"Shot free" and "Drill free Dentisty"
Through the use of air micro abrasion
One benefit of the newest generation of porcelain fillings is that, usually, not as much tooth structure needs to be removed compared to a silver filling. This is because porcelain fillings are "bonded" to the tooth while silver amalgam fillings are held in place by drilling undercuts into the enamel. The phenomena of bonding generally seals the interface between the filling and the tooth in a way a silver amalgam filling can't do. It has been shown that, in some instances, the bonding of tooth structure can reinforce the tooth.
Silver amalgam material, on the other hand, sometimes swells over time acting like a wedge within the tooth that can cause fracturing.
The concept of "drill free fillings" refers to a technique we use called Air Mico Abrasion. Since a porcelain filling is "bonded" to the tooth, and only the decay needs to be removed, this can be done with a gentle stream of air and micro abrasion powder. This is like a "mini" sand blaster instead of a drill. Most of the time, this can be done without an anesthetic injection.
Even Monkeys Teach Their Young to Floss
The BBC reports that female monkeys in Thailand have been observed showing their young how to floss their teeth.
Researchers from Japan said they watched seven long-tailed macaques cleaning spaces between their teeth in the same manner as humans.
They spent double the amount of time flossing when they were being watched by their infants.
This suggests the mothers were deliberately teaching their young how to floss, professor Nobuo Masaka of Kyoto University's Primate Research Institute, said.
Effects of Sour Candy on Your Dental Health
Most of us know that excessive sugar is bad for our teeth, but we fail to realize that acidic foods and beverages can be far more damaging. It is so important to understand the basic principles of how acids break down our teeth, so here is a quick chemistry review: The strength of an acid is calculated by its 'pH'. Strong acids have a low pH (battery acid pH=1.0) and weak acids have a higher pH (pure water pH=7.0). Any food or beverage with a pH of less than 5.5 will soften teeth
and soft teeth are prone to cavities and excessive wear. Many of our favorite candies and beverages have very strong acidity; in fact many are closer to battery acid than water!
| Snack | pH |
| Skittles | 2.5 |
| Starburst | 2.4 |
| Mentos | 2.4 |
| Altoids | 1.9 |
| Nerds, Grape | 1.9 |
| Soda (diet or reg.) | 2.0-4.0 |
| Gatorade | 3.0 |
| Juices | 3.0-4.0 |
| Water | 7.0 |
So that is the bad news, but does it mean we must never eat candy or drink soda and sports drinks again? Not at all, however all of us have different levels of susceptibility to wear and decay and moderation in the diet is always necessary. Current dental research tells us that the frequency of acid attacks on our teeth is the most important thing to regulate. This means that sipping soda for longer periods of time is far more damaging than gulping the soda. Similarly, eating acidic candies throughout the day is much worse than eating them all at the same time.
It appears that the Swine Flu outbreak in our country will be a significant concern for all of us this year. The Center for Disease control has an interesting web site link call FluView www.cdc.gov/flu/weekly/ which gives weekly updates of the situation.
Nineteen more infant deaths have been attributed to the swine flu this week as well as three more adult women. This brings the death toll to more than seventy six people.
The CDC has other informative and interesting web sites giving the latest information on the details of the Swine Flu. See www.cdc.gov/ for more detailed information than I'll offer in this synopsis.
There is great concern over the safety and effectiveness of the vaccine that has been developed to prevent Swine Flu. First of all, you should know that the so called 'seasonal flu' is different from Swine flu. There is already a vaccine available for the seasonal flu.
The Swine Flu vaccine is still forthcoming and will be available soon. You will need both if you are a person who is considered at risk.
It is recommended that everyone get the seasonal flu shot.
The CDC recommends vaccinations against Swine Flu for five groups of people:
-Pregnant women
-Anyone who lives with or care for children under the age of 6 months of age
-Health care personnel
-Anyone between the ages of 6 months and 24 years of age
-People from age 25 to 64 who have compromised immunity or chronic health disorders which would make them more susceptible to the effects of the flu
The Swine Flu is made in the same way and by the same companies that have made the seasonal flu vaccinations for years. There have been no deaths or complications from these past vaccines including any for pregnant women or infants. In the past the vaccines developed have been less effective in some years than in others. This is probably because the drug companies have to somewhat guess early in the year as to which virus will be the most serious when flu season comes in the fall of the year.
This year the drug makers have guessed completely accurately when making the Swine flu vaccine. All cases of flu that have manifested have been responsive favorably to the vaccine developed.
Evidence based research has shown the Swine Flu vaccine to be safe and effective for all at risk groups that need it. This fact in light of the serious nature of this disease should weigh heavily in anyone's decision making in regards to taking the vaccine. Swine Flu is many times more lethal for people at risk than the seasonal flu we see every year. This is not your usual flu.
Fluoride, Not Just For Kids
People are living longer today and maintaining their own natural teeth. Studies throughout the years have proven flouride to be a measurable tool in prevention against dental caries (cavities) in children and adolescents. Recently a study done in Indianapolis at Indiana University School of Dentistry, has investigated the advantages of flouridated water, as well as fluoride application in all age groups, noting that the older adults benefited the most.
