Healthy Body, Healthy Smiles Blog

The Boston Globe believes that performing fewer pap smears would free up medical services and funds that could “be better utilized in other ways.” In today’s editorial, “Curb Unnecessary Pap Tests,” the Globe goes on to state that the pap smear need only be done once every three years for women who have had negative test results in years past and who haven’t had new sexual partners.

According to the Globe, an estimated 4,200 women will die of cervical cancer this year (that’s 11.5 women every day, in case you’re counting). Of these, “most cases are found in women who have never been screened, who have not been screened within five years, or who had an abnormal Pap test without subsequent follow-up.”

Hence, the end justifies the means: women don’t need to be tested annually.

But here’s the thing: physicians do a whole lot more than simply scrape some cells off the cervix for a peep under the microscope. They feel for tumors and cysts in the ovaries, rectum and other areas. They check a woman’s breasts and thyroid as well as check for and ask questions about STDs.

And, they ask lots of questions: experiencing any pain during sex? night sweats? frequent urination? Are you planning on having more children? What’s your method of birth control and how is that working for you? How many partners do you have?

In fact, a woman we know learned she had ovarian cyst due to her doctor finding it during her annual pap — something that scared her to death as two women in her family had died of ovarian cancer. She subsequently had her ovary and fallopian tube removed (and also went on to have two children).

The pap smear, in other words, is the only time when women get undivided attention about their **reproductive** health — and cutting this “unnecessary” exam to once every three to five years is wrong, wrong, wrong.

What do you think? Do you agree or disagree with the Globe editorial?

I hope you like the new site — my team and I have been working on it for a couple of months. The site was designed with you in mind. I wanted to make it easy for you to find information, to see more Before and After Stories, and to learn about how cosmetic dentistry can make you feel like a new person.

You’ll also find a new dentistry forum — something I’m really excited about as I’ve been wanting to do one for a couple of years now. If you have any questions about your oral health or about cosmetic dentistry, please post your questions and I’ll answer them.

And while we’re talking about the new site, I’m also pleased to announce that the blog was named one of the top 30 dental blogs by Medical Coding and Billing for “exuding overall brilliance.” How wonderful is that? In addition, I was named one of the Top 25 Women in Dentistry by the Dentistry Products Report. I’ll post a link as soon as I get one.

Thank you for your continued support and trust. As I say on my Office pages, cosmetic dentistry is all about you . . . and I and my team are here for you. Let me know what you think of the new site and if I need to include additional information.

Did you know that 7,500 men and boys will contract HPV-related cancers each year — and that 1,000 will die?

That’s the statistic cited in the article by Sarah Wildman, “HPV Vaccine: Why Boys — Not Just Girls — Need a Shot in the Arm.”

Whether boys should get the vaccine or not has become political. Women and girls are getting the $360 shot in order to prevent contacting HPV — a sexually transmitted disease.

By getting the shot, they’re effectively shouldering the burden of STD prevention in addition to birth control.

But boys are at risk too and can contact anal and penile cancers and throat and oral cancers. The FDA recommended in September that boys get the Gardasil shot.

When it comes to the shot for boys, however, the discussion centers on whether it’s cost effective — not whether it will increase boys’ promiscuity as some have argued about the shot for girls.

Oral cancer, which can be caused by HPV infection, is serious. It kills. The question isn’t whether the HPV vaccine is cost effective or if it increases promiscuity. The question really is, how valuable is your child’s life?

I write another blog for dentists on Dr. Bicuspid.com and was shocked to read last week that one dentist is advocating that all dentists should treat children on Medicaid.

This statement shocked me because not all dentists are geared toward treating children — even those not on Medicaid. This is certainly the case for me. As I’ve written before in an interview with my colleague, Dr. Lance Kisby, about the David After Dentist video, treating children comes with its own challenges.

I’m not a pediatric dentist nor have I received the specialized training required to be one, so when my patients ask me to treat their children as well, I have to tell them no.

