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brbrIt is always easier and more effective to come in during regularly scheduled hours when we are fully staffed. Life isn’t always that simple. We do our best to give sound advice, prescriptions as needed, and open the office when necessary for severe emergencies.
McCarl Dental Group
As the only fellowship trained Rhinologist in the area, I have experience in all of the latest nasal and sinus surgery techniques. Balloon Sinuplasty is a safe and minimally invasive method of opening blocked sinuses. It is performed in an outpatient setting with minimal downtime. This means less pain and a quicker recovery, which saves patients time and money.
Back to Top Dentists 2016-2017
*A Special Advertising Section*
My face has begun to sag and show my age. How can I tell if a mini face lift would work for me or if I need the “real thing?”
brA face lift is a procedure designed to improve the most visible signs of aging by removing excess skin, tightening underlying muscles and re-draping the skin to create a more youthful appearance. If you are a candidate for a full face lift then the mini lift may only provide you with a result that does not last as long as you would expect. A real face lift should last you a lifetime. You will continue to age but you should look ten to fifteen years younger than you would had you not had the face lift. The result is a younger and more rested-looking appearance.David H. Lowe, Plastic Surgery Specialists
I have recently lost a significant amount of weight and am uncomfortable with the excess skin around my stomach. I am considering a tummy tuck, what kind of results can I expect?
brThe tummy tuck procedure is designed to remove excess skin and fat from the abdomen, while tightening and flattening the muscles of the abdominal wall. This excess skin & fat can be caused by pregnancy, aging or recent weight loss. Tummy tucks correct loose skin that diet and exercise cannot remove. Most incisions are kept just above the pubic area, and can be easily camouflaged. The procedure is performed under general anesthesia and requires some recovery time of about two weeks for most patients, and it takes several weeks before being able to return to pre-surgery activities. If you are considering a tummy tuck, our board-certified plastic surgeons at Plastic Surgery Specialists can help determine if this procedure is right for you.Dr. Paul Buhrer, MD, Surgeon, Plastic Surgery Specialists
Is my dental work going to hurt?
brI always let my patients know that I am good at alleviating fear and doing a painless injection with a very strong topical anesthetic. My goal is to make the patient feel as comfortable as possible.DR. APRIL CALTON, About Smiles Dentistry
What is sedation dentistry and am I a good candidate?
brSedation Dentistry is a safe, comfortable, and relaxing method of accomplishing dental treatment. Conscious sedation is achieved through small pills, eliminating the need for an IV. It is simple and painless; the patient is conscious throughout the appointment; however, little, if any, of the visit will be remembered. Patients who are fearful, have a strong gag reflex, require complex dental treatment, or have difficulty getting numb are excellent candidates for Sedation Dentistry!DR. APRIL CALTON, About Smiles Dentistry
What are porcelain veneers?
brVeneers are thin wafers of porcelain, about the thickness of a fingernail, that are bonded on top of your natural teeth. With recent advancements in material, they can be extremely thin, requiring little or no preparation of the tooth surface in ideal situations. With proper planning and design, veneers can be as durable as any restoration placed in the mouth and can be a conservative and beautiful option to upgrade your smile.DR. CHRIS ANDERSON, Scott Finlay DDS & Associates, PA
What can dental implants do for me?
brDental implants have become a proven and durable solution for missing teeth. Implants can serve as support for a single tooth, help stabilize many teeth in the form of removable dentures, or even provide fixed solutions for all teeth that are not removable by the patient. With today’s technology, this can often be completed in the same day that the teeth are removed, which helps to insure the individual’s quality of life.SCOTT FINLAY, DDS, Scott Finlay DDS & Associates, PA
I am thinking about Botox and fillers to look younger, but will it make me look unnatural?
brInjectables such as Botox and dermal fillers (Juvederm, Voluma, and Restylane among others) have revolutionized how we can combat aging. Botox helps reduce the appearance of fine lines around the eye area and forehead by paralyzing the muscles. When done well, Botox injections provide a very natural and refreshed appearance. Dermal fillers are used to restore fullness in areas of our faces that loose fat, such as our cheeks, under our eyes, and around our mouths. As with Botox, when the placement of dermal fillers is done well to restore lost volume, the look is very natural.Claire Duggal, MD, Sandel Duggal Center for Plastic Surgery
I’m interested in a breast augmentation. How do I know what size implants to choose?
