Your need for healthy teeth and gums is our main focus. We offer dental services for families and individuals of all ages. We are located at 1320 Fortino Boulevard, Suite D in Pueblo, Colorado 81008.
Dr. Kottenstette is known for using a unique approach in treating each patient with individual care. Dr. Kottenstette’s expertise in modern dental procedures leads to long-lasting solutions for patients.
Give us a call and we will be glad to answer all of your questions or concerns regarding dental treatment!
A beautiful smile can give patients a lifetime of happiness!
The team at Twin Rivers Dental has continuously upgraded themselves and the practice on the newest and latest techniques in modern, state of the art dentistry.
At Twin Rivers Dental you will find quality services that can give you a perfect smile. We thank you for allowing us to take care of your dental needs and look forward to helping you.
After graduating Cum Laude from the University of Colorado School of Dentistry in 2005, Dr. Kottenstette went on to finish a 1 year General Practice Residency at the University of Texas Health Sciences Center, San Antonio. During her residency she learned how to do advanced clinic dentistry, including the placement and restoration of dental implants, Oral and IV conscious sedation/Sleep Dentistry, treat medically complex patients in office and an Operating Room setting, and do medical clearances for patients undergoing chemotherapy, radiation or joint replacement.
After she completed her residency in 2006 she moved back to her hometown of Pueblo, Colorado where she has continued to give quality care to her patients both in her office and in an Operating Room setting, when needed. She is truly unique in her abilities to be able to offer a wide range of general dental services to a great number of people in the community. Her services include, but are not limited to, cosmetic dentistry, oral surgery, Sleep Dentistry, placement and restoration of dental implants, crown and bridge procedures, fillings, dentures, partials, and treatment of patients in an operating room setting.
Dr. Kottenstette is certified in oral and IV sedation, is a member of the American Dental Association, the Colorado Dental Association, the Delta Sigma Delta dental fraternity, the Southern Colorado Study Club, the Denver Implant Study Club and the recipient of the Pierre Fauchard Award for Academic Excellence. Dr. Kottenstette has also helped train assistants in the Pueblo Community College Dental Assisting program.
Dr. Kottenstette believes in quality dental care for her patients and tries to give everyone a unique and friendly experience in her office. Her team works hard to make you feel at ease and give you the attention you deserve, to give you the best possible care and options for your dental health.
Many people ask why the office was named Twin Rivers Dental! Our response is that it was named after Dr. Kottenstette’s twin daughters, who also happened to be named after rivers here in Colorado. Dr. Kottenstette and her family love to be outdoors and are often found hiking, camping, running, biking, swimming and fishing in this beautiful state.
The team at Twin Rivers Dental has continuously upgraded themselves and the practice on the newest and latest techniques in modern, state of the art dentistry.
A native of Pueblo, Jehan graduated from Pueblo Community College with an Associate’s Degree in Dental Hygiene. She has wanted to be a hygienist since the age of 4, after her first visit to the dentist. “It makes me sad that many people have a fear of going to the dentist.
Along with helping patients maintain optimum oral health, I want to be able to put patients at ease. My goal is to provide quality dental treatment in a comfortable setting”. Jehan and her husband Mark have two grown children (daughter, Tayler and son, Hunter). She enjoys spending her free time with family and friends.
Kaylia is a Pueblo native. Kaylia graduated from the Pueblo Technical Academy in 2005 and has associates degrees in surgical technology (Colorado Technical Unviersity, 2007) and dental assisting (Pueblo Community College, 2012).
Kaylia worked at Parkview Hospital for several years, first in the OR and then as an OBGYN assistant in the delivering room (helping bring babies into the world). After the birth of her daughter she went back to school to become a dental assistant and has also completed the Expanded Functions Dental Assisting program and is a certified EDDA.
Christa was raised in Pueblo and has been in the dental field since 1986. She worked as an assistant in general dentistry and periodontal practices for 15 years and for the past 10 years as an office manager and receptionist.
Christa and her husband Tony have two kids and three dogs. They enjoy riding motorcycles and rooting for the Denver Broncos.
I grew up in Pueblo and moved away in my early 20s. I have just moved back from Washington state to marry my high school sweetheart.
I have two children and I’ve been in dentistry for 20 years. I was lucky enough to have worked for my previous dentist for 16 years. I received my dental assistant training in Tampa Florida where I was certified in expanded duties.
