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Family Dentistry

Anxiety Free Dentistry – Frequently Asked Questions on Reducing Dental Anxiety

Q. Why do you need to have regular dental care check-ups?

A. Regular check-ups are needed to monitor your overall oral health. In addition to checking for cavities, your dentist examines the health of your entire mouth and surrounding soft tissues, checking for pre-cancerous or cancerous lesions, oral sores, and gum disease.

Your oral health is connected with your general health. Dental care check-ups can alert the dentist to other medical conditions that have symptoms in the mouth such as diabetes, nutritional deficiencies, and hormonal irregularities. Regular dental care visits are vital to prevent tooth decay, gum disease, and other conditions affecting your mouth.

Q. What can you do to feel more relaxed during a dental care appointment?

A. With the combination of modern anesthetics and new conscious sedation dentistry technology and techniques, many procedures only have minimal discomfort or are now entirely painless. Dental care providers want their patients to have maximum comfort and approach their treatments with a relaxed attitude and less dental anxiety.

There are a number of ways to decrease dental anxiety:

  • Tell the dental care staff your concerns. Studies have shown that talking about your fears of possible discomfort actually reduces pain.
  • Use visualization to picture yourself relaxed, or repeat messages that have a calming effect.
  • Play your favorite music on a Walkman you bring with you (some dental offices are equipped with Walkman's too.)
  • Arrange a signal with the dental care staff, such as raising your hand, if you need a break or feel discomfort.

Some dental care offices are now offering patients new options for stress relief: hypnosis, self-hypnosis instructions, relaxation tapes, soft lighting, warm gel-filled eye masks, scented candles, and massaging pillows. These are helpful in reducing stress in patients that suffer from dental anxiety. Be sure to avoid the use of stimulants such as caffeine prior to your visit.

Q. Aromatherapy has a relaxing effect for many people. Is this effective for patients undergoing dental treatment?

A. Research studies conducted at Case Western Reserve University have noted that the use of aromatherapy has a significant positive effect on dental anxiety patients. Two-thirds of the patients receiving aromatherapy were more calm and relaxed than those patients without exposure to the scented fragrance oils.

Dentists are concerned about your comfort. Ask your dental provider if aromatherapy is available in the office to help reduce dental anxiety, or if you can bring your own for your dental care visit. Essential fragrance oils are available in health food stores, spas, and some grocery and drug store outlets.

Q. Are dental patients who are considered at risk for bacterial infections advised to take antibiotic medication prior to their appointments?

A. Certain medical conditions, such as heart valve problems or a recent total joint replacement, are considered at risk for infection at the site of the cardiac abnormality or joint replacement. This infection results from bacteria from the mouth entering the bloodstream and working its way to these vulnerable areas.

Consequently, dental care procedures likely to result in bleeding from the gums or mucous membranes will require patients to take antibiotics prior to that procedure. Such procedures could include, but are not limited to, extractions, implant surgery, incision, and drainage for oral infection, and professional teeth cleaning.

Guidelines have been established by the American Heart Association and the American Dental Association to provide dentists and physicians with information regarding appropriate regimens for antibiotic therapy. It also outlines those situations when antibiotic therapy is or is not indicated.

There also are other medical conditions warranting antibiotic therapy prior to dental procedures. Be sure to update your dentist regarding your medical history. Your dentist and/or physician will advise you of any special needs.

Q. Where can you receive dental services if you do not have the money to cover the related expense?

A. If you do not have either dental insurance or the money to pay for a dental visit, you should inquire about financial aid from various sources within your community.

You may need to make several calls, but the local dental society, the local public health department, or social service agencies may be able to direct you to sources of assistance. Also, check local hospitals, dental schools, and outreach clinics that may be able to provide dental services at a reduced fee.

Enjoy Your Dentists and the Dentistry Your Parents Never Had

What did your parents tell you about going to the dentist?

Did they talk about how your dentists could help you take care of your teeth, gums, and even your smile? Instead, they probably emphasized the negative: "It won't hurt much," or "Your toothache will be gone."

For most of us, the stories we heard about visiting dentists described how the person in the white jacket helped relieve tooth pain. We didn't hear about the dentists creating opportunities for good dental health and an attractive bright smile.

Comparing the dentistry your parents knew with the new dentistry that has emerged over the past ten to fifteen years is like comparing the computers of the 1950s with today's powerful desktop machines. The differences are vast. Yet, as dental care consumers, most of us have not updated our old stories. You haven't added new chapters about the great possibilities for dental care and dental well-being that the new dentistry offers.

You can experience these new possibilities for oral and dental health by creating partnerships with your dentists and their dental teams. You can take advantage of innovations and advances in the following areas:

  • Treatment technologies and equipment
  • Specialization
  • New materials
  • Preventive techniques
  • Scientific knowledge
  • Cosmetic enhancements like invisible fillings
  • Integrated multi-specialty treatment teams

Today's dental care teams have the knowledge, skills, and information to help create a positive dental health future. A partnership is based on communication and mutual responsibility, and you can actively foster that first communication.

You can begin to partner with your dentists and their dental care teams by doing the following:

  • Asking about advancements in treatment technologies and materials.
  • Finding out what steps you can take to maintain healthy teeth and gums.
  • Creating a positive dental future through the recommended steps of flossing and brushing.
  • Taking an active role in contacting your dentists and dental care team at the first sign of any concern about teeth or gums.
  • Using your curiosity to make sure you understand the reasons for a referral to a specialist such as a periodontist or endodontist and the outcomes your dentists are seeking.

Your parents didn't have the choices or the opportunities that you have today for optimal dental health. The new dentistry can create more than a warm bright smile; it can improve your overall health.

The future of your dental health is in your hands just as the future of your bodily health is. Taking steps to increase your knowledge about the new dentistry will provide great benefits for you today and tomorrow.

By Brian DesRoches, PhD

FAQs on Dental Implants, Wisdom Teeth, and Sealants for Children

Q. How does one care for primary teeth?

A. As soon as the first tooth erupts, primary teeth may be cleaned with a clean, wet wash cloth or wet gauze. The gums should also be gently wiped. If a toothbrush is used, it should be an appropriate size.

Q. Where does decay on the primary teeth occur most often?

A. With inappropriate or prolonged use of the baby bottle, decay may occur on the upper front teeth (incisors). The second most often occurring site are the upper primary molars, which are found furthest back in the mouth. If there is no spacing between the primary teeth, there is a much greater chance of decay between the primary molars. These teeth should be flossed as soon as they come in.

Q. Why are dental sealants beneficial for children?

A. Dental sealants are applied by your dentist as protective coatings for the chewing surface of permanent molars. They protect the teeth from decay. Read on for more information.

Q. What is a dental implant?

A. A dental implant is a permanent artificial tooth replacement.

Q. What is the procedure for receiving dental implants?

A. Dental implants are inserted surgically in two steps. The first step is to insert a "post" into or onto the jawbone. This post will then become the "anchor" for the artificial tooth that will be placed over the "post."

Q. How long is the procedure for dental implants?

A. Getting a dental implant is a two-step process. Once the "post" is inserted into the jawbone, the patient will have between three and six months with a temporary restoration. During this period, the bone and gum area around the post will heal to create a strong and healthy bond.

Once this bond is complete, an additional set of smaller posts is attached to the original post and then the artificial tooth is secured to the posts. The entire procedure could take anywhere from three to ten months.

Q. Can I eat regularly while the implants are bonding?

A. While the "post" is bonding with your jaw and gums, your dentist will place a temporary artificial tooth on the post. During the bonding period, you will need to eat soft foods.

Q. Do implants require special care?

A. Yes and no. Dental implants need to be brushed, flossed, and checked regularly by a dentist, just as you would do with your regular teeth. But dental implants don't need special brushes or pastes.

Q. Can you eat and chew normally with dental implants?

A. Yes. Consider that natural teeth can absorb up to approximately 540 lbs. per square inch of biting pressure and properly placed dental implants can withstand up to approximately 450 lbs. per square inch of the same pressure.

Q. How long should a dental implant last?

A. With proper placement, excellent home care, regular dental visits, and good overall health, dental implants should be permanent.

Q. What are wisdom teeth?

A. Wisdom teeth are the third molars.

Q. Why is it necessary to remove wisdom teeth?

A. It is necessary to remove wisdom teeth to avoid problems, such as an impacted tooth destroying the second molar.

Q. Why do wisdom teeth cause problems?

A. Wisdom teeth generate problems because the shape of the modern human mouth is too small to accommodate these teeth, and they become impacted or unable to come in or move into their proper place.

Q. What problems occur from impacted third molars?

A. Partially erupted wisdom teeth are breeding grounds for bacteria and germs that may cause infection. Cysts and tumors may grow on trapped wisdom teeth.

Q. How is a wisdom tooth removed?

A. Wisdom teeth are removed by surgery. The gum tissue over the tooth is removed, the connective tissue is stripped gently away from the tooth and bone, the tooth is removed, and the gum sutured.

Q. When are lasers used in dentistry?

A. Lasers are used in oral surgery, gum surgery, tooth whitening, cancer sore treatment, and the treatment of gums that have been diseased.

FAQs on Dentures, Seniors Dentistry, and Woman's Oral Health Needs

Q. How do you clean your dentures?

A. In cleaning your dentures, you should first rinse away loose food particles thoroughly. Then moisten your toothbrush and apply denture cleanser. Brush every surface, scrubbing gently to avoid damage.

Q. Why do your teeth seem darker as you age?

A. Your teeth may seem darker because plaque can build up faster and in larger amounts as you age. Changes in dentin can cause your teeth to appear a little darker as well.

Q. Why does your mouth seem dry?

A. Dry mouth is a common problem among seniors. It is caused by certain medical disorders and is often a side effect of some medications.

Q. Are seniors more susceptible to gum disease?

A. Yes. The severity of gum disease may be increased due to ill-fitting dentures or bridges, poor diets, poor oral hygiene, other medical diseases, and even some medications.

Q. Why do seniors lose their sense of taste?

A. Seniors tend to lose their sense of taste because age decreases the sense of taste and smell. Certain diseases, medications, and dentures can also contribute to the decrease of your sense of taste.

Q. Should seniors be worried about cavities?

A. Yes. The majorities of seniors have tooth-root decay and are more susceptible to cavities.

Q. Why should women be more careful with their oral health?

A. For many women, dental care depends on their different stages of life that are directly related to surges in sex hormone levels. Your dentist may request to see you more frequently during hormonal surges.

Q. How do oral contraceptives affect women's oral health?

A. Gingivitis may occur with long-term use of oral contraceptives because they contain estrogen or progesterone. Women who use oral contraceptives are two times as likely to develop dry sockets and require dental care more often.

Q. How does pregnancy affect oral health?

A. There is an increase in the amount of plaque on your teeth due to pregnancy because there is an increase in estrogen and progesterone.

Q. How does morning sickness affect oral health?

A. The acid in vomit causes tooth erosion. Women can neutralize the acid by using a baking soda and water paste and rubbing it on their teeth. Rinse the paste off after 30 seconds and then brush and floss.

Q. What is the likeliness of having tumors during pregnancy?

A. Women are at risk for developing pregnancy tumors that are benign growths that develop when swollen gums become irritated. The tumors usually shrink soon after the pregnancy is over.

Q. How does plaque build-up affect pregnant women?

A. If plaque is not removed, it can cause gingivitis and women with periodontal disease may be at risk for pre-term, low-birth weight babies.

Q. What problems occur for girls experiencing puberty?

A. The surge in hormones that occurs during puberty may cause swollen gums, especially during menstruation. Herpes-type lesions and ulcers can also develop. They may also experience sensitive gums that react more to irritants.

Q. What are intraoral cameras?

A. An intraoral camera is a miniature video camera that the dentist places in the patient's mouth so that together they can view any dental problems that the patient is having. The image from the camera is enlarged and sent to a monitor for viewing.

Q. What is the purpose of intraoral cameras?

A. The purpose behind intraoral cameras is to allow the patient to see the specific area that needs treatment so that they are more likely to understand the dentist's recommendation and accept it.

Q. How can CD-ROM be beneficial in dentistry?

A. CD-ROM is beneficial in dentistry because patient education will be much simpler with information stored on CD-ROM. Procedures can be explained to patients in advance and post-operative instructions can be provided for them to take home.

How Pregnancy Affects Your Dental Care

Thinking about your baby and prenatal care is normal during pregnancy; however, thinking about your oral health and dental care may not be forefront on your mind, but dentistry is still very important. Women need to pay special attention to their teeth and gums especially during pregnancy to avoid the increased risk of dental problems.

Your changing body and changing dental care needs during pregnancy

Pregnancy brings a change in oral health and hormones, especially increased levels of estrogen and progesterone, which are linked to plaque buildup on teeth. Plaque that is not removed can cause gingivitis and swollen gums that are tender and prone to bleed. Most pregnant women experience gingivitis to some degree, but it doesn't usually surface until the second trimester.

If you had gingivitis before becoming pregnant, your condition will likely be aggravated; untreated gingivitis can lead to a more serious problem—periodontal disease. Swollen gums that become irritated can also lead to pregnancy tumors, benign growths that will usually shrink and disappear without treatment. However, if the tumor causes discomfort or interferes with chewing or brushing, the dentist may suggest removing it.

Special preventive dental care tips for pregnant women

  • Brush at least twice a day with fluoride toothpaste and after each meal, if possible.
  • If brushing your teeth causes morning sickness, rinse with anti-plaque and fluoride mouthwashes or water.
  • Pay close attention to your gum line and keep it clean.
  • Floss daily.
  • Focus on nutrition, including plenty of vitamins C and B12.
  • Visit your dentist for a check-up and cleaning in both your first and second trimesters to control plaque and maintain good oral health.

Handling dental care emergencies during pregnancy

If you experience dental emergencies causing pain, you can be treated at any time; however, consult your doctor if anesthesia is required or a medication is prescribed to you. Avoid X-rays during pregnancy, unless they are critical to emergency treatment.

It is recommended to schedule elective procedures after your baby's birth. While you're expecting, have great expectations for maintaining good oral health. By doing so, you'll keep your beautiful smile and share it with your baby!

By Brian J. Gray, DDS, MAGD, FICO

New Dental Care Technology and Your Teeth

The world of modern dentistry is embracing exciting advances in technology for increased patient comfort, care, and convenience. Here are some ways dentistry is taking oral care into the new millennium:

Air Abrasion

High-speed delivery of "blasting particles" to a decayed tooth can replace the drill in many cases. The fine stream of air and aluminum oxide provides dentists with a more precise tool for removing decay quickly, without damaging surrounding sections of the tooth. This exciting dental treatment is also a plus for patients because it normally doesn't require any local anesthesia. While air abrasion may not be suitable for large areas of decay or the removal of silver fillings, it can be used to repair tiny cracks, remove stains, and smooth the tooth surface so that bonding materials adhere to the tooth.

Intra-Oral Cameras

A tiny camera inserted into the patient's mouth allows the dentist to show the patient the exact nature of the problem. The image is enlarged and sent to a monitor that the patient and doctor view together. When patients can see the specific area in need of treatment, they're more likely to understand and accept the dentist's recommendation.

Lasers

Research continues at a fast pace in laser dentistry. Lasers have been used for years in a limited capacity, but their role in oral surgery is likely to increase.

Digitized X-Rays

Computerized technology will allow a small sensor inside the patient's mouth to take the X-ray and immediately display it on a computer screen, eliminating film and darkroom processing, and reducing the radiation exposure for the patient.

Computers

There is a growing recognition of the role that computers can play in dental care. In the future, patient records may be kept on computer disks, including visual images captured on intraoral cameras. A computerized workstation beside the patient's chair will give the dentist the ability to view the patient's history from disk. The dentist might also use a voice-recognition system to ask the computer to assist in finding that data, or generate a "before and after" image so the patient can preview the result of dental treatment before it is done.

CD-ROM

Patient education will be a snap with information stored on CD-ROM. Procedures can be explained to patients in advance and post-operative instructions can be provided for them to take home.

With a new hi-tech face on modern dentistry, patients can look forward to a new face in dentistry and greater comfort with more byte!

By Brian J. Gray, DDS, MAGD, FICO

Seniors – Age Brings Changes in Dental Care Treatment

It's an indisputable fact: our bodies change as we get older and so does our need for dentistry. These changes take different forms in different people, depending on our inherited physical traits, our lifestyle and nutritional habits, and our medical conditions.

Age brings changes in oral health and your need for dental care, too. There are some specific areas where seniors need to pay close attention to protect and extend their oral health.

Tooth Color

Plaque is an invisible layer of bacteria that forms on our teeth and can trap stains at any age. But as we get older, plaque builds up more quickly and is harder to remove. At the same time, the tissue that lies underneath the tooth enamel, called "dentin," is changing, and those changes can make teeth appear darker. Finally, decades of consuming coffee, tea, or tobacco leave stains that build up over time.

Daily brushing and flossing are important, particularly first thing in the morning and just before bed, to combat the plaque that builds up overnight. You may also want to consult your dentist about using commercial rinses that remove plaque.

Dry Mouth

Many seniors experience a reduced flow of saliva, sometimes as a side effect of medications such as painkillers or decongestants. For some, the lack of moisture inside the mouth can lead to sore throats, a burning sensation, hoarseness, or difficulty swallowing. In addition, if you leave dry mouth unattended, it can damage teeth, since saliva's natural rinsing keeps bacteria washed away from teeth and gums. Sugar-free chewing gum and hard candy will stimulate natural saliva, and artificial saliva and oral rinses will provide much-needed relief. Ask your dentist which commercial products are the best for you.

Cavities

If your gums begin to recede, the portion of the tooth that used to be below the gum line is now exposed. Roots are softer than tooth surfaces and are susceptible to decay; they are also likely to be sensitive to hot and cold beverages and food. Most people over age 50 suffer from some form of dental care disease. Make sure you take good care of teeth and gums with daily brushing and flossing. A word of caution: your gums may be starting to thin. Brush thoroughly but gently to keep from tearing your gums.

Fillings

Your fillings are getting older, too. They can weaken or crack, or your tooth may decay around the edges of the filling. As a result, bacteria can seep into your tooth, causing more decay. Regular check-ups will give your dentist the chance to keep an eye on your existing fillings.

Gum Disease

Daily cleaning and good nutrition are critical for healthy gums. When gums become infected and diseased, they set off a chain reaction that can result in losing teeth or weakening the jawbone. Either condition creates more problems for your health and increases your medical costs. Contact your dentist if your gums become red or you have bleeding gums.

Good Nutrition

What you put into your mouth has a direct impact on the health of your mouth—and the health of the rest of your body. As you age and your lifestyle changes, keep your nutritional goals in mind. Balanced meals are one the best ways you can contribute to your own good health.

Regular Exams

The dentist will check your mouth, teeth, and jaw for any problems. You should also mention any sores, swelling, or pain you might be experiencing or if you have diabetes or other medical conditions. Regular checkups enable the dentist to spot problems early. Early resolution of problems will help you keep your natural teeth.

Good dental care, regular check-ups, and good nutrition are the keys to really keep you smiling in your golden years!

By Brian J. Gray, DDS, MAGD, FICO

The New Dentistry and Medicine – A Partnership for Your Oral Health

A world of opportunities for dental health awaits us in the new dentistry. Using the old dentistry, dental care professionals did their best to provide a high quality of service given the state of knowledge and technology at that time.

Through advancements in treatment, research, and the desire of the dental care profession to do more and do it better, the new dentistry has emerged giving you a better smile. It is based on a foundation with specific characteristics that are of great benefit to us as consumers.

Efficiency

Your time and your resources are valuable to you, and your dentist recognizes this. New dentistry treatment techniques and methods have considerably reduced the amount of time that the dental care now takes. The return on your investment in dental health is excellent.

Comfort

Not only are the dental chairs and the dentistry office environment more comfortable and pleasant, improvements in the use of local anesthetics and new equipment provide more comfort than ever before.

Collaboration

The dental relationship is now based on the value that you can derive from your dentistry team and what you want for your dental future rather than just on the techniques and procedures your dentist can do. Through dental continuing education, your dentist has the skills and knowledge to help you make decisions for your dental health in a positive and informed way.

Predictability

New materials and advances in treatment provide you with opportunities to maintain your dental health throughout your life. With the innovative cosmetic and specialized dentistry approaches to reclaiming teeth that formally would be lost, your dentistry professional can help create and maintain teeth and gums. Predictable treatment, effective prevention methods, and the longevity of treatment are now part of any treatment plan.

Thoroughness

Advances in assessment and diagnosis now enable dentists to make thorough evaluations of your overall dental and oral health. The outcome is a plan for your health that will give you peace of mind, knowing you can have a well-informed dentistry plan in place.

Prevention

This characteristic of the new dentistry has received much publicity in recent years. It has been proven over and over again that there are several measures that you can take as a consumer of dental care to create and maintain your dental health in collaboration with your dental team. It bears repeating again—flossing and brushing combined with regular dental hygiene checks are your greatest allies in maintaining your teeth and a bright smile.

Precision

The new dentistry utilizes instruments and technologies that are far advanced from what was available even 15 years ago. Both general dentists and specialists have access to technologies that provide precision in diagnosis and treatment. The value for you is higher quality care.

The dental profession has established a strong foundation for a pleasant smile and a healthy dental future for all of us. Dentistry improvements are continuously being made to this foundation. You can choose to avail yourself of these improvements by asking your dentist, "What can help me to maintain my dental health?" They have the knowledge and the desire to help you.

By Brian DesRoches, PhD

Toothache – Why Won't My Tooth Pain Go Away?

Technology in dentistry now offers attractive options in dental fillings for cavity restorations in dental care. Called composites, these new tooth-colored dental fillings are excellent choices for front teeth and other repairs that might be visible. Composites duplicate the natural appearance of a tooth in restoring decayed teeth or repairing a defect and giving you a more attractive mouth.

What dental care material is used in the Composite Filling?

Dental fillings composites are made from a mixture of microscopic plastic and ceramic resin particles. Another type of tooth-colored dental fillings used in dental care are called a resin ionomer, which releases fluoride useful for preventing tooth decay.

Besides their cosmetic value, what other benefits do Composites provide in dental care?

The bonding process used in restoration provides strength to the tooth, making it more structurally sound. It also seals the tooth, decreasing the chance of sensitivity to hot and cold. Some composites made with materials releasing fluoride are ideal for treating root decay, a condition when gums recede, exposing tooth roots to more cavity-causing plaque. These fluoride-releasing materials also are useful dental fillings for decayed baby teeth.

What is the process for dental care treatment?

Following removal of the decayed area, a mild acid solution is used to prepare the tooth's surface for bonding and dental fillings. A bonding agent is then brushed over the surface. Several layers of the composite are applied during the next dental care process. For a natural appearance, the dentist matches the color of the dental fillings composite to the tooth.

Then, it is chemically hardened or cured with a special light and finally polished for a natural-looking finishing touch.

How durable are these dental fillings?

In a five-year clinical study of dental care, some of the resin materials demonstrated 100% effectiveness for adhesion and retention. Like other types of dental fillings, they may require periodic replacement. While the material is very durable, they may not perform quite as long as silver fillings or amalgams for their resistance to the rigors of grinding and chewing.

Scheduling dental care on a regular basis is an important part of good oral hygiene. Your dentist will check your fillings each time to ensure their performance.

By Brian J. Gray, DDS, MAGD, FICO

What Occurs in Your Mouth during a Dental Care Examination?

During a dentistry examination, the dentist examines the mouth mucosa (soft tissues) for any abnormalities or pathology (including oral cancer), the teeth for tooth decay (dental caries) or defects, the gum tissues for periodontal (gum) disease, the neck for swollen lymph nodes, the amount of plaque, tartar (dental calculus), and debris on teeth, as well as the need to replace any missing teeth or dental prostheses.

The dental examination begins with a complete dental care and medical history, including medications the patient currently is taking. The skin of the face and neck is examined for any abnormalities, especially pigment changes. The lymph nodes in front and behind the ears, under the floor of the mouth and chin, and the midline of the neck, sides, and back of the neck are palpated to determine if any swelling or tenderness is present.

Inside of the mouth, the lips, cheeks, gums, and roof of the mouth are inspected and palpated. During this process, the tip of the tongue is placed on the roof of the mouth just behind the upper teeth for inspection of the front floor of the mouth and sides of the tongue.

The back floor of the mouth, the area behind the lower wisdom teeth, and the back sides of the tongue are inspected by grasping the tip of the tongue with a small gauze sponge and pulling the tongue forward and toward the opposite side of the mouth.

To inspect the back of the throat, soft palate, and tonsil area (sides of the throat), the tongue is depressed with a dental mirror or tongue blade and then a deep breath is taken by the patient.

To detect swelling on the floor of the mouth, the area inside the mouth is felt with the finger of one hand while a finger of the other hand feels below the chin. Salivary gland enlargement, saliva flow, or xerostomia (dry mouth) are determined by milking the major salivary glands to assess the quantity and consistency of saliva.

Today's dentist has many analytic tools available to pinpoint dental and oral diseases. The basic tools are the dental instruments, lights, and radiographs (X-rays). Depending upon the dentist and the individual's dental needs, additional diagnostic tests are available. Testing for essential proteins and buffering capacity can evaluate the protective ability of saliva.

To determine mouth carries risks, microbiological testing of saliva can measure the level of caries-producing organisms. Periodontal susceptibility tests, which test for the DNA of gum disease-producing organisms, can be performed to assess an individual's risk for gum disease.

If removable dentures are present, they are checked for bite, retention, stability, and overall fit. Dental impressions or models also may be taken to study the mouth and tooth structures to initiate fabrication of prostheses. Photographs may be exposed for a variety of reasons, including before and after treatment comparisons.

The level of oral hygiene and home care practices are assessed and reviewed. Recommendations for home care devices and products may be made. Instruction and methods for maintaining a good oral hygiene regimen can also take place.

Once basic information about oral health status is gathered, the dentist will be better able to discuss dental treatment alternatives that are available.

By Denise J. Fedele, DMD, MS

General Dentistry

Child Dental Emergencies

Uh-oh! A dental emergency! If a dental emergency should happen to your child, please remember to act quickly. Stay calm—a parent's apprehension can be transmitted to the child. Bring the child to us with the tooth replanted or kept moist in transit. We'll take care of you immediately.

