Name: ____________________________________________________________________________________________________________

Address (including city, state, zip): ________________________________________________________________________________________

Phone: (H) ___________________ (W)___________________ (C)___________________ E-Mail: ________________________________

Social Security #: __________________________ Date of Birth:______________________ Preferred Contact Method: ________________

Whom may we thank for referring you to our practice? ______________________________________________________________________

Who is the general dentist? ____________________________________________________________________________________________

Reason for visit? ____________________________________________________________________________________________________

Have you seen a periodontist before? If so, explain:__________________________________________________________________________

MEDICAL HISTORY

Patient’s Physician: ________________________________________________ Physician’s Phone Number: ____________________________

Are you allergic to: Latex Penicillin Codeine Local Anesthetics Other : ________________________________________

Do you require antibiotic pre-medication prior to dental treatment? YES NO If yes, please explain: __________________________

Do you smoke? YES NO If yes, how many packs? how often? ________________________________________________________

Do you have Excessive Urination thirst hunger or recent weight changes? ______________________________________________

Women: Are you taking oral contraceptives or other hormone supplements? YES NO If yes, please explain: ______________________

Have you ever taken bisphosphonates? (Boniva, Actonel, Fosamax, etc.) YES NO

Other important medical info: __________________________________________________________________________________________

Please list medications you are taking: ____________________________________________________________________________________

__________________________________________________________________________________________________________________

Have you ever been diagnosed with any of the following conditions?

AIDS: YES NO High Blood Pressure:YES NO Heart Murmur: YES NO Rheumatic Fever: YES NO

Anemia: YES NO Low Blood Pressure: YES NO Hepatitis A: YES NO Sinus Trouble: YES NO

Arthritis: YES NO Cancer: YES NO Hepatitis B, C: YES NO Stroke: YES NO

Artificial Joints: YES NO Diabetes: YES NO Herpes: YES NO Tuberculosis: YES NO

Asthma: YES NO Epilepsy: YES NO Cold Sores: YES NO Ulcers: YES NO

Hay fever: YES NO Heart Disease: YES NO Hypoglycemia: YES NO

PERIODONTAL HEALTH

Last Dental Visit: __________________________________________ Do your gums bleed when brushing/flossing? YES NO

How often do you brush your teeth? __________________________ Do your gums feel swollen or tender? YES NO

What texture toothbrush do you use? Soft Medium Hard Do you have any problems chewing? YES NO

Do you floss your teeth? YES NO How Often? __________ Are any teeth loose? YES NO

Are your teeth sensitive to cold liquids or foods? YES NO

Signature of Patient (parent/guardian if under 18): __________________________________________________________________________

Page 1 of 3

Page 2 of 3

RESPONSIBLE PARTY INFORMATION (Skip if self)

Name: _______________________________________________________________________ Date:________________________________

Address (including city, state, zip): ________________________________________________________________________________________

Social Security #: ______________________________________________________________ Date of Birth: ________________________

Phone: (H) ___________________ (W) ___________________ (C) ___________________ E-Mail: ______________________________

DENTAL INSURANCE INFORMATION (If not applicable, place an "X" in each field)

PRIMARY

Policy Holder Name: ____________________________________________ Employer Name: ______________________________________

Insurance Company Name: _______________________________ Group #: _______________ Phone Number: (______)______- ________

Social Security #: _________-________-_________ Member ID #: ____________________________ Birth Date: ____________________

Relationship to policy holder: Self Spouse Child Other

SECONDARY (If applicable)

Policy Holder Name: ____________________________________________ Employer Name: ______________________________________

Insurance Company Name: _______________________________ Group #: _______________ Phone Number: (______)______- ________

Social Security #: _________-________-_________ Member ID #: ____________________________ Birth Date: ____________________

Relationship to policy holder: Self Spouse Child Other

FINANCIAL CONSENT FOR SERVICE

***Please read and initial next to each item

________ As a condition of your treatment by this office, it is your obligation to inquire about financial arrangements in advance.

________ All dental services must be paid for at the time the services are performed.

________ Patients who carry dental insurance “in-network” with our office understand that they are responsible for their portion due(according to their dental plan) at the time of the visit. Furthermore, patients understand that they are responsible for any unpaidbalance by their insurance company.

