Do you have a toothache? Worried about root canal?
A toothache may be caused due to one of several reasons. The cause may be as simple as flossing too hard or it may be due to an inflamed nerve tissue deep inside the tooth.
Deep within the roots of your teeth run canals. Pulp and nerve within each tooth’s canal bring all of the nutrients your tooth needs to stay alive and healthy. When the pulp and nerve are damaged, or irritated, a tooth can die. This poses a risk for infection and can be extremely painful. Cracks, fractures decay, large old fillings and other factors can contribute to nerve damage in a tooth.
This scenario has two outcomes – remove the dead (non-vital) or dying (inflamed) tooth or remove only the pulp within the tooth. Root canal therapy, when possible, is the most conservative option. Many people think that a root canal is painful. However, the pain is caused not by the procedure, but by the inflamed and damaged nerve within the canal or any inflammation or infection that has reached the bone. Once the nerve is removed, and the infection is cleaned out, pain subsides. Pain killers and antibiotics are prescribed as required, to keep you comfortable.
How can you keep a dead tooth – a tooth without a nerve? We will fill the root’s canal with a manmade material to keep infection from entering the tooth. Most often, a porcelain crown seals off the affected tooth to restore structure and function.
If you’ve been told that you need a root canal, or if you have a severe toothache, don’t delay. Time will not heal this problem. Call (425) 558-ENSO (3676) and schedule an emergency / limited exam, ASAP.
Are you putting up with a smile that's not you?
Are you happy? Healthy? Successful? Full of life? Intelligent? Interesting? Young at heart? Your smile should be right there with you. Your smile should be able to convey all of that in a flash. Does it? Your smile should ADD to YOU not take away from you. If your eyes are the windows to your soul then your smile is the window to your personality! Let your personality shine.
What makes your smile less than ideal? Missing teeth? Unhealthy gums? Decay? Gaps? Crooked teeth? Unsightly old fillings? How about dull, worn and chipped teeth that make you look years older than you feel? Whatever it is, Dr. Keerti can make a complete treatment plan for you and help you get to your ideal smile.
What is holding you back? The time commitment? Fear of dentistry? Financial commitment?.
The answer to your ideal smile does not have to be an extreme makeover. In fact, It often is not. Most people can reach their ideal smile by simply focusing on the health of their teeth and gums. Get a complete exam, get the necessary cleanings, and replace any old discolored and failing fillings with tooth-colored composites and restorations. Add a tooth whitening procedure AND voila! You are on your way to dazzling everyone.
If you are interested in options that go beyond that, you might want to discuss porcelain veneers or chair side bonded veneers with Dr. Keerti. Dr. Keerti is specially trained and experienced in cosmetic dentistry. After finishing her post-graduate training in cosmetic dentistry from UCLA, she has continued to practice this field and gain even more advanced training in the field. Dr. Keerti will analyze your smile and then design a smile based on an in-depth interview with you. Measurements and molds would be taken and your entire smile will be designed in a mock-up so you can preview it, before you commit to it. Dr. Keerti works closely with some of the best labs in the area to turn your vision and her keen esthetic eye into reality.
Porcelain bonded veneers are a great and natural way to correct chipped and cracked teeth and regain a youthful smile. Porcelain veneers are also used for correcting misshapen and misaligned teeth. In case you are wondering….the best way to describe a porcelain veneer is that it is like an artificial acrylic nail on your natural nail. Of course, this is just an analogy. Discuss the details of the procedure with Dr. Keerti.
If a porcelain veneer is like an artificial nail then a crown is akin to putting a thimble on the finger. Again, this is only a rough analogy. Talk to Dr. Keerti about various options for a porcelain crown available today. Gone are the days of opaque, lifeless porcelain crowns. Do you hate that black line around your old crown? We at Enso provide our patients with only the best options in metal –free porcelain crowns such as Empress, Lava and Procera. Metal free porcelain crowns are a great way to go if you hate that black line around your old crowns. Porcelain crowns with tooth –colored zirconia cores (lava crowns) rival the strength of porcelain crowns with metal cores. They can hide discolorations on teeth completely without looking dull and lifeless. Procera crowns are another great way to go if you need strength and beauty. Empress crowns can mimic the translucency and vibrancy of a young, healthy luminous tooth. Dr. Keerti never places crowns with metal margins that ruin your smile line.