Our dental team is well experienced in all areas of modern dentistry:
Composite bonding can work wonders for your smile. Using materials that match the shade, translucency and the texture of your teeth, gaps between teeth can be closed, spots and discolorations can be eliminated, and your self-confidence can be enhanced through the improved appearance of your smile.
The dentist will match the shade of your existing teeth and then tooth-colored composite resin is applied to the tooth much like the filling procedure.
The procedure is sometimes referred to as bonding because an adhesive agent is used to actually bond the resin to the tooth structure.
The resin is hardened (cured) with a curing light and then shaped, contoured, and polished to give a cosmetic and natural appearance. Bonding is the least expensive cosmetic procedure and can be completed during a single dental visit.
Composite bonding is excellent for small defects in the teeth -- spots, chips, or gaps between teeth. For smile alterations involving an entire tooth or multiple teeth, porcelain is the material of choice.
Dental crowns and bridges fit over injured, discolored, or cracked teeth or fill the space resulted after dental extractions and protect the teeth from further injuries or damages helping also to the prevention of any toothaches or discomfort you may experience.
Crowns are used to restore both anterior and posterior teeth that have been broken or are at high risk of doing so due to large old fillings or fractures. There are a variety of materials used to design these reconstructions in laboratories. The crowns will look and feel close to your real teeth.
Crowns, also called caps are indicated if a significant portion of the tooth is missing. Usually, extensive decay, injury or root canal therapy, are the reasons when a crown is recommended. Crowns are usually either made of noble alloys, or porcelain. There are many different types of porcelain crowns and we will determine which type is best suited for your particular need.
During your first visit, we will prepare your tooth structure and then take an impression of the prepared tooth, make a temporary crown to place on the tooth, and send the impression to a dental laboratory to fabricate the crown. At your next visit, we will try-in the crown to ensure a good fit and then cement the crown in place. When a tooth is compromised by decay or damage, we may suggest a crown, inlay, or onlay. These restorations, made in a lab from fine dental porcelain, will blend seamlessly with your teeth, return the strength that you need for comfortable oral function, and maintain your all-white smile.
Bridges are fixed, or non-removable prosthesis constructed to replace one or more missing teeth. The teeth on both sides of the existing space are used to attach the bridge to restore functionality and esthetics. Materials used for this process are noble alloys, porcelain or porcelain fused to metal. Bridges are indicated whenever at least one tooth is missing. A bridge is composed of abutments and pontics. Abutments are the supports for the bridge and consist of crowns placed on the teeth surrounding the empty space. The pontics are special crowns that span across the empty space and connect to the abutments. When teeth are prepared for a bridge, the abutments are prepared for crowns just as described in crowns. We will then take an impression of the prepared teeth, make a temporary bridge to place on the teeth to protect them and maintain their positions, and send the impression to a dental laboratory to fabricate the bridge. At your next visit, we will try-in the bridge to ensure a good fit and then cement the bridge in place.
Our practice offers a wide range of cosmetic dentistry options to provide each patient with individual dental care to achieve our goal of improving or maintaining the appearance of your smile.
Dentures are divided into two main categories: complete dentures and partial dentures.
Complete dentures are designed to replace the teeth in an entire arch when all the teeth are missing.
Partial dentures are used when there are still teeth present in the arch.
Complete and partial dentures can provide patients with a functional replacement when teeth have been lost.
Complete dentures consist of an acrylic base to imitate gum tissue, and the teeth that can be made of acrylic or porcelain. The denture base is made to closely fit the contours of the arch to ensure the denture is stable during normal oral functions such as eating, speaking, or swallowing.
Partial dentures can be made with a metal framework and teeth attached in the areas where the teeth are missing. The metal framework also has clasps or arms that extend out and fit around some of the existing teeth. The combination of the framework and the arms that wrap around some of the teeth keep the partial denture stable during normal oral functions.
There are a lot of indications for the patients wearing dentures in order to maintain the health of oral tissues. The dentist will provide all necessary information for patient education.
Our practice operates emergency services for our patients. Call us to find out more information.
Dental extractions are performed for a wide variety of reasons. Tooth decay that has destroyed enough tooth structure to prevent restoration is the most frequent indication for extraction of teeth. Other indications are related to impacted or problematic wisdom teeth and also to make space for orthodontic treatment in some particular cases.