________ Any unpaid balance exceeding 90 days from the date of service was rendered will be subject to third party collection. I agree to payall costs associated with the collection of the unpaid balance.

________ I understand that if an appointment is cancelled less than 48 hours notice there may be a fee equivalent up to 25% of the procedureimposed.

________ I grant my permission to you or your assignee, to telephone me to discuss matters related to this form.

________ I consent and authorize South Jersey Periodontics & Dental Implants, LLC and/or Dr. Kubikian to use my radiographs, periodontalcharting, impressions and/or clinical photographs for the purpose of communicating with insurance companies, dental providers, orany other lawful purpose. [release and forever discharge any claim, demands or liability on account of such use.]

I have read the above conditions of treatment and payment and agree to their content.

Signature of Patient (parent/guardian if under 18): ________________________________________ Date: ____________________________

Page 3 of 3

Written Financial Policy

Thank you for choosing South Jersey Periodontics and Dental Implants, LLC. Our primary mission is to deliver the best and mostcomprehensive dental care available. An important part of our mission is making the cost of optimal care easy and manageable for our patients byoffering several payment options.

Payment Options:

• Cash or Check

• Visa, MasterCard, American Express, or Discover Card

• Convenient Monthly Payment Plans from CareCredit or Chase (Subject to credit approval.)o Allows patients to pay over timeo No annual fees or pre-payment penalties

Please note:

South Jersey Periodontics & Dental Implants, LLC requires payment on the date of service.

For patients with dental insurance, we are happy to work with the carrier to maximize benefits and directly bill them for treatment feereimbursement.

• However, if we do not receive payment from the insurance carrier, patients will be responsible for any remaining balance.

A fee of up to 25% of the procedure fee is charged for patients who miss or cancel without 48-HOUR NOTICE.

South Jersey Periodontics & Dental Implants, LLC charges $30 for returned checks.

If there are any questions, please do not hesitate to ask. We welcome the opportunity to help and provide the care our patients want and need.

Patient, Parent or Guardian Signature:___________________________________________________ Date: __________________________

340 Egg Harbor Road • Sewell, NJ 08080T: (856) 256-7778 • F: (856) 256-7702 • W: www.sjperio.com • E: info@sjperio.com

NJ Dental Specialty #5659 • Clinical Asst. Professor, University of Pennsylvania Diplomate, American Board of Periodontology

IMPORTANT INSURANCE INFORMATION (Please read carefully)

Here at South Jersey Periodontics & Dental Implants, LLC, we work together with insurance providers to maximize your dental benefits. As a patient, you are able to save money on all periodontal treatment and implant procedures, even if they are not covered, through our designation as a participating dental practice with the various insurance companies listed below.

It is your responsibility to check with your carrier if we are in your network. Please note most plans generally cover two exams in a 12-month period. If you have any questions, please do not hesitate to contact our office.

Insurances we participate with: (as of January 2020)

• Aetna PPO (PPO/PPO II) • GEHA

• Ameritas • Guardian

• Assurant- DHA • Horizon BCBS (Dental Option/PPO)

• Cigna • MetLife

• Delta Dental (Premier/PPO) • United Concordia

• Dentemax (National Fee for Service/Traditional/Advantage Plus)

• Fidelio • United Healthcare

Please be aware we may not participate with all plans associated with your insurance provider. For example,we do not participate with BCBS Federal, Benecare and any HMO plans.

If your insurance company is not listed, we can still provide you with excellent care and help with insurance-related paperwork. We can submit claims on your behalf to help maximize your benefits.

For all patients with insurance, in or out of network, you are responsible for any balances not covered or paid for by your insurance company. Please be aware payment is expected at the time of service.

At South Jersey Periodontics & Dental Implants, we offer convenient office hours.

Monday

Tuesday

Wednesday

Thursday

Friday

8:00 AM – 6:00 PM8:00 AM – 6:00 PM 8:00 AM – 6:00 PM 8:00 AM – 5:00 PM 8:00 AM – 4:00 PM

Please call us to schedule your appointment.

