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.
It’s not often that really astounding news crosses my desk, so I am really excited to report that DMG America has introduced a product that gives dentists an option in treating cavities — one that requires no filling and drilling!
When I see decay on a patient’s tooth, I have two options: either “wait and see” if the decay develops further and if it does, “drilling and filling,” or I can offer patients a fluoride treatment to help delay the onset of a cavity.
Now with Icon(r), I can treat surface tooth enamel — without having to remove healthy tooth structure! According the company’s press release, Icon is a “micro-invasive infiltration technology that can be used to treat [the tooth's] surface. . . . In just one patient visit, Icon can arrest the progression of early enamel lesions” [dental speak for caries or cavities].
I know this information doesn’t sound that extraordinary, but trust me, it is!
You can learn more about Icon by visiting the company’s Website — using the aptly named URL, www.drilling-no-thanks.com. After you choose your country, click on the “For Patients” button where you’ll find animated illustrations of how the product works.
I’m very excited about this and will be ordering my supply this week!
I’ve been using social media tools, such as Twitter, more, and am surprised at the number of “Tweets” from people who post that they are visiting the dentist.
Few people write that they enjoy visiting the dentist. Quite a number of people write that visiting the dentist is like being in hell and their dentist is Satan (or worse).
I know many people have fear and anxiety when visiting the dentist. Sharp pointy instruments look scary and can cause pain. People have had bad experiences with inept dentists — I see these patients all the time and get angry that they received such poor dental care.
This fear and anxiety is one reason why I educate my patients about procedures before we begin. I also provide a soothing environment where they can relax, and I offer various sedation techniques — ranging from topical gels to Valium — in order to ease people’s anxiety.
I’ve also learned how to do “little” things that help ease pain. For example, when giving multiple injections into a patient’s mouth, I will use a needle for a maximum of three injections and then use a new one. Why? Dull needles can cause more pain. (I also buy high-quality needles.)
I’ve learned where to give injections in the areas of the gum that are less sensitive, and if a needle hits the jaw bone, I throw it away immediately. This is because hitting the bone can create a “burr” on the needle — again, causing more pain.
But more important, like many modern dentists today, I continually take classes in order to learn how to best use advanced technologies and techniques. My mission is to give patients the ultimate in dental care, preserve teeth wherever possible, and give back to patients the ability to eat, smile, kiss, and laugh with freedom.
I’m passionate about educating my patients about the benefits for taking care of their oral health. For example, one patient came in recently and while checking her mouth I said, “Wow, your teeth and gums look beautiful. What have you been doing?” and she replied, “I followed your advice and started brushing and flossing every day.”
Brushing twice a day and flossing once a day can go far in helping you to have a pleasant — and stress-free — visit. You’ll have less plaque (and less scraping), your gums won’t bleed, and you’ll spend less time in the chair.
But more important, you’ll leave the dentist’s office feeling happy about your visit and your dentist — someone who is your partner in maintaining good oral health, not Satan.
The American Dental Association issued a press release Thursday, Feb. 5 that commends, “Reps. Bart Stupak (D-Mich.) and Candice Miller (R-Mich.) for introducing the ‘Dental Emergency Responder Act’ (H.R. 903), a bill that would bolster America’s capacity to respond to natural disasters or terrorist attacks by taking advantage of the extensive education, training and professionalism of the nation’s dentists.”
According to the release, the bill will not require additional federal spending. The thinking behind it is that because dentists receive a “sound general medical background . . . their knowledge and experience can make them valuable assets in the community response to man-made and natural disasters.”
As a dentist, I’m very glad that this piece of legislation has been introduced to Congress. It makes complete sense, as dentists are very well educated and can help during emergencies.
We celebrated the New Year last week with dinner out in a local Boston area restaurant. As you know if you’ve visited the dentist, it’s the staff who help make — or break — the atmosphere in a dental office. When I hire staff for both my Boston and Dedham offices, I hire for attitude and skill.
