Thursday, December 10, 2015

"How hard will my wisdom teeth be to remove?" It's a question I hear all the time. People who are nervous about wisdom teeth removal, want some kind of reassurance that things will go alright. Truth is, no one knows. We can make assumptions, but that's about it. It's kind of like a woman about to deliver a baby. Some woman deliver in the car on the way to the hospital, and some woman are in the delivery room for 48 hours before Jr. is getting the phlegm spanked out of his airway. It's hard to tell. Sometimes teeth come out fast and sometimes they come out slow.
Here is a case where it was BOTH, in the same patient!!
Take a good look at the x-ray. The wisdom teeth are the very last teeth on the right and left hand side of the picture, on the top and the bottom (4 teeth total). The top teeth (the ones that look fairly parallel to all the other teeth) both came out in about 5 minutes each. The bottom 2 teeth (the ones that look like they are laying on their sides) took about 40 minutes each.
So, Dentists can give you an estimate. But that's about all it is.

Thursday, November 12, 2015

Fluoride is poison. And why I will give it to my kids everyday.

Fluoride can be poisonous. 

But I will keep giving it to my kids every day.
And will also continue to recommend it to my patients.

Why???!!! You may ask. 

Because, as one of the famous fathers of the field of toxicology,
 Paracelcus, once said, "The Dose Makes the Poison."

It's all about the DOSE.
ANYTHING can kill you if taken in the wrong dose. 

Water Toxicity is a condition where too much water is  ingested, 
 bringing on hyponatremia. Water can then enter the brain
leading to severe electrolyte imbalances, brain swelling, and death.  
And that's just water. 
So ....... water ........ can be poison!!!!!!!

But just like you wouldn't stop drinking water please don't stop 
using fluoride to assist in keeping your teeth healthy and strong. 
Fluoride, IN THE PROPER AMOUNTS, has been proven, 
in thousands of studies, to be completely safe and effective.

Don't be like this guy.

Monday, November 9, 2015

The Dangers of Lip Rings

Take a look at the tooth below. 
What happened?!
The gums above this tooth are way higher up then they should be. 
The gums of the other teeth look unaffected. 
How does only 1 tooth sustain such damage?

In THIS case.
A lip ring. 

In this picture you can see that I have pulled the lip back.
You can still see the damaged tooth in the back ground.
But in between my fingers is the culprit.
That white disk is the backing for the patients lip ring.
That disk has rubbed the gums right off of the tooth.
And since the gum recession was so bad the root of the
tooth was exposed and the tooth became much more 
susceptible to decay.

PLEASE PLEASE PLEASE be careful with lip rings.
Plastic is better then metal but anything rubbing against 
another surface can cause damage over time. 

Thursday, October 29, 2015

Dentists and Halloween Candy

People always ask me what I do special for Halloween. "Do you give out toothbrushes"?  "Do you give out stickers and pencils?" "Do you buy candy?"

Buy Candy? Heck yah I buy candy. Then I put it in a bowl and give it to the kids that knock on my door. IT'S HALLOWEEN!!! 

I have eaten mine, or my kids, candy for years now. 41 years to be exact. And I have had 1 cavity. My whole life. That is not me bragging. That is me telling you all that eating candy at Halloween AND being cavity free is possible. 

Here's what you do. Give the kids 30 minutes. Let them trade and eat all the candy they want. Then take the candy and send your kids to the bathroom to brush AND floss. Then the next night give the candy back for another 30 minutes and then send them back to the bathroom. Repeat the process until the candy is gone. 

The key is to not let your kids take the candy to there rooms. Its the eating the candy and then letting it sit in between the teeth all night that is the problem. Short stints of candy followed by brushing and flossing will do very very little, if any, harm to your child's or your teeth.

Happy Halloween everyone. 

Monday, October 12, 2015

How does a tooth implant work?

What are the steps in getting a dental implant?

Here we go. 
The tooth on the left had a root canal.
The root canal is failing. 

