the simple blog

Gum disease, like diabetes, is incurable, but very treatable.  Most of our patients get better after treatment, but a few don't.  Here's the three most common reasons people can't beat gum disease...

In the current issue of the CDA Journal, Dr. Bradley Lewis calls for a worldwide ban on formocresol, a dental medicament commonly on children during pulpotomies (baby root canals).    We have never stocked this at our practice, and after reading this thorough literature review, we never will.  All the component ingredients are carcinogenic, and what's worse, we place it DIRECTLY on the live inner cells of your child's teeth, where it's free to circulate throughout the body.  I call on all dentists to stop using this cheap, outmoded, smelly substance and put our pediatric patients' health above our supply costs.     MTA, ferric sulfate, and calcium hydroxide are all alternatives, with MTA having the most clinical success.

With all the identity theft going on, a lot of people are legitimately asking, "Do I need to give out my social security number at the dentist's office?"   If dental insurance is involved, the answer is ideally no, but the reality is sometimes different for some carriers.

Okay, dental appliances are not the best for your love life.  But for many of us, nightguards are the best way to prevent damage from clenching and grinding, also known as bruxism.  For others, they also help with TMD related jaw pain.

Sometimes a recent cold or flu can cause sinusitis, an inflammation of the lining of your sinus cavities.  Swelling and irritation are often symptoms.  The maxillary sinuses happen to be directly over the upper back teeth.  The swelling can bear down on the teeth, creating a dull toothache.  Sometimes the sinus literally elevates the teeth a tiny bit out of socket, creating a high bite and chewing difficulties.

If your dentist is not careful, you can end up with an unnecessary root canal treatment.  A proper diagnosis of every toothache usually includes an x-ray, cold test, percussion (tapping test), biting test, and periodontal probing (gum check).   A positive biting or tapping test during or after a recent cold or allergy event may just indicate sinusitis, not a dental problem.  If dental findings are inconsistent or inconclusive, you can be referred to your medical doctor for a consult.  We had one or two such cases last year, and possibly one this morning.  I routinely ask my patients with dull toothaches, especially on upper teeth, if they've had recent sinus infections, colds, flu, or allergies.  The best way to get correct diagnosis, as always, is to be thorough (collect a lot of data), and look at all the facts, not just the dental ones.

Yesterday I spoke with a gentlemen who left his previous dentist.  From what I gathered, this doctor had all the highest tech gear imaginable: intraoral cameras, digital xrays, 3D patient educational videos.   When asked whether he liked it, my new patient said, "No, it just seemed too slick and salesman like.  I felt like I was at a car dealer."

Our office, because it's only four years old, has much more high tech gadgets than the dental office you may have grown up in.  Sure, we have digital xrays and cameras.  We also have high definition monitors for movies at the chair.  But at the end of the day, the fundamentals of dentistry haven't changed.  You still have to be open, honest, and fair with people.

A lot of dentists have purchased all the right gear for all the wrong reasons.  People are starting to wise up to the sell, sell, sell, high pressure techniques of large dental chains.  But when you get oversold on a car, you're just out money.  Dental procedures are almost always permanent and irreversible.  If you get oversold on dentistry, you can end up with lasting physical consequences.  

Follow theSimpleTooth on twitter:  learn what's new in dentistry in manageable 140 character bites.  Our dental office has its first dedicated twitter feed.

For every new twitter follower we get between now and the end of the year, we'll donate one toothbrush to a child  in need.  Pass it on.

Our office now accepts Blue Shield, United Healthcare, Secure Horizons and several other new plans:

This is the first comparison case I am doing to test a new crown technology. Glidewell Labs has a new type of crown for back teeth made out of zirconia, a high strength ceramic. Like gold crowns, they are virtually unbreakable, don't require a lot of tooth height. Unlike gold crowns, they are tooth colored.

Many people know about 3M's Lava crowns. They are porcelain fused to zirconia. They are beautiful in the front, but they are expensive to produce, and the porcelain is relatively fracture prone. Few problems on front teeth, but using them on high-load molars is risky; I've actually had a couple of them break myself. In every documented case of failure, (I'm talking the published clinical studies) the outer porcelain breaks off, leaving the inner zirconia intact. So the folks at Glidewell decided to make the entire crown out of zirconia.

The Australian Dental Journal reports that milk fortified with amorphous calcium phosphate (marketed here in the US as ACP or Recaldent) remineralizes enamel 81-164% more than your standard milk.  I've seen firsthand how amorphous calcium phosphate can remineralize damaged teeth .   If ACP-fortfied milk ever makes it to the states, it could have a greater effect on preventing cavities than any municipal water fluoridation effort.  (and with less angry anti-fluoride comments on my blogs, too.)