South Jersey Periodontics & Dental Implants, LLC Daniel Kubikian, DMD 340 Egg Harbor Road

Sewell, NJ 08080 EFFECTIVE DATE AS OF January 1, 2020

HIPAA AUTHORIZATION

PHONE: (856) 256-778 FAX: (856) 256-7702 EMAIL: INFO@SJPERIO.COM

Office Contact Person: Dr. Daniel Kubikian __________________________________________________________________________________

AUTHORIZATION FOR RELEASE OF IDENTIFYING HEALTH INFORMATION __________________________________________________________________________________ Patient Name: _____________________________ I authorize the professional office of my dentist named above to release health information identifying me [including if applicable, information about HIV infection or AIDS, information about substance abuse treatment, and information about mental health services] under the following terms and conditions: 1. Detailed description of the information to be released: 2. To whom may the information be released [dentist, doctors, insurance companies, etc..]: 3. The purpose(s) for the release (if the authorization is initiated by the individual, it is permissible to state "at the request of the individual" as the purpose, if desired by the individual): 4. Expiration date or event relating to the individual or purpose for the release: It is completely your decision whether or not to sign this authorization form. We cannot refuse to treat you if you choose not to sign this authorization. If you sign this authorization, you can revoke it later. The only exception to your right to revoke is if we have already acted in reliance upon the authorization. If you want to revoke your authorization, send us a written or electronic note telling us that your authorization is revoked. Send this note to the office contact person listed at the top of this form. When your health information is disclosed as provided in this authorization, the recipient often has no legal duty to protect its confidentiality. In many cases, the recipient may re-disclose the information as he/she wishes. Sometimes, state or federal law changes this possibility. [For marketing authorizations, include, as applicable: We will receive direct or indirect remuneration from a third party for disclosing your identifiable health information in accordance with this authorization.] I HAVE READ AND UNDERSTAND THIS FORM. I AM SIGNING IT VOLUNTARILY. I AUTHORIZE THE DISCLOSURE OF MY HEALTH INFORMATION AS DESCRIBED IN THIS FORM.

Effective date of notice: January 1, 2020 NOTICE OF PRIVACY PRACTICES

South Jersey Periodontics & Dental Implants, LLC

_________________________________________________________________ THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. _________________________________________________________________

We respect our legal obligation to keep health information that identifies you private. We are obligated by law to give you notice of our privacy practices. This Notice describes how we protect your health information and what rights you have regarding it. TREATMENT, PAYMENT, AND HEALTH CARE OPERATIONS

The most common reason why we use or disclose your health information is for treatment, payment or health care operations. Examples of how we use or disclose information for treatment purposes are: setting up an appointment for you; examining your teeth; prescribing medications and faxing them to be filled; referring you to another doctor or clinic for other health care or services; or getting copies of your health information from another professional that you may have seen before us. Examples of how we use or disclose your health information for payment purposes are: asking you about your health or dental care plans, or other sources of payment; preparing and sending bills or claims; and collecting unpaid amounts (either ourselves or through a collection agency or attorney). "Health care operations" mean those administrative and managerial functions that we have to do in order to run our office. Examples of how we use or disclose your health information for health care operations are: financial or billing audits; internal quality assurance; personnel decisions; participation in managed care plans; defense of legal matters; business planning; and outside storage of our records.

We routinely use your health information inside our office for these purposes without any special permission. If we need to disclose your health information outside of our office for these reasons, we usually will not ask you for special written permission.

We will ask for special written permission in the following situations: USES AND DISCLOSURES FOR OTHER REASONS WITHOUT PERMISSION In some limited situations, the law allows or requires us to use or disclose your health information without your permission. Not all of these situations will apply to us; some may never come up at our office at all. Such uses or disclosures are:

When a state or federal law mandates that certain health information be reported for a specific purpose;

For public health purposes, such as contagious disease reporting, investigation or surveillance; and notices to and from the federal Food and Drug Administration regarding drugs or medical devices;

Disclosures to governmental authorities about victims of suspected abuse, neglect or domestic violence;

Uses and disclosures for health oversight activities, such as for the licensing of doctors; for audits by Medicare or Medicaid; or for investigation of possible violations of health care laws;

