Short guides, written by the people who do the work.

A first visit at Riverstone runs ninety minutes. Plan for the full appointment; we will not be in a position to give you a rushed answer to anything that matters, and we would rather you leave with a complete picture than a partial one.

You will start with intake and intraoral photography. The hygienist will take a comprehensive set of digital x-rays. The dentist will then perform a full clinical examination — every tooth, every surface, the gums, the bite, the soft tissues, the way your jaw closes. None of this is delegated to anyone other than the doctor.

After the examination, you and the dentist sit down and look at the photos and x-rays together. We will tell you what we see, what we recommend, what is urgent and what is not, and roughly what each option costs. You will leave with a written treatment plan and a copy of your records, regardless of whether you decide to schedule the next appointment.

Most first-visit appointments do not include cleaning. If your gums and bone are healthy, we will schedule a regular hygiene appointment at the end of the visit. If they are not, the cleaning is itself a treatment that needs more time than the new-patient slot allows; we will plan it separately.

Bonded ceramic restorations — veneers, crowns, onlays, cosmetic bonding — last a long time when they are taken care of, and fail predictably when they are not. There are three things that matter most.

Brushing and flossing. The most common reason a veneer or crown fails is decay underneath it, at the margin where the restoration meets natural tooth. That margin is where plaque accumulates, and it is where every restoration is most vulnerable. Brush twice a day with a soft-bristled brush and floss once a day, every day.

Avoiding hard impacts. Porcelain is strong but it is not unbreakable. Do not chew ice, do not bite down on pen caps, and do not use your front teeth as scissors for tape, fishing line, or zip ties. If you grind your teeth at night, we will recommend a custom night-guard; wear it.

Routine maintenance. Hygiene appointments are not just cleaning — they are the appointments where we look at every restoration in your mouth, check the margins, and catch small problems before they become large ones. Skipping hygiene is the most expensive way to save money in dentistry.

Riverstone is fee-for-service. Patients pay us directly at the time of treatment. Patients with dental insurance receive everything they need to file a claim with their insurance company for reimbursement, but we do not contract with insurance networks, and we do not file claims on patients’ behalf.

This is a deliberate choice and worth explaining.

When a dental practice contracts with an insurance network, the network sets the fees the practice can charge for in-network patients. Those fees are typically thirty to fifty percent below the practice’s actual cost of doing the work at the standard most patients want. Network practices stay solvent by seeing more patients per day — twenty to thirty rather than eight to twelve — and by spending less time on each one. The math forces a particular kind of practice.

Our position is that the people who choose us are choosing the work, not the insurance network. By staying out of the networks we keep control over how much time each appointment takes, what materials we use, and what we recommend. The fee schedule is published and the same for everyone.

For most patients, this works out comparably or better than going through a network — the reimbursement check from the insurance company arrives directly in the patient’s mailbox. But the relationship is between the patient and Riverstone, not Riverstone and a network.