A child, learning to ride a two-wheeled bicycled, loses her balance, falls, hits a rock, and knocks out a front tooth. What do you do?

If the tooth is replaced in the tooth socket immediately, the chances are good that this tooth can be maintained for many years.

Do something and do it now

The success of this replantation procedure is directly related to how soon the tooth is replaced in its socket. If possible, just rinse the tooth with tap water and gently replace the tooth in its socket and come to the office. Otherwise, wrap the tooth in a clean, moistened cloth—or put it in a cup of water or milk—and get to the dentist, now. Never scrape the tooth or allow it to dry out.

Remember, time is of the essence

If the tooth is left out of the mouth for more than 30 minutes, the chance for successful replantation drops significantly.

We consider replantation successful if we can keep the tooth in position at least during a child's growth period. By maintaining the space, the replanted tooth prevents tipping of adjacent teeth. If it's necessary to replace the injured tooth, it's much easier to do it when the child is older—when all the permanent teeth are in.

The good news is that we have bonding and dental implant techniques today for tooth replacement and new materials to fill in for a lost tooth.

Computerized Dental Radiography

These days, computers are really changing the way we live and work. You've probably experienced their impact in your own home. And believe me, technology is also helping raise our dental practice to a new level of safety, accuracy, and comfort.

Keeping up with all these advances is a full-time occupation that's as important as my work at chair side. One of the most promising of these breakthroughs is an improvement on the oldest evaluation technology we have—dental x-rays.

For close to a century, dentists have used x-rays to detect cavities and damage invisible to the eye. We've long been aware of the drawbacks. Though x-ray radiation is slight, many patients find it a cause for concern. And reading the negative requires a skilled, professional eye—which means my patients can't see what I see.

That's why my office uses a Computed Dental Radiography System as an x-ray alternative. A computer enhances a "photo" of your teeth and shows it instantly on a screen. This new system requires 90% less radiation than the old film x-rays, and can magnify the image up to 300 times. It's as easy to read as a snapshot. When I discuss something I see in your mouth, you'll be able to view it right along with me.

This is an exciting time to be a dentist. We're re-thinking and refining virtually every aspect of our dental practice, and I wanted to pass a bit of it along to you.

Dental Care and a New Diagnostic Tool for Mouth Cancer

According to the American Cancer Society, about 30,000 new cases of mouth cancer are diagnosed annually in the U.S. About half of those who have oral cancer die within five years. Early detection can make a dramatic difference in treating the cancer at curable stages and reducing oral cancer deaths.

Early detection capabilities recently have been enhanced by a new computer-assisted mouth cancer screening tool. A nationwide study of 945 patients ranging in ages from 18 to 83 was conducted by dentists at 35 U.S. academic dental care sites.

Brush biopsy specimens were obtained from oral lesions as part of the extensive research, testing the accuracy of computer-assisted diagnostic equipment. The brush biopsy caused little or no bleeding and no anesthetic was required. The computer-assisted image analysis was used to identify suspicious cells in the samples.

The computer analysis properly identified every case of pre-cancerous and cancerous lesions as confirmed by lab tests from their traditional tissue evaluations. Additionally, it also correctly identified some lesions that were benign in appearance, but were actually found to be pre-cancerous or cancerous. Had it not been for this new diagnostic equipment, these lesions would have escaped detection and the patient would not have received any additional oral cancer testing.

"Early evaluation of oral pre-cancerous lesions can have a dramatic impact on oral cancer mortality rates," says Dr. James J. Sciubba, DMD, PhD, professor of Oral and Maxillofacial Pathology at State University of New York at Stony Brook, who also serves as a spokesperson for the study. Early-stage mouth cancers are not easily detectable by visual inspection and may be overlooked.

The oral cancer scanner provides dentists a new evaluation tool that can lead to a significant reduction in cancer deaths. An estimated 8,100 people will die from mouth cancer this year. This new dentistry tool has shown remarkable merit as a reliable dental health device. By providing an accurate diagnosis, it has become a crucial weapon in the fight against oral cancer.

By Brian J. Gray, DDS, MAGD, FICO

Dental Emergencies and First Aid Procedures

The following first aid procedures are important steps for handling dental emergencies or facial injuries. They provide temporary relief and help in their proper repair or healing. As with any injury, always follow up with personal care from your dentist or physician.

Bitten Tongue/Cut Lip

Clean gently with a cloth. Apply cold compresses to reduce swelling. If bleeding is severe, go to an emergency services provider. After bleeding has subsided, rinse with warm salt water.

Broken Jaw (Possible)

Don't move the jaw. Secure it in place by tying a scarf, necktie, or towel around the jaw and over the top of the head. Apply cold compresses to reduce any swelling. See your dentist or emergency services provider immediately.

Broken Tooth

Rinse the mouth with warm water. Try to remove any dirt, blood, or debris from the injured area using sterile gauze or a clean cloth and warm water. Apply cold compresses on the face next to the injured tooth to reduce swelling. See the dentist immediately. Place the broken piece in a small container of whole milk.

Knocked-Out Tooth

Annually, more than two million teeth are knocked out accidentally; more than 90% of them can be saved with proper treatment.

Holding the tooth from the crown (top part), rinse off the root. Don't scrub or remove any attached tissue fragments. Gently hold the tooth in its socket. (Young children may accidentally swallow; use your judgment.) If this isn't possible, place the tooth in a cup of cold whole milk. Avoid using low fat milk, powdered milk, or milk products like yogurt. Never put the tooth in mouthwash or alcohol. Avoid scrubbing the tooth or touching the root end. Get to the dentist immediately (within 30 minutes) and take the tooth!

Objects Trapped between Teeth

Try gliding dental floss between teeth (dental tape is often useful in removing shredded dental floss.) Sometimes tying a small knot in the floss may help, too. Avoid using any sharp or pointed objects. See a dentist if object can't be removed.

Toothache

Toothaches can result from different causes. Rinse mouth with warm water. Remove any food trapped between teeth with dental floss. Avoid applying aspirin on the tooth or gum tissues. If a cavity is suspected, insert a small cotton ball or cotton tip soaked in oil of cloves (eugenol). Do not cover a cavity with cotton if there is facial swelling or pus. See a dentist as soon as possible.

Always consult with a dentist if you have questions regarding any dental problem.

By Brian J. Gray, DDS, MAGD, FICO

Dental Waterlines

Have you heard about biofilm? Our dental office monitors it daily. Possibly you'll catch something on TV about biofilm as some sort of newly discovered health threat. It's neither, really. Here are the facts:

Most of our dental equipment is connected to long, flexible tubes that deliver water to your mouth. We call these tubes dental waterlines. Every day, fresh water rushes through them. But overnight or over the weekend, water trapped in these long tubes has the potential of being colonized by a thin layer of microorganisms.

Those microorganisms are biofilm. It's just as important we keep our waterlines free of biofilm as it is you keep your teeth free of plaque through regular brushing.

We've known about biofilm for years. Every morning, all our waterlines are cleared before the first patient arrives. Our dental chairs are equipped with check valves that make sure waterline delivery goes only one way—into the mouth and down the drain.

All this to combat a health hazard that is so far only theoretical—we have no evidence of illness related to water from a dental waterline. Even if it existed, the marginally higher bacteria counts wouldn't necessarily pose a hazard to healthy patients. Bacteria is everywhere: in drinking water, the air we breathe. Getting rid of it is the job of our immune systems.

News organizations love to discover what they believe to be health threats, because it keeps viewers tuned in. But biofilm (if it exists at all) is something we've known about and protected patients against for years.

Dental X-Rays

Taking X-Rays Seriously

We do believe the judicious use of dental x-rays is in our patients' best interests. And you deserve to know why.

X-rays aren't just another part of our office routine. We rely, first and foremost, on a clinical examination—that is, we look inside your mouth. Then we ask ourselves, what information do we expect to find with X-rays that will benefit this patient? If there is no good answer, we won't recommend X-rays.

X-Rays: What You Should Know

  1. New X-ray equipment reduces the size of the beam, and eliminates "scatter"-photons bouncing around the room.
  2. Fast film requires much less exposure time.
  3. Lead aprons are almost 100% effective against exposing other parts of your body to radiation.
  4. We monitor our equipment faithfully to keep timers precise and everything up to snuff.

We work with X-rays every day—they are our "eyes." There would be a very different kind of dentistry without them.

As a Consumer, You Can Protect Yourself Too!

Feel free to ask us why you need an X-ray. Don't insist on it just because "it's time." Let us know when you are having X-rays for medical reasons. If you move, or we refer you to a specialist, ask for your X-rays to be sent to your new doctor.

Dentist Office Fear? Find a Dentist Who Makes You Feel Comfortable

The dentist office may feel like a scary place to many people, but there's no reason to dread a dental appointment. In fact, the consequences of avoiding the dentist's office can be a lot more frightening!

The dental office is where you'll get the regular dental hygiene that will prevent future dental problems. A dental hygienist will give you a teeth cleaning about twice a year. Kids can get fluoride treatments, and patients with gum disease can get periodontal cleaning. Every dental patient also gets a dental exam by a dentist, who looks for any current dental health issues or signals of future oral health problems.

If you don't already have a dentist, you should seek to find a dentist office where you will feel safe and comfortable. Look for a dentist who is caring and experienced, a staff that is friendly and supportive, and an atmosphere that is welcoming and relaxing.

During your first dentist appointment with a new dentist, you'll probably get your teeth cleaned. The dentist exam will be quick and easy, and you may also get dental x-rays. If the dentist sees teeth problems that need to be addressed, you'll work together to develop a treatment plan.

Early Dental Practices

Every science has its beginnings in myth and folklore. Early dental practices, in particular, are deeply tied to the mysticism surrounding the teeth and tongue. Because the mouth is the center of speech and nourishment, diverse cultures treat dental events in their lives with respect.

There is a universal human belief that teeth confer power. These remedies and practices were intended to cultivate that power by keeping teeth for a lifetime. The same spirit—much refined—motivates modern dentistry.

Toothache

For relief, boil earthworms in oil and pour into the ear on the side where there is pain (Pliny, 77 AD).

Pour juice of onions by drops into the mouth, bite a piece of wood struck by lightning (ibid.).

Put tobacco in the armpit; hold a heated root of a birch on the cheek; or hold a small frog against the cheek or lick a toad's abdomen (Norwegian folklore).

Lay roasted parings of turnips, as hot as they may be, behind the ear; keep the feet in warm water, and rub them well with bran, just before bedtime (John Wesley, 1747).

Tooth Extraction

"Round the tooth to be drawn, he fastened a strong piece of catgut; to its other end he affixed a bullet. Then he charged a pistol with this bullet and a full measure of powder. The firing performed a speedy and effectual removal of the offending tooth" (Dr. Monsey, 1788).

In the US and Europe, the blacksmith did extractions, presumably because they had the "proper tools."

"If one had a tooth extracted, it must be burned, because, if a dog got it and swallowed it, one would have a dog's tooth come in its place" (Dr. Holmes, 1862).

Tooth Cleaning

To clean the teeth, rub them with the ashes of burnt bread (Poor Will's Almanack, 1780).

To stable and steadfast the teeth, and to keep the gummes in good case, it shall be very good every day in the morning to wash well the mouth with red wine (London, 1598).

In parts of England, the superstition persists: one prevents a toothache by "clothing one's right leg prior to the left" (G.P. Foley, 1972).

Tooth Growth

To make the teeth of children grow hastily, take the brain of a hen and rub the gums therewith. It shall make them grow without any sorrow or diseases or aching (London, 1934).

Roast the brains of a rabbit and rub a small amount on the gums (US, 1942).

Find a Dentist to Help You Answer Why I Have a Toothache

There are many causes of toothache and pain in the area of the mouth. When experiencing pain and/or swelling, it is important to see your dentist to have the area evaluated. The pain and/or swelling is most often related to a disease process that originates within a particular tooth.

The pulpal tissue within the tooth can be irritated by bacteria, external traumatic events, repetitive or extensive dental care procedures, or even periodontal disease causing a toothache. When this irritation occurs, the pulpal tissue reacts by becoming inflamed.

Since the pulpal tissues and the tissues supporting the tooth have a rich supply of nerve fibers, the inflammatory process can cause pain as these nerve pathways are stimulated. Additionally, the pulp tissue is encased inside tooth structure and it cannot swell and expand in reaction to injury like tissues in other areas of the body.

When the injured pulp tissue attempts to swell within the confined root canal space, the pressure buildup can cause a significant toothache.

Pain originating from the dental pulp can be either "spontaneous" or "elicited." Spontaneous pain occurs without an identifiable stimulus, whereas elicited pain occurs only in specific situations. Elicited pain requires a specific stimulus such as drinking cold or hot fluids or biting on the tooth.

As is typical anywhere in the body, the initial stages of a disease process do not always cause symptoms. Millions of teeth have irreversible pulpal disease yet the patients have no clinical symptoms.

Most of these situations will become evident when the dentist obtains a thorough history, does a clinical examination, performs specific tooth tests, and takes a series of well-angulated radiographs. It is important to note that pulpal disease can refer pain to other areas within the head and neck.

If the results of the endodontic examination indicate that root canal disease is not the source of the patient's toothache, then the dentist must consider other possibilities. When attempting to identify the source or cause of facial pain and/or swelling, the dentist must consider that the symptoms could actually originate in a tooth (endodontic disease), the gum tissues (periodontal disease), the muscles (myofascial pain), the joints (TMJ), the sinuses (sinusitis), or even the surrounding vascular (blood vessels) or nerve tissues.

Facial pain requires an accurate diagnosis so that the proper treatment can be recommended. At times, various medical and dental specialists may need to be consulted before an accurate diagnosis can be determined.

By Clifford J. Ruddle, DDS, in collaboration with Philip M. Smith, DDS

Find a Dentist to Stop Bad Breath

Bad breath, or halitosis, is a signal that something is not right inside your mouth. It may be as simple as the need to pay more attention to your daily oral hygiene, or it may indicate tooth decay, gum disease, or another medical or dental health problem. Whichever it is, bad breath is a red flag: take another look at your mouth!

Commercial products claim they will make your breath fresher, but the only way to make sure your breath permanently fresh is to practice good oral hygiene. In fact, too many breath mints and hard candies with sugar will lead to tooth decay. If you are constantly using breath mints, breath sprays, or mouth rinses in an effort to cover up your bad breath, realize that you may have a medical or dental care problem that needs addressing.

There are a number of reasons you may experience a bad taste in your mouth and even be able to smell your own breath. Food may be lodged between your teeth if you are not brushing at least twice daily and flossing regularly. Food particles can be very tiny and can wedge themselves between teeth and below the gum line.

Brushing after meals is important and flossing is imperative to get at the particles that the brush can't reach. Brush your tongue or use a tongue scraper, even if it feels odd at first. Bacteria collects on the tongue and can contribute to bad breath. If you wear removable dentures, take them out at night and clean them thoroughly before you wear them again.

If you neglect your daily hygiene over time, bad breath can become a symptom of more serious dental health problems. Teeth that are not cleaned properly become a place for bacteria to reside as food particles stay in your mouth and decay. Bacteria attack your teeth and gums and cause cavities and gum disease. If this is happening, gum disease will cause an unpleasant odor.

If you are brushing and flossing on a regular basis, but are still experiencing bad breath, you may have teeth that are crooked or crowded, and it may be hard for you to clean between them. If you wear dentures that do not fit properly, they may be trapping food or irritating your mouth. Your bad breath is may be caused by another medical problem: drainage from your sinuses, gastrointestinal problems, kidney or liver problems, or other medical conditions.

Here's what you can do to investigate on your own. Write down what you're eating and notice whether your breath smells bad because of certain foods. Garlic and onions actually cause odor, but the odor is coming from your lungs as you breathe, not from your mouth itself. The odor from these foods is temporary and will be gone once the food is out of your bloodstream.

Are you dieting? Hunger can contribute to bad breath, because of the chemical changes as your body turns fat and protein into the energy it needs. Are you taking prescription or over-the-counter medications? Add these to the record of what you're eating to see whether there's a relationship between your medications and your bad breath. And don't forget to tell your dentist if there's been a change in your overall health since your last visit.

Are you suffering from dry mouth? Saliva provides constant rinsing in your mouth and washes away food particles. Your dentist may recommend more liquids, or sugarless candy to stimulate natural saliva, and perhaps some of the commercial products that are available to combat dry mouth.

If bad breath continues after you have done your best job of regular brushing and flossing, go see your dental care professional. He or she can tell you whether the odor is caused by an oral problem; if it is not, then your dentist will suggest you see your doctor for a physical check-up.

Regular dental check-ups with a dentistry professional will help keep your mouth healthy and working well. Your dentist can stop problems before they cause trouble, including problems that cause bad breath.

By Brian J. Gray, DDS, MAGD, FICO

Four Questions Your Dentist Wishes You Would Ask

The technology and treatment options for consumers of dental care have greatly improved over the last 20 years. The new dentistry now provides you with the opportunity of maintaining your natural teeth throughout your life. One of the ways this is accomplished is by referral to a dental specialist to treat specific dental problems.

When dentists refer you to a specialist, your understanding of the problem and decision for treatment is vital in determining a specialized dental plan. The plan for your dental health and your general dentist's overall goals often depend on these specialized resources.

When you are referred to a dental specialist, he or she becomes a part of your dental team. Although your specialist will give you information about the reasons for the referral and the treatment, there are also some active steps you can take to increase your participation in the dentistry treatment and healing process.

A query of dental specialists indicates that there are some questions that they would like you to ask to enhance the treatment outcomes they seek as a result of your dental plan. Answers to the following questions will often augment the information provided by your general dentist and enable you to clarify any further questions you may have about the specialized treatment you are receiving.

  1. What is the cause of the condition that you are treating?
  2. What treatment gives you the best overall outcome and how will it help you?
  3. What can you do after treatment to help the healing process?
  4. What can you do to control the condition in the future or make sure it doesn't happen again?

These four questions will help you gain insight into the disease process that led to the need for dental care treatment and the prevention and self-care measures you can incorporate into your life to avoid future problems. With this information, you can also work with your general dentist and the dental team to maintain your dental health plan.

Specialized dental care for your dental needs is one of the ways the new dentistry has brought innovations in diagnosis and treatment to benefit consumers.

By Brian DesRoches, PhD

Healthy Eating for Good Oral Health Can Stop Tooth Decay

What you eat affects your health destiny. You can dramatically impact your dental health by eating a well-balanced, healthful diet. Research has shown that poor nutrition jeopardizes our oral health, which puts you at risk for a number of serious dental problems.

The food factor for good oral health

Our food choices can make a big difference in two of the most common diseases today: tooth decay and gum disease. Certain foods, especially those containing sugar, are directly linked to increased levels of cavity-causing bacteria.

Tooth decay results when acids from the bacteria attack the teeth forming cavities. While diet doesn't directly cause gum disease, a condition affecting the supporting tissues of the teeth, researchers believe the disease is more rapid and severe when poor nutrition is a factor. Gum disease is a serious problem, since it can lead to tooth loss if untreated.

Diet and dental health

The American Dietetic Association and the National Institutes of Health recommend eating a well-balanced diet including plenty of the following:

  • fruits
  • vegetables
  • a good variety of breads and cereals
  • dairy products
  • fish
  • chicken
  • dried beans
  • peas
  • meat

Enjoying a variety of foods is the best way to get all the important nutrients needed for keeping healthy. Beware of fad diets that exclude entire food groups. This can cause nutritional deficiencies.

Snack Smart to Avoid Tooth Decay

Snacking is a favorite pastime, but certain snack choices promote tooth decay such as soft, sweet, sticky foods. Select nutritious snacks better for your teeth and general good health, especially colorful, juicy fresh fruits and crisp, crunchy vegetables. Choose your snacks based on any other dietary concerns, such as low cholesterol, low-fat, or low sodium diets.

If you snack on crackers, cookies, or chips, it's better if you eat them in combination with other foods, such as cheese with crackers, rather than alone. This is because these foods, when eaten alone, tend to produce more bacteria in the mouth leading to tooth decay. Remember, each time you snack, oral bacteria is activated. Drink plenty of water to rinse away some of the disease-causing bacteria. If possible, brush your teeth after snacking.

Select from the wide variety of foods for healthful eating—that are good for you and your teeth and be sure to check-in with your dentist.

Laser Dentistry

I'm proud to offer you laser dentistry for the treatment of many types of cavities. The laser works by emitting a specialized light that targets and destroys dental decay.

Drills are very powerful, and the vibration and the large hole produced can cause discomfort, making some type of anesthesia almost always necessary. With a laser, the light works to destroy and remove decay with no uncomfortable tooth vibration and resulting discomfort. Because the laser is so precise, the decayed part of the tooth often can be selectively removed, leaving a more healthy part of the tooth. Rather than that loud drilling sound, you hear only a gentle tapping.

More benefits of Laser Dentistry

  1. Clinical studies show that 96% of all patients—both adults and children—required no anesthesia when the laser was used to remove dental decay.
  2. No time is spent waiting for Novocain to take effect or wear off.
  3. Multiple teeth and sections of your mouth can be worked on in ONE sitting instead of having to return multiple times to have a cavity filled.

Laser treatment has proven to be appropriate and safe in over tens of thousands of applications throughout the world, and works well for young children as well as adults. Laser of technology allows us to take the fear out of going to the dentist and gets the patient actively involved in their own dental care.

Learn How Plaque and Gum Disease Relate to Older Adults

The proverbial way of referring to older people as being "long on the tooth" suggests that it is predetermined that as we get older our teeth get "longer" or "no longer." This is not true.

Periodontal disease, plaque, and loss of teeth is not an inevitable aspect of aging. Loss of attachment or bone support around a tooth is the result of a bacterial infection. What is true is that as we get older, we have more exposures to these infectious organisms, and more probability of being infected and developing periodontal disease. Half of the people over 55 have periodontal disease.

Risk factors that make older adults more susceptible to periodontal disease include:

Systemic Diseases

Certain systemic diseases such as diabetes may decrease the body's ability to fight infection and can result in more severe periodontal disease. Osteoporosis also can increase the amount and rate of bone loss around teeth. Systemic illnesses will affect periodontal disease if it is a pre-existing condition. To reduce the effects of systemic diseases on the oral cavity, maintain meticulous plaque control and visit your dental care provider routinely for examinations and professional cleanings.

Medications

Heart medications can have a direct effect on the gums by creating an exaggerated response to plaque and resulting in gum overgrowth. Antidepressants may create dry mouth and reduce the saliva's ability to neutralize plaque.

Immunosuppressants and other disease-fighting medications may reduce the body's ability to combat infection, increasing the risk for periodontal disease. The dental care provider needs to be aware of any medications you may be taking and you need to maintain meticulous plaque control and visit your dental care provider routinely for examinations and professional cleanings.

Dry Mouth

Lack of saliva can result from the use of certain medications or as a result of illness. If there is not enough saliva available to neutralize plaque it can result in more cavities and periodontal disease.

Also, dry mouth, or xerostomia, can make dentures more difficult to wear and may also complicate eating, speaking, or swallowing of food. Oral rinses or artificial saliva can be very helpful with these problems.

Frequent sips of water or eating candy may be helpful as long as it doesn't contain sugar. Fluoride rinses and gels are helpful in reducing or preventing the cavities that can be caused by having a dry mouth.

Dexterity Problems

Physical disabilities can reduce dexterity and the ability to remove plaque on a daily basis. Poor oral hygiene can increase the risk for cavities and periodontal disease.

Electric toothbrushes and floss holders are helpful in improving plaque control. Frequent professional cleanings combined with oral anti-microbial or fluoride rinses also may be helpful in reducing the incidence of cavities and periodontal disease.

Estrogen Deficiency

Older women may have some special concerns in relation to periodontal disease. Scientific studies have suggested that the estrogen deficiency that occurs after menopause may increase the risk for severe periodontal disease and tooth loss. Estrogen replacement therapy may reverse these effects.

It is important to keep teeth as we age because every tooth has an important function in chewing and speaking. They affect our appearance and self-esteem.

Having dentures or loose or missing teeth can restrict our diets, resulting in poor nutrition and systemic complications. With the advances in modern dentistry and with current prevention and treatment techniques, we must count on keeping our teeth for a lifetime—no matter how "long" that may be!

New Dentistry – A Partnership for Your Health and Well-Being

A world of opportunities for dental health awaits us in the new dentistry. Using the old dentistry, dentists did their best to provide a high quality of service given the state of knowledge and technology at that time.

Through advancements in treatment, research, and the desire of the dental profession to do more and do it better, the new dentistry has emerged. It is based on a foundation with specific characteristics that are of great benefit to us as consumers.

Efficiency

Your time and your resources are valuable to you, and your dentist recognizes this. New dentistry treatment techniques and methods have considerably reduced the amount of time that the dental care now takes. The return on your investment in dental health is excellent.

Comfort

Not only are the dental chairs and the dentistry office environments more comfortable and pleasant, improvements in the use of local anesthetics and new equipment provide more comfort than ever before.

Collaboration

The dental relationship is now based on the value that you can derive from your dentistry team and what you want for your dental future rather than just on the techniques and procedures your dentist can do. Through continuing education, your dentist has the skills and knowledge to help you make decisions for your dental health in a positive and informed way.

Predictability

New materials and advances in treatment provide you with opportunities to maintain your dental health throughout your life. With the innovative cosmetic and specialized dentistry approaches to reclaiming teeth that formally would be lost, your dentistry professional can help create and maintain teeth and gums. Predictable treatment, effective prevention methods, and the longevity of treatment are now part of any dental plan.

Thoroughness

Advances in assessment and diagnosis now enable dentists to make thorough evaluations of your overall dental and oral health. The outcome is a plan for your health that will give you peace of mind, knowing you can have a well-informed dental plan in place.

Prevention

This characteristic of the new dentistry has received much publicity in recent years. It has been proven over and over again that there are several measures that you can take as a consumer of dental care to create and maintain your dental health in collaboration with your dental team. It bears repeating again—flossing and brushing combined with regular dental hygiene checks are your greatest allies in maintaining your teeth and a bright smile.