Are you worried about the time commitment? You may be surprised at how quickly your smile can come together. Dr. Keerti pre-books her large cases at the lab for a quick turnaround time. Saturday appointments are available for smile-makeovers.
If you are wondering about finances, you may be surprised at what might be covered by your insurance. For truly cosmetic cases, talk to us about financing options.
If going to the dentist bothers you,or makes you anxious, click on “your comfort” section and remember – Dr. Keerti is a sedation dentist. You can choose laughing gas alone for mild anxiety or use oral conscious sedation if you want to be deeply relaxed.
All out of excuses? Contact us and take that first step.
Are chipped and broken teeth marring your smile?
The American Academy of Cosmetic Dentists (AACD) conducted a study that found people with an attractive smile are considered more friendly, successful, and intelligent. We all want that for ourselves. What makes your smile less than perfect? For most patients, chips, fractures, discoloration, gaps, uneven and misshapen teeth are the reasons for a less than perfect smile. Dr. Keerti believes that everyone deserves a confident, attractive smile. Don’t you?
Dr. Keerti and our team are up-to-date with the latest developments in cosmetic dental materials and procedures. For chipped and broken “smile – line teeth” , we offer various options ranging from tooth-colored fillings and restorations, cosmetic bonding, single visit chair-side veneers to natural looking porcelain veneers. Doctor will do a detailed exam to figure out not only your best treatment option but also to come up with strategies to avoid further damage to your dentition by exploring the cause of chips and fractures. Composite bonding works for smaller defects in non-stress bearing areas. However, In most cases, the best, custom option to redesign a smile is porcelain veneers.
Each set of porcelain veneers is handcrafted by a dental ceramist for a unique, natural look. Dr. Keerti will do a complete smile analysis for you and create a smile, uniquely “you” to complement your overall appearance. She will adhere the permanent porcelain veneers to your front teeth for a lasting smile that will make you feel great about yourself.
Call (425) 558-ENSO (3676) for your complimentary 20 point smile analysis.
Do you have missing teeth?
Missing teeth can ruin your smile even if they are not right in the front. Teeth that have been lost due to decay or gum disease lead to spaces that create a less than optimum bite/occlusion for you. Eventually this leads periodontal and other occlusal stress related problems with adjacent teeth.
We have many options to restore your missing teeth including dental implants, bridges, minimally invasive Maryland bridges for missing front teeth and esthetic partial dentures.
Your best option can be determined after an exam and x-rays to see your bone level.
Have you been told that you have cavities?
Cavities are caused when bacteria on your teeth demineralize and destroy the hard outer enamel surface of your teeth. Once the hard enamel is dissolved, bacteria gain easy access into the tooth to feast on the relatively softer second layer called the dentin.
With cavities – the rule is really simple – the earlier you catch them, the better and more conservative the treatment can be! Some cavities that are just on the enamel surface may sometimes be “arrested” with just strict oral hygiene and religious fluoride treatment. On the other hand, cavities that go unchecked eventually turn into teeth that may need very large fillings and crowns, root-canals or even extractions. Cavities can be prevented.
We at Enso believe in prevention. Your teeth are examined every 6 months or more often if needed. Digital x-rays would be taken typically every year to check for small cavities in their early stages. Digital x-rays expose a patient to 80 to 90% less radiation than traditional x-rays. Not only that, the image can be enhanced to look for small surface cavities more closely. We also use a cutting-edge laser device that can aid in detecting cavities not only on the tops and sides of the teeth but also the hard to reach “in-between area” between two teeth. Of-course, a thorough clinical exam, aided by an intra-oral camera is performed at each recall visit, if indicated. To prevent cavities from forming, we teach you the correct brushing and flossing techniques if you so desire. We offer high concentration flouride application to all our patients at each visit. AND – no. Not the old fashioned fluoride rinse stuff that makes some people nauseous. We have newer techniques for delivering high concentration fluoride to your teeth now.
It’s never too late to start taking good care and never too early either! Good oral care begins when your child is an infant. ….even before the little pearly whites have popped-up. Bet you didn’t know that it’s the loving parents who, through their close contact with the child, end up transmitting the cavity causing bacteria to their little babies. Moms with low caries rate tend to have kids with fewer cavities! So, listen up moms-to-be…. give yourselves an oral overhaul and give your baby a leg-up!