brThere are several breast measurements your plastic surgeon will take during your consultation to help narrow down a selection of implant sizes that are right for you. From there, it depends on what type of results you would like to achieve and what type of look you like from very natural to more “augmented.” In our office we have a Vectra 3D camera that takes your picture and shows you what you would look like with different sized implants in place, so you can “try on” different sizes prior to your surgery. It’s a fun process!Claire Duggal, MD, Sandel Duggal Center for Plastic Surgery
At what age should my child see an orthodontist?
brDid you know that the American Association of Orthodontists recommends that every child first visit an orthodontist by age 7 to advise if orthodontic treatment is required and the best time for that patient to start treatment? Early treatment can simplify later treatment by allowing your orthodontist to guide the growth of your child’s jaws, guide incoming permanent teeth, regulate the width of the upper and lower dental arches and create more space for crowded teeth.Ora Reinheimer, DMD, MS, Philbin & Reinheimer Orthodontics
I’ve heard about Invisalign and want to know if it’ll be good for my teenager?
brSure, there are other options out there for straightening your teeth, but none offer the level of comfort, convenience and confidence that you’ll find with Invisalign Teen. And without brackets and wires, your teen will have the confidence of a great smile even during treatment.Philip Philbin, DDS, Philbin & Reinheimer Orthodontics
Why worry about baby teeth if they are going to fall out anyway?
brIt’s important to achieve and maintain health in baby teeth. My goal as a pediatric dentist is to keep the baby teeth healthy to maintain function for eating, manage space for the developing adult teeth and ensure a healthy environment for those developing adult teeth. As a pediatric dentist, I strive to provide safe, comprehensive and compassionate care to your child to keep their baby teeth healthy. Healthy teeth are an integral part for a healthy body.MAYA A. VERNON, DDS, Vernon Pediatric Dentistry
What is the difference between early interceptive treatment and comprehensive treatment?
brEarly interceptive treatment is performed for problems that, if left untreated, could lead to the development of more serious dental problems over time. The goal is to reduce the severity of a developing problem and eliminate the cause—such as correction of thumb/finger sucking; guiding permanent teeth into positions through primary tooth removal; or gaining/holding space for permanent teeth. Comprehensive treatment is undertaken for problems that involve alignment of the teeth, how the jaws function, and how the top and bottom teeth fit together. The goal is to correct the identified problem and restore the occlusion (the bite) to its optimum.DR. STEPHEN LABBE, DDS, Labbe Family Orthodontics
Help! Why am I suddenly gaining weight at 50, when I haven’t changed what I do?
brThere are multiple factors at work that can contribute to this. As we age, muscle mass tends to decrease (especially if exercise habits diminish), which slows metabolism. For this reason, our calorie needs decrease about 5 percent every 10 years. Stress hormones, and in women the hormonal changes of menopause, can work against you by increasing appetite. Medications can also impact your weight. The good news is that there are certainly things you can do to maintain or even lose weight. A medical weight loss plan can devise effective strategies and the appropriate calorie balance for you to achieve and maintain your healthy goals.DAVID ANDERSON, MD, Annapolis Medical Weight Loss
What are my options for treatment of periodontal disease with minimal recovery time?
brSome types of Chronic Periodontitis can be treated with the use of a laser. We have incorporated the Periolase — the first FDA approved laser with research showing new bone and attachment around previously diseased teeth. The LANAP procedure (or Laser Assisted New Attachment Procedure) involves minimal recovery time with most patients returning to routine activities the same day. Even patients who have experienced traditional surgery in the past or avoided treatment accept LANAP treatment without hesitation. With LANAP treatment, diseased gums become healthy and firm with minimal gum recession. This significantly reduces sensitivity or longer appearing teeth.Dr. Angela Miele, Annapolis Periodontics
I haven’t been to the dentist in years. Where do I start?
brJust start at the beginning with a new patient exam and x-rays. We aren’t here to judge you, we just want to help you achieve the happy, healthy smile you deserve. Many patients are nervous, or have not had the time or finances to seek dental care. We can help sequence your treatment to work with your life. The best time to start is now!DR. MEREDITH ESPOSITO, Chesapeake Dental Arts
I’ve never been happy with the shape or color of my teeth. What are my options?