Precision

The new dentistry utilizes instruments and technologies that are far advanced from what was available even 15 years ago. Both general dentists and specialists have access to technologies that provide precision in diagnosis and treatment. The value for you is higher quality care.

The dental profession has established a strong foundation for a pleasant smile and a healthy dental future for all of us. Dentistry improvements are continuously being made to this foundation. You can choose to avail yourself of these improvements by asking your dentist, "What can help me to maintain my dental health?" Your dentist has the knowledge and the desire to help you.

By Brian DesRoches, PhD

Research Your Dentistry and Dental Care Frequently Asked Questions

Q. What is endodontics?

A. Endodontics is the area of dentistry that specifically deals with what is called the pulp within a tooth.

Q. What is dental pulp?

A. The dental pulp is a soft tissue comprised of tiny arteries, veins, nerves, and lymph vessels for the tooth.

Q. Where does the term root canal come from?

A. The tooth is comprised of three basic components. The first component is the crown/enamel, which is seen by the naked eye.

The next level of the tooth is dentin, which is under the enamel and the "housing" for the dental pulp. The final component is the dental pulp and is the core of the tooth. This bulk of the dental pulp is in the center of the tooth or the pulp chamber, and is connected to the Mandibular Canal through the root canals. The root canals are like veins for the dental pulp.

Q. What does the procedure root canal mean?

A. Root canal has become a term for a procedure involving the dental pulp. When the dental pulp has been exposed and damaged, it must be treated professionally and this process is usually referred to as getting a root canal.

Q. What does a root canal procedure entail?

A. Once the dental pulp has been infected, it must be removed from both the pulp chamber and the root canals. Once it has been removed, the pulp chamber and root canals are thoroughly cleaned and enlarged. Based on the level of infection, the dentists may choose to clean the area more than once. After the area is free of infection, the dentist will fill the root canals and pulp chamber with a filling that will prevent any bacteria from entering the area. Finally, the dentist will place a crown over the tooth to restore it to its original shape.

Q. What causes dental pulp to become damaged or infected?

A. Normally, when a deep cavity occurs, it exposes the dental pulp to the bacteria inside the mouth. When exposed to this bacteria, the dental pulp can become infected and thus cause the inside of the tooth to be infected.

Q. What can happen if infected dental pulp is not treated?

A. Overtime, the infected pulp will die. At the same time, pus from the infection will develop at the base of the tooth and cause an abscess to form. If this occurs, it is not uncommon for the abscess to cause the bone holding the tooth to deteriorate. If this deterioration becomes too severe, the tooth will fall out.

Q. What role does the computer play in the dental care industry?

A. In the future, patient records may be kept on computer disks, including visual images captured on intraoral cameras. A computerized workstation beside the patient's chair will give the dentist the ability to view the patient's history from disk.

Also, the dentist might use a voice-recognition system to ask the computer to assist in finding that data, or create a "before and after" image so the patient can preview the result of dental work before it is done.

Sterilization of Dental Equipment

The times are trying enough without having to worry about a visit to the dentist. There is much talk about the transmission of disease in any given medical environment. Well, we're here to say dentistry in our practice still is a safe and healthful experience. And it's not just a matter of trust.

It took the AIDS epidemic to bring it to the public eye. But we've been guarding against it at our dental office since the day we opened our doors.

I'm talking about communicable disease. AIDS is the one you hear most about, but there are others. A quiet new killer (HCV, hepatitis C virus) currently infects about four million Americans who will never be able to rid themselves of it. Here at the office we're also aware that hepatitis B, tuberculosis, influenza—even the common cold—are communicable. The good news is that the same strict standards of asepsis (cleanliness) we use against one disease also defend us against all the others.

You may not be aware of all we do to ensure your protection from cross-communicated viruses during your dental care. In fact, it's a large part of our day, and we're committed to the task.

We use disposable items wherever we can. Every surface in the operatory is secured against airborne bacteria with physical barriers. Our sterilization procedures are complex, monitored by an outside agency, and, not incidentally, much more than OSHA, the American Dental Association, the Centers for Disease Control, and local agencies require.

Metal instruments are cleansed in an ultrasonic bath before autoclaving in chemical pressurized heat. Handpieces, for instance (you know them as drills), take an hour's preparation—heat-treated then cooled—for each patient. We disinfect everything in sight.

All this costs, but it's worth it.

We wouldn't be here if we didn't care about you, your health, and your good looks. We want you to feel comfortable, all the time. Please ask about our sterilization program and we'll be more than happy to show you what we're doing.

You know we care about open communication in our dental office. This letter is another way we hope to show it.

Toothache Causes

An aching tooth you get from a cavity is no fun, but it's something that can be easily seen and quickly solved. Unfortunately, toothaches also stem from problems that aren't so easily recognized.

Tooth pain can be a little like that weird noise your car engine makes but always disappears the moment you drive it into the repair shop.

A tooth that aches only in the morning may be the result of overnight tooth grinding (bruxism). Bruxism is quite common, and has the potential of deteriorating tooth enamel. But it's also treatable. Occasionally a patient will experience some hot/cold sensitivity after a new filling or crown. That's normal, and should go away after a few days. If it doesn't, the problem may lie elsewhere. And we want to know about it.

There's also pain from "root surface sensitivity." This can result from years of brushing teeth too hard, "heartburn acid" which enters the mouth overnight and attacks the enamel of your teeth, receding gums, or periodontal pockets of infection. A toothache may even be the result of a microscopic crack in a molar. These pains are not easy to pinpoint, and often require that you and I work together to help determine the actual cause.

And, yes, toothaches come from decay. But whatever the reason, if you're experiencing tooth discomfort, call the dentist so we can help you solve the mystery of an achy tooth. With all the resources at our disposal, an aching tooth is something no one should have to live with.

What Occurs During a Dental Examination

During a dental examination, the dentist examines the soft tissues of the mouth for any abnormalities or pathology (including oral cancer); the teeth for tooth decay or defects; the gum tissues for periodontal (gum) disease; the neck for swollen lymph nodes; the amount of plaque, tartar, and debris on teeth; as well as the need to replace any missing teeth or dental prostheses. Regular examinations by a dentistry professional are crucial to maintaining your dental health and are a necessity in any dental care plan.

Dentists begin the dental examination with a complete dental and medical history, including medications the patient is currently taking. The skin of the face and neck is examined for any abnormalities, especially pigment changes. The lymph nodes in front and behind the ears, under the floor of the mouth and chin, and the midline of the neck, sides, and back of the neck are palpated to determine if any swelling or tenderness is present.

Inside of the mouth, the lips, cheeks, gums, and roof of the mouth are inspected and palpated. During this process, the tip of the tongue is placed on the roof of the mouth just behind the upper teeth for inspection of the front floor of the mouth and sides of the tongue.

The back floor of the mouth, the area behind the lower wisdom teeth, and the back sides of the tongue are inspected by grasping the tip of the tongue with a small gauze sponge and pulling the tongue forward and toward the opposite side of the mouth.

To inspect the back of the throat, soft palate, and tonsil area (sides of the throat), the tongue is depressed with a dental mirror or tongue blade and then a deep breath is taken by the patient.

To detect swelling on the floor of the mouth, the area inside the mouth is felt with the finger of one hand while a finger of the other hand feels below the chin. Salivary gland enlargement, saliva flow, or xerostomia (dry mouth) are determined by milking the major salivary glands to assess the quantity and consistency of saliva.

Today's dentist has many analytic tools available to pinpoint dental and oral diseases. The basic tools are the dental instruments, lights, and radiographs (X-rays). Depending upon the dentist and the individual's dentistry needs, additional diagnostic tests are available. Testing for essential proteins and buffering capacity can evaluate the protective ability of saliva.

To determine tooth decay risks, microbiological testing of saliva can measure the level of decay-producing organisms. Periodontal susceptibility tests, which test for the DNA of gum disease-producing organisms, can be performed to assess an individual's risk for gum disease.

If removable dentures are present, dentists check them for bite, retention, stability, and overall fit. Dental impressions or models also may be taken to study the mouth and tooth structures to initiate fabrication of prostheses. Photographs may be exposed for a variety of reasons, including before and after treatment comparisons.

The level of oral hygiene and home dental care practices are assessed and reviewed. Recommendations for home care devices and products may be made. Instruction and methods for maintaining a good oral hygiene regimen can also take place.

Once basic information about dental health status is gathered, the dentist will be better able to discuss dental care plans that are available.

By Denise J. Fedele, DMD, MS

Your Dental Visit

When you first visit a new dentist, part of your initial exam is an assessment of your "bite"—the way teeth meet as the jaws close. Later, after a filling or placement of a dental crown, your bite will be tested again to be sure the tooth restoration fits well with other teeth. Nearly all dental patients have "been there." And there's good reason for this attention to bite.

Chewing, tooth wear, and joint function all depend on the balanced opposition of teeth in each jaw. Any disruption of a good bite, either by broken, loose, or lost teeth, is trouble in need of repair. In the worst-case scenario—the jaws themselves present skeletal problems—orthodontic treatment is considered. However, most malocclusions (bad bites) are treatable right in your dentist's office.

Your dentist will first locate ill-fitting teeth by routine bite analysis. You will bite down on a sheet of special paper that marks teeth with uneven wear. If this doesn't tell your dentist enough, he or she may take impressions, from which study models are built. This gives your dentist a very visual demonstration of what's wrong.

High points in enamel that interfere with normal contact may be filed away. Eroded fillings call for replacements. Lost teeth need a bridge or dental implants to prevent opposing teeth from overgrowth. There are any number of solutions to a bad bite, all important to your dental health.

Anytime you notice a change in your chewing habits, or feel more pressure than usual on a solitary tooth, bring it to your dentist's attention. You'll notice the abnormality, maybe before your dentist detects it. Since you'll be working together, tell your dentist your suspicions and, if it's broken, it can be fixed.

Implant Dentistry

A Simple Description of a Dental Implant Procedure

Permanent Replacements That Feel like Original Teeth

If you have a missing tooth or have lost teeth, you're far from alone. In fact, you're one of over 100 million North Americans with a similar problem. Some lack but a single tooth; others are completely edentulous (without teeth).

Dentures are generally the first thing considered in connection with tooth loss. However, over time, a jawbone lacking natural teeth will shrink. Dentures begin to slide, irritating gums. After a while, patients either cannot or will not continue wearing dentures. Their quality of life diminishes as they go on to become "oral invalids."

For many patients, dental implants can be almost the same as having their natural teeth back again. That's because instead of being a removable device inside the mouth, teeth implants are bridges that are permanently anchored into the jaw itself. The dental implant procedure is surgical, yes, but usually performed under local anesthesia.

The key to a successful tooth replacement is something we call osseo-integration, or the meshing together of implant and bone. Good candidates for tooth implants need jawbone ridges that are in good shape and healthy oral tissues. Then, when the implant device is inserted, a chemical and mechanical bond is formed. The jawbone actually grows into the tooth implant.

That's a highly simplified discussion of an extremely complex and technical procedure. For more details on dental implantology, contact your dental implant dentist.

Dental Implant Cost: Comparison of a Three-Unit Bridge v. a Single Dental Implant

Tooth implants are considered the ultimate dental restoration solution for tooth replacement, especially when only a single tooth needs to be replaced.

Traditionally, the best dental restoration for a single missing tooth was a three-tooth bridge, better known as a three-unit bridge. This type of missing teeth restoration worked by linking three false teeth together. The middle tooth was used to bridge the gap. Even though this type of dental restoration was considered state-of-the-art for many years, it had its limitations.

For instance, the fabrication of a three-unit bridge required the teeth on both sides of the gap to be whittled down to allow for the false teeth to be slipped over the top of the teeth. Because the three teeth were linked together, they could not be cleaned in the same way as normal teeth. In addition, they required special dental cleaning tools in order to maintain healthy gum tissue.

Today, dental implants are the first choice to replace missing teeth and dental restoration. In the case of a single missing tooth, a tooth implant can be placed by the implant dentist in the jawbone area of the missing tooth. The implant will serve as a replacement for a tooth root and an individual dental crown. The total apparatus is referred to as a single-tooth implant crown.

Once in place, the dental implant crown will look, feel, and function like your natural teeth. They are cleaned and flossed just like your natural teeth, and best of all, they do not require any special tools to clean around them, like bridges. Although tooth implants will not decay, they require that you maintain impeccable oral hygiene.

Does a dental implant crown last forever?

Even though dental scientists are developing advanced materials to create a more durable crown, the old adage "nothing lasts forever" also applies to dental implant crowns. Because each patient is different, dental implant crowns last a varied amount of time depending on the patient.

Dental crowns that were thought to last only 3 to 5 years can last 10 to 20 years if meticulously cared for. On the other hand, dental crowns that should last for ten or more years can last only two years in a mouth that is neglected.

The dental implant cost factor is hard to determine precisely. The bottom line is that no one can tell you how long a tooth implant will last, but if you take excellent care of your mouth and see your dentist every six months, you stand a better chance of extending the life of your dental implants and other dental restorations.

How does the cost of a dental implant crown compare to a three-unit bridge?

The cost of a three-unit bridge can range from $2,000 to $3,000. The cost of single tooth implants is approximately $3,000. If teeth associated with a dental bridge fail due to recurrent decay or periodontal disease, ordinarily, dental restoration must be done on the entire dental bridge and possibly add a new filling or build-up of the teeth.

The cost of any foundations under a new dental bridge will add to the dental restoration and tooth replacement cost. If and when a dental implant crown has to be reconstructed, most likely, it would be due to the wearing away of the dental crown material.

The only dental restoration cost would be for that of a new dental implant crown and would not incorporate any adjacent teeth. The dental implant cost over your lifetime would be much less than compared to a three-unit bridge and is the most natural replacement for a missing tooth.

By Benjamin O. Watkins, III, DDS

Dental Implant Prices: Can I Afford It?

Deciding whether you can afford dental implants can be a complicated process. Dental implant prices depend on many factors including your own overall health, the complexity of the problem, whether additional bone grafting may be necessary, and the cost of the materials used.

There are different types of dental implants used in dentistry. There's been great success with "osseointegrated" implants. It's a system where the bone and implant mesh. A chemical and mechanical bond is formed so the jawbone actually grows into the implants. The most rewarding part of these successful implants in dentistry is that patients are happy with the results for years.

Dental implants are used in different ways by dentists. You may require a single implant to bridge a gap or two implants to support a bridge. Or, if a lower denture needs to be stabilized, two to four implants might be required.

Unfortunately, if your jawbone can't support an implant due to bone loss, tooth implants may not be an option. However, if you have a sound jawbone, dental implants are the best thing offered in dentistry next to real teeth

Dental Implantology

Much is being said about dental implant procedures. A national radio spot states that steak and corn-on-the-cob are no longer just a memory for people with tooth loss. Tooth implants, they say, can bring back bite strength and, certainly, improve all-around dental function.

Just what are dental implants though?

Tooth replacement systems differ but continue to evolve as materials and methods allow. Teeth implants are a great and functional alternative to removable dentures.

An implant device is inserted into the upper or lower jawbone. After a healing period, posts are attached to each implant. And to that, a fixed bridge or "over-denture" is placed by the implant dentist. This is known as the "business end" of the implant. Only the "tooth part" is visible. The result is not new teeth. But for more and more people, tooth implants count plenty as the next best thing.

Why go for it?

Over 42% of people 65 and have a missing tooth or teeth. Dentures work fine in some cases and not so well in others. In fact, ill-fitting dentures can contribute to the loss of supporting teeth or bone and aggravate deterioration of your mouth.

Other tooth replacement alternatives?

Well, you could go toothless. But along with that comes a change in eating habits, quality of speech, and level of self-esteem.

"My Mouth Is Me Again."

In many dental practices, implant dentists have had great success with "osseointegrated" (osseo = bone) dental implants, a system where bone and implant mesh. As implant research has grown into dental implantology, many types of appliances have been tested (and some discarded). The Branemark implant, a titanium device developed in Sweden, has the longest track record, a 95% success rate over 20 years.

What makes a successful tooth implant?

In the Branemark system, it's the osseointegration, the meshing of implant and bone. The properties of the implant are such that a chemical and mechanical bond is formed. The jawbone actually grows into the implant. But the real benchmark for the success of a dental implant procedure is this: The patient has to be happy with it. For years.

For certain people, a single implant to bridge a gap is called for. Another person might require two to support a bridge, or two to four implants to stabilize a lower denture. In other people, bone loss is already severe, and what remains cannot support an overdenture, so a tooth implant procedure is not the solution. However, when they work, they're as real as it gets.

If you think you might benefit from teeth implants, call your implant dentist for a consultation.

Dental Implants – An Alternative to Missing Teeth: Are You a Candidate for Implant Dentistry?

Are you missing a permanent tooth? Do you have gaps in your smile? Do you wear dentures and experience some of the following problems?

  • Slipping and clicking while talking?
  • Irritation and pain when you chew?
  • Fear of eating in public?
  • Feeling or looking older than your age?

You may be a candidate for dental implants, an alternative to missing teeth. Implant dentistry uses your jaw to hold a tooth replacement or bridge, rather than anchoring it to a healthy, neighboring tooth. The results are natural-looking teeth implants that look, feel, and function as your own!

Healthy teeth are a gift we often take for granted. Losing one or more teeth impacts our smile, our confidence, and our enjoyment of our favorite foods. Dental implants are technology's way of taking us a step closer to a tooth replacement that feels secure and looks like our own.

You may be a candidate for dental implants, an alternative to missing teeth. Implant dentistry uses your jaw to hold a tooth replacement or bridge, rather than anchoring it to a healthy, neighboring tooth. The results are natural-looking teeth implants that look, feel, and function as your own!

Healthy teeth are a gift we often take for granted. Losing one or more teeth impacts our smile, our confidence, and our enjoyment of our favorite foods. Dental implants are technology's way of taking us a step closer to a tooth replacement that feels secure and looks like our own.

What is involved in getting dental implants?

Implants take several steps, but you will be able to continue your regular professional and social routines. Initially, the dentist will evaluate your mouth, teeth, and jaw to determine whether dental implants are a good option for you.

For most patients, there are two surgical procedures involved. First, in the actual tooth implant placement, the implants are surgically inserted by an implant dentist into or atop the jawbone. Over the next three to six months, the implants are left alone, so that the anchor can bond to the bone, creating a strong foundation for the teeth to come.

Second, the new tooth or teeth are created and attached to the anchored dental implant. You now have teeth implants that might as well be your own: they look natural, are comfortable, and withstand the rigors of grinding and chewing. No one will know that your tooth has an artificial, man-made tooth implant root.

Dental implants are not for everyone

It's true. Your current dental health will influence whether you're a good candidate for a dental implants. Some medical conditions may interfere with normal healing, such as diabetes or heart problems. Finally, the supporting bone in your jaw must be healthy; if you clench your jaw or grind your teeth, the success rate for your dental implants will drop. Less success also is noted in smokers.

A complete examination and X-rays by your dentist will determine if you are a suitable candidate for dental implants. You must also commit to a strict schedule of flossing, brushing, rinsing, and check-ups to keep them healthy.

Proven technology for a new quality of life

Technology gets the credit for this exciting alternative to missing teeth, dentures, and bridges. Researchers noticed in the 1950s that titanium and some other materials formed a strong bond to the bone. That gave rise to the use of dental implants. Today, there are patients who have had dental implants for more than 25 years. Hundreds of thousands of tooth implants have been inserted, boasting more than a 90% success rate! Metal joint implants used in other parts of the body were actually developed from the success of dental implants.

It has been around for decades and people know it works. Schedule an evaluation with your dentist to determine if dental implants are right for you. Discover how they can improve your quality of life and put a genuine smile on your face.

By Brian J. Gray, DDS, MAGD, FICO

Dental Implants – Common Questions Answered by an Implant Dentist

If you have lost a tooth, it is likely that one of your options is to replace it with a dental implant. Before you decide a course of action, you should consider asking your implant dentist some simple questions:

What is a dental implant?

A dental implant is a titanium metal replacement for a root of a tooth that is surgically implanted in the jawbone by a specially trained implant dentist or oral surgeon. As the body heals for approximately two to six months after the surgery, the bone around the implant fuses to the implant through a process called osseointegration. After the healing phase is complete, the implants are used to anchor crowns, bridges, or dentures. Dental implants are the most natural replacement for a missing tooth.

What does the implant dentist do?

The process should begin with a thorough evaluation of the patient's medical and dental history and a full clinical examination of the entire mouth and missing tooth area by your dentist. The clinical exam should also include specific X-rays. After assessing the patient, a comprehensive treatment plan can be devised. From that point, implants are surgically placed in the jawbone under local anesthesia. The length of the healing time is based on the quality and quantity of bone, as well as the type of implant placed. After adequate healing is allowed to occur, the implant can be used to support a crown, bridge, or denture.

What happens if the dental implant fails to fuse to the jawbone?

If an implant fails to bond to bone, another implant can immediately be put in its place, usually of a slightly larger diameter. In situations where another implant cannot be immediately placed, the area is allowed to heal for a few months and then another one can be put in the same place.

How many implants should be placed?

This is a question that should be determined during the treatment plan. A good rule-of-thumb is to place one implant for each tooth replaced. Other decisive factors for the number of dental implants needed for success is the quality and quantity of the patient's bone. Equally as important are the existing anatomy of the bone and the financial resources of the patient.

Placing enough implants to restore teeth is vitally important to the long-term success of the restoration. Simply stated, the most costly mistake is to have an implant fail because not enough implants are placed to support the teeth. If the number of implants is limited due to financial constraints of the patient, then the implant treatment should be avoided or the type of restoration must be altered.

When you are more knowledgeable about your implant treatment, you will be able to have more input to give your dentist and better your chances of a successful treatment outcome.

By Benjamin O. Watkins, III, DDS

Dental Implants: Spare Parts, Small Miracles

In spite of the tremendous reduction in dental cavities in the past 20 years, a missing tooth or teeth remain a problem in the adult population. The sheer numbers of tooth loss in people over 35 indicate many of us could benefit from dental implants.

Tooth implants have been part of many dentist practices for over 20 years. The success rate has been, and continues to be, over 95 percent.

Many people are now considering using implants to replace one tooth or all their missing teeth. Many adults with missing teeth have partial or complete dentures and bridges, and they work fine.

However, conventional prostheses may not do for everyone—the patient may have trouble with a removable denture or is otherwise unable to chew. These are the very people who could stand to benefit most from as a few as two teeth implants.

How does the dental implant procedure work?

A root-form tooth implant is inserted into the upper or lower jawbone. After a healing period of a few months, posts are attached to each implant. Then a fixed bridge or overdenture is placed—the business end of the implant. Only the tooth part is visible.

For certain people, a single tooth replacement to bridge a gap is called for. Another patient might want to stabilize a lower denture.

The procedure is no more uncomfortable to the patient than a simple tooth extraction.

The success of the new dental implants is due to osseointegration, the meshing of implant and bone. The properties of the implant are such that a chemical and mechanical bond is formed. The jawbone actually grows into the implant. This contributes to the stability and comfort of the implant—and a patient rediscovering the joys of steak and fresh apples.

Give your dental implant dentist a call. Tooth implants might work for you.

Evolution of Tooth Implants

Dental implantology has made huge strides in just the past 20 years—but the concept is anything but new.

The idea of a tooth replacement anchored permanently into the jaw has been around since antiquity. Archeologists know the ancient Egyptians tried to implant precious stones into the jawbone where teeth were lost. Half a world away, Mayan ruins in Mexico turned up jawbones with tooth implants carved from seashells.

Tooth loss is one of humankind's most common afflictions—and permanent replacement one of dentistry's fondest dreams. If you have a missing tooth or teeth, you probably understand why.

Fast-forward now from the Third Dynasty to today's dental research labs. Three major research advances—all in the past 15 years—combined to make dental implants practical and workable in a wide range of patients.

Tooth implants substitute the rooting of 32 individual teeth with a few metal anchor posts onto which snaps either an overdenture or a fixed bridge. Investigators found that posts made of the metal titanium were strong, non-toxic over years in the mouth, and biologically compatible.

The next critical discovery was the concept of "osseointegration"—in which the healing jawbone actually grows into the dental implant post. This union is capable of sealing harmful bacteria out of the bone tissue.

Credit the computer revolution with the final critical breakthrough: Computerized Tomography (CT) can be used to develop a model of the jawbone's surface. This eliminates the need for preliminary surgery required to make impressions of the jawbone. For certain patients, CT imaging can make tooth implant surgery a one-step procedure.

Teeth implants aren't for everybody. But research technicians have expanded its potential beyond the dreams of - well, certainly Ramses II.

Frequently Asked Questions about Dental Implant Surgery

Q. What is a dental implant?

A. A dental implant is a permanent artificial tooth replacement.

Q. Who should you see about getting dental implant surgery?

A. When getting a dental implant, you should select a dentist or dental team with in-depth knowledge and prior experience with all aspects of the treatment. It is important to know that dental implant treatment consists of two components: a surgical phase and a restorative phase.

Traditionally, a dental surgeon, like an oral surgeon or a periodontist, performs the dental implant surgery. A general dentist or prosthodontist and laboratory technician perform the restorative component. However, as implant dentistry has become more sophisticated, sometimes a dentist who specializes in restorative dentistry conducts the entire procedure.

Q. How long has dental implant technology been available and what is the success rate?

A. The technology has been around for decades. In fact, some patients have had dental implants for more than 40 years. Hundreds of thousands of dental implants have been inserted with more than a 90% success rate. All other metal implants in the body (including hips and knees) are the result of the dental implant technology.

Q. Are there different types of dental implants?

A. Yes, several types are available. The American Dental Association considers both the endosteal and the subperiosteal implants to be acceptable. An important factor for selection is to determine whether your jawbone can adequately support the implant. Most dental implants placed today are endosteal root form fixtures (similar to a man-made tooth root).