Disclosures for judicial and administrative proceedings, such as in response to subpoenas or orders of courts or administrative agencies;

Disclosures for law enforcement purposes, such as to provide information about someone who is or is suspected to be a victim of a crime; to provide information about a crime at our office; or to report a crime that happened somewhere else;

Disclosure to a medical examiner to identify a dead person or to determine the cause of death; or to funeral directors to aid in burial; or to organizations that handle organ or tissue donations;

Uses or disclosures for health related research; Uses and disclosures to prevent a serious threat to health or safety; Uses or disclosures for specialized government functions, such as for the protection of the president

or high ranking government officials; for lawful national intelligence activities; for military purposes; or for the evaluation and health of members of the foreign service;

Disclosures of de-identified information; Disclosures relating to worker's compensation programs; Disclosures of a "limited data set" for research, public health, or health care operations; Incidental disclosures that are an unavoidable by-product of permitted uses or disclosures; Disclosures to "business associates" who perform health care operations for us and who commit to

respect the privacy of your health information.

Unless you object, we will also share relevant information about your care with your family or friends who are helping you with your dental care. APPOINTMENT REMINDERS We may call or write to remind you of scheduled appointments, or that it is time to make a routine appointment. We may also call or write to notify you of other treatments or services available at our office that might help you. Unless you tell us otherwise, we will mail you an appointment reminder on a post card, and/or leave you a reminder message on your home answering machine or with someone who answers your phone if you are not home. OTHER USES AND DISCLOSURES

We will not make any other uses or disclosures of your health information unless you sign a written "authorization form." The content of an "authorization form" is determined by federal law. Sometimes, we may initiate the authorization process if the use or disclosure is our idea. Sometimes, you may initiate the process if it's your idea for us to send your information to someone else. Typically, in this situation you will give us a properly completed authorization form, or you can use one of ours. If we initiate the process and ask you to sign an authorization form, you do not have to sign it. If you do not sign the authorization, we cannot make the use or disclosure. If you do sign one, you may revoke it at any time unless we have already acted in reliance upon it. Revocations must be in writing. Send them to the office contact person named at the beginning of this Notice. YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

The law gives you many rights regarding your health information. You can: Ask us to restrict our uses and disclosures for purposes of treatment (except emergency treatment),

payment or health care operations. We do not have to agree to do this, but if we agree, we must honor the restrictions that you want. To ask for a restriction, send a written request to the office contact person at the address, fax or E Mail shown at the beginning of this Notice.

Ask us to communicate with you in a confidential way, such as by phoning you at work rather than at home, by mailing health information to a different address, or by using E mail to your personal E Mail address. We will accommodate these requests if they are reasonable, and if you pay us for any extra cost. If you want to ask for confidential communications, send a written request to the office contact person at the address, fax or E mail shown at the beginning of this Notice.

Ask to see or to get photocopies of your health information. By law, there are a few limited situations in which we can refuse to permit access or copying. For the most part, however, you will be able to review or have a copy of your health information within 30 days of asking us (or sixty days if the information is stored off-site). You may have to pay for photocopies in advance. If we deny your request, we will send you a written explanation, and instructions about how to get an impartial review of our denial if one is legally available. By law, we can have one 30 day extension of the time for us to give you access or photocopies if we send you a written notice of the extension. If you want to review or get photocopies of your health information, send a written request to the office contact person at the address, fax or E mail shown at the beginning of this Notice.

Ask us to amend your health information if you think that it is incorrect or incomplete. If we agree, we will amend the information within 60 days from when you ask us. We will send the corrected information to persons who we know got the wrong information, and others that you specify. If we do not agree, you can write a statement of your position, and we will include it with your health information along with any rebuttal statement that we may write. Once your statement of position and/or our rebuttal is included in your health information, we will send it along whenever we make a permitted disclosure of your health information. By law, we can have one 30 day extension of time to consider a request for amendment if we notify you in writing of the extension. If you want

to ask us to amend your health information, send a written request, including your reasons for the amendment, to the office contact person at the address, fax or E mail shown at the beginning of this Notice.