Modern dentistry has allowed us to combine beauty as well as strength when filling teeth. Restorations are close to their original strength and appearance with composite resins and other modern materials. The patient comfort is always the main priority of the dental team, leading to a positive experience.
Fillings (restorations) are used to replace tooth structure that is decayed. Caries can be detected through direct observation or x-rays. Fillings are also used to repair fractured, broken, or severely worn teeth.
The dentist will proceed to cavity preparation, removing any remaining decay and shaping the final cavity. The next step will be the addition of composite-resin filling material, cured (hardened) after with a curing light. The final step will be polishing the filling to adapt it smoothly to the natural shape of the tooth.
Composite fillings are very aesthetic restorations since they are available in natural shades matching tooth color. They are also being tolerated perfectly by all the patients.
In some cases cavity preparation could become very large for usual fillings and the dentist will recommend an inlay or an onlay (partial crown), restorations designed to replace more tooth structure. Those restorations are made in a dental laboratory after the dentist has taken you an impression of the preparation. The final placement of inlay or onlay will be made in a second visit at the dental office.
Fillings do not last forever so it is essential that you visit the dentist regularly for further examinations. Fillings can develop cracks or simply wear down due to chewing forces.
The dentist monitor the integrity of your fillings during regular exams and will recommend replacing a filling if a problem is detected.
Implants are indicated whenever at least one tooth is missing. If the missing space(s) is not filled, the teeth surrounding the space often drift, the opposing teeth in the other arch will erupt further into the oral cavity (hypereruption) which can change your bite, bone erosion can occur in the area, and even changes in speech might occur. The popularity of implants has increased steadily over the years.
Implants are designed to replace the root of a missing tooth and can be used to support crowns, bridges, or dentures. The root-form implant is the most common type and basically consists of three main components:
Oral Surgery is the specialty of dentistry that includes the diagnosis, surgical and related treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the head, mouth, teeth, gums, jaws and neck.
It involves, but is not limited to: wisdom teeth removal, apicoectomy, TMJ disorder, facial trauma, corrective jaw surgery, oral pathology, dental implants, osseous tissue surgery, anesthesia and bone grafts.
Periodontal or gum disease is an infection of the tissues that surround and support your teeth. It is a leading cause of tooth loss in Canadian adults. Good oral hygiene and regular dental examinations are essential in prevention and early detection of gum disease – which sometimes developing without any warning signs.
The inflammation and infection of gums, ligaments, bone, and other tissues surrounding the teeth. Gingivitis (gums disease) and periodontitis (gums and bone disease) are the two main forms of periodontal disease also called gum disease or pyorrhea.
Periodontal disease is an infection of the tissues that support your teeth. Periodontal disease, also known as gum disease, is one of the most common infections today. More than 75% of North Americans over 35 years of age have some form of periodontal disease. Although many are infected, few know they actually have the disease. In a recent study, 8 out of 10 people surveyed believed they did not have periodontal disease, 7 out of 10 exhibited one or more symptoms.
Root canal therapy is an indispensable procedure in treatment of teeth that are severely decayed, infected, or broken. Root canal therapy can maintain your teeth life for more years, saving them from extraction.
The dentist will access the pulp chamber in the crown of the tooth and will reveal the root canals contained in the roots of the tooth. The infected nerve is removed and the canals are shaped using special files to smooth the walls and ensure no pulp tissue or infection is left. The canals are then filled with a special material that seals off the root canals.
A root canal is part of a naturally occurring space within a tooth that consists of the pulp chamber, the main canal, and more intricate anatomical branches that may connect the root canals to each other or to the surface of the root. The smaller branches are most frequently found near the root end (apex) but may be encountered anywhere along the root length.
Unfortunately, after root canal therapy the tooth often becomes brittle. To protect the tooth from fracture, it is recommended that a tooth that has undergone root canal therapy be restored with a crown.
Because of the complexity and difficulty of root canal therapy (due to multiple configurations and particularities of root canal in each individual) this treatment is always a challenge for the dentist. Sometimes is necessary to refer the patient to endodontists specialized in root canal therapy.