Q. Is dental implant surgery available for a single missing tooth?

A. In the case of a single missing tooth, dental implant surgery is used to place a dental implant in the jawbone area of the missing tooth. The dental implant will serve as a replacement for a tooth root and an individual crown. The total apparatus is referred to as a single-tooth implant crown. Once in place, the dental implant crown will look, feel, and function like a natural tooth. They are cleaned and flossed just like natural teeth, and best of all, they do not require any special tools to clean around them like bridges. Although a dental implant will not decay, they require impeccable oral hygiene.

How the Success Rate Is Related to Possible Dental Implant Complications

The endosseous system of dental implants, currently the most popular system used in dentistry today, has been utilized to replace missing teeth for over thirty years. Dental implants are very successful. Dental implants are made of titanium, an inert metal that bonds with the bone and forms a very tight union. Dental implants have a 90% to 95% success rate and, once placed and restored, can last for an indefinite amount of time.

Although rare, dental implant complications do occur. If the bond between the dental implant and the bone breaks, or the dental implant itself breaks, it may have to be removed. If so, it may be possible to replace the failed dental implant, either at the same time or after doing a bone grafting procedure.

There are two main reasons for dental implant complications:

  1. Infection of the implant surface can result in disintegration of the bond between the implant and the bone. Eventually, the dental implant may have to be removed. To avoid infection at the time of dental implant placement, sterile operating techniques are recommended and most implant surgeons prescribe antibiotics after surgical implant placement.
  2. The oral bacteria that causes periodontal disease can also affect implants. Around implants, this infection is called peri-implantitis. Just as with the natural teeth, meticulous oral hygiene that includes brushing and flossing, combined with periodic professional cleanings are critical to prevent peri-implantitis.
  3. Excessive loading: If the forces on the dental implants are too strong or not in the right direction, the implant components can break or the bond between the implant and the bone can disintegrate. The bite on a dental implant has to be properly designed.

There are certain risk factors that may increase the risk of dental implant complications. Smoking, for example, halves the success rate of dental implants and is the number one risk factor for dental implant complications.

Also, persons that have a diminished healing ability such as people with uncontrolled diabetes may have an increased risk for dental implant complications. To reduce the risk of dental implant complications and to prevent serious health complications from surgery, a thorough medical evaluation is required before dental implant treatment.

To reduce the risk of dental implant complications, make sure that the dentist that places the dental implants and the one that restores the dental crown on the dental implant have plenty of experience with dental implant procedures.

The success of dental implant treatment is dependent on the expertise of the dental team and the patient's ability to control plaque. With proper dental implant design and follow-up maintenance, you could enjoy the benefits of dental implant treatment for a lifetime.

By Laura Minsk, DMD

Immediate Dental Implants: What Are They?

Implant dentistry is a safe, predictable method for replacing missing teeth. "Immediate dental implants" or the placement of tooth implants at the time of extraction is a great method of implant placement. This method can be considered when a single upper front tooth is traumatized, when one or two teeth have advanced decay or when the remaining roots are too short to support a crown. The purpose of this method of tooth replacement is to maintain as much bone volume as possible. This means preserving bone height and width. The benefits to the patient after restoration of dental implants are a beautiful, natural-looking tooth without cutting down healthy adjacent teeth and being able to eat in comfort without the fear of having the tooth loosen or fall out.

An implant dentist can easily determine if a person is a candidate for the immediate dental implants method of replacing missing teeth. They will examine the teeth adjacent to the involved tooth for periodontal disease and take a traditional dental X-ray. Impressions of the teeth will aid in determining one's prognosis. Additional X-rays may be necessary to determine the exact bone width and height, as well as the root position.

Implant placement is performed with local anesthesia. The remaining root is removed and the gum tissue is gently displaced from the surrounding tissue. The dental implant site is prepared with small drills. Special equipment is used to gently place the tooth implant into the prepared site, after which the gums are replaced over the implant with sutures. A temporary tooth replacement is placed in the space where the tooth was removed. Post-operative discomfort is minimal. The sutures are removed in a week, and oral hygiene is resumed.

In the upper jaw, bone grows and adheres to the tooth implant within five to six months, while the immediate dental implants in the lower jaw require three to four months for proper bone formation. After healing, there is a series of visits when an implant dentist will make a tooth that will be attached to the implant. Within a few weeks after receiving the implant-supported crown, patients consider the restoration as their own tooth, rather than an implant.

Implants require good oral hygiene, dental maintenance, and periodic evaluation by a dentist. For further information regarding placement of tooth implants at the time of extraction, look in PubMed, searching the following key words: placement of implants at time of extraction, dental implants, and immediate implants.

By William Becker, DDS

Implant Dentistry Gives You Better Fitting Denture Implants

The art and science of implant dentistry has advanced rapidly during recent years and new techniques and materials have greatly improved our ability to replace missing tissues with functional and natural-looking artificial prostheses called dentures implants. However, it must be remembered from the outset that no prosthesis or artificial substitute will ever function as well as the original living tissues. Research has shown that the chewing efficiency of experienced denture patients is, at best, less than 20% as efficient as the average chewing efficiency of patients with natural teeth.

Why is the lower complete denture so hard to wear?

Both upper and lower dentures are retained in the mouth by an intimately close fit of the plastic denture base to the gums. The intimately close fit is achieved by a combination of muscle control and suction. Mastering the function of the lower denture is more difficult than learning to use an upper complete denture. By comparison, the lower denture has less stable tissue with which to rest on than the upper denture. The lower denture stays in place largely due to the ability of the denture wearer to control their tongue well enough to hold the denture down while they speak and chew. Therefore, lack of tongue coordination in a lower complete denture wearer can severely affect the patient's ability to wear a lower complete denture.

Bone loss and complete dentures

For various reasons, teeth have to be removed. After tooth removal, the residual bone that is used to support the teeth will then shrink away quite rapidly over the first year because the body knows that the residual bone is no longer needed. The greatest amount of shrinkage occurs during the first year after tooth removal. Research has shown that wearing dentures will accelerate jawbone shrinkage. As the shrinkage of the jawbone support progresses over time, new dentures will need to be fabricated in approximately six to ten years. Because each denture wearer is unique, sometimes the internal surface of the denture needs to be readapted to the gum tissues. This procedure is called a reline.

Lower complete dentures and denture implants

Some patients are never able to adapt to functioning day-to-day with their complete dentures. Many of these patients do not have adequate bone to stabilize a lower denture. Others never develop enough muscle coordination to learn to chew with their dentures. For many years, dentistry had nothing more to offer patients other than a denture adhesive. Today, such problems can often be managed through the use of implant dentistry. Even with as few as two dental implants, the retention and stability of a lower denture can be greatly increased with denture implants. In fact, the chewing efficiency can also be greatly increased. Some patients have estimated that they regained up to 70% of their original chewing capacity. Overall, patients feel more confident when they are in public because they no longer fear that their dentures will slip or cause them embarrassment with denture implants.

By Benjamin O. Watkins, III, DDS

Learn How You Can Find the Best Implant Dentistry in Your Area

When the concept of dental implants and the mechanisms in which they work were introduced to mainstream dentistry during the late 1970s, the advent of dental implants opened up an excitingly new chapter in dentistry.

Through the 1980s, the news of the successful procedure of dental implant surgery spread at an explosive rate. It took approximately ten years of repeated long-term success for the procedure to gain validity.

By the early 1990s, dentists readily accepted implant dentistry as an adequate and routine substitute for missing teeth in all areas of the mouth.

Restoring dental implants has undergone a paradigm shift from simply validating that dental implants work to recreating missing teeth with a chameleon-like effect. Even though implants can be restored with a very high degree of success, one of the most difficult and critical areas in the mouth to achieve great esthetic results is in the upper front jaw—specifically when replacing a single upper central incisor tooth.

Single-tooth implant dentistry present dentists with unique challenges. When a single central incisor tooth is removed due to periodontal disease, tooth decay, trauma, or nerve failure, the body responds by shrinking the bone and gum tissue in place of the missing tooth. The body no longer needs the supporting bone structure; therefore, the bone is decreased and the gum tissue shrinks because of bone resorption.

In order to achieve a natural appearance to the final restoration, restorative dentists must attempt to replace what nature has taken away. An unnatural appearance will be the result if the tooth is replaced without considering augmenting or "plumping up" the support structures. It would be like placing a great painting in the wrong frame, thus having a diminished outcome.

Achieving Esthetic Implant Dentistry with Crowns

Certain steps are necessary to achieve a successful outcome, especially in the most demanding implant cases, like replacing a single upper front tooth. Before the decision to place an implant is made, patients should know the sequential steps.

The process starts with a thorough exam. Clinically, dentists should examine the affected area and the entire mouth. A comprehensive exam of the bone and soft tissues must be performed along with taking specific X-rays and possibly detailed bone scans to identify any potential complications.

An analysis of your smile should also be performed. Do your teeth and gums show when you smile? Does your upper lip drape over your teeth? If the patient has a high lip line that shows teeth and gums, the need for bone and soft tissue grafting may be necessary.

By discussing several of the aspects necessary for implant treatment, you can be more aware of the possibilities, as well as the limitations, associated with implant dentistry. Armed with various soft and hard tissue grafting techniques, ceramic material advancements, and better dental implant components, dentists are able to satisfy even the most esthetically-minded patients.

Replace a Missing Tooth with a Tooth Implant

Compared to previous generations when tooth loss was common, modern dentistry has made it possible for people to keep their teeth healthy and attractive for their entire lives. But for people who have experienced tooth loss, a full or partial denture has been the answer.

But dentures have drawbacks. Food gets caught under the denture with resulting sore gums. Or a denture can loosen and cause embarrassment.

Today, dental implants can replace missing teeth. Although the concept of a tooth implant is not new, advances in technology have improved the treatment process and the longevity of implants.

Modern day dental implants are made of pure titanium and are surgically inserted in the jawbone. The tooth implant is covered with gum tissue and allowed to heal for three to six months. During this time, the titanium meshes with the bone (osseointegration), becoming part of the jawbone itself. After the gums are healed, the implants are uncovered and permanent tooth replacements are attached to the implants.

Dental implants can be used for single tooth replacements, support for a permanent bridge, or as attachments to anchor a full denture securely to the jaw.

If you think a tooth implant could help you or someone you know chew more comfortably, speak more clearly, or look better, call your dental office for more details.

By Laura Minsk, DMD

Replacement of Missing Teeth with Implant Dentistry

In implant dentistry, devices are used to replace missing teeth. They are made of titanium, an inert metal that bonds with the bone, forming a very tight union called osseointegration. The modern system of dental implants, the endosseous system, is extremely successful and has a 90% to 95% success rate.

The dental implant itself replaces the root of the tooth. It is usually in the shape of a screw or a cylinder. The implant connects to a component (the abutment) that joins the implant to the replacement tooth (the crown).

Dental implants are ideal replacements for teeth. When healthy teeth have to be prepared for crowns or bridges, healthy tooth structure needs to be removed. But if only one tooth is missing, the dental implant can simply replace it without having to sacrifice the adjacent teeth.

Dental implants can also be used to replace many missing teeth. Multiple teeth can be replaced with implant dentistry and can avoid the need for a removable denture. Removable dentures can be hard to get used to. They may have clasps that can be unsightly and put additional stress on the existing teeth. Full dentures may be difficult to wear and may interfere with eating and speaking. People who wear dentures for a long time may have additional loss of the bone that supports the denture. This bone loss can be accelerated by osteoporosis, and eventually dentures may be very difficult to wear if not impossible. Poor-fitting dentures can interfere with proper nutrition and quality of life.

Generally, one implant is needed to replace each missing tooth. In some situations, several implants need to be joined together into a bridge. This adds greater strength to the implant restoration. If there is not enough bone available to replace a whole set of teeth, implants may be used as anchors for dentures. When dentures are supported by implants, they can be much more stable and the implants help prevent the deterioration of the bone that supports the denture.

The endosseous system of implant dentistry has been used for over 30 years. They can look and feel like natural teeth, adding comfort and improving the smile of people of all ages.

By Laura Minsk, DMD

Teeth Implants, Close Up and Natural – Is Implant Dentistry for You?

Teeth implants are a tooth replacement therapy offering natural-looking options for patients. Dental implants anchor artificial or prosthetic teeth into the jawbone. Their performance is nearly equal to natural teeth, providing a secure and comfortable fit, a natural appearance, and a big dose of confidence for people of all ages.

A tooth implant duplicates the tooth's structure. Dental implants are inserted into the jawbone is made of titanium. This metal does well in the body and rarely causes any reaction in patients. It is the same material that is used in knee and hip replacements.

  • The implant is cylindrical in shape, resembling a screw, and may even have a thread-like surface. They're uniquely designed with small holes at the outside surfaces for a very good reason. Like the roots of natural teeth, tooth implants stimulate bone growth. It even fools Mother Nature! Over time, the bone tissue actually grows into the small holes, securing the implant.
  • The abutment rests over the metal implant. It's a small piece of metal whose purpose is to connect the prosthesis to the tooth implant.
  • The prosthesis is the replacement tooth, a natural-looking crown, or bridge (if there are multiple teeth missing). A prosthesis that's used to replace a complete set of teeth can be either fixed or removable. A removable prosthesis can be taken out for easy cleaning; a fixed one can only be removed by the dentist, but usually offers better reliability for chewing.

How Do These Different Teeth Implants Parts Work Together?

Since the tooth implant duplicates the tooth's structure, each part contributes to a natural-like functioning of the teeth. Whether replacing one or more teeth, the process of repair is the same. The teeth implants insertion procedure involves three main steps:

  1. The first is the surgical insertion of the metal implants.
  2. This is followed by a second surgery, about three to six months later, to insert the abutment.
  3. The third step, usually two to four weeks later, is custom-making the prosthesis and attaching it to the abutment. There are typically several adjustments needed until the prosthesis is attached to the abutments.

Once the prosthesis comfortably fits, your future is secure. You'll enjoy comfort, confidence, and security in meeting the world and smiling in a whole new way with your new teeth implants.

Teeth Implants: The Permanent Solution to a Lost Tooth

Whether it's due to accident or decay, tooth loss can be a pretty traumatic event. But it's not irreplaceable. If you lose a tooth, you might be surprised at the options modern dentistry can offer to replace that missing tooth.

If it's a sudden, accidental injury and you lose the entire tooth, roots, and all, it may even be possible to replace the tooth in its socket. But time is of the essence, the tooth replacement must occur within an hour of the accident.

A more realistic alternative is a tooth implant. Teeth implants are the next best thing to having natural teeth restored to your mouth. That's because, instead of being a removable device inside the mouth, like dentures, implants are permanently anchored into the jaw itself.

The key to a successful dental implant procedure is called osseointegration, or the meshing together of implant and bone. Good candidates for dental implants need jawbone ridges that are in good shape and healthy oral tissues. Then, when the implant device is inserted, a chemical and mechanical bond is formed. The jawbone actually grows into the dental implant.

The thing to remember is . . . if you lose a tooth, it's not the end of the world. Tooth implants are only one of your options. Regardless of the cause of your tooth loss, there's something you can do to recreate a healthy, natural-looking smile. Contact your dentist today to get more tooth implant information.

Tooth Implants: The Single Missing Tooth Solution

Single Missing Tooth Problem

You're missing a single tooth. Until recently your only options were limited: a fixed bridge or a removable partial denture—which meant removing enamel from adjoining teeth. It was a very short list.

Single Missing Tooth Solution

Thanks to modern dentistry techniques, single tooth implants are now a good alternative. Although most patients use tooth implants to replace an ill-fitting denture, or to bridge a large gap of several missing teeth, it's now possible for you to have a single tooth replacement.

You're a good candidate for single tooth implants if you are in good health and the jawbone where the tooth implant will be fitted has not receded. You have to be of age, since your facial growth must be complete.

There are many advantages to this procedure. Single tooth implants are strong. Unlike dentures, they require less care. And the implants look and feel natural. So instead of being embarrassed by a missing tooth, you'll have something to smile about.

What Is the Cost of Dental Implants?

Many people considering implant dentistry wonder how the cost of dental implants compares to the cost of a more traditional three-unit bridge.

Generally speaking, the cost of a three-unit bridge can range from $2,000 to $3,000, while the cost of a single implant tooth is approximately $3,000.

One important factor to consider when making the decision is that if the teeth that are associated with a bridge fail due to recurrent decay or periodontal disease, the entire dental bridge must usually be replaced. Or the addition of a new filling or build-up of the teeth may be required. The cost of any foundations under a new bridge will add to the replacement cost.

If and when a dental implant crown has to be reconstructed, most likely, it would be due to the wearing away of the dental crown material itself. The only reconstruction cost would be for that of a new implant crown and would not involve any work on the adjacent teeth.

The cost of dental implants over your lifetime, therefore, is likely to be much lower than the cost of a traditional three-unit bridge, and is the most natural replacement for a missing tooth.

What to Expect in Dental Implant Cost and Treatment Issues from Your Implant Dentist

If dental implants are what you need to best replace your missing teeth, you should select an implant dentist with in-depth knowledge of and prior experience with all aspects of the treatment. It is important to know that dental implant treatment consists of two components: a surgical phase and a restorative phase.

Traditionally, a dental surgeon, like an oral surgeon or a periodontist, performs the surgical component. A general dentist, or prosthodontist and laboratory technician, performs the restorative component.

As implant dentistry has become more sophisticated, the restorative dentist, at times, also has become the one that places the dental implant. However, each clinician involved in implant treatment must be aware that the type of final restoration a patient wants dictates the position, size, and number of teeth implants within the jaws.

What Types of Dental Implant Restorations Are There?

For each unique missing tooth situation, there is an equally unique way to use implants to replace teeth. However, all of the treatments can be placed in two categories: removable or fixed prostheses.

Implant dentist use removable implant dentures when a patient is missing all of his or her teeth. Fewer dental implants are necessary when used in conjunction with a removable denture.

Conversely, more implants are necessary when used in conjunction with a fixed bridge. Fixed bridges feel most like your natural teeth and are usually more desirable than removable dentures.

Mastering new surgical and restorative techniques as they are developed is the mark of an excellent implant dentist as well as overall dental implant dentistry. An implant dentist's meticulous attention to fine detail conveys a feeling of confidence to the patient. The implant dentist should be committed to restoring full function to the missing teeth as well as recreating natural-looking teeth. These are the qualities a patient should look for in an implant dentist to place and restore their implants.

By Laura Minsk, DMD

What's the Difference Between a Dental Bridge and a Dental Implant?

What is used to get across a gap—a bridge of course! A dental bridge spans the gap between one or more missing teeth giving you a better smile.

Your teeth not only help you chew and speak correctly, but also contribute substantially to your smile and overall appearance (your teeth give form to your face and without them, your facial features can be significantly affected). If lost teeth are not restored, other teeth often shift, causing crooked teeth, leading to cavities and gum disease. Dental bridges restore potentially compromised oral health to full function.

What Is a Dental Bridge?

A bridge is a special dental appliance used to restore missing teeth. There are several types of bridges used to span the space. The three most common types include:

  • Fixed Dental Bridge – This type of bridge is cemented next to the teeth adjacent to the gap, called the "abutment" teeth. A replacement tooth, called a pontic, is attached to crowns that provide added support and cover the abutment teeth. Fixed bridges can only be removed by the dentist.
  • Removable Partial Dentures – When the span is large, your dentist may suggest this type of bridge. A removable partial denture fastens to natural teeth with clasps or attachments. This type of appliance can be removed for cleaning and is less expensive than the fixed type. However, it's usually not as durable as the fixed bridge.
  • Dental Implant Supported Bridges – When implants have been placed in spaces that have no teeth, they serve as "abutments" or anchors for a bridge.

What Materials Are Used in a Dental Bridge?

An assortment of materials are available depending on the function and appearance. Porcelain, tooth-colored acrylics, gold alloys, and alloys made from non-precious metals all provide important restorative qualities along with making your smile the way you want it.

What's Involved in the Procedure?

Normally at least two visits are needed for preparing the teeth, custom-designing the bridge, and making adjustments for proper fit and comfort.

How Do I Care for My New Dental Bridge?

With bridges, extra care must be given to your gums and teeth. Bridges add more stress to existing teeth and must be supported by healthy gums. Otherwise, these key teeth are susceptible to decay and affect the bridges.

Brushing twice a day and flossing daily along with regular dental visits are essential to good oral hygiene. Flossing is often easier by using floss threaders that help to remove cavity-causing bacteria between the dental bridge and adjacent teeth.

Because bridges are intricate and sometimes difficult to clean, your dentist might suggest a special instrument that helps in caring for your teeth. Similar in design to professional dental cleaning instruments, it's made of tiny filaments that rotate to "swoosh" into the crevices between the teeth and below the gum line. Ask your dentist about this special cleaning device.

With good oral hygiene, a fixed dental bridge can last eight to ten years or more and provide years of service enhancing your smile and appearance and your oral health.

By Danine M. Fresch, DDS

Who to See When Thinking about Getting Dental Implants

If dental implants are what you need to replace your missing teeth, you should select an implant dentist with in-depth knowledge of and prior experience with all aspects of the treatment. It is important to know that treatment with tooth implants consists of two components: a surgical phase and a restorative phase.

Traditionally, a dental surgeon, like an oral surgeon or a periodontist, performs the surgical component. A general dentist, or prosthodontist and laboratory technician, performs the restorative component.

As dental implant dentistry has become more sophisticated, the restorative dentist, at times, also has become the one that places the dental implants. However, each clinician involved in implant treatment must be aware that the type of final restoration a patient wants dictates the position, size, and number of the tooth implants within the jaws.

What types of dental implants are there?

For each unique missing tooth situation, there is an equally unique way to use dental implants for tooth replacement. However, all of the treatments can be placed in two categories: removable or fixed prostheses.

Implant dentists use removable implant dentures when a patient is missing all of their teeth. Fewer tooth implants are necessary when used in conjunction with a removable denture.

Conversely, more dental implants are necessary when used in conjunction with a fixed bridge. Fixed bridges feel most like your natural teeth and are usually more desirable than removable dentures.

Mastering new surgical and restorative techniques as they are developed is the mark of an excellent tooth implant dentist as well as overall implant dentistry. An implant dentist's meticulous attention to fine detail conveys a feeling of confidence to the patient. The dentist should be committed to restoring full function to the missing teeth as well as recreating natural-looking teeth. These are the qualities a patient should look for in an implant dentist.

Your Tooth Implant Options

Dentistry has come a long way in the past 10 years—new cosmetic dentistry procedures, stronger dental materials, and improved techniques all the way around.

Some of us, though, have not had the opportunity to take advantage of these breakthroughs until later in life. In fact, more than 42% of people over 65 have experienced significant tooth loss and must resort to dentures. Now there are options: dental implants.

Tooth replacement systems differ, but they are all intended to provide a better alternative to removable dentures. As any denture wearer will tell you, there's nothing more irritating than a slippery lower denture and the uncertainty it brings. An ill-fitting denture may cause accelerated bone loss and aggravate oral decline. Teeth implants can bring back bite strength, stability, and, most important, self-confidence.

The dental implant procedure is a three-stage process. First, an implant device is inserted into the upper or lower jawbone. Usually only local anesthesia is required, though a hospital stay may be advised. You will be given a temporary appliance so you can go on your way until the second stage.

After a healing period of some months, implant and bone have grown together. Posts are then attached to each tooth implant—these protrude through gum tissue. After a few weeks a fixed bridge, or "overdenture," will be inserted. Then teeth will be attached to the posts. In some cases, an existing denture can be modified to secure over tooth implants comfortably.

The dental implant procedure takes some time and some money. You need sufficient viable bone in the jaw to support teeth implants and a willingness to take good care of yourself during treatment. Finally, your expectations must be reasonable. Dental implants won't behave like natural teeth, but do promise better eating and speaking abilities and vitality.

Implant dentistry has been around for 25 years and the success stories are very impressive. In these, the best years of life, you owe yourself the gift of self-esteem. See your tooth implant dentist today!

TMJ Dentistry

Grinding Teeth: Do You Have a Problem with Your Bite?

Problems with the way your teeth fit together occur in many different ways. Some bite problems cause discomfort or even pain, and that pain can masquerade as problems that you would not readily associate with your teeth. Some bite problems can cause major damage to your teeth without producing any obvious discomfort.

There are some pretty simple ways that anyone can detect when a problem with the bite is causing or at least contributing to pain or discomfort.

The Clench Test

With your mouth empty so there is nothing between your teeth to bite on, close your teeth together, and squeeze hard. If clenching your teeth together causes any sign of discomfort in any tooth, you have a disharmony in your bite.

Teeth that are sensitive to cold often get that way from the extra pounding they take if any part of that tooth strikes before the rest of the teeth contact during closure. Use the clench test to see if the extra sensitivity is related to an uneven bite. Squeeze hard. If you can make any tooth hurt by empty mouth clenching, the bite is probably the main reason for the sensitivity. This is a good way to find out if a new filling or crown is "high." If it hurts when you clench, it is probably not in perfect harmony with a correct bite. You should be able to bite hard and grind your teeth together in all directions without feeling discomfort in any tooth if your bite is perfect. The exception to this is if you have advanced periodontal disease, you may have several teeth that can't accept firm biting, but even then, you should not normally feel pain in a single tooth when biting.

If biting hard causes pain or discomfort in the jaw joint (you may feel it just in front of your ear), you can suspect a possible relationship between your bite and a temporomandibular joint problem. It may be associated with a structural disorder in your TMJ, but more often the pain is coming from certain muscles that move your jaw joints to accommodate a bite that is not in harmony with your TMJs. Your TMJ dentist should be able to diagnose the exact source of the pain.

Look for severe wear on your teeth, as this is another sign that your bite is not in harmony. If you have worn all the enamel off the biting edges of your teeth, you will see a darker colored surface. This is dentin and it will wear down seven times faster than the much harder enamel that you've already worn through. So ask your dentist to evaluate what is causing so much wear. This wear can be especially damaging when it is on your front teeth, so if you notice your lower front teeth have worn down to dentin, have your bite checked. Better yet, don't wait till all the enamel is gone. Correcting your bite may stop or at least slow down the wear process.

By Peter E. Dawson, DDS

Malocclusion of the Mouth

The term malocclusion literally means "bad bite." It is a generalized term that refers to many different types of mal-relationships of the lower teeth to the upper teeth. In popular usage, any arrangement of the teeth that is at variance with a prescribed ideal is considered to be a malocclusion. But that is an oversimplification because some occlusions that appear to be ideal may be in disharmony with the jaw joints (the TMJs).