The ADA has reviewed certain factors that also increase decay rate for a person. The list includes but is not limited to: poor oral hygiene, multisurface restorations, chemotherapy or radiation therapy, eating disorders, drug or alcohol abuse, irregular dental care, presence of exposed root surfaces, poor dental margins, and/or side effects of medications. Looking at this list, some or many of these factors may apply to you or someone you know.
While we are always using fluoride on children at their regular dental visits, we may not be so diligent with our adults and older adults. An exciting new material called "Fluoride Varnish" is now availible that is highly recommended by the American Dental Association. The fluoride varnish is applied after a dental cleaning and exam. We are very excited about this new application of fluoride and the ADA has strongly recommended this process over the application of gels and foams due to the long-term advantages.
Our role as dental health professionals is to stay on top of new preventaive measures and share them with our clients to help save time, money and discomfort.
Doc, why are you taking a picture of my tooth?
Throughout the past year, we have incorporate digital photography into the way we practice dentistry. In todays digital age, it is often necessary and quite easy to snap a picture of a tooth or specific areas of your mouth. Some of the reasons we do this are:
- To educate you on the condition of your mouth and understand why we are recommending treatment (cracked tooth, decay, gum disease, etc)
- To document any abnormalities of the gums, tongue, palate, lips, and cheeks for later comparison
- To communicate to our dental laboratories for more lifelike looking crowns and dentures
- To communicate with your dental insurance company on recommended treatment (results in fewer cases of declined treatment)
We hope you view these photos as a service that will enhance dentist-patient communication and will raise the level of your dental treatment.
Payment plans and extended financing now available
When presented with your treatment plan, we want you to feel as comfortable as possible communicating your concerns. Many of our patients say that financing is their biggest concern. With our new financing options, we hope you feel at ease about proceeding with your dental work.
We have added the services of Care Credit and Citi Health Card at our office in order for our patients to have more financial options that can accommodate any budget.
Citi Health Card is great for those that are looking for flexible financing that will allow the treatment to start immediately.
Care Credit offers extended payment options with the versatility to be used at other dental specialists, health care providers and even veterinarian offices.
Immediate Placement of Dental Implants
Dental implants are one of the most exciting treatments offered in the world of dentistry today. However, the traditional healing protocols following a tooth extraction often delayed the surgical placement and restoration of an implant for up to 1 year. New research has now concluded that it is very possible to extract a tooth and immediately place a dental implant into the tooth socket without sacrificing the success rate of the implant. This allows the dentist to do only one surgical procedure instead of two or three seperate surgeries to get the implant into place. It also allows treatment time to be shortened by up to 8 months. Todays dental implants have improved designs and are coated with advanced surfaces that promote faster healing of the bone onto the implant surface.
Dental Implants
Dental implants are artificial tooth replacements that are used to counter tooth loss. Although you have a number of restorative options for the treatment of missing teeth, none have proven to be as functionally effective and durable as implants. In may cases, dental implants may be the only logical choice for the restoration of all necessary functionality of teeth and supporting structures.
Teeth are lost because of:
- Tooth decay
- Root canal failure
- Periodontitis
- Trauma to the mouth
- Exessive wear and tear
People who have lost teeth might feel too self-conscious to smile or talk. Additionally, biting irregularities caused by tooth loss can have a negative effect on eating habits and this can lead to secondary health problems like malnutrition. Regardless of the nature of problems related to tooth loss, dental implants may provide a simple remedy with proven results.
Dental implants are stronger and more durable than their restorative counterparts (bridges and dentures). Implants offer a permanent solution to tooth loss. Additionally, implants may be used in conjunction with other restorative procedures for maximum effectiveness. For example, a single implant can serve to support a crown replacing a single missing tooth. Implants can also be used to support a dental bridge for the replacement of multiple missing teeth, and can be used with dentures to increase stability and reduce gum tissue irritation.
Reversing Decay
Wouldn't it be great if we could prevent and reverse tooth decay instead of continually placing fillings? This is the modern goal of preventative dentistry. Well, believe it or not we now have several products that can reverse the progression of decay (at early stages) and strengthen teeth to make them more resistant to tooth decay.
Let's first review how a cavity starts. There needs to be three things present to form a cavity: 1) a tooth, 2) bacteria, and 3) sugar. Dental Plaque is a sticky film that forms on our teeth after we eat, it consists of large quantities of harmful bacteria and broken down food products. A specific type of bacteria in dental plaque (named Streptococcus mutans) and is the primary cause of cavities. This bacteria gets energy from sugars and releases acid on the tooth as a by-product of its metabolism. The more sugar to energize the bacteria, the greater the acid attack is on the teeth. this is a big reason why dentists and hygienists will stress diet changes and plaque removal by good brushing and flosing. The acid released from the bacteria over time will cause serious tooth decay.