If you do have cavities that need to be treated, the treatment of choice can range from tooth colored fillings (composites) to porcelain inlays and onlays. On rare occasions, porcelain crowns may be needed. Tooth –colored fillings (composites) and porcelain inlays and onlays are all relatively conservative approaches. If your cavity involves more than two surfaces, porcelain inlays and onlays are the best options if you are looking for longevity and superior esthetics. Tooth colored fillings (composites) don’t have the same strength and resistance to wear as porcelain inlays and onlays.
Are discolored teeth not letting your personality shine through?
Do you command attention when you walk into a room? Do people want to get to know you more because you put them at ease with your warm smile? If you are comfortable in your own skin (read “enamel””), it shows…..and people are attracted to that. A dazzling smile makes a person not just look great but also feel confident.
After just one session of Zoom! Whitening at Enso, you could enjoy a smile up to eight shades brighter. We use a professional bleaching gel to remove stains caused by foods, smoking, and heredity. An appointment takes about an hour and a half, so you can come in before work or over lunch.
If you prefer the convenience of home teeth whitening, ask Dr. Keerti for custom bleaching trays and a take-home teeth-whitening kit. With home teeth whitening, you can monitor the lightness of your teeth by simply discontinuing use when your smile is the color you desire. Most patients wear take-home trays for an hour a night over about two weeks. Our In Office Teeth Whitening patients supplement their office teeth whitening with complimentary take-home kits for touch up, as well.
Patients with dental or gum problems are advised to address these issues before any bleaching procedure. On the other hand, some patients benefit from lightening their teeth first and then matching the veneer/crown porcelain shade to their new, bright smile.
Everyone should expect some degree of sensitivity with this procedure. This can be counteracted with fluoride application. Unfortunately, there is no device to measure tooth sensitivity. You, the patient, are the best judge. Discontinue the use of lightening agents if you think that you are experiencing unusual symptoms and call your dentist.
Are sensitive teeth not letting you enjoy your double fudge sundae?
Sensitive teeth may be caused due to various reasons. Most people think they have cavities when they have sensitive teeth. While tooth decay may make teeth sensitive, it does not always do that.
The reason for sensitivity may be due to simply brushing your teeth the wrong way or grinding and clenching your teeth at night. On the other hand sensitive teeth may be an early warning sign for cracked or decayed teeth or failing and leaking old fillings.
Whatever be the cause, we will try to get to the bottom of it and take care of it for you. And no…you don’t have to worry about your dental cleaning appointment making your teeth even more sensitive. We use warm water for all our work. Not only that, we at Enso, have invested in technologically advanced special scalers with disposable “sensi-tips” for your cleaning appointments. These scalers are known for being gentle on teeth with gum recession, teeth with periodontal disease and also for teeth that have veneers. These tips are designed to be safe and gentle on your veneers to increase their longevity.
Is bad breath keeping your loved ones away?
Bad breath or halitosis is one of the most socially offensive problems to have. Yet, most patients who have bad breath are completely unaware of it. Bad breath /halitosis can ruin your interactions with other people. If you want to know about the quality of your breath, do this at midday before lunch… breathe into the cup of your palm, then inhale. How is your breath?
Bad breath comes from the Anaerobic Sulfur Producing Bacteria which reside in the surface of the tongue and throat. These bacteria are supposed to be there, as they assist humans in the digestion of proteins .During certain conditions, the bacteria start to break down proteins at a rapid rate. Proteins consist of Amino Acids, and two of these Amino Acids (Cysteine and Methionine) are dense with sulfur. When these bacteria come in contact with these amino compounds, the smelly sulfur compounds are released from the back of the mouth. These compounds are frequently called volatile sulfur compounds (VSC), where volatile means ‘Vaporous’ which accurately describe their ability to offend other people with halitosis.
You can reduce the number of these bacteria if they are over populating your mouth or you can eliminate the areas where they might be hiding (such as around inflamed wisdom teeth or enlarged and infected tonsils)Since they are part of our normal oral flora balance, you can’t permanently remove these VSC producing , halitosis causing, bacteria from your mouth. However, you can get to the bottom of the cause of bad breath in your particular situation. For instance… are you brushing and cleaning your tongue regularly? Not keeping your tongue clean provides a safe haven to these bacteria to grow and cause bad breath. Or to take another cause, do you have dry mouth? Saliva helps wash away excess bacteria. If you are not producing enough saliva, you could have a foul smelling breath. We could discuss strategies to cure your dry mouth and help you eliminate bad breath.