Such disharmony can be a source of many different problems with the teeth, the TMJs, or the jaw muscles. Even minute disharmonies of the bite can be a major factor in loosening the teeth, wearing away of the enamel, or fracturing off cusps. Other malocclusions can cause headaches or cause the teeth to be sore or sensitive to cold. Some malocclusions may be most noticeable because they result in an unattractive smile. Some severe malocclusions cause no discomfort whatsoever, while some minor bite problems can be a major source of pain.

Perhaps the best way to understand malocclusion is to understand what an ideal occlusion is. This understanding starts with a basic appreciation for how the jaw joints (the TMJs) function. The TMJs are important because they form the hinge for opening or closing the jaw. During closure in an ideal occlusion, the teeth should all contact simultaneously and with equal pressure when the jaw joints are fully seated up in their sockets. This harmony between the TMJs and the teeth is the most important requirement for a comfortable, stable bite. Any disharmony between the TMJs and the teeth requires the jaw muscles to hold the jaw joint out of its socket in order to completely close the teeth together. This type of malocclusion can cause many different problems but unfortunately the disharmony is easily missed unless the dentist is very careful in examining for it. It is commonly missed because the occlusion is examined visually without first verifying that the jaw joints are completely seated when the bite relationship is examined.

Depending on the type of malocclusion, correction of a bite disharmony requires careful selection from a variety of different treatment procedures. Even though principles of bite correction have been established with enough clarity to permit highly predictable results of comfort and stability, some dental educators claim that occlusal harmony is unimportant because the body can adapt. This viewpoint has resulted from a profuse amount of misinformation that has found its way into the literature. Patients with bite problems should feel free to ask the dentist to show them the problems that are resulting from the bad bite such as loose teeth, excessive tooth wear, or other visible signs, in addition to an understandable explanation of why the recommended treatment was selected.

The most common, and also the most practical methods for correcting most minor occlusal disharmonies is called occlusal equilibration. It involves direct reshaping of the biting surfaces by grinding and polishing selected tooth surfaces that interfere with comfortable jaw movements. When correctly done on properly selected patients, it is a conservative and effective treatment.

Some malocclusions may require more extensive treatment such as orthodontics. Teeth that are badly worn or that need the biting surfaces re-shaped may need crowns or other types of restorations. Surgical correction may be needed in some severe jaw misalignments to achieve the best result and appearance.

Most malocclusions can be corrected in a reversible trial approach by making a plastic appliance that fits over the teeth to change the biting surfaces so the jaw can close with even tooth contacts. These appliances are referred to as occlusal splints. A fancier name for them is "orthosis" but it means the same thing.

The important thing to understand about your bite is that you should be able to close your teeth together and squeeze very hard without causing any sign of tenderness or pain in any tooth or in the jaw joint. If you can't do this, you probably have a malocclusion. You should know that the discomfort is almost always correctable with the right selection of treatment. Your dentist must also examine for other possible causes of pain that may exist in combination with your bite disorder. Nothing takes the place of a carefully made examination to determine the specific cause (or causes) for your discomfort.

Subliminal Stuff: Teeth Grinding and TMJ

Sensitivity to heat and cold. Loosened teeth, fractures, and a debilitating headache. All this can occur while you sleep—from grinding your teeth. Dentistry calls it bruxism.

Talk about shell shock. Dentists see evidence of life in the fast lane every day. As many as 90 percent of us grind our teeth each night, on the average of five episodes per evening. The bite force is so powerful—over 200 pounds per square inch—and the noise so fearful, you cannot physically duplicate this phenomenon when you're wide awake. While you're sleeping, a lot of damage is being done that could be causing TMJ symptoms.

Bruxing seems to be associated with the REM stage of sleep, that never-never land where dreaming and rapid eye movement occur. There is some evidence that a bite out of alignment contributes to bruxing, but most agree stress is the problem. Or, even more alarming, the anticipation of stress.

Most people learn about a bruxing habit from the spouse who has to put up with it every night. More clues: waking up in the morning with jaw pain, jaw popping, jaw clicking, migraine or muscle fatigue, and loose teeth.

Physical therapy, muscle relaxants and, sometimes, a custom dental appliance can help. But learning how to handle the stress in your life could salvage more than your teeth and help eliminate TMJ syndrome.

TemporoMandibular Joint Syndrome

A tooth that aches in the morning can result from teeth grinding during sleep. Teeth clenching can usually be treated. Are you troubled by a jaw popping or jaw clicking sensation, or jaw pain when you eat? You may be suffering from a dental problem that has nothing to do with teeth or gums. We call it TMJ disorder.

TMJ is short for temporomandibular joint, which is the hinge attaching your jaw to your skull. TemporoMandibular Joint syndrome usually means that there's a misalignment within the network of muscles, bones, and joints that make up this hinge. When your hinge isn't coming together as it should, the jawbone grates on sensitive tissues and other bones. Sometimes the pain can be intense and cause a migraine headache. Sometimes the jaw popping is merely annoying.

Regardless of pain level, you should be concerned. It's important to have a thorough evaluation before permanent damage is done, especially since TMJ syndrome can often mimic symptoms of other medical problems (sinus infections especially) and escape identification.

Every TMJ case is unique. But your dentist probably has plenty of experience treating this common disorder. His or her response may be minor tooth reshaping, mouth splints, or possibly muscle relaxants. Sometimes a simple massage is effective to control pain. Only in rare cases is there a need for surgery to correct TMJ disorder.

If you feel you're experiencing symptoms of TMJ syndrome, please call your dentist immediately. He or she can provide a thorough evaluation and recommend corrective measures before the problem escalates.

Temporomandibular Joint Treatment: How Migraine Headaches Relate to TMJ Dentistry

You may know people with Type-A personalities. You may even be Type-A yourself. Always connected, high energy, and hard driving. These people may be even more successful than their associates and friends. That's the positive side. But there's a negative side, too. For some Type-A personalities, stress and anxiety can intensify the symptoms of TMJ disorder (Temporomandibular joint disorders). TMJ disorder symptoms can take the form of everything from migraine headaches and earaches to neck, shoulder, and facial pain. Teeth clenching, a stress-related habit, increases pressure on the jaw, resulting in pain or even lockjaw in severe cases.

You can't change your personality type (nor would you want to!), but treatment is available for those suffering from TMJ disorder. We can realign and reduce pressure on the jaw and reduce or even eliminate pain.

Don't stress out. Accentuate the positive. Call your dentist for help in diagnosing and treating TMJ disorder.

TMJ: Everything You Need to Know about Temporomandibular Joint Disorder

TM disorder describes a variety of conditions affecting the temporomandibular joint—TMJ (the point where the jaw opens and closes) and nerves related to chronic facial pain. These problems are now more easily diagnosed and treated than in the past. Women are twice more likely to be affected than men.

How is it caused?

The exact cause of the disorder is unknown. Some factors are related to an improper bite or malocclusion, injury, arthritis, severe stress, or a combination of factors. Clenching or grinding teeth, a condition called bruxism, may develop from stress or as part of a sleep disorder. This can tire muscles and create painful spasms, causing even more pain. Repeated muscle problems may affect the joints, resulting in tissue damage, muscle tenderness, and more spasms, perpetuating a cycle of pain.

What are some of the symptoms?

  • Jaw pain or soreness, more noticeable in the morning or afternoon
  • Jaw pain while chewing, biting, or yawning
  • Earache without an infection, sometimes spreading into the face
  • A clicking or grinding noise while opening and closing your mouth
  • Difficulty opening and closing your mouth
  • A stiff jaw when eating, talking, or yawning
  • Sensitive teeth without any signs of dental problems
  • Aching on the side of the head and neck pain
  • "Locking" of jaw in an open or closed position

How can this condition be treated?

Proper diagnosis is critical to make sure you receive treatment for your particular condition. Your dentist will recommend treatment after conducting a thorough health history and clinical exam, taking appropriate X-rays, and perhaps confirming the condition through other diagnostic tests.

Your dentist may prescribe a multiple-phase treatment plan. Only minor corrective treatment may be needed. Treatment may be simple or require more steps for alleviating the condition, depending on the degree of severity. Some of these treatments include:

  • Taking a non-aspirin pain reliever or prescription medications such as muscle relaxants, analgesics, or anti-inflammatory drugs
  • Eating soft foods
  • Avoiding chewing gum
  • Applying moist heat or ice
  • Physical therapy
  • Teaching relaxation techniques to control muscle tension
  • Stress management training techniques
  • Posture training
  • Wearing bite plates to eliminate the harmful effects of clenching or grinding the teeth, and a better positioning of the jaws
  • Adjusting the bite, known as "occlusal equilibration" involving removing interferences when the teeth touch
  • Replacement of defective restorations that prevent the jaws from meeting properly
  • Orthodontics to put the teeth in proper position
  • Surgery

In most cases, the symptoms related to TM disorders can be successfully treated to reduce or eliminate your discomfort. Postponement of treatment usually results in more damage to the joint, muscles, or teeth. Be sure to discuss any questions you may have about TM symptoms and treatment plans with your dentist.

By Brian J. Gray, DDS, MAGD, FICO

TMJ Dentist – Learn How Your Dentist Can Help You End Your Headache, Neck, and Jaw Pain!

TMJ dysfunction is a living nightmare for an estimated 50 million Americans who suffer from this distress. And the fact that many dentists and physicians fail to diagnose this disorder means that people are suffering needlessly and spending money on office visits and drugs that give them no relief. But there is hope when TMJ is diagnosed correctly.

Symptoms include head, neck, and back aches. You may also have earaches, bouts of deafness, or ringing in your ears. You may hear clicking and popping when you chew. Some patients experience dizziness, chronic fatigue, and difficulty swallowing. And it usually starts with jaw misalignment.

When there's an imbalance in the jaws, the muscles in the neck and shoulders try to compensate, causing pains and headaches that can't be relieved until the jaws are realigned.

How do dentists realign the jaws? With a special dental splint and by repositioning the teeth using grinding procedures to produce a better fit between the upper and lower teeth. In a small number of instances, surgery may be required.

If you or someone you love suffer from the symptoms of TMJ dysfunction, call your dentist's office and set up a consultation. It may end years of suffering and pain.

TMJ Symptoms – How Headaches and Jaw Pain Can Be Relieved with TMJ Treatment form a Qualified Dentist

One out of every 10 Americans suffers from chronic headaches, and they spend over half a billion dollars every year for over-the-counter medications to relieve their pain.

They never imagine that their headaches may be caused by TMJ and that their pain is the result of a bad bite.

A bad bite can put your jaw-to-skull relationship out of alignment. When this happens, TMJ symptoms occur. This cluster of TMJ symptoms can include headaches, earaches, ear ringing, loud jaw clicking, and even stiffness and pain in the jaw, neck, shoulders, and back. This cluster has puzzled doctors in the past. Now we can put a name to it: TMJ.

According to recent studies, more than 40 million Americans suffer from TMJ (Temporomandibular Joint Disorder) or MPD (Myofascial Pain Dysfunction). The good news is dentists are taking the lead in finding solutions.

If you, or someone you love, suffer from the symptoms of TMJ, set up an appointment with your dentist soon. You may find that TMJ is the missing piece in the puzzle–and that the treatment works!

What Is TMJ Syndrome Anyway?

The first symptom you may notice is that you can't eat a Big Mac anymore; it's just too big for your mouth.

Or you have a headache and your shoulders are stiff; the pain fluctuates from bothersome to excruciating.

Or chewing gum becomes torture, and you find yourself ordering soup and yogurt.

These are some of the signs of a TMJ disorder.

The term is a catchall for a variety of disorders relating to the temporomandibular joint—or TMJ—of the jaw.

The TMJ, which lies just in front of the ears, is a complex system of bone, cartilage, muscle, and nerve that when working properly gives the jaw tremendous versatility and strength.

When the joint is abused by teeth grinding, injured by a blow to the jaw or head, or weakened by age, jaw pain can result. Stress, trauma, a bad bite, or arthritis can strain the jaw beyond design.

Dentists are more familiar today than in previous generations with the symptoms: jaw clicking, jaw popping, migraine, headache, and the causes and treatments for the complex disorders.

A more stressful society is also taking its physical toll. The most dramatic research shows one in five Americans suffer from some degree of TMJ disorder. More conservative estimates put the number at one in 10.

However, many of those cases only may reveal themselves through a rather benign clicking or popping in the jaw.

In turn, the treatments prescribed by TMJ treatment clinics range from counseling and psychological therapy to splints and, in severe cases, surgery.

Tooth Whitening Dentistry

Create the Smile That You Always Wanted with Tooth Whitening

Since the beginning of time, people have battled the effects of aging in order to look and feel younger. History has repeatedly shown us that people will journey to the far ends of the earth for ways to improve and maintain a youthful appearance—whether it is in search of the fountain of youth or to find a plastic surgeon or cosmetic dentist to surgically enhance their facial structures. Plastic surgeons have been instrumental in making facelifts and other related procedures more common to the mainstream population. As a result, a paradigm shift has occurred in how we view ourselves as we get older.

Dentists can now use laser tooth whitening to whiten teeth.

The shift has made the average person more knowledgeable of the link between lifestyle and appearance. Consequently, people are changing their habits, attitudes, and preconceived perceptions of aging.

Your Smile Affects How Old You Look

Laser tooth whitening dentistry procedures are like great paintings and sculptures. Your body is the canvas or clay, your face and bone structure are the frame, and at the center of the painting is your smile. In order to make masterpieces appear life-like, artisans must have an understanding of general anatomy and bone structure.

Equating those concepts to aging, you can say that your youthful appearance is as dependent upon how much support you have for your soft tissues. The old adage "Beauty is only skin deep" does not apply to plastic surgery and cosmetic dentistry. Time has a way of shrinking the underlying bone and teeth. If surgeons and cosmetic dentists do not restore what is lost, they will not be able to achieve a natural look.

Using cheek and chin implants in conjunction with facelifts are just some of the ways surgeons restore facial support and beauty. Cosmetic dentists use laser tooth whitening, bonding, and porcelain veneers to create a more youthful smile.

By Benjamin O. Watkins, III, DDS

Look Younger with Teeth Whitening

No doubt about it. We're living longer, we're living better. All that effort put into diet and exercise is paying off. And while you're going through your paces on the treadmill, consider another part of you that might need a bit of improvement: your smile and whether or not you have white teeth.

With age, one of the first things to go is the freshness of your smile. At about thirty, tooth color begins to dim. There is a natural tendency for dentin, just beneath the enamel, to yellow. And if you smoke or overindulge in coffee or cola, the darkening can be dramatic. Exercise and low-fat foods count for less if your smile gives you away.

But just as our health habits have improved, so has cosmetic dental technology. Now we have the tools and teeth whitening products to perfect the color, and the healthful look, of your teeth.

Teeth whitening systems take many forms. There are gels and solutions accelerated by light; laser tooth whitening is coming into use to "jump-start" the tooth whitening process. We can change color fast or over time.

In any case, the result is visible in days and, with touch-ups, will last as long as you do.

You've lived this long, you've earned it. While perfect thighs are next to impossible, a pretty smile is within everyone's reach. Go for it; don't let your smile age faster than the rest of you.

Stop the Color Purple with Tooth Whitening and a Great Dentist!

Stains on your teeth can advertise your vices—coffee, cola, nicotine—or tell the world what you do for a living. Trumpet players and copper miners, for instance, can be picked out of a crowd by the blue-green stains on their teeth from copper dust. Furriers work with nitric acid, which causes the blackening of enamel.

Red teeth stains might show a history of typhus, cholera, pulp injury, or just beets for supper. And the color purple indicates a non-vital tooth or probably not—leprosy.

Whatever the color of your teeth stain, our teeth whitening methods can whiten it, mask it, correct it, and give you back your pearly white teeth.

Teeth Bleaching Questions

Do you wish that you had whiter teeth? Have you tried and been disappointed by the over-the-counter teeth whitening products, whitening toothpaste and those mail order kits? Well, here is a safe, easy, and successful way that you can REALLY whiten your teeth.

Using a professional teeth whitening system, you can get dramatic results in a matter of days by teeth bleaching at home. Some products use a pH neutral formula that has been approved by the FDA. Interested? Questions?

Q: What is tooth whitening?

It is a whitening process that lightens the discolorations of enamel and dentin. The teeth whitening system uses a whitening gel that is retained in a custom-fitted appliance.

Q: Is the process safe?

Clinical research has shown that using a properly formulated professional tooth whitening gel under the supervision of a dentist is safe for teeth and gums.

Q: How long does it take?

Results are usually seen in the first several days. Maximum results generally occur when the process is continued for 10 to 14 days (or nights).

Q: How long do the results last?

The teeth will ALWAYS be lighter than they were. However, some patients may choose to touch-up periodically, one or two nights every six months. If you think that you might benefit from this tooth bleaching process, be sure to let your dentist know. He or she would be happy to assist in providing you with whiter teeth and a brighter smile!

Teeth Whitening and Teeth Bleaching: Explore the Revolutionary Advanced Dental Techniques to Bright, White Teeth

Advanced dental techniques now provide consumers with exciting, new options for enhancing their smiles. Revolutionary methods are now available for tooth bleaching to make smiles sparkle!

Teeth bleaching or whitening lightens the color of teeth whether darkened from age, coffee, tea, or tobacco. The brightening effects of teeth whiteners can last up to five years after the treatment depending on your personal habits, such as smoking or drinking coffee or tea.

Is Tooth Whitening Right for You?

Teeth bleaching has a higher than 90% success rate. It is tough on stains but gentle on your teeth! Results vary depending on several factors such as teeth stained from smoking; from taking certain medications such as tetracycline during tooth development; or from fluorosis, a condition occurring in the presence of too much fluoride.

A tooth whitener will not lighten fillings or artificial materials used in dental repair such as crowns, porcelain veneers, etc. Your dentist may discourage treatment if you have sensitive teeth, periodontal disease, teeth with worn enamel, or if you're pregnant or breast-feeding.

Tooth Bleaching – Several Options Available

Some tooth whitening treatments are performed in the dental office using an in-office bleaching system, such as laser bleaching. This method lightens teeth instantly. The same results may be obtained more economically through dentist-supervised at-home tooth bleaching, but take longer to achieve. Some teeth whitening systems, which bleach your teeth while you sleep, work in 10 to 14 days (or more accurately nights)! Others bleach your teeth from two to four hours a day requiring three to six weeks to complete.

It's important to know that certain types of stains respond better to different types of whitening materials. In such cases, your dentist may recommend one tooth whitener method over the other.

Teeth Bleaching – The Steps to Bright, White Teeth

  • Your dentist will first examine your teeth and gums and discuss the procedure best suited to your individual needs. Any cavities or gum disease problems must be treated before teeth bleaching can begin.
  • The in-office method generally takes one to three hours and results in an immediate noticeable change.
  • For the at-home method, special molds will be made of your teeth. These will be used to make custom-fitted flexible trays that will hold the bleaching gel comfortably in your mouth.
  • When you get your tooth bleaching trays, you'll receive instructions about wearing them. These directions must be carefully followed. Only the materials provided by the tooth whitening dentist can be safely used.
  • After completing the treatment, your teeth will be checked by your dental provider to discuss the results.
  • Your new white teeth will radiate a bright look!

Safety

Research over the last five years has proven that teeth bleaching is both safe and effective. The American Dental Association's seal of approval has been given to a wide range of tooth whitener products. Generally, the only side effect from treatment may be some sensitivity to hot and cold foods. If this occurs, sensitivity normally disappears within 48 hours.

By Brian J. Gray, DDS, MAGD, FICO

Tooth Bleaching Before Dental Crowns from Your Dentist

If you require crowns to be placed, it is a good idea to evaluate how you feel about the color of your existing teeth before beginning the process. If you like the color of your teeth, the dentist will then match the crowns to that color. On the other hand, if you feel you would like to whiten or lighten your teeth, it is a good idea to communicate this to your dentist beforehand about tooth whitening. Once the final restorations are made, it will not be possible to change their color without redoing them.

At-Home Teeth Bleaching

If you desire whiter teeth before the crowns are placed, the best way to achieve this is to talk to your dentist about at-home teeth whitening. With this procedure, custom-fitted plastic trays will be made for your teeth and you will be given some small tubes of dental bleaching material. Your dentist will show you how to place a small amount of bleaching material in the tray and then place the tray in your mouth. The tray is then worn for one to two hours in the evening, depending on the type of material. The biggest advantage of this method of teeth whitening compared to procedures that are done in your dentist's office is, that you are the one who can control how white your teeth will be. Since you are the one in control, you can stop bleaching whenever you feel you have achieved the desired color. The typical bleaching time is one and one-half to two weeks, but it may be longer.

Sensitivity to Tooth Bleaching

Your teeth may become sensitive to cold air or liquids during the tooth bleaching process. This is normal and will subside and finally go away when you stop bleaching. There are a couple of things you can do to decrease this sensitivity if it arises during the tooth whitening process. One is to only bleach every other night. The other is to have your dentist prescribe for you a fluoride gel that you can place in your custom bleach trays every other evening. The fluoride acts to decrease the sensitivity by coating or sealing the tooth surface. It will not affect the color of your teeth. This is the most reliable way to decrease sensitivity while you bleach. Once you get your teeth to the desired color, your dentist will have you wait about three to four weeks before taking a color match of your new white teeth in order to make the final restoration. During this time, the color of your teeth will be stabilizing.

Once the Restorations Are Placed, What Can You Expect?

Teeth bleaching is a very predictable method for getting white teeth, but the results will not last forever. Since the restorations were placed when your teeth were at their whitest, you will most likely find that in one and a half to two years, the restorations may begin to appear lighter than your natural teeth. This result is to be expected. It is not caused by a change in color of the restorations, but rather by your own teeth getting darker. At this point, all that is required is to, once again, bleach your natural teeth until the color is evened out. Usually, this only requires bleaching a couple of times. After the color is evened out, you can then expect to have the color stability last for another one and a half to two years.

By Greggory Kinzer, DDS, MSD

Tooth Whitening – Why Are My Teeth Discolored?

If you're embarrassed by your discolored teeth, you're not alone. There's a reason cosmetic dentistry, including teeth whitening, is a multi-billion dollar industry. We all want brighter, whiter teeth. While it would be nice to get the smile you'd love naturally, that just isn't an option. So, who's to blame? Why are you struggling with tooth discoloration to begin with? Good news—it may not be your fault!

Common Causes of Tooth Discoloration

There are a number of causes of potential tooth discoloration, and some are completely unavoidable on your part. While the precise cause of your tooth discoloration may be difficult to peg down, chances are one or more of the following causes are to blame.

  • Food and Drinks. You may have heard that coffee, tea, and soda can stain your teeth, but did you know certain veggies, like potatoes and apples, can stain them as well?
  • This is a given. Smoking and chewing will not only discolor your teeth, but can also cause gum disease or contribute to oral cancer (among other health conditions).
  • Poor Dental Hygiene. If you don't want to give up your morning coffee or kick your smoking habit, then you're going to have to try to compensate with excellent dental care. Regular brushing and flossing can reduce the odds that you will stain your teeth. Regular checkups and cleanings are critical, too.
  • Ahh . . . finally, we're discussing possible causes for tooth discoloration that aren't your fault. Several diseases that affect tooth enamel and dentin can lead to tooth discoloration. What's more, treatments for certain conditions, such as chemotherapy to fight cancer, can discolor your teeth. If you're pregnant while suffering from one of these ailments or undergoing one of these treatments, the teeth of your developing child may be affected as well.
  • Certain antibiotics, such as tetracycline and doxycycline, can discolor your teeth, particularly if used before the age of 8. Mouth rinses and washes containing chlorhexidine and cetylpyridinium chloride can also stain teeth, while antihistamines (like Benadryl), antipsychotic drugs, and antihypertensive medications also cause discoloration.
  • When all else fails, blame mom and dad.
  • Nothing escapes the effects of age—not even your teeth.
  • Excessive fluoride from environmental sources, such as naturally high fluoride levels in the water, can contribute to discolored teeth.

While there are many causes of tooth discoloration, today there are also many ways to get whiter teeth.

Tooth Whitening Basics: Recapture Your Smile!

From unusual ointments to hydrogen peroxide injections (yikes!), people have sought the secret to longevity for decades. Now, more than ever, people are willing to go to extremes to retain their youthful looks. While many of these strategies are risky or downright unsafe, there is one relatively simple way turn back the years: teeth whitening. Sure, whitening your teeth may not help you live longer, but it can restore your smile, rolling back years of coffee and other stains. While there are a variety of professional tooth whitening and bleaching methods available today, most of them are safe and relatively effective. Those carried out under the supervision of a dentist will ensure maximum results and optimum safety! Here are a few of your options.

Teeth Whitening Toothpastes

While using a tooth bleaching toothpaste may be the easiest, most affordable way to brighten your smile, it isn't ideal for those searching for a significant improvement. Some produce marginal improvement, while others produce none at all. They are relatively safe, but be sure to contact our office if you find your teeth are more sensitive than usual. Some lightening chemicals can actually erode tooth enamel, damaging your teeth.

Over-the-Counter Tooth Whitening and Bleaching Agents and Strips

Whitening agents and strips are more popular than ever before, and vary dramatically in price and effectiveness. While most are generally safe, it's important to follow the manufacturer's instructions carefully. As with whitening toothpastes, some agents and whitening strips can be too harsh, damaging your teeth and increasing their sensitivity.

Dentist-Managed Teeth Bleaching Trays

One of the safest, most effective ways to whiten your teeth is through dentist-managed tooth bleaching trays and whitening agents. If you choose to go this route, your dentist will begin by taking a mold of your mouth to design a plastic tray that will fit snug against your teeth. You'll spread tooth whitening gel through the tray, slip it over your teeth, and let it do its job! Continue to do this over a course of a few days to acquire the results you were looking for. Once again, please report any sensitivity to your dentist.