Step #1
Remove the tooth. 
No chisels or knees to the chest with the pliers.
Tooth removal can be very simple and pain free.

Step #2 
Place the implant.
When leaving the office after getting your implant
you won't even be able to see that anything has been done.
The top of the implant should be around the same
as the level of the bone.
And since the bone is under a layer of gums you 
won't be able to see it.

Step #3

Place the connecting piece.
In a "normal" crown to tooth relationship the crown will cement 
to the tooth.
In an crown to implant relationship the crown will cement to
the connector which is screwed into the implant.

 Step #4 
Place the crown on the connector. 
Here is the finished project. 
It is now ready for FULL function.
Once the entire project is done the crowned implant should
be treated just like any other tooth when it come to brushing,
flossing, chewing, etc. 

Thursday, October 1, 2015

Do I really need a crown?

So, your dentist tells you that you need a crown.
How do you know if he/she is full of it and when 
they are telling you the truth?

Here's the #1 reason that teeth, in my office, need crowns.

The ratio between tooth and filling.
A filling is like a patch in a pair of pants. 
You rip a little hole and you place a patch. 
You rip 14 holes and you throw the pants away. 
Because the amount of patch material would be greater then
the amount of original pant material and that just wouldn't work.

It's the same with teeth. 
When that amount of filling material would be greater
 then the original tooth material, you know its time.

This tooth is a perfect example.
It used to have 4 corners. The patient came in because he
broke one of the corners off. 
When the 4 corners were in place the ratios were okay.
But not that there are only 3 corners the ratios are off.
There is now too much filling and not enough tooth to support it.
This tooth now needs a crown.

Hopefully your dentist uses a digital camera and can show
you images like this so that you can see what is going on. 

Wednesday, September 16, 2015

Beautiful Crowns

Fantastic case from today. Older restorations on the two front teeth that were starting to break down. Took off the old stuff. Had our lab guys come take a look and do a customized shade for us, and boom. Beautiful. Love this part of the job.  

Tuesday, September 15, 2015

What is a Dental Implant?

I'm not sure of the reaction that I will get here.
I am going to put up a picture of what a dental implant looks like.

Sometimes people just don't want to know about stuff like that.
When someone is going to get a hip replaced, bowel resection, etc
sometimes the worst thing they can do is go onto the internet and look
for pictures of the procedure they are about to have done. 
Sometimes ignorance is bliss. 

But even with all that being said, I'm going to do this anyway.
If you have children sitting on your lap you may want to 
have them look away.

I give you ...... a dental implant.

Yup. That's it.
We take out the bad tooth. 
We use the hole that is ALREADY THERE.
We thread the implant into the old tooth space.
We then put a crown on the implant.

If this doesn't seem that bad, it's because ...
it isn't.

Thursday, September 10, 2015

Tongue Cancer

What does Cancer of the Tongue look like, feel like, act like?

What I tell my patients is that if there is ANY change in your tongue,
that lasts longer then about 2 weeks, that you have never experienced before,
 you should go see an oral surgeon.

Things happen to your tongue.
You can bite it. 
You can burn it. 
You can get canker sores.
Etc Etc

And some of these things can happen repeatedly over time.
People with Geographic Tongue, for instance, can get odd 
shapes and feelings on their tongue, and it can be absolutely
normal for them.

But all of these things will go away. 
IF you notice something changing that DOESN'T go away.
And in fact continues to get larger and/or begins to feel hurt,
burn, and/or feel uncomfortable in any way.

Go to the oral surgeon and have it looked at.
A small biopsy should be taken to determine what is going on.

Here are some pictures of Tongue Cancers.

Wednesday, September 9, 2015

Great case from this morning. A patient came in with a tooth broken off at the gum line. A bridge was not an option due to one of the teeth, next to the broken one, already being tied into a different bridge. So an implant was chosen. We extracted the tooth. It had 2 roots. We backed filled one of the root holes with a bone graft. 
Prepared the other root hole for the size and shape of the implant we wanted. 