Halitosis is both preventable and curable. Treating bad breath is a very simple process once we get to the root cause of your problem. Don’t suffer… and don’t make your loved ones suffer either.
Are you worried about oral cancer?
Dr. Keerti has done advanced training in Oral medicine, a field of dentistry that bridges the gap between dentistry and medicine and deals with oral pathologies such as oral cancer and precancerous states. She believes in doing an oral cancer exam on all patients at each recall visit. Her passion for the field of Oral medicine directly translates into premium care for her patients. Dr. Keerti is a part –time faculty member in the department of Oral medicine at the UW school of dentistry.
More than 34,000 Americans will be diagnosed with oral or pharyngeal cancer this year. Of those 34,000 newly diagnosed individuals, only half will be alive in 5 years.
Cause and Risk Factors
The path that brings people to oral cancer contains at least two distinct etiologies (CAUSATIVE FACTORS) one through tobacco and alcohol and another via the HPV (HUMAN PAPILLOMA VIRUS) virus. The HPV virus may be transmitted through sexual contact. The risk of acquiring this virus increases as the number of sexual partners increases. The malignancy sites associated with each pathway appear to also be different from each other. In the broadest terms they can be differentiated into these areas; HPV related lesions appear to occur on the tonsil area, the base of the tongue and the throat and non-HPV positive tumors tend to involve the anterior tongue, floor of the mouth, the mucosa that covers the inside of the cheeks and alveolar ridges (the ridge area in which the teeth reside).
Signs & Symptoms
You are the most important factor in an early diagnosis. You should always contact your doctor or dentist immediately if you notice the following symptoms in yourself or a loved one:
- A sore or lesion in the mouth that does not heal within two weeks.
- A lump or thickening in the cheek.
- A white or red patch on the gums, tongue, tonsil, or lining of the mouth.
- A sore throat or a feeling that something is caught in the throat.
- Difficulty chewing or swallowing.
- Difficulty moving the jaw or tongue.
- Numbness of the tongue or other area of the mouth.
- Swelling of the jaw that causes dentures to fit poorly or become uncomfortable.
- These symptoms may be caused by other, less serious problems, but they also indicate the possible presence of oral cancer. Only a professional will be able to tell you definitively.
Diagnosis & Prevention
There is no substitute for education and awareness on the part of the patient and the clinician. Dr. Keerti has done a residency in Oral Medicine and Diagnosis (the field that deals with clinical presentation, diagnosis and treatment of oral and facial pathologies and conditions) from university of WA. She continues to be a faculty member in the department of Oral Medicine and keeps up with the latest. She is also a reviewer for the Journal of contemporary dentistry in the field of Oral Medicine and pathology. She believes in a complete Oral and head and neck exam at each recall /check up visit. She encourages her patients to familiarize themselves with the causes and signs and symptoms of Oral cancer. One of the best resources on this topic is the cancer foundation.
If you or the doctor encounters a suspicious looking lesion, a completely non-invasive, painless and easy exam called a vizilite exam can be performed. This exam is usually covered by your insurance provider. First, you will be instructed to rinse with a cleansing solution. Next, the overhead lighting will be dimmed. Then, your mouth is examined using Vizilite Plus, a specially designed light technology. Go to http:// www.vizilite.com
Another new way to test for oral cancer before incisional biopsy is beginning to be used by dental professionals — a system called Oral CDx. Here, a dentist uses a small brush to gather cell samples of a suspicious area. The specimen is then sent to a lab for computer analysis. In a recent study of 945 patients, Oral CDx detected all cases of oral cancer correctly, even when dentists didn’t suspect the presence of cancer from the lesion. This oral brush biopsy procedure is simple, and. results in very little or no pain or bleeding, and requires no topical or local anesthetic.
IF YOU NEED HELP WITH SMOKING OR TOBACCO CESSATION TALK TO YOUR MD OR YOUR DENTIST. FAMILIARIZE YOURSELF WITH ALL THE RISK FACTORS. EARLY DETECTION IMPROVES THE CHANCE OF A SUCCESSFUL TREATMENT OUTCOME.