brOptions can range from simply contouring and whitening, to bonding or veneers. Often we can incorporate Invisalign® for misaligned teeth. We can find an option to fit every budget and help you achieve a healthy, beautiful smile. The key is to design your smile in wax so that it can be custom made to fit you from the beginning. We use this as a blueprint for your treatment.DR. MEREDITH ESPOSITO, Chesapeake Dental Arts
What is a sleep study and why should I consider one?
brA sleep study is a painless, non-invasive test that records measures of your body’s functions during sleep for the purpose of diagnosing and treating a sleep disorder. It is a diagnostic tool that will give the physician a course of treatment that will assist you in your sleep that will leave you feeling refreshed and give you the opportunity to live a healthier life. Home studies are also available.Dr. Steve Resnick, Dr. Adil Degani, Dr. Ira Weinstein, Annapolis Pulmonary, Asthma and Sleep Specialists
I read the article recently; “Do I really need to floss?”
brAbsolutely, 100 percent, yes. Even with recent technological improvements such as Waterpiks and electric toothbrushes, you still must floss. People who do not floss leave foul-smelling and harmful bacteria behind, leaving them at a much higher risk of tooth decay, bad breath, and periodontal disease. Without flossing you aren’t properly cleaning 30 percent of your tooth.DR. MARTHA SIDLOWSKI, Chesapeake Cosmetic & Family Dentistry
Is there anything available to get rid of these spots that I keep seeing?
brThese little spots that you see may be floaters, which are clumps of vitreous fluid that cast shadows on your retina resulting in the spots you see. Fortunately, patients who feel that their daily lives are affected by these floaters can now have them treated with Vitreolysis – Laser Floater Removal. This is a minimally invasive, outpatient procedure, which takes less than 20 minutes to remove your floaters.Dr. Prisca Diala, Retina/Vitreolysis Specialist Chesapeake Eye Care & Laser Center
Is it possible to treat glaucoma and cataracts at the same time?
brFor patients who have cataracts and mild to moderate, controlled glaucoma, they may be a candidate for the iStent®. Implanted during cataract surgery, this tiny device, barely visible to the naked eye, can effectively treat glaucoma, allowing patients to have two procedures simultaneously. This amazing technology creates a bypass through the natural drain of the eye and helps increase the eye’s natural flow of fluid to safely lower intraocular pressure – the only effective treatment for glaucoma. Additionally, iStent may reduce the number of daily eye drops to control a patient’s glaucoma after the procedure.Dr. Heather Nesti, Cataract and Glaucoma Surgery Chesapeake Eye Care & Laser Center
If I have a cataract and an astigmatism, is there an option to give me good vision at all distances?
brIt is an exciting time if you have a cataract, as the technology just keeps getting better. We can now offer cataract patients, who also have an astigmatism, the option to correct their astigmatism and give them full range of high-quality vision. Previously, we were only able to offer astigmatism correction with either good distance or close up vision, which meant the patient usually still needed glasses. This advancement is an excellent option for patients who are looking to reduce or eliminate their need for glasses after cataract surgery.Dr. MARIA SCOTT, Cataract and Refractive Surgery Chesapeake Eye Care & Laser Center
When is a dental crown necessary?
brA crown becomes necessary when the long term restorability of a tooth becomes questionable due to one of several factors. A tooth with broken cusps or large cavities usually will need a crown to protect them for the long term. Teeth with large fillings that are breaking down sometimes require a crown. Also, teeth with root canals often need crowns because the root canal process can weaken a tooth. Crown procedures normally take 2 visits. The second visit is typically a short cementation visit, or as my one patient calls it: “the coronation”.DR. DENNIS CHERRY, Cherry Family Dentistry
What is accelerated orthodontics or Acceledent?
brOrthodontists manipulate the forces of pressure and tension to move teeth. In the presence of pressure and tension bone changes begin and tooth movement and bone remodeling can be accomplished. Bone remodeling can be enhanced with the application of micropulses like those utilized by Acceledent. When these micropulses are applied consistently for 20 minutes a day, bone remodeling is increased and tooth can move faster and more comfortably. Acceledent is commonly included with our Invisalign aligners allowing patients to change their aligners out every 5-7 days rather than every 14 days thereby reducing their time in Orthodontics nearly in half!MARY C. TRAHAR, DDS, PA, Smiles By The Bay
What is the “Brace Bus”?