However, the dentist that made this statement does have a point. It’s been well-documented that parents on welfare do not take their children to the dentist. It’s also well-documented that poor oral hygiene and oral health lead to other complications in children.

Children, whether they’re on Medicaid or live in $1 million dollar homes, need good dental care from the time their baby teeth begin coming in.

What this country really needs are dental clinics where low-income people can go for good basic dental care — i.e. routine check-ups, fillings, etc. These clinics could be staffed by newly minted graduates of dental schools and hygienists who earn a salary versus subsisting on Medicare reimbursements.

These clinics would help lower the abuse low-income people receive at the hands of dentists whose practices are based on seeing high numbers of Medicaid patients. They would also help lower the incidence of caries and other oral health problems in children — saving money in the long run as children would then not have to visit the doctor for complications due to poor oral health.

What do you think? Am I right or wrong?

Estelle, a lovely woman, came to my practice on the advice of two 90-year old women in her senior club.

Over a year ago she had been experiencing pain in her mouth, which her general dentist diagnosed as an infection.

As she describes in the video below, the dentist sent her on to a periodontist and after realizing her infection wasn’t responding to antibiotics, the periodontist sent her to an oral surgeon. The oral surgeon did a biopsy and, realizing she had oral cancer, sent Estelle to Dana Farber for treatment.

Estelle didn’t drink or smoke and definitely did not have multiple partners (her exact words!), so she definitely was low-risk with regard to oral cancer.

She also had all her teeth, which were in great shape, and perfect bone.

Due to the advanced state of her cancer, Estelle had to have more than half of her maxilla (upper jaw) removed and underwent radiation treatment every day for months.

In the video she describes how oral cancer has affected her life.

Despite her travails, she remains upbeat.

But here’s the deal: Every single dentist in the United States should be performing an oral cancer screening every single time he or she sees a patient for a routine checkup.

And, any type of sore or “infection” that looks even slightly suspicious should be checked — pronto. It’s a shame that a woman as beautiful as Estelle lost half of her upper jaw bone due to her cancer not being caught in time.

Don’t let this happen to you. It’s your right to insist on oral cancer screenings. If your dentist doesn’t do them, find a new dentist.

A patient came to the office recently. She had spent a considerable sum of money with another dentist for bone grafting and implants and wanted to know why she had “a gray line” showing at the top of her relatively new crowns (two years old).

Her dentist had placed crowns on her top front teeth and the reason for the gray line is that her gums had receded and now the crowns’ metal substructure was showing — as you can see in the photo below that was taken of another patient.

With today’s advanced dental technologies, dentists don’t have to use metal-based crowns and bridge work — something that was virtually unthinkable even five years ago. Using reinforced porcelain, dentists can develop crown and bridge treatments that look 100% natural.

Porcelain also has a natural translucency so that when you smile, the light reflects off your teeth and the porcelain in a natural manner — and making it very hard to tell the difference between your real teeth and your crowns.

As you can see in these before and after photos, non-metal crowns are gorgeous!

These new porcelains are also very strong and last up to 10 years with good care. Although metal-based crowns do last longer — approximately 15 years — non-metal crowns and bridges provide you with a beautiful smile for their entire lifetime.

So instead of having to suffer with ugly crowns for 13 years, you get a beautiful smile for 10 years!

We’ve been “metal free” for over 10 years at our Boston office and have placed many non-metal crowns for patients. The benefits of our cosmetic dentistry services include:

• Custom-made porcelain crowns that exactly match existing tooth color for a perfect smile
• Correcting crooked or mis-spaced teeth and/or closing gaps between teeth
• Smooth and even gum lines with no tell-tale gray line
• Fabricating crowns and contouring your gum line so that when you smile, your top teeth show naturally but not your gum line

If you have unsightly crowns, be sure to ask you dentist about non-metal crowns. You deserve a dazzling and perfect smile!