There are three products we now use to counteract the harmful effects of the acid attack on the tooth.
1). Xylitol, a natural sweetner which helps prevent cavities. It works because the harmful bacteria responsible for acid attacks on teeth cannot use Xylitol for energy, thus cannot metabolize it, and therefore cannot multiply in number or release acid. In addition to reducing cavities, it also reduces plaque build-up and bacteria, stimulates saliva flow, buffers the mouth, and allows for re-mineralization of the tooth to take place. Xylitol is now found in many types of chewing gum and mints.
2). Fluoride, is a naturally occuring element found in vegetation, rock, soil, and air. In most parts of the country is in incorporated into the water supply and is also applied topically to teeth in dental offices. Fluoride works by creating an acid resistant 'shield' on the outside surface of teeth. Fluoride is also toxic to the acid producing bacteria (S. mutans) found in dental plaque, thus reducing the overall acid attack on the teeth. It makes tooth enamel less soluble to these acids, and will remineralize (repair) soft areas of the tooth before a full cavity develops. Fluoride also has profound desensitizing properties when it is topically applied to cold sensitive teeth. Many types of toothpaste contain small amounts of fluoride but it is also dispensed in many forms of oral rinses, foams, varnishes and gels. Research continues to show that fluoride is both effective at reducing tooth decay and is safe.
3). Recaldent, derived from natural milk protein, and is essentially vitamins for your teeth. It contains bio-availible calcium and phosphate that will bind to areas of a tooth that have been damaged by acids. Recaldent allows for an increased effect of fluoride when used in comination. It also stimulates saliva production, buffers plaque acids, and has fantastic desensitizing properties for cold sensitive teeth.
To review the basics of tooth decay...acid is the enemy! Depending on how susceptible you are to cavities, dry mouth, sensitivity or acid attack, Dr. Reid and Dr. Perrett will recommend a customized approach (using one or more of the above products) to protect your teeth.
Lab Work from China
The recent news stories reporting of lead content in dental crowns has been all the buzz in recent dental publications. These stories are about crowns and bridgework that have been outsourced to Chinese dental labs from American dentists. With international shipping these days, this is actually seen as an option by some dentists. Apparently the lab bill for crowns made in China can be as cheap as $10 per crown compared to the American lab costs of several hundred dollars per crown.
The American Dental Association has asked the nation's leading health agencies to address saftey concerns raised by these reports.
The Centers For Disease Control have responded by saying that the amount of lead present in these crowns is so small as to be inconsequential and "unlikely to cause adverse effects in adults."
The FDA has assured the ADA that they are working on the concern but as of yet, they will not be issuing a Consumer Update.
The ADA noted in letters to the various government agencies that they would be conducting their own studies on contaminants in dental prosthetics from both overseas and domestic laboratories.
I called the local dental laboratories and was assured that there are no contaminants such as lead in any of the materials they use. Their response was the same as mine. Why would you use some overseas lab!? Of course it's all abou the money.
I have worked with some of the same lab technicians for over twenty five years. Our office works with two laboratories. We have settled on these two labs after scrutinizing several other labs over the years. We know that we can count on the quality of work they deliver. This, of course, is best for the patient but also makes our job easier. We can't imagine compromising the quality of our care and increasing the stress it would take to deliver the work for the sake of price.
Which Toothpaste To Choose?
The good news is that Americans have a wide variety of toothpastes from which to choose. The bad news is that this vast array can be very confusing. In choosing any toothpaste, be sure that it contains fluoride and has the American Dental Association Seal of Acceptance. Here are some tips to help you select the best toothpaste for you. Also, talk with your dentist about which toothpaste would best meet your needs.
Tartar-Control Toothpaste
Tartar-control toothpaste prevents tartar, a hardened plaque, from forming above the gum line, possibly by as much as 36 percent. These toothpastes do not remove tartar that has already formed, which can only be done by a professional cleaning.
Abrasives
Abrasives help remove stains and plaque and polish the teeth. All ADA-accepted toothpastes contain a mild abrasive that, along with your toothbrush, helps remove plaque. There is no need to be concerned about abrasives wearing away enamel.
Desensitizing Toothpaste
Many people with receding gums have teeth that are especially sensitive to temperature extremes, making it uncomfortable to ingest hot or cold drinks or foods. Desensitizing toothpastes can help block this pain, though it may take four to six weeks before improvement is noticeable.
Baking Soda
Baking soda toothpastes have become popular in recent years. While this ingredient can act as a mild abrasive, there is no scientific evidence that baking soda helps fight gum disease. An advantage of baking soda as an ingredient is that if you like the taste or feel of these toothpastes, you are likely to brush more often and thoroughly.
Hydrogen Peroxide
When hydrogen peroxide is found in toothpaste, it is usually found in conjunction with baking soda. The concentrations of peroxide are not sufficient to bleach teeth, but the bubbling action may improve the feel of the toothpaste in the mouth. Peroxide has not been shown to have a therapeutic effect on gum disease.