Plaque is a sticky substance that adheres to tooth structure and is teeming with bacteria. Over time, plaque becomes calcified (hardens) and at this stage, it becomes what is called calculus. Plaque and calculus are actually irritants to the tissues of your mouth. The reaction of your body to the irritants and the subsequent gum inflammation, gum recession, bleeding and eventual bone loss around the teeth constitute periodontal (gum) disease. The earliest stage of periodontal disease is called gingivitis (which is reversible) and is characterized by bleeding gums, especially when one brushes and flosses. If the disease is not addressed, it will progress to periodontitis, which is far more destructive, and is characterized by further gum deterioration, bone loss, and ultimately tooth loss.
Scaling and root planning are the most common form of treatment for periodontal disease. Scaling removes calculus (also called tartar) and plaque from the tooth surface above and below the gum line. Root planning smoothes the root's surface and removes any remaining calculus. When the amount of plaque and calculus to remove is extensive, the dentist will numb the area to make the procedure comfortable for you. A combination of sonic and hand instruments are used in the procedure. The sonic instruments remove the large deposits of plaque and calculus. Hand instruments are then used to remove any remaining tartar and ensure all surfaces of the crown and root are clean and free of bacteria. Sensitivity and soreness may be present a few days following treatment and usually can be relieved with over-the-counter pain relievers. /p>
A follow-up visit is usually scheduled for four weeks following treatment to check the improvement of gingival status, and regular intervals (3 month and 6 month intervals are typical) thereafter to monitor the disease. The goals are to eliminate the active inflammation caused by bacteria and reduce the periodontal pockets around the teeth so they cannot trap plaque or calculus thus maintaining the present bone height around the teeth.
If you feel uneasy about your dental visit and are looking for a safe alternative you've come to the right place.
At Twins Rivers Dental your teeth can be fixed, sore gums restored, and your smile brightened without discomfort while you will sleep through your appointment. Have years of dental treatment in just one appointment. No more hiding your smile behind your hand or putting up with pain.
If you present one or more of the following conditions, dental anesthesia can help you:
In-office treatment can brighten your teeth by six to ten shades. Using a special, light-activated whitening gel, this procedure is a quick and convenient way to achieve the smile you've always wanted.
Tooth whitening is a procedure that can lighten the shade of your teeth and remove stain or discoloration caused by aging, certain medications, tobacco, coffee, and tea. Tooth whitening will not last forever, so the procedure will have to be repeated on a regular basis.
Tooth whitening can be done at home or in the dental office. The dentist will often take a photo of your existing tooth color to monitor your progress and compare the new lighter shade of your teeth throughout treatment.
For in-home whitening, the dentist will take an impression of your teeth and then make custom mouthpieces (trays) to fit your teeth. The dentist will give you a supply of bleaching gel (usually containing hydrogen peroxide) that is applied to the tray and then you will be instructed to wear the tray for a certain amount of time. Care should be taken to use only the prescribed amount of whitening gel as excess material can contact your gums and cause irritation.
In-office whitening often takes between 30 to 90 minutes to complete and usually requires a few visits to the dentist's office to achieve the amount of whitening required. The whitening agent (again, a gel containing hydrogen peroxide) is applied to your teeth. Some of the in-office whitening agents require special lights or heat for activation.
Both in-home and in-office bleaching can cause increased tooth sensitivity in some people. this is a normal side effect and usually subsides a few days after the whitening treatments have been completed. Whitening procedures should be avoided if you are pregnant.
Veneers are routinely used to cover teeth which are discolored, worn, chipped, or misaligned. Veneers are used for many of the same reasons as bonding but they involve a different procedure.
Veneers are thin shells of porcelain or resin that measure less than 1.5mm thickness. First, the dentist will prepare your tooth and then take an impression of the prepared tooth, possibly place a temporary filling in the space, and send the impression to a dental laboratory to have the veneers manufactured.
The veneer is then cemented into place. Although veneers are more expensive and time-consuming than bonding, they are less expensive and conserve tooth structure when compared to crowns.
Typically veneers are difficult to stain, making veneers a very popular solution for many people seeking that perfect smile. Strong and very durable, veneers last from ten to fifteen years, and come in colors that will brighten dark teeth without the worry of them changing color.
The following forms can be downloaded to your computer and printed at home.
By filling out these forms ahead of time you will save significant time on your visit. If you have any questions when filling out the form, please do the best you can, and our staff will assist you with your questions on the day of your appointment.