Chair-Side Teeth Whitening

Also one of the safest, most effective whitening techniques, chair-side whitening is chemical teeth bleaching done by your dentist, in-office, in about an hour or so. There are a variety of options available today—your dentist can steer you in the right direction. While chair-side professional tooth whitening and bleaching can be a bit more expensive than other alternatives, it's done under the supervision of a professional and delivers fast results.

White Teeth Look Sensational!

How would you feel if your smile was a bit brighter than it is right now? Whiter teeth not only look sensational, they build the kind of inner confidence that really gives a smile its electricity. And you might be surprised what simple, affordable teeth whitening systems are available these days.

You may have seen TV advertising for toothpastes that whiten your teeth. The results can't match what a dentist can do for you. Professional tooth whitening products used by your dentist effectively lighten brown and yellow enamel discoloration caused by smoking, cola, coffee, or tea, and sometimes by childhood antibiotics use. A special gel is placed inside a custom-made tray that covers your teeth. The process takes place under a dentist's supervision to insure that it's safe for your teeth and gums.

The best candidates for professional teeth whitening are people with otherwise healthy teeth, minimal enamel loss, and stains that are on the surface of their teeth (from coffee, for instance) rather than inside.

Typically, improvement is seen in the first few days but maximum results occur when the process is continued for 10 to 14 days. Some patients may choose to return for periodic touch-ups to maintain their pretty smile.

If the color of your teeth concerns you, professional teeth bleaching may be the answer. Call your dentist and schedule a personal consultation.

Who Wants Whiter Teeth?

Tooth bleaching is a way to lighten teeth without bonding material to the teeth or removing any sound tooth structure. In this respect, it's one of the most conservative cosmetic procedures. It's an "old" procedure, back in vogue.

How does professional tooth whitening work?

First, the tooth is isolated with a rubber dam. This protects your gums and tongue, too. Then the tooth is cleaned thoroughly. Your tooth may or may not be pre-conditioned to help the teeth whitening products penetrate.

The tooth is covered with gauze, and the teeth bleaching solution is carefully applied. A heat source "cures" the bleach and hastens the process. These steps are repeated several times, depending on the appropriate level of whiteness you want to achieve. The color of adjacent teeth will be considered too, so you'll look natural (there is such a thing as too white).

A professional tooth whitening session takes 30 to 45 minutes—and there you are. After three to five sessions, the tooth really shows the difference.

Does professional tooth bleaching work for everyone?

The success of the procedure depends in part on what caused the tooth staining in the first place. Surface coffee, tea, and tobacco stains that resist cleaning can be bleached away (the stains will reappear over time if you continue to indulge, of course). Antibiotic staining—from tetracycline, for example—is a bit harder to treat with simple teeth bleaching. Alternatively, a jacket or porcelain veneers may be called for. The idea is to be very selective about which tooth is a good candidate for the procedure.

Wouldn't You Love to Have White Teeth and a Bright Smile?

How would you feel if your smile was a bit brighter than it is right now? White teeth not only look sensational, but they build the kind of inner confidence that really gives a smile its electricity. You might be surprised at what simple, affordable professional teeth whitening, teeth bleaching, and other cosmetic treatments can offer to do just that and which are available today.

You may have seen advertising for tooth whitening toothpastes. However, the results of those teeth whiteners can't match the results we can give to you with our professional teeth whitening. Our tooth whitener effectively lightens brown and yellow enamel discoloration. We use a special gel inside a custom-made tray that covers your teeth.

Dental Financing

Avoiding Big Dental Costs

Whoever warned against being "penny wise and pound foolish" must have been thinking of times like these. When the economy is just limping along (and dollars are tight at home), it's natural to look for ways to cut down on unnecessary expenses. Too often, cutting back on today's unnecessary expense leads to far greater costs just a ways down the road. And that's especially true of dental care.

Of course, your dental practitioner recognizes that every household economy goes through its own ups and downs. But they also believe that maintaining a high level of health is the cheapest form of insurance. So they'll work with you to get the dental care you need, and information on dental financing—when you need it.

When You Wait Too Long, a Lot Can Happen

  • Gum problems don't hurt at first, so you may not even know you have disease lurking. And periodontitis can flare up despite conscientious home hygiene.
  • Old fillings can leak at the margins where filling and tooth meet, inviting decay under a filling. If you let it go, it's crown time.
  • A fractured tooth is often invisible and may require a root canal to save it. Waiting for it to heal usually results in dental bridges.
  • If you're missing a tooth, your neighboring teeth will grow disrupted and loose.
  • Topical fluorides and sealants are a good idea for children, even adults.
  • Early orthodontics can save you a bundle later on.

Another wise philosopher pointed out, "There's a time in the life of every problem when it's large enough to see . . . and small enough to solve." It might be a good idea to look into dental financing. By catching dental problems before they grow, you'll be spared both money and discomfort in the long run.

Choosing Dental Health: Three Reasons Why It Is a Wise Choice for Care

Most of us think that taking care of our teeth is about having a great smile and avoiding the discomfort of a toothache. Although these are valid and important reasons for maintaining a good oral health program, there are three other equally strong reasons to consider.

First of all, dental health is part of your overall health. Second, choosing dental health is a wise investment of your time and dental financing resources. Third, your emotional well-being is influenced by how you think and feel about yourself. Your smile is a big part of your image of yourself. Let's examine each of these areas more thoroughly.

Your Physical Health

How easy it is to forget that our teeth, gums, and mouth are essential parts of our physical body. Periodontal disease, bone and gum loss, and infections all affect the overall picture of our physical health. The ability to chew our food well helps digestion and reduces stress on the gastrointestinal system.

Like any physical system, each part of the body plays a role in the overall health of the system; taking care of your teeth and gums is a part of an intentional plan for physical health. In collaboration with your dental team, you can create a plan for your dental health that will contribute to your overall health plan.

A Wise Investment

There are two important resources that you use and allocate in your everyday life: your time and your money. When it comes to your dental care, they are closely related. The time you take every day to invest in your dental health is also an investment in your financial health. When treatment is necessary, the dental financing is also an investment in your financial future.

Proper treatment today prevents more costly complications and uncomfortable problems tomorrow. For those who seek to maintain their dental health for life, it is a wise investment to get the most value from the knowledge and skills your dentist and the new dentistry offers you.

Emotional Well-Being

How you feel and think about yourself is an important part of your emotional well-being and a pleasant smile plays a big role in this. In addition, when you take an active role in caring for yourself, it also contributes to your overall sense of competence in managing your life and maintaining a positive lifestyle. The habit of dental self-care and regular dental hygiene examinations reinforces taking positive steps for yourself in other areas of your life.

The new dentistry also can provide you with innovative and effective ways to create and maintain a pleasant smile that you feel good about. When it comes to feeling good about yourself and your smile, the new dentistry offers many exciting and effective options.

By Brian DesRoches, PhD

Dental Costs

Most everyone is feeling the economic pinch in some way or another. We can't pretend the picture is particularly rosy.

On the other hand, we've all heard the term "false economy." In difficult financial times, some people put off the dental care they need and wait for things to "get better." When it comes to dentistry, that's false economy.

We know budgets go through ups and downs. We also believe that catching small dental problems before they grow will, in the long run, save dental costs. A lot of expensive damage can happen over time.

Say you miss a regular cleaning. You're inviting gum problems like gingivitis, which multiply painlessly, to set in. Old fillings can crack or leak—decay may invade the tooth beneath the filling. Inattention to broken restorations eventually means a crown, certainly the more costly alternative to early repair.

Don't put off dentistry. Don't sacrifice your family's health for economy's sake. When it comes to your mouth, in most cases, a small problem only gets bigger—and more expensive. Preventive care is money in the bank.

Your dentist would like you to share your concerns with his or her financial coordinator. They'll do their part by helping you keep healthy with dental financing. For patients who qualify, they probably can arrange a personal dental loan plan for your care. They're there with options. And they believe good dentistry is good economy.

Dental Fees

Imagine this: a homeowner, to save a few dollars, decides the roof shouldn't be repaired, the broken windows replaced, the leaky pipes fixed. Think that's the best way to protect such a valuable asset? Of course not.

Yet many people put off caring for the most important asset they have—their health—because of economic reasons. Penny wise and pound foolish, wouldn't you agree?

When it comes to payment for treatment, your dentist's office is committed to helping you comfortably manage your treatment and dental costs through a variety of options.

Their first concern is always the state of your oral health. They start by evaluating your current and future needs, and then creating an individualized treatment plan. You may be given a detailed description of their recommendations, plus an estimate of the dental fees that may be incurred.

If you're covered by dental insurance, they will map a plan to achieve the most benefits possible from your carrier. For instance, they may plan to have treatment spread over two "insurance years" to take full advantage of your available benefit dollars.

While you are always responsible for your total obligation (even if insurance benefits result in less coverage than anticipated), your dental office is available to work on an individual basis to develop a dental financing program that makes sense.

Remember that your adult teeth are the last natural set you will ever have. Economics should not stand in the way of preserving and protecting them.

Dental Information: The Costs Associated with Root Canal Treatment

What Are the Costs Associated with Root Canal Treatment?

There are many factors that affect the costs and payment associated with root canal treatment. Each patient and tooth presents a different set of circumstances. Generally the cost of root canal treatment is directly related to the chair time necessary to perform the treatment as well as to the costs of the dentist staff, training, and technology that the dentist has available when performing the procedure. Be sure to ask your dentist about dental financing credit, dental treatment financing, or if there is a possible loan for dental work available.

There are many factors that influence the amount of chair time necessary to treat any particular tooth:

  • The position of the tooth in the mouth.
  • The number of roots and the number of canals within these roots.
  • Root curvatures and the length of the roots.
  • The presence or absence of calcifications within the root canal space.
  • Special dental considerations. For example, it may be more difficult for the dentist to work through an existing crown or a bridge than to work on a tooth with only a small previous filling. Also, some teeth may have been severely broken down by past dental disease and these may have to be "built-up" before root canal treatment can even be started so that an aseptic field can be established and maintained during treatment.

In addition to the chair time involved for treatment, other factors are also taken into consideration when determining a fair fee for root canal treatment:

  • The cost of technology. Dentists who use state-of-the-art technology for certain procedures have invested in microscopes, computer digital radiography, ultrasonics, and specialized training courses for themselves and for their staff. The costs of these items are shared by those patients who benefit from them.
  • The costs of the dental office overhead include staff, rent, and supplies in addition to many other expenses. These costs vary significantly in different areas of the country.
  • Fees vary among practitioners due to differences in their endodontic treatment philosophies, which in turn dictate the chair time required, the materials selected, and the technologies utilized.

In conclusion, there can be marked discrepancies in the fees charged for root canal treatment by different dentists. Ultimately, the best value for care is treatment that is done once and works over a period of many years. Conversely, the most expensive dental treatment is the treatment that may cost less initially but does not work predictably and needs to be redone one or more times. The wise dental consumer does not make a treatment decision on the basis of cost alone.

Will Insurance Cover the Cost of Root Canal Treatment?

Dental insurance will usually help with a portion of the endodontic treatment fee. A variety of dental insurance plans are available. A specific benefit package is selected contractually by each employer for the benefit of the employees. Some benefit packages may restrict or not recognize certain procedures, while in other instances the yearly maximums are unrealistic for anything other than the most basic care. The dentist will make a professional judgment and treatment recommendation based on what is best for the patient, not on what is best for the for-profit insurance company. The total fee is the patient's responsibility but the dental office will work with the insurance carrier to get the maximum contracted benefit. The patient should speak with the dental treatment coordinator before treatment begins in an attempt to estimate the available insurance benefit. Be sure to ask your dentist about patient financing, dental treatment financing, dental credit cards, or if there is a possible loan for dental work available.

By Clifford J. Ruddle, DDS, in collaboration with Philip M. Smith, DDS

Dental Patient Financing

Your dentist's biggest concern is your dental health. Teeth are a priceless possession. Maintaining them should never have to take a back seat to details like dental costs or insurance coverage.

Your dentist's patient financing policy is probably pretty basic: somehow, they'll find a way that lets them perform the work you need now, rather than put it off for money reasons. Simply put, they're there to help.

As a patient, you should receive a proposed treatment plan that's right for you. You should also receive a complete description of what's needed and a dental fees estimate—so you know what, when, and how much—right from the start.

If you're covered by dental insurance, your dentist's staff will work to obtain the maximum benefit your plan allows. They may even elect to spread your treatment over two "insurance years" to expand your coverage. Every plan and patient, of course, is different.

If you're not covered by insurance, your dentist can still find a way to get you the dental work you need done. Credit cards, a dental loan, and monthly payments are all dental financing options you can explore in tailoring a program that fits your dental needs.

Your dentist realizes that dental costs will always play a part in the decisions you make together. But cost alone should never prevent you from seeking the dentistry you need early on before the problem gets worse—and more expensive.

Facts You Should Know about Dental Insurance

What Is the Best Dental Insurance Plan for Financing Health Care for Me?

Choosing a dental expense plan can be a confusing experience. Although there is no one "best" dental payment plan for financing health care, there are some plans that will be better than others for you and your family's dental payment plan needs. We will try to guide you in simple terms. However, rather than just giving you answers, the best thing we can do is to make sure you are equipped with the right questions for the dentists.

There are three major things to consider, each with their own unique set of questions. By considering the questions thoroughly, you will arrive at the right dental payment plan for you and your family.

  • How affordable is financing health care (cost of financing health care)?
  • How much will a dental payment plan cost me on a monthly basis?
  • Should I try to insure just major dental expense or most of my dental expense?
  • Can I afford a policy that at least covers my children?
  • Are there deductibles I must pay before the insurance begins to help cover my costs?
  • After I have met the deductible, what part of my dental expense is paid by the dental plan?
  • If I use dentists outside a plan's network, how much more will I pay to get financing health care?
  • How often do I visit the dentist and how much will my dental payment plan be each visit?
  • Do the included services match my needs (access of health care)?
  • What other dental providers are part of the plan?
  • Are there enough of the kinds of dentists I want to see?
  • Where will I go for financing health care? Are these places near where I work or live?
  • Do I need to get permission before I see a dental specialist?
  • Are there any limits to how much I must pay in case of a major illness?
  • Is the prescription medication which I need covered by the dental plan?
  • Have people had good results when covered by a specific dental payment plan?
  • How do independent government organizations rate the different dental plans?
  • What do my friends say about their experience with a specific plan?
  • What does my dentist say about their experience with a specific dental payment plan?

If you consider these elements carefully when choosing a dental financing plan, you can be assured the best possible outcome and minimize dental expense paid by you.

Four Ways to Be Understood by Your Dentist

What do you want from your relationship with your dentist? Oftentimes, this question is answered when there is a dental problem or emergency requiring immediate attention. There is a different approach to your relationship with your dentist that relates to your own needs and dental health. This approach is designed to help you create the kind of experiences you want with your dentist.

You have a choice about this relationship and how it can support and assist you in your life. It begins with the simple question stated at the beginning of this article: What do you want from your relationship with your dentist?

The answer to this question can take many forms. For some people, it may mean having a lot of information about their dental health and future. They seek facts to know they are making good, informed decisions. Others may want a friendly relationship in which openness and communication are valued. They want information but, more importantly, they want to know they are important to the dentist and the dental team. Some individuals want minimal information and discussion—just the facts and the solutions to take care of any dental or dental financing problem.

We all have different wants in our relationships with health professionals such as dentists. Here are four tips to assist you in deciding what you want in your relationship with your dentist:

  • Do you want a lot of detailed information about actual problems or potential problems or do you prefer a quick summary of data with recommendations about what to do?
  • Do you like to make quick decisions or do you prefer to think about things before you act?
  • Do you like to talk about what is happening or do you prefer to have your dentist just tell you what is going on?
  • Do you want the dentist to describe a problem situation and solution with pictures so you can see what it happening or do you prefer to go on gut feeling?

Each person looks for different things in their relationships. It is your responsibility to determine what you want and look for that in the relationship with your dentist. The answers to the questions above will tell you something about this.

The next step is communicating what you want so that you are understood. Only you know when someone else understands you. Here are four tips to assist you in this communication process:

  • Tell your dentist that you have some ideas about how he or she can assist you with your dental health and dental financing.
  • Ask when it would be a good time to discuss your needs and desires for your dental care and relationship with your dentist.
  • Communicate what you want and how that will help you.
  • If you had a negative experience in the past with another dental professional, always discuss what happened. Past hurts or disappointments have a way of negatively influencing present situations that are similar in nature.

Communicating what you want is important to your dentist for it is the best way for him or her to plan for the optimal dental health for you.

By Brian DesRoches, PhD

Maximizing the Benefits of Your Dental Team

The new dentistry brings together a unique complement of skills, knowledge, and capabilities with one primary focus: ensuring your dental health care. Working as a team, your dentist and the dental finance team he or she has assembled wants to recruit you to join them in making sure this focus is maintained. The dental team has two major parts that you may hear referenced during your visits: the "back" and the "front." These terms refer to two very specific functions of your dental team. The front office handles all the administration, scheduling, and dental financing, and the back office provides the treatment.

Your front office team makes sure you know about scheduling opportunities, handles dental finance, and keeps the administrative details under control to provide you efficient services and support. The back office team is thus free to do what they do best: provide the best dental health care, financing health care and service for you. You'll find the dentist, dental hygienist, and dental assistant ready to assist you during your appointments.

The key component for success of any team is each member's commitment to do their part. As a consumer and team member, your commitment involves three things:

  1. Maintaining your commitment to your dental health through regular hygiene appointments and the daily practice of flossing and brushing.
  2. Asking questions and getting the essential information you need about your teeth and gums or to understand any treatment plans or dental financing.
  3. Staying open to options and opportunities that the new dentistry offers you by thinking about the information and feedback that your dentist provides you about the status of your dental health.

You can maximize the benefits of the skills and expertise of your dental finance team by deciding for yourself what kind of relationship you want with your dentist and the dental team and how they can help you achieve a positive outcome for your dental future.

New Dental Procedure FAQs

Q. What is the new technology dentists are using that reduces or eliminates discomfort from shots given during a dental procedure?

A. A computerized injection system called The Wand has been shown to significantly reduce patient discomfort in delivering oral anesthetics. In a study of patients who have had procedures using it, more than 80% of them reported that it was a completely painless process. Consult your dentist to see if this dental procedure is covered by your dental care payment plan.

A very thin needle is attached to a pen-sized wand and placed near the gums. A drop of anesthetic numbs the gum before the needle is inserted. There is no prick or burning sensation with this system. As the needle glides through the gum, the anesthetic continues to be released. When the needle is fully inserted, the computer slowly releases the anesthetic. This eliminates the usual cause of the discomfort of the traditional dental shot—the pressure associated with the stream of anesthetic flowing into the gum.

Q. How can early tooth decay be detected?

A. A dentist can put a "caries detection dye" on a suspicious tooth. This colored liquid helps identify the position and the extent of decay that is not visible to the naked eye. The dental procedure price may vary.

Q. Are there any new prevention treatments for reducing tooth decay?

A. New prevention treatments are being studied. Research has shown that a tooth-decay inhibiting treatment can effectively eliminate the bacteria that cause tooth decay in humans. One promising treatment still in development is a caries vaccine, CaroRX, a tasteless, colorless antibody from genetically-altered plants, which is painted on clean teeth to prevent decay-causing bacteria from sticking to teeth. Planet Biotechnology, the manufacturer of CaroRX, hopes to gain FDA approval and make this product available to dentists within the next few years.

Q. What are intraoral cameras?

A. An intraoral camera is a miniature video camera that the dentist places in the patient's mouth so that together they can view any dental problems that the patient is having. The image from the camera is enlarged and sent to a monitor for viewing.

Q. What is the purpose of intraoral cameras?

A. The purpose behind intraoral cameras is to allow the patient to see the specific area that needs treatment so that they are more likely to understand the dentist's recommendation and accept it. Ask your dentist about this dental procedure and whether it's covered under your dental patient financing program.

New Dentistry: A Partnership for Your Health and Well-Being

A world of opportunities for dental health awaits us in the new dentistry. Using the old dentistry, dental professionals did their best to provide a high quality of service given the state of knowledge and technology at that time. Through advancements in treatment, research, and the desire of the dental profession to do more and do it better, the new dentistry has emerged. It is based on a foundation with specific characteristics that are of great benefit to us as consumers.

Efficiency

Your time and your resources are valuable to you, and your dental professional recognizes this. New treatment techniques and methods have considerably reduced the amount of time that the dental care now takes. The return on your investment in dental health is excellent.

Comfort

Not only are the dental chairs and the office environments more comfortable and pleasant, improvements in the use of local anesthetics and new equipment provide more comfort than ever before.

Collaboration

The dental relationship is now based on the value that you can derive from your dental team and what you want for your dental future rather than just on the techniques and procedures your dentist can do. Through continuing education, your dentist has the skills and knowledge to help you make decisions for your dental health in a positive and informed way.

Predictability

New materials and advances in treatment provide you with opportunities to maintain your dental health throughout your life. With the innovative cosmetic dentistry and specialized approaches to reclaiming teeth that formally would be lost, your dental professional can help create and maintain teeth and gums. Predictable treatment, effective prevention methods, and the longevity of treatment are now part of any treatment plan.

Thoroughness

Advances in assessment and diagnosis now enable dentists to make thorough evaluations of your overall dental and oral health. The outcome is a plan for your health that will give you peace of mind, knowing you can have a well-informed dental plan in place.

Prevention

This characteristic of the new dentistry has received much publicity in recent years. It has been proven over and over again that there are several measures that you can take as a consumer of dental care to create and maintain your dental health in collaboration with your dental team. It bears repeating again—flossing and brushing combined with regular dental hygiene checks are your greatest allies in maintaining your teeth and a bright smile.

Precision

The new dentistry utilizes instruments and technologies that are far advanced from what was available even 15 years ago. Both general dental professionals and specialists have access to technologies that provide precision in diagnosis and treatment. The value for you is higher quality care.

The dental profession has established a strong foundation for a pleasant smile and a healthy dental future for all of us. Improvements are continuously being made to this foundation. You can choose to avail yourself of these improvements by asking your dentist, "What can help me to maintain my dental health?" They have the knowledge and the desire to help you, including information about a wide range of dental payment plans.

By Brian DesRoches, PhD

Scheduling and Planning for Dental Financing

Long-term dentistry always works best with a plan. So as each New Year begins, some dentists sit down with their patients and organize dental health care—in phases—for the coming year.

In the spirit of prevention, one patient might be scheduled for cleanings and periodic examinations to watch closely for developing problems and catch them before they grow. Another patient may call for complex restoration and will visit more often; in this case, the dentist will propose treatment step by step, over time.

Prearranged care makes sense. You know what to expect from the practice and can plan your time and dental costs accordingly. By phasing treatment, your dental fees are minimized and, in the end, you still arrive at the same finished product - a healthier you. Moreover, you'll rest assured, knowing you're getting the care you need. Because postponed dentistry inevitably means more dentistry.

For with dental insurance, tight guidelines are in place for pre-determination of coverage, submitting claims, and timely reimbursement. As treatment is planned for the year, you must monitor your benefits "bank" through the months, to be sure you're making the most out of your coverage. When year-end approaches, treatment may accelerate to take advantage of any remaining dental financing benefits before the next New Year and a new deductible.

Everyone is different: different needs, comfort level, and financial situation. So most dentists are flexible. Insured or not, patients deserve choices. Your dentist is willing to work with you and arrive at a schedule that suits you, a schedule you'll both respect.

Dental Hygiene

A Dental Hygienist Refresher Course on Flossing

How many times have you heard your dentist and dental hygienist tell you to floss? You nod your head and, maybe, you try flossing for a while. Then old habits take over. Well, it bears repeating: it is one of the best things you can do to keep your teeth and gums healthy.

Bacteria accumulate between the teeth and where the tooth meets gum tissue. Every 24 hours brings a new batch. Brushing won't get rid of the bacteria, flossing correctly will.

Flossing before or after brushing should be a part of your home oral health care program. It doesn't matter which floss you use, and it doesn't require special skills, although practice makes perfect.

Here's a general routine to follow: wrap floss around your fingers, leaving five to six inches to work with. Keep the floss tight.

When the floss frays, re-loop the floss and continue flossing.

If you feel as if you're all thumbs, use a flossing threader. Your dentist or dental hygienist can show you how.

Choose a section of teeth, say, your upper molars, which are most difficult to reach. Follow the curve of enamel on every surface, reaching wherever you can, with about three passes each time.

If an opening between teeth is tight, you may have to gently pull the floss toward the gum line. Be careful not to damage soft tissue.

Work from the back teeth toward the front while flossing, and then repeat the process on the other side. Rinse when you're done. The time you invest in plaque removal will pay real dividends at your next dentist cleaning visit. Your dental hygienist will be proud!

Are Your Teeth Temperamental? Dealing with Sensitive Smiles

Are you overly sensitive? Relax, it has nothing to do with crying during life insurance commercials. Millions of adults struggle with hypersensitive teeth, which means they are sensitive to hot and cold temperatures, very sugary or acidic foods and drinks, and vigorous tooth brushing. This kind of sensitivity is often called "dentin hypersensitivity."

Dentin is the tissue that makes up the core of each tooth. Above the gum line, dentin is protected with a coating of enamel. Unfortunately, as enamel is worn away or decayed, dentin becomes exposed and receptive to sensations that cause painful nerve responses. This can also occur as the result of receding gums, a common symptom of gum disease.

So what causes sensitive teeth? A number of things may be to blame. Overzealous brushing with a firm bristled toothbrush or abrasive toothpaste can lead to dentin hypersensitivity, as can gum disease, which is the result of poor brushing and flossing habits. Your diet may also play a role, as frequent consumption of acidic foods and drinks can chemically dissolve tooth enamel. Finally, abnormal wear on tooth surfaces from chronic clenching or grinding of teeth, nail biting, and chewing on hard objects can lead to sensitive teeth. To avoid the problem, brush and floss daily to maintain healthy gums and protect dentin from exposure. Avoid vigorous tooth brushing with a hard-bristled toothbrush.

If you're already suffering from overly sensitive teeth, your best bet is to contact your dentist for guidance on dental hygiene. In the meantime, there are products that can help. Desensitizing toothpaste used in conjunction with a soft-bristled toothbrush can help. Toothpaste designed for those with sensitive teeth can reduce the pain associated with the condition after only a few days of use.