We then placed the implant. The patient came in at 9 and left by 11. We carry the most common sizes of implants on hand. If you can replace a hip, knee, or lung, you can replace a tooth. Only much easier.

Monday, August 31, 2015

What should my root canal look like?

What is my root canal supposed to loo like when it's done?
Ask your dentist to show you the before and after pictures.
Here is a case that I did last week. 

The tooth on the left needs a root canal. 
The black line running through the middle of the tooth
represents the "canal" that runs through the middle of the "root".
Thus a "root" "canal".
In order for a root canal to have the best chance of succeeding
the ENTIRE canal needs to be cleaned out. 
Meaning 360 degrees and all the way to the end of the root.

Below you will see the finished product.
Now, is this "perfect"? 
I am not saying that. I am sure there is always room for improvement.
But, I do like what I see here.
The filling material is all the way to the end of the root. 
There is even just a little out the end, which is great 
(if it weren't do you think I would put it out there for the world to see)?
The filled canal also looks a tad larger then the original, which 
shows that cleaning and shaping took place.
The final filling also has no large voids in it. 

Now some of this may be total Greek to some of you. 
But the take home point is to make sure that the filling material
looks solid and that it is all the way to the end of the tooth.

It is your right, as a patient, to see the after pictures of any procedure. 
Take control of your own health. 
Make sure you are happy with your results. 

Thursday, August 13, 2015

Just extract my tooth!

"I know its bad Doc. Just pull it out. I can take it."

I hear things like this all the time. 
People come in thinking that its the end of the world.
They think that they are a lost cause.
Truth, usually, is that things aren't even that bad.

Take this case for instance.
Corner broken off of a top lateral incisor. 

Not only did we not pull it but we didn't even crown it.
We simply numbed that patient. 
Removed any decay and then placed a filling.

Chances are, its going to be okay.

Tuesday, August 11, 2015

Do I need a Root Canal?!

You need to ask yourself 3 questions.

#1 Does my tooth hurt to chew on?
#2 Does my tooth hurt to hot or cold liquids?
#3 Does my tooth hurt spontaneously (Just watching a movie, for example).

The more of these questions you answered yes to, the more 
likely you are to need a root canal. 

Here is a before and after picture of a root canal.
The tooth in the middle of the screen needs a root canal.

This is a picture of the completed root canal.
In very simple terms teeth are like the tires of your car.
They look solid, but they aren't.
They are actually hollow.
A root canal procedure is when a dentist goes into the middle of the tooth,
cleans out the damaged, hurting, nerve tissue, and then fills the inside of 
the tooth with a filling.
The tooth is now solid, like a tricycle tire. 
Now it looks solid, and it IS solid.
The white stuff in the tooth is the filling that we placed.

Wednesday, March 25, 2015

Do old metal (amalgam) fillings need to be replaced?

Everything wears out at some point.
After getting a knee replaced the Dr. will typically say,
"that should last you about 15 years."

I got Lasik done and the Dr, told me that I would
have to come back in to get it touched up over time.

The same can be said for metal fillings.
Over time, they will break down and need to be replaced.

Just beware of a few scams out there. 
#1 All of you metal fillings need to be replaced at one time.
#2 The metal is bad for you and will cause a disease so they need to come out.

Neither of these are true. 
If all of your metal was placed at the same time then perhaps a few of them
are going bad together but MANY factors dictate rate of decay. 
Where the filling is on the tooth. 
Where the tooth is in the mouth.

Also, it has been proven over and over again that the contents
of metal fillings (in the state they are in in your mouth) do
not cause diseases. 

Here is an example of a filling that was going bad. 
It's pretty plain to see that there is decay around the 
edges of the filling.

We then put a white one in. 
The effects are fairly dramatic. 
The patient was very pleased. 

Wednesday, March 11, 2015

Broken tooth AND Toothache

Fairly involved case here. Patient comes to my office with problems on the upper right hand side of his mouth. He is in a lot of pain and has a broken tooth. He figures the problems are one and the same. That the broken tooth is the one that is hurting him.