Get a list of the disclosures that we have made of your health information within the past six years (or a shorter period if you want). By law, the list will not include: disclosures for purposes of treatment, payment or health care operations; disclosures with your authorization; incidental disclosures; disclosures required by law; and some other limited disclosures. You are entitled to one such list per year without charge. If you want more frequent lists, you will have to pay for them in advance. We will usually respond to your request within 60 days of receiving it, but by law we can have one 30 day extension of time if we notify you of the extension in writing. If you want a list, send a written request to the office contact person at the address, fax or E mail shown at the beginning of this Notice.

Get additional paper copies of this Notice of Privacy Practices upon request. It does not matter whether you got one electronically or in paper form already. If you want additional paper copies, send a written request to the office contact person at the address, fax or E mail shown at the beginning of this Notice.

OUR NOTICE OF PRIVACY PRACTICES By law, we must abide by the terms of this Notice of Privacy Practices until we choose to change

it. We reserve the right to change this notice at any time as allowed by law. If we change this Notice, the new privacy practices will apply to your health information that we already have as well as to such information that we may generate in the future. If we change our Notice of Privacy Practices, we will post the new notice in our office, have copies available in our office, and post it on our Web site. COMPLAINTS If you think that we have not properly respected the privacy of your health information, you are free to complain to us or the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you if you make a complaint. If you want to complain to us, send a written complaint to the office contact person at the address, fax or E mail shown at the beginning of this Notice. If you prefer, you can discuss your complaint in person or by phone. FOR MORE INFORMATION If you want more information about our privacy practices, call or visit the office contact person at the address or phone number shown at the beginning of this Notice.

ACKNOWLEDGEMENT OF RECEIPT

I acknowledge that I reviewed and am entitled to a copy of South Jersey Periodontics & Dental Implants, LLC's HIPAA AUTHORIZATION AND NOTICE OF PRIVACY PRACTICES. Patient Name: _____________________ Date: ____________ Patient (Parent/Guardian) Signature: __________________________

To Our Patients:

During this time of the COVID-19 pandemic, dental practitioners may be at higher risk of disease

transmission due to the close proximity required for dental work to be done. Given this risk, any

elective dental procedures will not be performed until this national public health emergency crisis is

resolved. We are taking precautions to limit the spread of disease, yet there is still a possibility of

transmission.

I, _______________________, knowingly and willingly consent to have emergency dental treatment

completed during the COVID-19 pandemic. I understand the COVID-19 virus has a long incubation

period during which carriers of the virus may not show symptoms and still be highly contagious. It is

impossible to determine who has it and who does not given the current limits if virus testing.

Dental Procedures creat water spray which is how the disease is spread. The ultra-fine nature of the

spray can linger in the air for minutes to sometimes hours, which can transmit the COVID-19 virus.

I understand that due to the frequency of visits of other dental patients, the characteristics of

the virus, and the characteristics of dental procedures, that I have an elevated risk of contracting

the virus simply by being in a dental office. _________________(initial)

I have been made aware of the CDC, ODA and ADA guidelines that during this pandemic all non-

urgent dental care is not recommended. Dental visits should be limited to the treatment of

pain, infection, conditions that significantly inhibit normal operation of teeth and mouth, and

issues that may cause anything listed above during the next 3-6 months. ____________(initial)

I confirm that I am seeking treatment for a condition that meets these criteria. ________(initial)

We are vigilantly monitoring ourselves for any adverse symptoms and if any were to develop, we would

move to be immediately tested. There has been documented transmission when people are

asymptomatic as well.

Please answer the questions below as a pre-screening for receiving dental treatment.

COVID-19 Patient Pre-Screen Sign-Off

1. Have you or anyone in your immediate family traveled on an airplane in the last 14 days?

YES/NO

2. Have you had contact with anyone who has been suspected to have COVID-19 in the last 14

days? YES/NO

3. Do you currently have a fever, shortness of breath, cough, runny nose, sore throat or

congestion? YES/NO

4. CURRENT TEMPERATURE _________________

If you have answered yes to any of the above, contact your personal physician by phone. Do not go

unannounced to the doctor’s office. We will postpone your dental treatment to a healthier time.