Call (425) 558-ENSO (3676), if you are worried about a suspicious sore in your mouth.
Do your jaw joints hurt?
Jaw joints called TMJs, short for temporo-mandibular joints are the most unique joints in the human body. No other set of joints works individually and as a pair, in the human body. This also makes their function and physiology quite complex.
Do you think you have TMJ problem?
Dr. Keerti has postgraduate training in diseases and disorders of the joints. She enjoys helping her TMJ patients and designing a treatment protocol for them.
The treatment for TMJ pain starts at identifying the underlying cause. Is it your disc, your capsule or your joint itself?
Living with TMJ pain can be debilitating. Call us and let us help you.
Do you need a cleaning? Worried about gum disease?
Most young and healthy patients with great home care generally only need a “preventive” cleaning every six months. If the doctor determines that you have areas of inflammation in your gums around your teeth, you may be advised to get cleanings more frequently.
Some patients may have areas of chronic, low –grade gum infection or inflammation, (gingivitis or periodontitis). People who have this condition may notice that their gums look redder and bleed upon brushing or flossing. They may complain of sensitive teeth and gums and perhaps bad-breath. For patients with areas of periodontitis, a more in-depth treatment and cleaning is advised. Periodontal disease, if unchecked, leads to alveolar bone loss, lost teeth and an unsightly smile.
How long has it been since your last cleaning? Irregular dental care and cleanings can be a precursor to periodontal disease. According to American Dental Association, Periodontal disease has been linked to heart disease in several reputable studies. It seems that the studies might be suggesting that a great smile is a sign of a great heart… but you already knew that 🙂
Periodontal disease is also linked to Diabetes. Diabetic patients tend to be more susceptible to this condition. One study also suggests that treating periodontal disease may actually have a positive impact on diabetes. Gum disease is also strongly linked to low-birth weight babies in pregnant women.
Treating gum disease is usually not difficult. Dr. Keerti will create a plan to suit your condition. We use special scaler tips called “sensi-tips” if you are very sensitive. We also use these special tips around veneers to increase the life span of the veneers by not damaging them with regular metal tips. What’s more – your gums can even be numbed up, painlessly, using a special technique, without any shots. We can also use warm water during your cleaning, to reduce any cold-sensitivity.
At the end of your cleaning appointment comes “teeth polishing” leaving your teeth feeling squeaky clean and your mouth feeling minty fresh.
Are you nervous about going to the dentist?
Dr. Keerti has achieved the fellowship status in the dental organization for conscious sedation. Needless to say; she has vast experience in this field. Dr. Keerti has successfully worked with patients who display mild dental anxiety to patients who can be considered severely dentophobic. Where do you fall in this spectrum? Come on in. Get to know us first. And let us get to know you. Dr. Keerti will first meet anxious patients in her private office if they are averse to sitting in the dental chair. Just let us know when you call to make your appointment. We, at Enso, cherish our patients and enjoy taking care of them. We believe that once you get to know us, you will become comfortable with us over time. We will tailor a plan to address all your dental concerns and your level of anxiety. We may start with simple procedures such as exams and cleanings in the beginning just so you become familiar with your surroundings. Sedation dentistry works even better when the patient is comfortable with the doctor and the staff. Depending on your level of anxiety we may use only nitrous oxide or if you are more anxious we may use oral conscious sedation.
If you choose the conscious sedation route, you’ll need to have a responsible care-giver to bring you to your appointment and take you back home and be around you for some time, to assist you. You and your caregiver would be given, easy to understand detailed instructions before your appointment. Typically, you’ll be asked to make a morning appointment and arrive in comfy clothes that you could take a nap in. Once you arrive, we take you to our tranquil treatment room. You will be tucked into a very comfy blanket on our ultra soft chair. You would be surrounded with warmth and comfort to put your mind at rest even before we start the sedation process. During the procedure, your pulse rate, oxygen saturation levels and blood pressure is constantly monitored and recorded. After the procedure is done, we wake you up in case if you are dozing and offer you some refreshing juice or cool yogurt and a warm moist towel.
Sedation works really well for most patients. However, some people are not suitable candidates for sedation. Dr. Keerti will discuss your medical and meds history in detail before appointing you. Sedation is absolutely contraindicated if you are pregnant or trying to get pregnant. Sedation protocol is modified slightly for nursing moms. Sedation protocol is modified for smokers as well. Talk to Dr. Keerti in detail. Ask any questions. Get comfortable.