Last spring I read the book Socialnomics: How social media transforms the way we live and do business. I enjoyed the book . . . and so was thrilled to meet the author, Erik Qualman, at HubSpot last Friday.

HubSpot produces a weekly TV show about social media and Internet marketing (or inbound marketing, as they call it) — Erik was their guest. You can read the episode’s show notes here.

Erik talked about how social media has become a revolution and that it’s changed how we communicate and even purchase things. When he went into Babies R Us to purchase a car seat, for example, he was overwhelmed by the sheer number of seats available. He said, “I instantly wanted to ask my network which seat to buy to make the decision process much easier!”

Erik has a great new YouTube video that gives recent data for how quickly social media has grown — and how powerful it’s become.

Lots of news to report for the last month.

First off, I’ve been working with California Center for Advanced Dental Studies where I am learning how to mentor dentists who want to advance their training. The mentoring and coaching is quite satisfying. I’m very excited to be working with CCAD and will keep you posted on further developments.

While enroute to CCAD, I stopped off at my alma mater, Manhattanville, for an alumni luncheon where I was seated with Joan Kennedy.

It was a pleasure to meet her as well as Manhattanville’s new president, Molly Easo Smith.

And lastly, I’m very pleased to announce a new partnership with Gary Genard, PhD, a leading speech coach to dentists. He and I have started Dental Communications Group where we’ll be helping dentists achieve practice management excellence.

Dental Implants: The Five Questions to Ask Your Dental Professional – Download now. No registration required.

As the “new” thing in dentistry, dental implants have received considerable press of late. And it’s no wonder. With implants, dentists can replace patients’ missing teeth with strong, stable devices that look and feel just like real teeth.

Many medical procedures are now marketed directly to consumers, including liposuction, laser eye surgery and cosmetic surgery, which means you need to do your homework in order to safeguard your health.

The same is true for dental implants as having one or more placed in your mouth is not a trivial matter.

Dental implants require know-how and expertise that can’t be obtained in a weekend continuing education course. In an effort to educate you, Dr. Favaloro, a board certified periodontist, and I developed this e-book.

In it you’ll learn the technical details about dental implants and how the procedure is performed. Most important, we give you the five questions you must ask your dentist before agreeing to dental implant surgery, including:

• Am I dental candidate? – Not everyone can accept dental implants. You’ll learn why.
• What is your training? – Not all dentists are qualified to perform implant surgery. We tell the differences between the various dental specialties and the training each type of professional received in order to help you choose the right professional.
• Where will the CT scan be performed? – Qualified dentists use CT scans to properly place your implant — we tell you why they’re important.
• How many implant procedures have you performed? – You’ll learn the difference between those who took weekend “mill” courses and those who really know what they’re doing.
• Do you have pictures of previous cases? – A picture speaks a thousand words – and we tell you why you shouldn’t settle for “smile” photos.

Download your copy of Dental Implants: The Five Questions You Must Ask Your Dental Professional, forward it to your friends, and post it to your blog. It’s information you need to make good medical choices.

If you like this e-book, please let me know. And, if you have questions about dental implants or other procedures, please post them below and I’ll answer them.

Undergoing local anesthesia at the dentist office means one thing: numb gums for hours after your appointment. As a dentist, I know you hate when you feel like your lower lip is hanging down past your chin.

I’m very pleased to announce that our office now offers OraVerse. In official language, it’s an “anesthesia reversal agent.” In regular English, it means you can reverse the numbness associated with local anesthetics in about 30 minutes.

Average numbness can last 3 – 5 hours and can make it difficult to speak, smile, and eat or drink. If you’re a professional and need to get back to work to make a presentation or attend a meeting, you don’t want the after effects of local anesthesia.

OraVerse is a new product released earlier this year. In clinical trials with over 700 patients, there was no significant differences in adverse events versus control.

Be sure to ask for it the next time you’re in my office (or your own dentist’s office). I’m pleased to offer yet another way to increase my patients’ comfort.