My signature below confirms the information above is accurate and true. I understand it is my

responsibility to South Jersey Periodontics & Dental Implants, LLC should any of the above change:

Signature:_____________________________________________ Date:__________________

Print Name:___________________________________________

DANIEL KUBIKIAN, DMD

Born in Washington, D.C.and raised in Roslyn, NewYork, Dr. Daniel Kubikianmajored in Pharmacy at St.John’s University in NewYork. In 2001, he receivedthe Doctor of DentalMedicine degree (DMD)from the School of DentalMedicine at The Universityof Pennsylvania.

Dr. Kubikian continued his studies completing a 4-year post graduate program in Periodontics and Periodontal Prosthesis while earning theChairman’s Award from The University ofPennsylvania.

Dr. Kubikian is board certified as a Diplomate ofthe American Board of Periodontology and is anAssistant Clinical Professor in the Department ofPeriodontics at The University of Pennsylvania. He is a featured lecturer in implant dentistry at The University of Pennsylvania and Albert Einstein Medical Center. He has lectured at theGreater New York Dental Meeting and at variousmeetings throughout the east coast. Since 2007,Dr. Kubikian has taught a comprehensive implantcourse accredited by the New Jersey State Board ofDentistry which is geared to provide state of the art implant education to the dental community.In 2008, Dr. Kubikian founded the South JerseyDental Study Club which meets monthly andprovides continuing education lectures to thedental community from prominent national andinternational lecturers.

Outside of dentistry, Dr. Kubikian spends timewith his wife and three daughters. He is an avid sports fan and enjoys baseball, basketball and football.

INSURANCE INFORMATION(As of Winter 2014)

Our office accepts a variety of dental insurances andour insurance coordinators are happy to assist you inreceiving the maximum benefit possible. Weparticipate with many insurance companies and dueto this unique relationship, we are able to provide youwith as much information regarding fees and copayson the day of your appointment.

The following is the list of insurance companies thatwe participate with:

***Our office also sees patients who have otherdental insurances and we can providepredeterminations to prepare you for yourinsurance benefits.

FINANCIAL POLICYOur office is committed to providing excellent dentalhealth care. We are also concerned with making itaffordable for you. At South Jersey Periodontics &Dental Implants, LLC, we have various paymentplans, including CareCredit®, which enables you tobenefit from procedures immediately, whilecomfortably managing your resources. We accept Visa, MasterCard, American Express, Discover, checksand cash. Our office requires at least 48 hours noticeprior to cancellation to avoid a cancellation fee.

(856) 256-7778www.SJPer io .com

FIRST VISITYour initial office visit consists of acomprehensive periodontal examinationin order to provide an accurate diagnosisand proper treatment plan. Dr. Kubikianperforms a periodontal and occlusalexamination, taking necessary x-rays anddiscussing medical and dental historiesbefore discussing the treatment plan withyou and your referring dentist.

Since a variety of risk factors, includingstress, teeth grinding/clenching, genetics,smoking, diabetes and compliance topreventative care can affect dental health,it is important to gain an understandingof any and all factors that may impactrecommended therapies.

Additional information and formsavailable at www.sjperio.com.

WelcomeSouth Jersey Periodontics & Dental Implants, LLCwelcomes you to learn about our practice andbetter understand the various treatments offered atour facility. We are here to answer any questionsrelated to periodontal and dental implant care aswe strive to offer comfortable, sophisticated andquality therapies to our community.

Our office utilizes digital radiographs andcomputerized clinical records. We strictly adhere to Occupational Safety and HealthAssociation (OSHA) guidelines for infectioncontrol and universal privacy protections. Acombination of computer technology and thelatest in modern dental and surgical equipmentallows all aspects of our clinical and businesspractice to function efficiently.

340 Egg Harbor RoadSewell, NJ 08080

AetnaAmeritas

Assurant-DHABlue Cross/Blue Shield

CignaDeCare

Delta Dental

Dentemax FidelioGuardian Horizon Metlife

United ConcordiaUnited Health Care

DANIEL KUBIKIAN, DMDSouth Jersey Periodontics &

Dental Implants, LLC340 Egg Harbor RoadSewell, NJ 08080

phone: (856) 256-7778fax: (856) 256-7702

email: Info@SJPerio.com

www.SJPerio.com

Dental ImplantsDental implants are titanium screws which can provide a long term foundation for replacementteeth that can look, feel and function like natural teeth. Implants may preserve facial structure,preventing the normal bone deterioration that occurs when teeth are missing. The lifeexpectancy of a dental implant is usually for the rest of your life.