brThe “Brace Bus” is like an Uber for your child’s orthodontic appointment. We understand when both parents are working that it becomes challenging getting your child into their routine check-up appointments without having to take time off from work. This is especially true for our Kent Island families who may both work west of the Bay Bridge. We are here to help by offering complimentary shuttle pick-up on the Brace Bus (an outfitted H2 Hummer complete with Xbox) to and from your child’s school for their orthodontic appointment. Let us do the driving so you don’t have to!MARY C. TRAHAR, DDS, PA, Smiles By The Bay
What is a “true dental emergency?”
brWhen you have one, you know it! It’s that moment of fear when you just don’t know what to do about a broken tooth or denture, oral pain, or facial swelling and fever. The dentists at McCarl Dental Group see dental emergency patients in both our Greenbelt and Millersville offices.brbrIt is always easier and more effective to come in during regularly scheduled hours when we are fully staffed. Life isn’t always that simple. We do our best to give sound advice, prescriptions as needed, and open the office when necessary for severe emergencies.
McCarl Dental Group
Are dental treatments safe while pregnant?
brThe two big concerns for an expecting mother are gingivitis due to rising hormone levels that cause gums to swell, and increased risk of tooth decay, from increased intake of carbs and acid from morning sickness. You should definitely continue and possibly increase your routine visits to your dentist during this time. Oral infections like gum disease have been linked to preterm birth. Make sure to mention what stage of pregnancy you are in when you make your appointment. And, keep in mind, it’s always better to prevent an issue than to have to repair permanent tooth loss due to gingivitis and tooth decay.ONEAL RUSSELL, III, DDS
I’ve been told I have a cataract, now what?
brCataracts are removed surgically and an intraocular lens placed to restore vision. Cataract surgery is elective. The decision about when a cataract is ready for surgery is when you believe your sight has failed to the point that you are having difficulty reading print, driving, or performing activities of daily living. An ethical surgeon will not force you into surgery. Patients should also be aware that there are new intraocular lenses available that not only provide single vision correction but also correct astigmatism and presbyopia. You should discuss these options when you talk with your ophthalmologist about cataract surgery.DIANE T. CHANG, MD, Maryland Eye Associates
Why do I keep chipping and breaking my teeth?
brThis commonly occurs in people who clench or grind their teeth, a condition called bruxism. Unfortunately, many people are not even aware that it is occurring. This can lead to premature tooth wear and fracture. There are many reasons you may grind your teeth including stress, the way your teeth come together, habits such as nail biting, and sleep apnea. The good news is that once the cause is determined it is possible to restore your teeth in a beautiful and long-lasting way.DR. MICHAEL BILLINGS, South River Dental Care
How do cataracts form?
brA cataract occurs when there is a buildup of proteins in the lens, creating protein clumps. These clumps, or deposits, prevent light from passing clearly through the lens, thus disrupting normal vision. A patient with a cataract cannot see images clearly. Instead, images appear cloudy or blurry, especially at night. Cataracts can begin to affect the patient’s ability to perform simple, everyday tasks like reading and driving. Cataract surgery is the recommended treatment in these cases and has a 98% success rate.DR. SAMUEL BOLES, Anne Arundel Eye Center
What are Dental Implants?
brWhen you are missing teeth, you may feel uncomfortable eating, speaking or worst of all SMILING. Dental implants offer a permanent solution to these problems. Dental implants are titanium replacements for missing teeth that act as a strong foundation to support new crowns, bridges or anchor slipping dentures. The implant procedure is painless and involves placing the implant under the gums and into the jawbone just like the roots of your own natural teeth. Recovery time is usually no more than 24 hours and total treatment time from the day of your implant placement to the time of attaching the new teeth range from 2 months to as little as 1 day. Dental implants are the next best thing to your own teeth...IT’S TIME TO SMILE AGAIN!NEIL SULLIVAN, DMD, Oral Surgery Specialists
Why is flossing so important?
brBelieve it or not, flossing children younger than age 10 is just as important as brushing, if not more important. Seventy-five percent of cavities in children younger than 10 occur between the baby molars, which do not “fall out” until 10 or 12 years of age. The dexterity for flossing is not achieved until age 10. Therefore, we recommend that parents help their children floss until then. Eighty percent of cavities on permanent teeth occur on the biting surface, but this can be prevented with sealants.DR. COLLINS, BROSS & ASSOCIATES
Why does my tooth need a crown?