Choosing Dental Health: Three Reasons Why It Is a Wise Choice for Care

Most of us think that taking care of our teeth is about having a great smile and avoiding the discomfort of a toothache. Although any dentist will say these are valid and important reasons for maintaining a good dental health program, there are three other equally strong reasons to consider.

First of all, dental health is part of your overall health. Second, choosing dental health is a wise investment of your time and financial resources. Third, your emotional well-being is influenced by how you think and feel about yourself. Your smile is a big part of your image of yourself. Let's examine each of these areas more thoroughly.

Your Physical Health

How easy it is to forget that our teeth, gums, and mouth are essential parts of our physical body. Periodontal disease, bone and gum loss, and infections all affect the overall picture of our physical health. The ability to chew our food well helps digestion and reduces stress on the gastrointestinal system.

Like any physical system, each part of the body plays a role in the overall health of the system; taking care of your teeth and gums is a part of an intentional plan for physical health. In collaboration with your dentist and dental team, you can create a plan for your dental health that will contribute to your overall health plan.

Dental Care – A Wise Investment

When treatment is necessary, the new dentistry is also an investment in your financial future. Proper treatment today prevents more costly complications and uncomfortable problems tomorrow. For those who seek to maintain their dental health for life, it is a wise investment to get the most value from the knowledge and skills your dentist and the new dentistry offers you.

Dental Hygiene – Emotional Well-Being

How you feel and think about yourself is an important part of your emotional well-being, and a pleasant smile plays a big role in this. In addition, when you take an active role in caring for yourself, it also contributes to your overall sense of competence in managing your life and maintaining a positive lifestyle. The habit of dental health self-care and regular dental hygiene examinations reinforces taking positive steps for yourself in other areas of your life.

The new dentistry also can provide you with innovative and effective ways to create and maintain a pleasant smile that you feel good about. When it comes to feeling good about yourself and your smile, the new dentistry offers many exciting and effective options.

By Brian DesRoches, PhD

Dental Cleaning and Toothbrush Basics

A good toothbrush is an essential tool for daily dental care and good dental hygiene. Not long ago, toothbrushes were all rather standard in design. Now they are available in a dazzling array of colors, sizes, and styles, angled heads, tufted bristles, powered by hand, electricity, or sonic waves.

When selecting a toothbrush for your teeth, always look for the American Dental Association's (ADA) Seal of Acceptance. This is awarded only to products meeting stringent testing for safety and effectiveness. Claims made by dental care products must be accurate for what they say, as well as imply, to receive the ADA Seal.

Manual Dental Cleaning

Choose a brush with soft, polished bristles and rounded ends, comfortable in both size and shape that allows you to reach every tooth. Hard bristles can injure your gums.

For good dental health, replace your toothbrush every three to four months or earlier if the bristles are frayed. Some brushes are designed with replacement indicators to help remind you when a new brush is needed.

Old, worn out toothbrushes don't achieve desirable results and may also hold harmful bacteria that can cause gum disease. It's also recommended that you replace your toothbrush after an illness. Children's toothbrushes may need to be replaced more often due to wear.

Electric Toothbrushes

There are a variety of powered brushes featuring different speeds, bristle rotations, and head sizes. Products vary and the manufacturer's instructions must be carefully followed. Check with your dentist to make sure you're using the brush correctly. Use a light touch and slow movements for maximum tooth cleaning effectiveness.

Electric toothbrushes offer convenience for the disabled and elderly with limited manual dexterity. Children under ten years old should be supervised.

Sonic Toothbrushes

With this new dental care technology, sonic waves remove plaque bacteria without actually having to touch it. Through the motion of sound waves, these toothbrushes are able to sweep away plaque in hard to reach places, between teeth, and below the gum line.

The sonic wave technology is gentle on teeth, even sensitive ones. These toothbrushes also have proven effective in reversing gum disease, shrinking periodontal pockets, and removing tough stains like coffee, tea, or tobacco.

If you have any questions about choosing a toothbrush for your preventative dentistry needs, consult your dentist. Whichever toothbrush you select, use it at least twice a day, as part of a good dental health care program.

By Brian J. Gray, DDS, MAGD, FICO

Dental Cleaning: The Right Schedule for You

The chemistry of your mouth is as unique as your signature. No two are exactly alike. And so, when it says in popular magazines that "you" need only a dental hygiene appointment twice a year to stay in good dental health, some dentists get very concerned. They don't know you. They're referring to an "average" patient. Dental insurance plans also tend to believe in this mythical "average patient" and may not pay for more than a bi-annual visit.

Sure, two visits are fine for many patients, even most. But some mouths build up more deposits of calculus than others. Some mouths are naturally decay-prone. Still others, and this is critical, may be showing signs of periodontal problems.

Bleeding gums need to be taken seriously. They're signs of an infection that can be a significant risk factor for heart disease. If you had a bleeding sore on your hand that didn't heal, you'd get to a doctor and have him check it out, right? Type I perio (gingivitis) consists of tender gums and a little bacteria-filled pocket between your tooth and gum. It's easily treatable at this point. But if the infected pockets are allowed to enlarge, that inflammation can extend to the bone beneath and erode it.

Your dentist's concern is for your overall oral health and your teeth, not whether you've made the standard number of appointments for this year. He or she wants the chemistry to be right in your mouth . . . and between the two of you.

Drink and Be Merry: Study Says Red Wine Is Good for Your Smile

If you were looking for an excuse to drink more red wine, it's your lucky day.

A study released by scientists from Université Laval in Quebec, Canada reports that compounds known as polyphenols in red wine have been found to stave off periodontal diseases. Periodontal diseases are those that affect the gums and bone around the teeth, often leading to permanent tooth loss. The research shows that the polyphenols, derived from red grape seeds, neutralize one of the major tissue destroying compounds associated with periodontitis, which affects a significant number of adults.

Red wine boasts a number of additional oral health advantages as well, such as having anti-tumor properties and preventing heart disease. Along with green tea, fresh fruits, and green vegetables, it has been known to reduce the risk of cancer and mortality. Still, it's important to err on the side of caution and drink only in moderation—no more than a glass or two a day. Needless to say, if you're prone to heavy drinking, it's best to steer clear of alcohol.

While red wine is preserving smiles across the globe, other sugary drinks are destroying them. U.S. schools have begun to restrict the types of sodas to prevent child obesity and tooth decay. Acidic drinks like coffee, a crutch for millions of groggy Americans each day, can have a negative effect on teeth as well. Even good old-fashioned juice has come under fire as of late, often noted for having a high sugar content but very few of the nutritional qualities attributed to whole fruit, such as fiber. Your best bet for good dental hygiene? Drink plenty of water. If you must have a sugary or acidic beverage, be sure to either brush your teeth rinse your mouth out with warm water afterwards.

Fighting Bad Breath with Good Dental Hygiene

Bad breath, or halitosis, is a signal that something is not right inside your mouth. It may be as simple as the need to pay more attention to your daily oral hygiene, or it may indicate tooth decay, gum disease, or another medical problem. Whichever it is, bad breath is a red flag: take another look at your mouth!

Bad breath is a social problem; if you have bad breath, you may notice that people actually back away as you talk to them. Mouth odors are embarrassing, and they tell other people that you aren't taking care of yourself.

Sometimes people are not aware that their breath smells bad; be alert to how other people react when they're close to you, and be grateful if a friend or family member lets you know about the problem.

Commercial products claim they will make your breath fresher, but the only way to make sure your breath permanently fresh is to practice good oral hygiene. In fact, eating too many breath mints and hard candies with sugar will lead to tooth decay. If you are constantly using breath mints, breath sprays, or mouth rinses in an effort to cover up your bad breath, you may have a dental or medical problem that needs addressing.

There are a number of reasons you may experience a bad taste in your mouth and even be able to smell your own breath. Food may be lodged between your teeth if you are not brushing at least twice daily and flossing regularly.

Food particles can be very tiny and can wedge themselves between teeth and below the gum line; brushing after meals is important and flossing is imperative to get at the particles that the brush can't reach. Also, you must brush your tongue or use a tongue scraper.

As odd as it will feel at first, bacteria collects on the tongue and can contribute to bad breath. If you wear removable dentures, take them out at night and clean them thoroughly before you wear them again.

If you neglect your dental hygiene over time, bad breath can become a symptom of more serious dental problems. Teeth that are not cleaned properly become a place for bacteria to reside as food particles stay in your mouth and decay. Bacteria attack your teeth and gums and cause cavities and gum disease. If this is happening, gum disease will cause an unpleasant odor.

Perhaps you are brushing and flossing on a regular basis, but are still experiencing bad breath. If you have teeth that are crooked or crowded, it may be hard for you to clean between them, and this can cause bad breath.

If you wear dentures that are not fitted properly, they may be trapping food or irritating your mouth. Or perhaps your bad breath is caused by another medical problem: drainage from your sinuses, gastrointestinal problems, kidney or liver problems, or other medical conditions.

Here's what you can do to investigate on your own. Write down what you're eating and notice whether your breath smells bad because of certain foods. Garlic and onions actually cause odor, but the odor is coming from your lungs as you breathe, not from your mouth itself. The odor from these foods is temporary and will be gone once the food is out of your bloodstream.

Are you dieting? Hunger can contribute to bad breath, because of the chemical changes as your body turns fat and protein into the energy it needs.

Are you taking prescription or over-the-counter medications? Add these to the record of what you're eating to see whether there's a relationship between your medications and your bad breath. And don't forget to tell your dentist if there's been a change in your overall health since your last visit.

Are you suffering from dry mouth? Saliva provides constant rinsing in your mouth and washes away food particles. Your dentist may recommend more liquids and sugarless candy to stimulate natural saliva and perhaps some of the commercial products that are available to combat dry mouth.

If bad breath continues after you have done your best job of regular brushing and flossing, start with your dentist or dental hygienist. He or she can tell you whether the odor is caused by an oral problem; if it is not, then your dentist will suggest you see your doctor for a physical check-up.

Regular dental check-ups will help keep your mouth healthy and working well. Your dentist can spot problems before they cause trouble, including problems that cause bad breath.

By Brian J. Gray, DDS, MAGD, FICO

Forks Are for Eating: Dental Hygiene across the Pond

Forks Are for Eating: Dental Hygiene across the Pond

From Austin Powers to The Simpsons, American pop culture has heckled the British for their allegedly bad teeth for years. Let's face it—even Prince Charles could use a good orthodontist. Now it looks like comedians will have fresh material, thanks to a national survey that polled Brits on their dental habits.

An overwhelming number of respondents admitted to cleaning their teeth with just about everything but floss, opting for everyday household tools instead. Nontraditional tooth picks included screwdrivers, earrings, forks, scissors, and (wait for it) knives. (Maybe they should consider putting restrictions on the use of ice picks.) To top it off, about half reported they don't bother cleaning food out from between their teeth at all. Yikes! Needless to say, the English dental community has admittedly fallen behind in dental education.

While it's easy to laugh at our friends across the pond, the truth is a number of Americans aren't doing much better when it comes to oral hygiene. Gum disease and tooth decay are two potentially serious conditions frequently overlooked by the American press. (Maybe they're too busy critiquing jolly England's smiles.) They are also linked to other health problems, including heart disease and low birth weight.

In order to maintain your own dental health, it's important to brush and floss every day. If you find particularly tricky debris stuck between your teeth, skip using your PDA's stylus to dig it out. Your best option is a wood (and therefore flexible) toothpick or dental ribbon, which is smoother than floss. Tying a small knot in it can help dislodge larger pieces of food.

So, the next time you hear somebody crack a joke at the queen's expense, consider your own flossing habits. And for Pete's sake, never use anything to clean your teeth and gums that wasn't designed for that purpose!

Healthy Eating for Good Oral Health

What you eat affects your oral health destiny. You can dramatically impact your dental health by eating a well-balanced, healthful diet. Research has shown that poor nutrition jeopardizes our oral health which puts you at risk for a number of serious dental problems.

The Food Factor

Our food choices can make a big difference in two of the most common diseases today: tooth decay and gum disease. Certain foods, especially those containing sugar, are directly linked to increased levels of cavity causing bacteria. Tooth decay results when acids from the bacteria attack the teeth forming cavities. While diet doesn't directly cause gum disease, a condition affecting the supporting tissues of the teeth, researchers believe the disease is more rapid and severe when poor nutrition is a factor. Gum disease is a serious problem, since it can lead to tooth loss if untreated.

Diet and Dental Health

The American Dietetic Association and the National Institutes of Health recommend eating a well-balanced diet including plenty of fruits, vegetables, a good variety of breads and cereals, dairy products, fish, chicken, dried beans and peas, and meat. Enjoying a variety of foods is the best way to get all the important nutrients needed for keeping healthy. Beware of fad diets that exclude entire food groups. This can cause nutritional deficiencies.

Snack Smart

Snacking is a favorite pastime, but certain snack choices promote tooth decay such as soft, sweet, sticky foods. Select nutritious snacks better for your teeth and general good oral health, especially colorful, juicy fresh fruits and crisp, crunchy vegetables. Choose your snacks based on any other dietary concerns, such as low cholesterol, low-fat, or low sodium diets. Dental cleaning should always follow snacking, whenever possible.

If you snack on crackers, cookies, or chips, it's better if you eat them in combination with other foods, such as cheese with crackers, rather than alone. This is because these foods when eaten alone tend to produce more bacteria in the mouth leading to tooth decay. Remember, each time you snack, oral bacteria is activated. Drink plenty of water to rinse away some of the disease-causing bacteria. If possible, brush your teeth after snacking.

Select from the wide variety of foods for healthful eating—that are good for you and your oral health.

By Brian J. Gray, DDS, MAGD, FICO

Healthy Smooching: Good Oral Hygiene Leads to Great Kisses

Whether you're preparing for holiday mistletoe or are just in the mood for some love, you're probably fully aware of the connection between the state of your mouth and the quality of your kisses. Still, a little reminder never hurt. Here's the skinny on getting lucky without embarrassment (from your mouth, anyway)!

Kick the Smoking Habit

I'm sure you're very familiar with the smoking lecture. Not only do tobacco products taste awful to your partner, but they put you at greater risk for oral cancer and periodontal or gum disease. Why put so much effort into knocking your sweetheart's socks off if you aren't going to be around to pick them up? If you don't kick the habit for your partner, do it for yourself.

Don't Chew Gum

The best smooches are spur of the moment, so it's best to be prepared for them. Besides, sugary gum can lead to tooth decay, a.k.a. cavities. If you must chew gum (maybe you want your breath to be in top shape), choose a sugar-free variety like Xylitol.

Brush and Floss

Nothing leaves an impression like bad breath, but it's not the kind of attention you want. Besides, healthy white teeth will help you build confidence in your smile. Brushing your teeth and gums is a good start, but take it a step further and floss each night. You'll dislodge food particles and remove odor-causing, not to mention tissue- and tooth-destroying, bacteria. If you don't have your toothbrush handy after you eat, at least rinse your mouth out with warm water. There are also a number of handy little dental hygiene products available for great breath on the go.

Take good care of your partner by caring for yourself. If you find that your gums are exceptionally tender or swollen, or if you have habitually bad breath, make an appointment with your dentist. These could be symptoms of a more serious problem!

Learn How Dental Hygiene, Tooth Abrasion, and Over Brushing Relate from Your Dental Hygienist

The issue of over brushing and its direct link to tooth abrasion has been a topic in many journal and news articles. A story in The Wall Street Journal (February 4, 2000) stated that in many cases, "the culprit in tooth abrasion is the toothbrush itself."

This issue is particularly important to because people can damage healthy teeth and gums by brushing too hard, oftentimes with a medium- or hard-bristled toothbrush. In fact, dentists and dental hygienists have a recommendation on how to brush your teeth they recommend that you use a soft-bristled toothbrush for your dental cleaning.

Your teeth and gums are susceptible to wear and tear like all other parts of your body. In cases of improper dental hygiene and brushing, such as brushing too vigorously, gum tissue can be worn away. Receding gums then lead to other significant dental problems such as sensitive teeth, periodontal disease, cavities, root canals, and potential loss of teeth.

Your dental hygienist will explain that brushing your teeth correctly includes adjusting the angle of your toothbrush (it should be at a 45-degree angle), lessening the amount of pressure you use, monitoring the length of time, as well as making sure that you are using a soft-bristled toothbrush. In addition, always ask your dentist for specific recommendations related to your dental hygiene care and healthy teeth.

While the potential harm to healthy teeth and gums through poor dental hygiene and over brushing is significant, an even greater percentage of the population suffers damage to their teeth from occlusion (bad bite), genetic factors, and poor overall dental cleaning. It is critical to carefully maintain and monitor your oral health.

The best approach to maintaining good oral hygiene is to brush your teeth twice a day with a soft-bristled toothbrush with fluoride toothpaste, floss or clean between the teeth using an inter-dental cleaner (special brushes, picks or sticks), and visit your dentist every six months. Follow your dental hygienist's advice with regard to any changes to this regimen.

By Brian J. Gray, DDS, MAGD, FICO

Make Your Dental Health a Priority

What's the best thing that's happened to you over the past year? A special vacation you'd been promising yourself? Or purchasing that new car you've had your eye on for a long while?

All of us look forward to pleasure purchases. They add luster to life. And if you think about it, the things we seem to find easiest to afford are the things that make us feel good about ourselves.

Yet, for most of us, number one on the list for a good life is good health. Today we know that good dental health is just as important as your overall physical wellness. After all, you only have one body and one set of adult teeth. How they serve you depends on the priority you assign them.

Make feeling good about yourself a priority. One component may be that dream vacation. But certainly another component is keeping yourself physically healthy enough to enjoy the experience. And that means paying attention to your oral hygiene and practicing preventive dentistry.

You don't need to be told that the actual cash you spend to keep yourself dentally fit is only a tiny fraction of what you spend to feel good about yourself. After all, it's no fun being able to afford a gourmet meal if it's painful to chew and swallow it.

Your dental hygienist will welcome your visit and looks forward to helping you help yourself to dental health with a good dental cleaning.

Oral Cancer and Smokeless Tobacco

"Dip." "Chew." "Pinch." Snuff." "Dirt." "Plug." All are different names for smokeless tobacco, a finely ground version of processed tobacco. No matter the name, smokeless tobacco is harmful and puts your health at risk. Chew on these facts:

  • About 30,000 new cases of oral cancer will be diagnosed in 1999.*
  • More than 8,000 oral cancer patients will die this year.
  • Tobacco products cause about 75% of oral cancers affecting the mouth, tongue, lips, throat, and parts of the nose and larynx.
  • Nearly 30 cancer-causing substances have been found in smokeless tobacco.
  • One can of smokeless tobacco a day delivers as much nicotine as 60 cigarettes!
  • You have a 50% greater risk of developing oral cancer with long-term use of smokeless tobacco.

*Cancer Facts and Figures, American Cancer Society, 1999

Smokeless tobacco has been glorified over time by images of "macho" men performing feats of fame and prowess, whether as athletes, rodeo cowboys, or country music stars. In reality, many want to kick the habit, but nicotine is addictive. It's hard for them to quit.

In a survey of major league baseball players, more than a third reported they had mouth sores, white patches, or gum problems. Nearly 60% said they wanted to quit. The nicotine actually decreases performance, causing dizziness and slowed reaction time.

Smokeless tobacco causes problems for your oral health:

  • White, leathery patches in your mouth or lips
  • Painful sores that may be pre-cancerous or cancerous
  • Yellow teeth and permanent tobacco-stained teeth
  • Exposed tooth roots from receding gums, likely to cause decay, sensitive teeth, and pain
  • Cavities from the sugar added to the tobacco
  • Bad breath
  • Greater risk for developing oral cancer

Additionally, smokeless tobacco can affect your general health:

  • Increased blood pressure and heart rate
  • A greater risk of heart attack
  • Withdrawal symptoms ranging from headaches, moodiness, and problems concentrating when you try to quit
  • Cancer that can be fatal

If you use smokeless tobacco, chew all these facts over. Choose to quit. Your health is serious business. Talk to your dentist about getting help to quit. Make the right choice—it's for your body, your health, and maybe even your life.

By Thomas Warner, DDS

Oral Health and Early Disease Detection

Most of your dentist's patients enjoy robust health, and he or she is thankful for that. In fact, if you are faithful about your "recall" appointments (regular check-ups), he, or she probably sees you more often than your physician does. That means much more to him or her than finding a small cavity or more than a chance to catch up on your comings and goings between visits.

As your primary dental health care provider, your dentist has a singular and weighty responsibility: early detection of disease. When he or she sizes up the health of your gums, tongue, neck, jaw, etc., he or she looks and feels. He or she "invisibly" observes your general health, head, skin, glands, sinuses, (and teeth, of course).

What is your dentist looking for? Simply put, anything wrong. Among them: dry mouth, bacterial infections, any lesions on the mucous membranes, gum color and texture, soreness or ulcerations, you get the idea. It's important for you to share with your dentist any general health problems you may have noticed or changes in medications. He or she needs the whole picture.

Practicing preventive dentistry is very important. There are more than 200 known diseases of the oral cavity. Your dentist is on the look-out for all of them. Not only can an oral problem signal local trouble, but it may indicate something systemic, something throughout your body.

For this reason, your six-month recall visit may be the most important exam you have all year. If a cavity is found, that can be fixed. If evidence of something more serious is found, then you benefit from the advantage of early detection.

Your dentist and dental hygienist want all of their patients to take these exams seriously. A cavity or canker sore, after all, is one thing. Your whole health, quite another.

Oral Health and Fluoride

We've all heard the success story of fluoride, perhaps the most dramatic turnaround of a population's dental health in history. But we're finding the benefits of fluoride extend beyond decay prevention in our children. There's something in fluoride for adults, too.

As we get a little older, the gums tend to recede, exposing the tooth root. Since the root surface is dentin, rather than tough, protective enamel, the root becomes more susceptible to decay. Dentin is closer to nerves, too, so teeth can be sensitive to heat and cold.

Fluorides can help with your dental hygiene program. The numbers in a recent University of Iowa survey are impressive. At the end of a year-long study, adults aged 54 to 93 enjoyed 67% less decay on the root surfaces (and 41% less on tooth crowns) than non-fluoride users. We've seen the same kinds of success when it comes to gum problems with fluoride, there is less plaque, less tartar, and less bacteria all around to multiply into gum disease.

Gel-Kam

Many patients know Gel-Kam well.

Gel-Kam is a prescription stannous fluoride, much more effective than other fluoride compounds on the market.

Just after you visit your dental hygienist to have your teeth cleaned is a good time to introduce you to Gel-Kam. Right away it restores the fluoride lost during dental cleaning. At home, you apply Gel-Kam once daily, after your regular preventive dentistry regimen.

We're seeing good results with Gel-Kam. It's easy to use and it's safe—a low fluoride concentration that still works.

Your dentist is likely to recommend a home fluoride program if you're having recurrent caries, difficulty in keeping free of plaque and calculus, or gum recession.

Oral Hygiene and Bad Breath

Bad breath (halitosis) has been the subject of a lot of laughter and some pretty bad TV commercials over the years. Yet, if you're like nearly one in five patients dentists see, you know the embarrassment and insecurity it can bring.

There's no one reason for persistent halitosis. You may have the very best dental hygiene in the world and still suffer from bad breath. Sometimes it's undiagnosed periodontal disease. Or it could be sinus problems or digestive ailments brought on by stress or other factors. Even though the primary cause of persistent halitosis is almost always a treatable medical condition, millions of dollars are spent yearly for mouthwashes and breath fresheners that barely mask the problem, much less solve it.

Because dentists and dental hygienists take halitosis seriously, some offices have established Fresh Breath Centers. These Centers are dedicated to determining the source and extent of a patient's dental health problem and then treating the cause, not simply covering it up.

If halitosis is a problem for you, you are encouraged to visit an office near you. Their approach will be as thorough and as caring as it is with any of other professional dental procedures. You'll begin with a breath gas analysis that identifies and measures odors. Based on the findings, a simple, effective treatment program will be recommended—so you won't have to worry about bad breath again.

If this problem is undermining your self-confidence, practice preventive dentistry and please call a Fresh Breath Center near you for a consultation. You can schedule an analysis and get back on the road to breathing freely again.

Plaque Control Toothpastes: Good Preventative Dentistry?

The marketers of toothpastes have come up with a new spin that will work on your teeth—toothpaste that helps prevent plaque. Since most American consumers are now aware of oral hygiene and the threat of gum disease, toothpaste manufacturers and marketers have spent upwards of $77 million to sell anti-plaque and tarter control home care products. The media blitz in the dentistry world is on.

Dentists have always known that plaque is the cause of gum disease. And plaque will eventually contribute to the formation of tarter on your tooth. But if you use these new toothpastes, will they work?

Crest and Colgate and other major brands have added a substance that seems to slow the accumulation of tartar on the tooth. You can try it and see for yourself if it works.

But the bottom line for many dentists would be to make sure you're brushing right, no matter what toothpaste you use. A new group of bacteria forms on a tooth every 24 hours, so the object of brushing is to disrupt these colonies. Dental hygiene includes good tooth brushing techniques, a learned skill that takes practice. However, even the most determined brushing won't always get rid of debris beneath the teeth.

That's why an annual dental cleaning and refresher course on brushing and flossing should bring you up-to-date on the oral health front. And what about those new toothpastes? Can't hurt. Call your dentist today.

Preventive Dentistry

One of the simplest dental hygiene exercises you can do for yourself is something you've heard before and it bears repeating: floss.

Every 24 hours, bacteria contribute to a new batch of plaque. Brushing, no matter how well done, will not get all the "bugs," especially between teeth and where tooth meets gum tissue. Flossing before or after brushing should be a part of everyone's oral health care program. The kind of floss—waxed, unwaxed, tape—doesn't matter. Just choose the product you're comfortable with and use it.

Maybe you never quite got the hang of flossing or are a little out of practice. Here's a quick refresher course.

