities found. If they have specific advice related to the diet, oral hygiene or cavity prevention, they will explain their suggestions and how to carry them out. If you have questions, feel free to ask them at this point. The dentist will then suggest a schedule for continued care.

After the Appointment
Before leaving the office, schedule your child’s next appointment at the front desk. They may give you contact information in case of a dental emergency. After the appointment, you will have a good idea of your baby's overall oral health, their stage of development and what to expect in the future. You’ll feel confident knowing how to care for your baby's teeth and identifying any problems that may appear.


If you have any questions about baby's first dental visit that haven't been answered by this post, please get in touch. The friendly team here at Bertagnolli Dental will guide you through the process. If you live here in Westminster or nearby, we would be happy to attend to the needs of your family. Give us a call.

Monday, February 12, 2018

All About Porcelain Veneers

All About Porcelain Veneers at Bertagnolli Dental Westminster
Ready to learn all about porcelain veneers? Our team at Bertagnolli Dental in Westminster, Colorado can guide you through the best options for your teeth. Getting dental veneers is typically a fast, simple, and painless procedure that can solve a range of cosmetic problems. If you are unsure whether veneers are the right option for you, keep reading. We will take you through the ins and outs of the procedure as well as the advantages and potential drawbacks of getting veneers.

What are Porcelain Veneers
Veneers are custom-made shells of a material designed to look exactly like your natural teeth. They are applied to the front surface of a tooth and are very successful in improving the tooth's appearance by changing its shape, size or color. Dental veneers are typically made of composite resin materials or porcelain. They are slightly more true to the appearance of tooth enamel, as they have similar light reflecting properties. Another reason to favor porcelain is that they are more resistant to staining than resin veneers.

Who Should Consider Porcelain Veneers?
Veneers are most often considered by people that have a cosmetic issue with one or many of their teeth. Acquired problems can include a chipped or broken tooth. If the tooth in question is still structurally sound and functional, having a porcelain veneer applied will instantly fix the aesthetic problem. Some people with overly worn down teeth, especially those at the front of the mouth, choose to get veneers to even out the size of the affected teeth.

Veneers also provide a solution for heavily stained teeth. Tooth yellowing can be a result of smoking tobacco or frequent consumption of dark-colored drinks such as coffee and red wine. Tooth discoloration can sometimes occur as a side effect of the antibiotic tetracycline or after a root canal treatment. If traditional teeth whitening methods do not produce good results, porcelain veneers allow you to choose the exact shade of white they prefer for the visible surface of their teeth.

Porcelain veneers are also great if you want to get the appearance of a straight, even smile without investing a lot of time and money into orthodontic braces. Veneers can be custom shaped to fill out the gaps between teeth, increase the size of smaller teeth, and even out the surface and borders of any oddly shaped teeth.

What Does the Procedure Involve?
The first stage of getting veneers is the consultation and diagnosis. For this, you need to schedule an appointment with your dentist to have your teeth examined and discuss your goals. Your dentist will be able to decide if you are a suitable candidate for veneers and the extent to which veneers can achieve your desired look. During this appointment, the dentist may take X-rays of your mouth or impressions of your teeth with a mold.

The next stage involves prepping the tooth or teeth. The enamel on the front of each tooth receiving a veneer has to be filed down by around half a millimeter to allow space for the veneer. You can be given a local anesthetic to numb the whole area and reduce any discomfort during this process. A mold can then be taken of the prepped tooth and sent to a dental laboratory where the veneer will be constructed over a period of two to four weeks. Constructing the dental veneer involves painted a number of layers of porcelain ceramic onto the mold of your tooth, to build it up to the desired thickness and shape.

The final step is to permanently bond the veneer to your prepped tooth. Your dentist will fit the veneer onto the tooth and make any last minute adjustment to the shape by filing it down before using a specialized cement to adhere the veneer to your tooth. Once the veneer is in position and cemented onto the tooth, a curing light is used to activate chemicals in the cement, causing it to harden quickly. Your dentist will remove any excess cement and check your bite with the veneer in place. You may be asked to return in a few weeks to check how your gums have responded to the veneer.

Advantages of Porcelain Veneers
This option highly recommended by dentists as a long-term solution for teeth in need of aesthetic improvement. The material closely mimics the appearance, color, and texture of your natural teeth. The color of a porcelain veneer can be chosen to match the surrounding teeth and will not stain over time. Porcelain is tolerated well by surrounding gum tissue and unlikely to cause irritation. One big advantage is their ease of placement. They do not require the level of invasive shaping and molding used when placing a crown.

Disadvantages of Porcelain Veneers
The main downside to veneers is that they are not completely permanent. They usually last at least 7 to 15 years, but due to normal wear and tear they can eventually chip, crack or come loose completely. If this happens, you will need to replace the veneer with a new one, as once the tooth has been filed down and prepped for a veneer it is unwise to leave it bare. In this way, veneers are a non-reversible procedure. Another disadvantage associated with veneers is that some people will experience an increase in sensitivity to hot and cold due to the removal of some enamel from the tooth. They also cost more than composite resin veneers.


Porcelain veneers are an excellent option for anyone interested in changing the appearance of their teeth without opting for the more invasive and expensive procedure of a full crown. Once they are placed, they are low-maintenance and require no special care, apart from the usual brushing and flossing. Now that you know all about them, why not schedule an appointment with your dentist to discuss your suitability for the procedure? At Bertagnolli Dental, we are fortunate to have the use of an in-house laboratory where we can create custom porcelain veneers. This means a lower overall cost and less waiting time than in other clinics where the lab work must be outsourced.