brThe main purpose of a crown is to repair a tooth from damage that may have occurred, such as the presence of a large cavity, a broken tooth, a tooth worn from grinding, or a root canal treated tooth. Additionally, a crown is attached to a dental implant to replace a missing tooth. Sometimes a discolored or misshapen tooth will also be crowned to improve its cosmetic appearance. In many situations a crown is the best option to keep your tooth strong and functional so that you can eat, speak, and smile comfortably and confidently!DR. ALISON WRIGHT, Severna Park Family and Cosmetic Dentistry
What does it mean to have “dense breasts?”
brDense breast tissue refers to the way breast tissue appears on a mammogram, and it’s a normal and common finding. Breast tissue is composed of milk glands and ducts, supportive tissue (dense breast tissue), and fatty tissue (non-dense breast tissue). Dense breasts contain more dense tissue than fatty tissue. When viewed on a mammogram, non-dense breast tissue appears dark and transparent, while dense breast tissue appears as a solid white area, making it difficult to see through. This could increase the chance that breast cancer may go undetected by a mammogram, since dense breast tissue can mask a potential cancer. If you’ve been told you have dense breasts, you and your doctor may consider additional or supplemental testing in addition to regular mammograms, based on your other risk factors and your personal preferences.BARBARA URBAN, MD, Medical Breast Specialist, Aiello Breast Center
What is a nurse navigator?
brThe nurse navigator at the Aiello Breast Center is an essential point-of-contact for our breast cancer patients. I work closely with patients from diagnosis, throughout treatment and beyond. I address both the physical and emotional concerns of every patient and bring in other essential providers such as our dedicated oncology social worker and dietician when needed. I provide each patient and family with personalized information, education and support. Each patient is given a Care Guide that is specific to their treatment plan. The navigator is the link to physicians, resources and therapies.Julie Siefert, RN, MA, ED, Nurse Navigator, Aiello Breast Center
My mammogram shows I have dense breasts and I also have a family history of breast cancer. My doctor ordered a breast MRI in addition to my annual screening mammogram. If MRI is better than mammography, can I just get an MRI instead of a mammogram?
brAnnual screening breast MRI should be used in addition to mammography, not as a replacement for mammography in women with dense breasts who have an increased risk of breast cancer. Breast MRI is a very sensitive test and finds many cancers that may be missed on a mammogram. This is especially true for women with dense breasts. On the other hand, there are some cancers that mammography might detect that are hard to see on MRI because mammography is better at detecting small calcium deposits known as microcalcifications that are often an indicator of early cancer.MARK D. BAGANZ, MD, Chesapeake Medical Imaging
Who is a candidate for sedation dentistry?
brSedation dentistry is a great option for patients who have anxiety or fear about going to the dentist. Dental sedation can also be helpful for patients with issues such as a sensitive gag reflex, fear of needles or difficulty getting numb. Just about any procedure can be performed with sedation – even a dental cleaning. There are several sedation options including inhalation sedation (laughing gas), oral medications and IV sedation. Sedation dentistry makes it possible to have multiple procedures done in one visit – meaning fewer visits to the dentist!KIAN DJAWDAN, DMD, Djawdan Center for Implant & Restorative Dentistry
My eyelids are droopy and I appear to have constant bags that make me look tired, what can be done to correct this problem?
brAn eyelid lift (Blepharoplasty) is the best option to rejuvenate the eyelids. An upper eyelid blepharoplasty trims the excess skin and puffiness of the upper folds, brightening the eyes and giving you a lifetime of rejuvenation. Lower blepharoplasty reduces puffy “bags”, wrinkles, and extra skin from the lower lids giving them a youthful appearance. Lasers and fillers, such as Restylane® can correct lines and circles under the eyes, perfecting the cosmetic results. As an experienced Oculofacial plastic surgeon, I am most qualified to offer you the best combination of surgical and non-surgical approaches to address your particular concerns.Dr. Elba M. Pacheco, Center for Eye & Laser Surgery
Is it a myth? Is root canal treatment painful?