My first priority is to find people who understand the patient is “king.” This means I want dentists, hygienists, and office personnel who will take the time to talk to patients and make them feel relaxed and comfortable. Then I hire for skill / technical knowledge. I can train someone who doesn’t have a particular skill set but I can’t train them on how to treat a patient (which I’ve learned the hard way!).
Pictured below is the combined staff from the Boston and Dedham offices — plus a few guests:
(left to right) Elaine, Mary, Ellen, Dr. Helaine Smith, Janet, Doris, Judy, Dr. John Favolaro, Dianna Huff, Evelyn, and Nancy. Missing: Missing, Suzi, Mai and Dr. Melanie Arruda
As a consumer, you don’t see how technology has advanced dentistry — especially since dentists phase technology (which is pricey) into the dental office over time. Some of the advances you may have witnessed with your own dentist include:
** Moving from film and lightbox x-rays to digital images that dentists can now view on a computer screen.
** Eliminating paper-based records in favor of using software that houses our patients’ records (plus the digial imaging files associated with the patient).
** Making crowns chair-side using a CERAC machine versus sending goopy impressions to a lab and then waiting two weeks for the crown to come back.
But one thing you haven’t seen is how dentistry has truly moved into the 21st-century due to technology — and no where was this more evident than at this year’s Yankee Dental conference.
As I stood on the exhibit floor, I was awed by the sheer number of companies presenting imaging software and hardware — digital impressions, CAD/CAM systems and CBCT units dominated the exhibition floor. Every where you looked technology was on display. (To see a good example, view this Sirona GALILEOS video — GALILEOS is Sirona’s new 3D imaging machine.)
All of this technology has revolutionized dentisty — and has raised the standard of care. Using CBCT scans, for example, a dentist or periodontist can see a patient’s facial structure and precisely locate the jaw bone, nasal passageways and airways, and most important, facial nerves. We can see how the jaw opens and shuts and how the jaw fits in relation to cranium and facial structure.
(image (c) Sirona)
Dentists no longer have to “guess” where to place an implant or whether a patient is a viable candidate for the procedure. A simple scan can tell the dentist instantly what is feasible — and new treatment plans being taught at advanced dental training facilities mean patients can walk away with not just a beautiful smile, but a smile that’s been designed precisely for him or her using the latest techniques.
While at Yankee I gave my first course, “Full-Arch, All-Porcelain Rehabilitation.” (This was a course other dentists could take and then receive continuing education credits. I’m very happy to report that both morning and afternoon sessons were sold out — and on a Saturday, too!)
While talking about my work as a dentist over the years I realized that dentists and their patients are on the cusp of truly extraordinary times.
Health technology will allow dentists and doctors to finally integrate patient health information into one place. At a point in the future, patients will come to me and I’ll know instantly which medications they take, if they have sinus troubles or migranes and the treatment they’ve had, any injuries or surgeries to the head or jaw, and any diseases.
Having this information literally on my computer screen chairside means that I’ll be able to give patients an unprecidented level of care.
Modern dentistry and the technology that supports it mean that dentists can no longer view themselves as “tooth plumbers.” Instead, we are truly “mouth physicians.”
As I stood in the Yankee Dental exhibit hall surrounded by this new technology, I realized how just how exciting it all is. As a modern dentist myself, I embrace this new technology — and am glad I’m able to provide my patients with the utmost in care.
NY Times reporter Sarah Bowen Shea wrote an informative piece last week, A Device to De-Stress Your Workout, about performance mouthpieces. You may have heard of professional or elite athletes who swear that these devices improve their performance.
Unlike the regular mouthguards you buy for your son or daughter at the sporting goods store and then boil, performance mouthpieces are custom-made by dentists — and they cost hundreds or even thousands of dollars.
Currently, two companies provide the performance mouthpiece technology: Makkar, a Canadian company, and Under Armour.
Developed by a Las Vegas Institute (LVI) dentist, Anil Makkar, the performance mouthpiece technology is based on neuromuscular dentistry and the theory that if you align your jaw and open it up slightly you have more strength.
As the NY Times article shows, many athletes now use these devices as they do enhance performance.