  • Wrap about 18 inches of floss around your fingers; give yourself about five to six taut inches to work with. If the floss frays or builds up with debris, re-loop the floss and keep at it.
  • Try starting on the upper molars, way in the back; they're most difficult to reach. Follow the curve of enamel on every surface you can, three to four passes each.
  • Where teeth meet, you may have to gently pull the floss to the gum line. Avoid sawing motions as that may damage soft tissue.
  • Proceed from the back teeth to the center front. Then repeat the process on the other side.
  • Rinse and there you are.

If you find all this tedious or feel you're "all thumbs," a floss threader can help. Your dental hygienist can show you how to handle one. Just ask for help.

And remember, any amount of time you spend on plaque removal is time well spent for better dental health. The more time the better. If you have more questions or for more information, just call your dentist.

Raisin Eyebrows: Is Dried Fruit Good for Your Teeth?

Do you remember how disappointed you were as a kid when some concerned adult dared put raisins in your Halloween bucket? Your mother was probably relieved, convinced they would be far better for you and your pearly whites than the rest of the junk food you'd strung out across the kitchen table. Ask a pediatric dentist, however, and you might get a different story.

It's true that there are a number of benefits to eating raisins. They're low in fat and cholesterol, but boast plenty of fiber, calcium, and potassium. Unfortunately, they're also both sticky and high in sugar, putting them high on the list of foods that can cause cavities. Some health professionals lump them in with all the other typical junk foods kids eat. Don't worry, raisins aren't the only foods once thought healthy that can contribute to tooth decay and poor oral health. Go ahead and add other dried fruit, sweetened cereals, and even fruit juices to the list.

Don't chuck raisins out just yet, however. According to Vincent Iannelli, M.D., raisins were recently found to contain phytochemicals, which have been found to inhibit the growth of bacteria that are commonly linked to cavities. Note that this study was conducted in a lab, and no study has even been done to show that cavities are either more or less likely to find kids who eat raisins.

So, where does this leave you? A good general rule when it comes to eating for good health is to stick with whole fruits and vegetables whenever possible. If you must eat something that you aren't sure is good for you, do it in moderation. For good dental hygiene, be sure to drink lots of water, always either brush your teeth, or rinse your mouth out with warm water after eating sugary or acidic foods to prevent tooth decay!

Scraping Your Way to a Healthier Mouth: The Benefits of Tongue Scraping

Want to reduce bad breath, gum problems, and tooth decay? Grab a tongue scraper! While the practice of removing food and bacteria trapped between your taste buds has been recognized and recommended by dentists for half a century, true tongue scraping is a relatively new phenomenon. Perhaps its sharp increase in popularity is the result of recent studies touting about all the wonderful things that come from removing all that "gunk," including healthier teeth and gums and sweeter smelling breath.

Tongue scraping is an easy way to improve your oral hygiene. People with bad breath, particularly smokers or those with a taste for pungent food, will notice an improvement. Also, those who suffer from a fungal condition called "Brown Hairy Tongue" will benefit tremendously from a good tongue cleaning. For those with sweet smelling, fungus-free mouths, know that tongue scraping will reduce the bacteria that leads to gum disease and tooth decay. In other words, just about anybody will be better off for the effort. So, how does it work?

A bit of research will tell you that there are dozens of tongue scraping appliances on the market today. One of the most popular and inexpensive types is a soft, flexible plastic strip that you bow and pull along your tongue. It's an incredibly simple design with the potential for amazing results. Two or three strokes are usually sufficient. Please note, scraping should be done before brushing your teeth. It's quick and easy; the most difficult part of the entire process is actually seeing what's been in your mouth.

If you're not interested in actually buying a tongue scraper, a toothbrush will work fairly well. Though they aren't nearly as effective in removing debris and bacteria from your mouth as tools made for the job, it's far better than doing nothing at all. If you'd like to learn more about tongue scraping, or would like help finding the right dental hygiene method for you, contact your dentist's office, or mention it during your next check-up!

Self-Care Toothbrush Tips for Special Needs

Maintaining good oral hygiene can be a challenge, especially if you have developed a health condition that makes brushing and flossing more difficult or have been in an accident that created new limitations. Dental professionals want to help all dental patients keep their mouths healthy, and they offer these suggestions about oral hygiene.

Dental Brushing Tips

Problems in hands, wrists, arms, and shoulders can hinder a person's ability to brush and floss. While each situation is different, there are some suggestions that have been effective in making dental care easier:

  • Use a wide elastic band to attach the toothbrush to your hand for extra gripping power.
  • Attach a small rubber ball, a sponge, or a rubber grip to the toothbrush handle with strong tape. This enhances gripping power and is often useful when hand or arm movement is weakened or limited.
  • Use a longer wooden dowel, a ruler, or plastic rod to lengthen the toothbrush handle, wrapping it securely with strong tape. This longer length may help in more easily reaching your mouth.
  • Use an electric or sonic toothbrush.

Dental Flossing Tips

If limitations make brushing and oral hygiene harder, flossing may be an even bigger challenge. Depending on your limitations, try these techniques:

  • Use a piece of floss, about 18" long, and wind one end of floss around each finger instead of holding it. This will increase your grip and prevent the floss from dropping out of your fingers with each tooth you floss.
  • Hold the floss tightly and seesaw it back and forth between the teeth, instead of pushing the floss right through.
  • Tie the floss into a long circle instead of using one long piece, which may make it easier to hold and less likely to drop from your hands.
  • Try using a floss holder, available wherever oral hygiene products are sold.

By Danine M. Fresch, DDS

Tongue Scraping: Improve Your Oral Health

Tongue scraping is a relatively new phenomenon in dentistry. It is simply the process of removing all the debris that gets trapped in between the taste buds (or bumps) on your tongue. While cleaning this "gunk" off your tongue has been recognized and recommended by dentists for over 50 years, it is only recently that studies have been conducted to show the decrease in halitosis (bad breath), gum problems, and tooth decay by scraping your tongue.

How Does Tongue Scraping Work?

There are dozens of different types of tongue scraping appliances. They are all made for at home use, ideally just before brushing. One popular and inexpensive model is a soft flexible plastic strip that you simply bend and pull over your tongue. Usually two or three strokes is enough to remove the "gunk." The sight of the gunk on the tongue scraper is a little unpleasant, until you recall that it's the same gunk that you would have left sitting on your tongue.

Who Benefits from Tongue Scraping?

Tongue scraping is acceptable and easy enough for anyone to do. People with halitosis (bad breath) will benefit greatly from tongue scraping. It also is very effective for smokers and people who enjoy pungent or strongly odored foods. Also, some people who get a condition called "Brown Hairy Tongue," a fungal growth, will really see a big change.

Will a Toothbrush Work?

Sure, a toothbrush will work well to clean your tongue. And it certainly is better than nothing. Toothbrushes just aren't nearly as effective as some of the scrapers available. Ask your dentist or dental hygienist for suggestions on the method of tongue scraping that may work best for you.

By Brian J. Gray, DDS, MAGD, FICO

Top 10 Reasons Not to Dodge Your Dental Cleaning Appointment

Sure, regular cleanings with our office promote good oral hygiene, but did you know it can also prevent a multitude of diseases? That 2 o'clock chair-side rendezvous may not seem nearly as exciting as a late lunch with a friend, but it will be well worth it in the end. Here are 10 really great reasons to stick with your regular dental cleaning schedule!

  1. It Prevents Oral Cancer. You may or may not realize that you're screened for oral cancer during your regular dental cleaning. According to the Oral Cancer Foundation, an American dies of oral cancer every hour of every day. It's a sad proposition, especially when you consider that it is highly curable with early diagnosis.
  2. It Wards Off Gum Disease. Gum disease, or an infection in the gum tissues and bone that keep your teeth in place, is one of the leading causes of adult tooth loss. It can be treated and reversed if diagnosed early. Unfortunately, not receiving treatment will lead to a more serious and advanced state of gum disease. Regular cleanings and checkups and daily brushing and flossing are key weapons in the fight against these conditions.
  3. It's About More Than Your Mouth. Sure, not getting regular check-ups may make you less kissable, but did you know that studies have linked heart attacks and strokes to gum disease associated with poor oral hygiene? A trip to your dentist every 6 months could reduce your risk of serious health problems!
  4. You Want to Preserve Your Smile. As mentioned, gum disease is one of the leading causes of tooth loss in adults. To keep your pearly whites intact, stick with your teeth cleaning schedule.
  5. It's Best to Detect Dental Problems Early. We've already touched upon early detection of gum disease and oral cancer, but don't overlook more basic dental problems. Cavities and broken fillings are easy to treat. Without regular trips to the dentist, these problems can lead to root canals, gum surgery, and tooth extraction. Which sounds worse? A 30-minute cleaning or an hour under the knife?
  6. You Want to Know You're Doing it Right. Maybe you bought a fancy new electric toothbrush or aren't keeping up with what current research has to say about caring for your teeth. Either way, checkups allow your dentist to examine your mouth and keep you on the right path.
  7. You Have Dental Insurance. Consider how much money you put into your dental insurance plan. Take advantage of it and save a lot of money in the long run by avoiding costly procedures that result from poor dental habits.
  8. You Want to Upgrade Your Smile. If you're already suffering from tooth decay or gum problems, regular appointments will allow our office to create a personalized treatment plan that will give you the best smile possible.
  9. You Want to Dazzle. Regular cleanings remove most tobacco, coffee, and tea stains, polishing your teeth to a beautiful shine!
  10. You Need Some Time Alone. Okay, maybe not completely alone, but the time you spend in the waiting room and chair is really your time. You can forget about the office or the stresses of family life and just relax. Read a magazine or work through a crossword if you want. Take advantage of the time you're given, rather than worrying about how to fit it in your tight schedule. Your health and well-being should never take a back seat to your daily planner.

If it's been more than 6 months since your last check up and cleaning, call your dentist to schedule an appointment today!

Xylitol: Chew Your Way to Healthier Teeth and Gums?

Are you crazy about gum, but not so much about its effect on your teeth? (Good for you!) Researchers presenting at the American Academy of Pediatric Dentistry Annual Session in Cincinnati found a natural sweetener may not only improve the taste of gum, juice, and candy, it may also reduce tooth decay and increase dental hygiene.

Their study observed children of Belize over the course of several years, some of whom chewed gum with sugar, others with artificial sweeteners. Results showed that those who chewed gum artificially sweetened with Xylitol, a natural sweetener found in trees and fruit that does not cause cavities, suffered from less tooth decay over the duration of the study.

Another study done in Finland found fewer mothers transmitted cavity-causing bacteria to their children when they chewed gum with xylitol. The bacteria transmission occurs when mother and children share eating utensils.

Xylitol is widely available in most supermarkets, but know that it's difficult to achieve the correct dosing. To see results, you'd have to chew gum with a high dose of Xylitol frequently and for prolonged durations. Products containing this natural sweetener may also cost more than those artificially sweetened with other additives.

So, the next time you're dying for a piece of chewy goodness, consider grabbing a brand containing Xylitol. While it can be difficult to obtain optimum results through its use, it is certainly better for your dental health to chew than gum containing sugar.

Dental Insurance

Choosing Family Dental Insurance for Your Child

I'm sure you've noticed that you and your child are two distinct people with entirely different needs, including dental health needs. When employers label children as dependents, however, they often see them as extensions of their parents. That means when it comes to awarding family dental benefits, you must be on the same policy. It's important to be sure you select a dental plan that works for both of you. Here are some things to consider when choosing your dental insurance carrier:

  • Your child has the right to see a pediatric dentist. Pediatric dentists are specially trained to address the unique dental needs of young children, such as early preventive care and alleviating dental anxiety. If your family dental insurance plan only allows your child to see a pediatric dental specialist after an unsuccessful visit to a general dentist, consider making a change.
  • What is the extent of your preventive care coverage? Children's teeth are in a critical stage of development. Any potential problems should be identified and resolved as early as possible. It's also crucial to establish positive dental care habits right from the start. This means dental exams early and often. If your dental plan puts unreasonable restrictions on a child's early dental care, look for dental coverage elsewhere.
  • What other procedures are covered? As mentioned, your child's teeth are only just developing. If they do not grow properly, your child can experience pain or misshapen facial structure. Special care, such as orthodontics, is often required to correct the problem, and is often medically necessary. If your family dental insurance plan considers this specialized care to be cosmetic, and therefore not covered, look for something better.
  • What is the extent of your emergency care coverage? Kids have accidents—it's a fact of life. Not only are they generally more active than many adults, playing sports and climbing trees, but many have not yet developed refined coordination. That means plenty of falls or balls to the mouth. If your child loses a tooth or experiences some other sort of dental trauma, be sure your plan allows you to seek immediate emergency care without anybody's permission.
  • It's important for you to have a reasonable amount of control over your child's dental care. If your dental insurance company makes it difficult to choose or change dentists when you feel it's necessary, or allows you very little say in whatever treatment is performed, shop around.

Insurance may seem like a costly investment, but a family dental plan that truly fits you and your children's needs is well worth it. The preventive and emergency care you'll receive will ensure all of you will enjoy good oral health for a lifetime.

Dental Fees

Fortunately, in these times, a lot of patients have dental insurance. Insurance is, on the face of it, a good thing. It minimizes out-of-pocket expenses for treatment and encourages people to keep up with the dental care they need. But most dental insurance plans do not pay 100%. There simply is no perfect insurance plan.

Part of the problem is what's called "usual and customary fees." Insurers have come up with a fee structure intended to reflect the "average" cost of "average" dental care. Urban residents may be allowed different compensation than people who live in rural areas. Reimbursement for a crown may be a certain percentage of the actual cost (the dentist's charge to you), and another percentage for a cleaning. Patients are sometimes puzzled at the discrepancy between insurer reimbursement and actual dental fees.

Of course your dentist can't dictate the amount your dental insurance plan decides is "average." And they don't ask your dentist what cost he or she thinks is fair. The dilemma is this: your dentist can't, in good conscience, recommend less than quality dentistry, even though your insurer may impose an unreasonable ceiling on treatment. It's a rock and a hard place.

For this reason, you should take objections directly to the insurer or compare dental plans with your employer. If enough people make enough noise, the reimbursement picture might improve.

Ask your dentist to sit down with you and go over your dental plan and your dental financing options. He or she will try to make your dental insurance plan work to your advantage. Your dentist cares about your finances and your health.

Five Things You Should Know When Choosing a Dental Insurance Plan

You've heard time and again that dental insurance can protect you and your family from dental and financial catastrophe. Even cheap insurance with minimal coverage will most likely save you big bucks over the course of your lifetime. A quick web search will show that insurance is big business, and your options are becoming more expansive and complicated by the day. Not sure where to begin? Here are five things to consider when selecting family dental plans or an individual dental insurance plan that works for you!

  1. Shop around! Finding a plan that works can be quite a feat. Even when employers offer dental insurance benefits to their employees and their families, it often isn't enough. This means you'll need to shop high and low until you find the best plan for your budget and lifestyle. The internet has made all of this much easier—you have access to informational materials on a multitude of companies right at your fingertips. Be sure to read all the fine print; when it comes to your health, surprises are rarely a good thing.
  2. Know your limits. All insurance plans have maximums—some good, others bad. A low maximum on your total benefits is never a good thing. That means if something major (and expensive) comes up, you may have to delve into your own pockets. A second maximum applies to your yearly deductible, which is the most amount of money you'd be expected to pay for your own care. A low maximum on your deductible is a great thing, so be sure to do the math when comparing policies.
  3. Maintain control over your health. A dental insurance company may or may not have your best interests at heart, but, either way, they're somewhat removed from the situation. It's important that you have a say in your dental health. For starters, shouldn't you be able to choose your dentist, or at least have a plethora of options should one provider not work out? It's also important that you and your dentist have a lot of pull when it comes to making important decisions—an insurance company should never put unreasonable restrictions on the type of care you can receive.
  4. Look for the 3 R's (sort of): PRevention, Restoration, and EmeRgency Care. Having access to these three types of dental care is critical for lifelong oral health. Preventive care reduces the likelihood that you'll develop a dental condition that could have been avoided. Restorative care ensures that things that do go wrong, such as damaged or decayed teeth, will be fixed. Finally, emergency care ensures you'll receive the proper care when you need it immediately, such as if your tooth is knocked out. Some family dental plans cover other specialty care, like orthodontics, so consider your needs and go from there.
  5. The waiting game. Some insurance companies make you wait a certain period of time before they will cover certain procedures. If you need immediate attention, find a policy that supports it. If everything's in order, however, a minor wait may not be a major issue for you.

A carefully selected family or individual dental insurance plan could not only save you in a pinch, but ensure good oral health for life. It's critical, however, to do your research and read the fine print. Don't let your dental insurance company take you for a ride!

Managed Dental Plans

"Managed" dental care is a great idea.

However, many dentists strongly feel that it should be "managed" by their patients, for their benefit—instead of by a dental insurance company for its benefit.

If you are covered by a dental insurance plan, and if your employer offers you a range of different programs, the time you spend investigating benefits will be time well spent. Doing so puts your family in control of the quality of dental care you can demand and receive from your dental coverage.

Words can have very different meanings, depending on an individual's point of view. Some low cost dental insurance plans restrict patients to "preferred providers" of dental care. That sounds impressive until you recognize that providers are "preferred" by the insurer, not necessarily by you. And in many cases they're preferred, frankly, because they agree to sell their services at a discounted rate.

Review your own insurance options carefully: some dental plans allow participants to continue receiving optimum care from their current physicians and dentists. Some don't. It's your choice.

The idea of solving dental health problems "at no (or minimal) cost to you" is understandably appealing. But recognize the tradeoff. Simply put, it's "little cost and less choice."

Selecting an Affordable Dental Plan for Your Family

Finding a family dentist and an affordable dental plan can be a confusing experience. Although there is no one "best" affordable dental plan, there are some plans that will be better than others for you and your family dental insurance needs. We will try to guide you in simple terms. However, rather than just giving you answers, the best thing we can do is to make sure you are equipped with the right questions.

There are three major things to consider, each with their own unique set of questions. By considering the questions thoroughly, you will arrive at the right and affordable dental plan for you and your family.

  • How affordable is the plan (cost of care)?
  • How much will it cost me on a monthly basis?
  • Should I try to insure just major dental expenses or most of my dental expenses?
  • Can I afford a policy that at least covers my children?
  • Are there deductibles I must pay before the family or individual dental insurance begins to help cover my costs?
  • After I have met the deductible, what part of my costs are paid by the family dental insurance plan?
  • If I use dentists outside a plan's network, how much more will I pay to get care?
  • How often do I visit the dentist and how much do I have to pay at each visit?
  • Does an affordable dental plan include services that match my needs (access of care)?
  • What other dental providers are part of the individual or family dental insurance plan?
  • Are there enough of the kinds of dentists I want to see?
  • Where will I go for care? Are these places near where I work or live?
  • Do I need to get permission before I see a dental specialist?
  • Are there any limits to how much I must pay in case of a major illness?
  • Is the prescription medication which I need covered by the dental insurance plan?
  • Have people had good results when covered by a specific, affordable dental insurance plan (quality of care)?
  • How do independent government organizations rate the different dental plans?
  • What do my friends say about their experience with a specific plan?
  • What does my dentist say about their experience with a specific dental plan?

If you consider these elements carefully when choosing an affordable dental insurance plan, you can be assured the best possible outcome.

Types of Discount Dental Plans – Coverage for Individuals and Families

Dental PPO Program

A dental PPO—preferred provider organization—is an individual dental insurance plan that uses a network of contracted dentists to provide a better value. Like a medical PPO, the dentists on the dental PPO network have agreed to a discount dental plan set of dental fees that have been established to be below the usual geographic area.

The dentists have agreed to the reduced fees in order to attract additional patients that might not have come to their office otherwise. The PPO network can replace some of the advertising that a dentist or dental group might rely on to bring in new patients. So you can see how medical and individual dental insurance plans are alike.

Dental Capitation Program – DHMO

A dental capitation or "Cap" program is another variation of discount dental coverage. They are sometimes referred to as Dental HMOs or DHMOs. Unlike the traditional discount dental plans described above, a dental capitation insurance plan does not use the fee-for-service system, but pays the dentist a fixed amount for each patient each month.

The capitation refers to this fixed monthly payment, which is determined from a combination of the premium received and the historic utilization of that group. While a way to transfer some of the risk of the cost for extensive services to the dentist, it can also be a source of conflict when a number of patients need multiple services from the same provider.

Dental Referral or Discount Dental Plans

A dental referral plan is not insurance. This type of dental plan uses a network of contracted dentists, like a PPO or DHMO, but the benefit is simply a discounted fee on their individual dental insurance plan. Nothing is paid on behalf of the member; they are simply entitled to a lower fee for their dental care. While this can appear to be of limited value, some referral plans are able to save their members a significant amount of money in dental fees.

Be sure when you are purchasing a discount dental plan that you are aware of the nature of the plan. A dental referral plan may help you with special fees at a limited number of dental offices, but it does not provide emergency benefits when you are away from home unless you contact the plan office and find a participating dentist where you are visiting.

Getting the Most from Your Dental Insurance

Dental insurance is focused on the preventive and diagnostic services for higher coverage. To get the maximum benefit from your insurance plan, you need to consider the following issues:

  • Is there an option that uses a PPO or DHMO network where you premium dollars will get more dental services? Often, using a PPO dentist can save you 10 – 20% from the usual fees.
  • Whether you are in a PPO or not, will your dentist provide a treatment plan for a large amount of work? To be sure that your dental services will be covered by your plan, it is best to have your dentist send in a pre-estimate of services. That way you will know that the services are covered and what your portion of the costs will be.
  • Can the treatment be set up in stages? If some care is more urgent than other services, perhaps your dentist can provide the services over two calendar years, thus utilizing two annual maximums. Annual maximums are usually $1500 or more, but that can be reached quickly with multiple services.
  • Are there alternatives? Often, a dental problem can be solved in several different ways, all satisfactory and appropriate, but different. For instance, missing teeth can be replaced by dental implants, or by a bridge (in most instances) or by a partial denture. All of these are acceptable dental care, but the costs can vary widely. Talk to your dentist about why he or she believes that this treatment is best for you and if you still have questions, seek a second opinion.
  • How often can you get your teeth cleaned? Some plans indicate twice per year, while others limit you to once every 6 months. If you have the second kind and your cleaning occurs before 6 months have passed, the insurance will not pay the benefit. Be aware of your plan coverage and the specifics before you get surprised.
  • Are your children too old for coverage? Dental insurance for your family usually covers children as dependents up to age 18 or 19. If your child is over 18, you should understand when coverage ends and if they are a full-time student, what you must do to prove that for the insurance company.
  • Are the services that your dentist is proposing covered? Sometimes, new forms of dental treatment or cosmetic services are not covered by your dental insurance. Be sure to check your benefits guide and/or have your dentist submit a pre-treatment estimate to confirm that the services will be covered. If the services are denied, you or your dentist may need to write a letter and send more explanation regarding the need for these services.
  • Do you have coverage from both parents? The dental insurance companies will then use coordination of benefits to determine which insurance is primary and which is secondary for your children. Once you know that, the claim should be submitted to the primary carrier first.
  • Does your dentist give a discount for cash? Some offices will allow you to pay and receive a discount for cash and then send in the insurance yourself. This method could save you up to 10% at some offices.
  • Does your dentist give a discount for referrals? If you send in your friends and neighbors, will the office give you a break on your bill? Ask what discounts might be available at your dental office to see how you might save more on your bill.

Understanding Your Dental Insurance Plan Options

The market place has provided you multiple options:

  • Discount Dental Plans
  • Dental Insurance
  • DHMO Plans
  • Capitation Plans

All of these plans have their pros and cons. Talk with the dentist you trust to help you make the best choice to maximize your individual dental coverage need.

By Dr. Fred Sharpe

Use 'Em or Lose 'Em: Take Advantage of Dental Coverage

  1. Yearly Maximums. Dental insurance plans put a maximum on the amount of money they're willing to pay for your dental coverage. Maximums vary from one company or policy to the next, but typically fall around $1000. Sounds like a lot of money, doesn't it? Insurance companies consider this amount to be a good investment. Allowing you to get regular dental care, your carrier can prevent the need for more serious (and more expensive) dental procedures down the road! Why not do you both a favor and use it, ensuring your mouth is in tip-top shape when next year rolls around?
  2. Premiums. Most people pay a monthly premium for their dental insurance plans. Even if you don't need extensive treatment, you should use that money for regular checkups and cleanings to prevent them in the future. Don't throw your money away!
  3. Deductibles. Insurance companies typically expect you to pay a certain amount of money for your dental care each year—usually about $500. If your smile isn't in good shape, your dentist can create a treatment plan to put you back on track. Deductibles begin anew each year, so spreading out this care over more than 1 year will mean you have to pay more out-of-pocket.
  4. Inflation. It seems everything becomes more expensive from one year to the next, and dental materials and equipment are no exception. Putting off necessary dental care could mean that you'll have to pay more down the road in dental financing costs.
  5. Dental Problems Escalate. If your pearly whites are anything but, they're only going to get worse. That is, of course, unless you take advantage of your dental coverage and tend to your teeth and gums. A little cavity that isn't bothering you one year may become a major headache (or toothache!) the next.

What Is an Office Visit Co-Payment, Dental Co-Insurance, and Plan Deductible?

What Is an Office Visit Co-Payment and Co-Insurance?

An office visit co-payment is a fixed dollar amount or a percentage that you pay for each family dental insurance dentist visit or for each dental service provided. For example, with some plans you may pay a fixed amount such as $5 or $10 per visit. Other plans will charge you a percentage of the total fee—or dental co-insurance—for the visit. So if your co-payment is 10% and the dentist visit was $200, you would pay 10% which, in this case, would be $20.

What Is a Dental Insurance Deductible?

A deductible is the amount of annual dental expenses that a dental plan member must pay before the dental insurance plan will begin to cover expenses. For example, if your plan has a $50 deductible, you will pay the first $50 of your dental expenses before your dental plan begins paying the expenses. Only expenses for covered services apply towards the deductible. For example, if you paid $1,000 for orthodontic work that was not an expense covered by the plan, then the $1,000 will not apply toward your annual deductible.

Crestwood Dental & TMJ Care