brIt is absolutely a myth! Modern technology, better local anesthetics, and advancements in endodontic therapy have made the root canal procedure as efficient as a dental filling. Years ago, it would take several visits and hours in the chair to adequately perform a root canal. Today, with digital radiographs, surgical operating microscopes, rotary instrumentation, and improved filling methods, most of these procedures can be completed in less than an hour, with little or no discomfort for the patient. I’m here to change the painful root canal perception one tooth at a time!Dr. Charles Herbert, Endodontics, PA
At what age should my child have their first dental visit?
brSimilar to the establishment of a “medical home”, finding a “dental home” is just as critical. Children who have a dental home are more likely to receive appropriate preventive care and routine oral health care. Our practice follows the American Academy of Pediatric Dentistry’s recommendation that a child’s first visit should occur six months after the first tooth erupts, or by age 1. This first visit allows the dentist the opportunity to provide guidance to families on a variety of topics, including oral hygiene, diet, and fluoride.C.J. TULL, III, DDS, Pediatric Dental Specialists
What happens after a tooth is extracted?
brbrAfter the extraction of a permanent tooth, bone and gingival tissue (gums) start to fill the extraction site. However, the body also starts to “melt away” the bone in a vertical and horizontal dimension. If implant tooth replacement is desired, a site preservation bone graft is usually required to prepare the surgical site, especially if bone loss occurred prior to the extraction. This recreates ideal bony contours, and makes dental implant success more predictable. The bone graft is usually performed at the time of extraction with no additional discomfort.ZIAD BATROUNI, DDS, Maryland Oral Surgery Associates
What is the latest and greatest available in dentistry today?
brFor patients with severe compromised dentition, the latest process is called “teeth in a day” via technologies used by TeethXpress and the like. Four to six implants are placed into the jaw with abutment posts. Your denture is then attached to the abutments. The procedure typically can be completed in one day and can be done under local anesthesia. Millions of people around the world are missing enough teeth to require the use of dentures. Dentures supported by implants have been successful and the number of patients is growing rapidly due to their effectiveness, durability and the high success rate of dental implants.PAUL KINSEY, DDS Severn River Cosmetic & Family Dentistry
I’m confused—when is the best time for my child’s orthodontic treatment?
brThere is no one “best time” for every child. Each child is evaluated and treated according to his specific needs. The American Association of Orthodontists recommends screening at age 7 and at that time, we are looking for any disharmony between the growth of the upper and lower jaws, seen by crowding, underbite, overbite, crossbite. If it exists, we will recommend early treatment, which is bone moving in nature. Otherwise, we can safely wait till all the permanent teeth have erupted for treatment, which is tooth moving in nature.Mairead M O’Reilly, DDS, MS, PA & Associates
Am I too old to wear braces?
brAbsolutely not. Orthodontic treatment can be successfully accomplished at any age. Treatment can proceed more quickly with adults because there is no growth with which to contend. There are many new and exciting treatment options available. One is Invisalign, a series of clear plastic – invisible – aligners which are changed on a rotating basis to accomplish the necessary tooth movement. Another is lingual braces, which are placed behind your teeth – also invisible. These unique braces, created using state-of-the-art technology, are completely individually customized. You’re never too old to achieve the smile you’ve always wanted!Mairead M O’Reilly, DDS, MS, PA & Associates
What are the latest plastic surgery procedures that require no downtime?
brSculpSure is a comfortable, non-invasive, light-based body contouring treatment that reduces stubborn fat in areas such as the abdomen and love handles. Viora Reaction uses the most advanced radio frequency technology to provide safe, painless, and effective skin tightening, cellulite reduction, and contouring. Revitalize your skin, treat acne scars, reduce wrinkles, and fade brown spots without discomfort with the PicoSure laser rejuvenation treatment. The Lumenis laser hair removal is painless and provides great results with no downtime. A liquid facelift with fillers or botox can last from six months to a year.LEE KLEIMAN, MD, Severn River ENT Plastic and Laser Surgery
What are the newest innovations in treating sinusitis?
brThere are a number of safe and cutting edge surgical techniques available including state of the art image guidance navigation and drug eluting stents.As the only fellowship trained Rhinologist in the area, I have experience in all of the latest nasal and sinus surgery techniques. Balloon Sinuplasty is a safe and minimally invasive method of opening blocked sinuses. It is performed in an outpatient setting with minimal downtime. This means less pain and a quicker recovery, which saves patients time and money.