You can see for yourself how the theory works.
Get a partner and have this person push your arm or arms down from an upright position. You should lose your balance and not be able to keep your arm in an upright position.
Now put a pen in your mouth sideways and bite down it. Lift your arm again — your partner should not be able to push your arms down. Amazing, yes?
November 19th, 2009 Last updated November 22nd, 2009
One of my team members watched the movie Twilight and wondered if heartthrob Robert Pattinson had dental work performed on his teeth — which look pretty good in the movie.
We did a little searching and found that yes, Twilight producers made him wear something close to an Invisalign brace to help straighten out his teeth. According to Pattinson, they wanted his teeth to “be perfect” in keeping with the character Edward — who like his vampire family, has perfect, “razor-sharp” teeth in the books by Stephanie Meyer.
This made us wonder about dental special effects in other movies — and after doing some searching, we found that movie stars do undergo (sometimes painful) dental procedures for the roles they play. Even better, the dentists who perform these procedures can get listed in the IMDb (Internet Movie Database)!
Case in point: Dr. Rick Glassman, who placed Johnny Depp’s gold crowns for Pirates of the Caribbean as well as performing work on Sean Penn in 2004 for the movie The Assassination of Richard Nixon.
And of course, you have Emma Thompson wearing that ugly jutting tooth in Nanny McPhee (we couldn’t find who did that one), and who can forget Richard Kiel, who played the steel-tooth Jaws in the James Bond movie The Spy Who Loved Me.
According to Kiel in a recent interview, the teeth were made by a dentist in Pinewood, CA:
‘The guy [dentist] ended up successfully making one set. He told me he couldn’t make any more – it was just too difficult,’ says Kiel.
During shooting, however, Kiel could only wear them for a few minutes at a time. He said: ‘They were nauseating. They were up in the roof of your mouth and gave you a gagging effect – you felt like you were going to be sick. It did add to the stoic part of my character – to keep from throwing up.’
‘They were kind enough to have a lady with a tupperware container with some cotton at the bottom. As soon as the director called cut, out they came. She would take them and rinse them with mouthwash and leave them to dry off for the next scene.’
Sometimes though, movie stars’ perfect pearly whites actually stand out too much in a movie. For example, while watching Pride and Prejudice, I was struck by the juxtaposition of the characters’ very white, very straight teeth against the very gritty 18th-century background — the dirt, the lack of running water, and closeness of people and their animals. In one scene, for example, you see a pig walking through the house.
And as we all know, people’s teeth rotted and fell out during this time period due to lack of knowledge about dental care and poor hygiene. (Remember, people took baths maybe once a week, if that!)
So the stars’ perfect white teeth were a modern day anachronism in the movie. In fact, in many scenes, Donald Sutherland (who has very bulky veneers!) actually covers up his smile with his hand.
Do you notice movie stars’ teeth? Do you know of other examples of stars who had their smiles enhanced for roles — or had veneers placed that made their teeth look more suited for a “working class” role? Leave your comments below.
November 11th, 2009 Last updated November 22nd, 2009
My colleague, Dr. Hugh Flax, recently posted a quiz on his blog. Titled, “Is your dentist ‘thoroughly modern’?” the post lists 20 questions you can ask about your dentist — and then score him or her based on the answers. (Dr. Flax based his quiz on a quiz I posted last month.)
I like Dr. Flax’s quiz, but I thought you might find it helpful to understand why he and I agree about asking these very important questions of your dentist. I won’t give details behind all 20 questions, but you might find the following information of interest.
1. Why a clean dental office is important — The obvious reason as to why you want your dentist to have a clean office is due to infection. Simply put, a dirty office spreads germs — such as the H1N1 virus. (The ADA has a wealth of information about infection control. You can also watch the video I did on this topic.)
However, a less than immaculate office also shows you how much your dentist pays attention to details — and a lack of attention to detail in the office setting can translate into how he/she works on your teeth. (Think about that for a minute.)