Single Tooth ImplantA single dental implant can provide the foundationfor a new crown without drilling otherwisehealthy neighboring teeth (like in a conventionaltooth supported bridge) and can preserve gum andbone structure.

Multiple Teeth ImplantsImplants can be placed either consecutively orstaggered over a span of missing teeth so a bridgemay be cemented on top of them. The advantageto planning a case like this is that the implantbridge is not removable and it is not susceptible tothe normal problems of a tooth supported bridge.

Complete Arch ImplantsSome patients are missing all of their teeth withina single arch. There are three major implantsupported options available to provide aestheticteeth with proper function. These options include:1) Implant Overdenture; 2) Implant Bridge & 3)Implant Hybrid.

Congenitally Missing Teeth3-6% of the population are born with congenitallymissing teeth. Often times, coordinating care with yourgeneral dentist and your orthodontist can allow forproper planning. These cases prove challenging in orderto provide a functional and esthetic.

What is Periodontal Disease?Periodontal diseases are often symptomlessinfections in the gums and bone, which graduallydestroy the bony support around natural teeth. Ifleft untreated, these infections can lead to looseteeth, bad breath, bone loss and eventual toothloss. Recent research has also linked periodontalinfections to heart disease, diabetes, respiratoryproblems, stroke and osteoporosis.

Scaling & Root Planing As part of basic periodontal therapy, scaling androot planing is performed to help removemicrobial flora, bacterial toxins, calculus andplaque. The desired goal is to reduce the size ofperiodontal pockets around teeth and make themmore maintainable by the patient.

Pocket ReductionAfter scaling and root planning procedures arecompleted, pocket reduction may be indicated totreat large remaining pockets which are too deepto clean with normal at-home brushing andflossing. This predictable procedure involvesreshaping diseased gum and bone tissue.

Crown LengtheningCrown lengthening is a procedure indicated toeither rehabilitate a tooth broken near or belowthe gumline so that it can hold a crown or toimprove the aesthetics of a gummy smile. Itinvolves reshaping gum and bone tissue.

“Wish I didn’t wait so long… the crown lengtheningwas simple and I had immediate results!”J.K., Philadelphia, PA

Gum GraftingGum grafting is recommended when recession ofgum around a tooth results in root sensitivity,unsightly appearance or lack of gum tissue. Ifleft untreated, the exposure of the root surfacemay lead to cavities and tooth defects.

Periodontics

GingivectomyA gingivectomy (reshaping of the gums) is a commonlyused procedure to improve the appearance of excess orovergrown gingiva. Poor hygiene, active orthodontictherapy (braces) and certain medications are some of themore common causes of gingival overgrowth.

FrenectomyThe frenum is a fold of tissue that passes from themovable lip or cheek onto the gum. The frenum maycause gum recession or interfere with tooth movement.A frenectomy relieves this tissue from contributing tofurther dental complications.

AfterBefore

AfterBefore

Single Implant Before Single Implant After

Multiple Implants Before Multiple Implants After

Complete Arch Implants Before

Complete Arch Implants After

Congenitally MissingTeeth Before

Congenitally MissingTeeth After AfterBefore

“I am grateful for the support and hard work of Dr. Kubikian. Dr. Kubikian was friendly and kind to me through my whole procedure. His staff was very friendly making the procedure painless. My gums look Great!”NB (Age 12), Woodstown, NJ

"It was not painful at all! I'm glad that I got the workdone and I smile all the time now. And I am veryconfident with my smile. I am serious! I feel moreattractive with my smile." M.K., Sewell, NJ

“The experience has been great. Confidence….. Not only willyou restore your own self�confidence, but you can haveconfidence in Dr. Kubikian and his skills! I’m a new man!” P.M., Marlton, NJ