Are old fillings causing cracks and fractures in your teeth? Are your mercury fillings serving you well?
Silver fillings expand and contract in response to the temperature variations in the mouth. The physical properties (such as resistance to shearing forces, yield strength and coefficient of thermal expansion) of silver fillings are SO vastly and incredibly different than that of a tooth; eventually they cause micro-cracks in the structure of the tooth. What look like cracks to us could potentially look like autobahns to the bacteria… a quick way into the depth of your tooth. Teeth with very large silver fillings fail regularly. Silver fillings are an amalgam of silver alloys with mercury, hence the name silver amalgam. Studies are unclear about the harm that silver/mercury amalgam fillings can cause to the human body. Silver fillings are banned in some European countries but not in the US. At the time of writing this web-page, it is known that a few studies are underway in US. At this point, the ADA does not recommend that mercury fillings be removed for the sole purpose of getting rid of the mercury from the mouth. They may however be replaced with new restorative fillings for other clinical reasons such as secondary decay or cracks etc.
We, at Enso, practice Amalgam-free dentistry. We don’t place amalgam fillings since we believe that we have very esthetic options available to us in today’s day and age that easily rival the strength of amalgams and easily exceed any other physical standards set by amalgam fillings. Don’t get us wrong. We believe that amalgams have served dentistry well. They have helped save many-a-teeth when nothing better was available. However, like most other things in life, we do better when we know better. Dentally speaking; we have better, healthier and safer options available to us now.
Enso dentistry amalgam removal protocol
We don’t want our patients to ingest or inhale the old silver filling dust, as the fillings are being removed. We follow a special protocol in our office when we remove your old silver fillings. We can discuss this when you come in for your appointment. We are also very conscientious of the effect the mercury has on the environment as it is removed from your mouth. Even though it is not mandated by the law, we have invested in an Amalgam separating unit. This unit removes the mercury from the liquid waste ever before it gets the chance to hurt our Salmon.
Unlike silver amalgam fillings, porcelain inlays and porcelain onlays will not expand or contract significantly, in response to temperature changes caused by hot or cold foods. Inlays and onlays can replace silver fillings to create a healthier, more natural-looking smile. In treating dental decay, or fractured and cracked teeth, inlays and onlays help to eliminate tooth sensitivity and eventual tooth loss. Inlays and onlays also offer the following benefits:
Since they can be made from tooth-colored material, including porcelain and composite resin, inlays and onlays are virtually invisible. The use of inlays and onlays requires less tooth reduction than does the use of metal fillings. This allows dentists to conserve more of a patient’s natural tooth structure in the treatment process. Because of the way porcelain inlays and porcelain onlays are made and bonded into the tooth structure, they help to strengthen teeth from inside out. The durable material from which inlays and onlays are made helps them last up to 30 years, much longer than that of conventional fillings. By saving decayed teeth, inlays and onlays prevent the need for more extensive treatment later on. However, if you have lost too much tooth structure due to decay or fractures caused by your old silver fillings, inlays and onlays may not be an option for you and you may need crowns (porcelain fused to metal crowns or porcelain fused to a ceramic substructure crowns) to protect and strengthen your teeth.
Do you need help with dental financial planning? Questions about insurance?
The relationship between you and your dentist should be just that, and not between your dentist and an insurance company. However, we will be glad to assist you while working with your insurance company to maximize any benefits you have. We are committed to helping you in any way we can, with or without insurance, either in network or out of network. We are contracted with most of the major insurance/benefits provider for most of the major employers in the greater Seattle area and the eastside. We, accept all insurance carriers.
We are contracted with Premera (blue cross), Regence (blue shield), Blue-cross, WDS (delta dental), and state and city dental plans amongst other plans. Call or email if you have questions about a specific plan.
If you are planning to have work done that may not be covered by your benefits plan, we can help you with savvy financial planning for your case. We can tailor a payment plan for you and we also work with care credit and capital one to secure dental loans.
When you come to visit us, be sure to also ask us if you need for us to treatment plan for next year to take advantage of your flex-plan. Most employers in our area have this plan for their employees.
Lastly, check out our the Ways to Pay page for more information.