If you walk into the lobby of your dentist’s office and see a dusty table covered with months old grubby magazines, what does this mean? Or, what if the exam rooms have cobwebs in the corners and old exam chairs covered with cracking vinyl? Such lack of attention can mean the dentist has lackadaisical sterilization procedures.
It also might mean the dentist isn’t offering perfection when it comes to your mouth. (I see this quite a bit when patients come in to have me fix dental work performed by other dentists.)
2. The importance of keeping abreast of new theories / dental advances — As with medical research, dental research is constantly uncovering how our mouths and teeth respond to bacteria and other substances. And, as I’ve posted before, bacteria doesn’t stay put in your mouth — it travels throughout your body and can complicate existing conditions such as heart disease and diabetes.
In addition, dentists today must keep abreast of things such as sleep apnea and new treatments for periodontal disease, tooth decay, and oral cancer, to name a few. And, modern dentists are all about preserving tooth structure — which means they may use non-mental fillings and other minimally invasive procedures.
3. Importance of showing their own work — Question number 17 of Dr. Flax’s quiz asks, “Does he/she have photos of their own work to show?” I thought this an insightful question as most consumers do not know that dentists can purchase pictures for a Website “smile gallery.”
As a consumer, you have no clue whether or not the photos of the smiling teeth on a dentist’s Website belong the dentist. (Yes, I’m serious — which is why it insults me when dental marketing companies tell dentists like me to use “canned content.” Grrrrr!)
This is one reason why I show the full face of my patients on my “Before and After” photos, and it’s the reason I have a photo album in my waiting area full of pictures of my cosmetic dentistry patients standing with me.
I don’t believe in “smile galleries” because I’m helping people transform their lives — and by extension their health — not simply smacking veneers over someone’s yellow teeth.
Dentistry has changed quite a bit in the last 20 years. It’s no longer about simply filling cavities! If your dentist is still using paper charts, x-ray films and light boxes, and has no idea how to place a dental implant, then it really is time you found a thoroughly modern dentist. Your health depends on it.
October 30th, 2009 Last updated November 22nd, 2009
In a recent post I wrote for DrBicuspid.com, I mentioned that during a recent congressional review of Medicare and Medicaid services, Rep. Diane Watson (D-CA) suggested that dentists should be discouraged from using amalgam in dental fillings because “you have gas constantly escaping,” a health concern she thought should overshadow any savings in cost.
Amalgam is the technical name for silver fillings. The reason dentists debate the pros and cons of silver fillings is because amalgam fillings incorporate mercury — a substance that’s beginning to be banned in landfills as more research comes out about the effects of mercury on the eco-system.
Amalgam fillings have been in use in the U.S. since the 1830s. According to a PubMed.gov article, 19th-century dentists mixed mercury with filings from silver coins.
You can find lots of research about whether or not amalgam fillings pose a risk to your health. Some believe, the way I do, that mercury doesn’t pose a risk if it’s combined with a metal alloy. Others feel that no mercury is the best course of action.
And too, illness can strike anyone without rhyme or reason. I recently had a patient who died of ovarian cancer at the age of 42 — and she didn’t have one filling. My uncle had a mouthful of amalgam fillings and lived to 92.
The bottom line, however, is that today dentists have more materials at their disposal and don’t have to rely on amalgam to fill cavities. These materials wear better and look better.
I haven’t used amalgam or other metals in my practice for 12 years now because I found the amalgam fillings cracked patients’ teeth — whereas composite materials do not.
Some of the pros and cons of using amalgam versus composite materials are:
Amalgam
A durable material that last many years
Comprised of 50% mercury
Mercury vapor can be released into the mouth, which is harmful for those with weakened immune systems
Can cause teeth to turn gray
Amalgam expands as you age, causing your tooth /teeth to crack or break
Composite materials (or bonded aesthetic fillings)
Filling is tooth-colored
Procedure requires less tooth to be removed
Insulates better against hot and cold
Easily replaced
Sometimes not as durable as amalgam
As a consumer, it pays to research this topic and do what makes you feel comfortable. If your dentist will only support amalgam fillings and you prefer composite fillings, then get a second opinion.