 Unfortunately he's not so lucky. The broken tooth needs to come out, yes. But, its the tooth behind the broken tooth, that is actually responsible for the patients discomfort. That tooth needs a root canal or needs to be extracted as well.

Here's what we did, step by step. We will call the teeth 1-2-3 (from left to right) to make it simple. We extracted #2 and #3.

 We then placed an implant in the spot of #3. In the spot of #2 we just placed a bone graft and let it heal.

 After several months we then placed a bridge that spanned from 1-3. 

The bad teeth are gone. The patient is no longer in pain. And a wonderful case in completed.

Tuesday, March 10, 2015

"It's like pulling teeth!"

There is an old saying that goes ....... "It's like pulling teeth!"
Well, is it really THAT hard to pull teeth? 
Answer ...... it can be. Especially when you have roots that look like these.
I took these pictures in my office over the past 3 days. 
It's like trying to get a fence post out of the ground, 
when the fence post has a huge fish hook hanging of the bottom of it.

Monday, March 9, 2015

1/2 Off Hip Replacement. Hips in a Day.

I had this happen to me, again, on Friday. It continues to happen and is becoming somewhat epidemic. Patients come into me for a 2nd opinion. I tell them they have 1 or 2 cavities. They are shocked. I ask them why they are so shocked. They tell me that they went to dental office XYZ because of a  1/2 off deal they saw. And that that dentist told them that they had around 8 or 9 cavities and that the patient also needed a crown.

Two things.

#1 Rules of economics. If a dentist offers 1/2 off of ANYTHING you have to understand what is going on. Where is the dentist getting that 1/2 off from?  The city is not charging him half price for electricity, water, sewer, garbage collection, etc. The owner of his building is not giving him 1/2 off his lease that month. The dentist is not cutting the staff wages by half for that pay period. The dental supply company is not offering 1/2 supplies. You see what I'm saying. The ONLY thing that can be cut is the profit of the company. In other words ..... the take home pay of the dentist. Now, it may be totally possible that the dentist is an amazing guy. And that he wants to take home less money for the good of mankind. And thus is offering these great deals. And I, when appropriate, have given discounts to folks that are having a hard time. But I know those people. And I know that they are in need. But to offer huge, across the board, discounts is something totally different. The dentist, more often then not, needs to make up the lost revenue. And where does he do it? By finding more work to do in your mouth. It happens ALL THE TIME. Bring people in on the cheap and then find a boat load of work to do. Weather they need it or not.  Thus making up for the freebies. PLEASE BEWARE OF THIS TACTIC. Get a second opinion.

#2 You get what you pay for? Just don't get taken to the cleaners. I often hear people talk about their aging parents. And they talk of them fondly. Especially when they become injured in a fall or other accident. They tell me, "I got mom the best hip surgeon in the state." or "I got dad the best cardiologist around."  I have NEVER heard. "Dad broke his hip. So I took him to "Hips in a day" or "1/2 price hip" or "I got a coupon in the mail for a free knee brace with hip replacement, so I took dad there."  It is a VERY good thing to save money. "I" want to save money. Everyone does. But WHERE you save the money is the important thing. Save money on the Blue Ray player, the cell phone bill, or not getting the under carriage treatment at the car wash. But going for the cheapy hip, knee, or brain surgery is just not smart.

Conclusion. I am NOT saying that I am the only honest dentist out there. What I AM saying is to get several opinions before you start any major work. Go to the coupon guy. Then go to the water fountain and marble counter top guy. Finally finish up at the guy in just the run of the mill office. Compare them. THEN make your choice. Also, make sure you decide where you want to spend the money for quality workmanship and where you don't really care. Do you want a Walmart bike or a bike shop bike? And its okay to get either of them at different times.  Compare prices. Call my office. I will give you my prices with no gimmicks or questions asked. Then call other offices. Get their prices. Compare.

Knowledge is power. Once you have done your homework, compared, and shopped around, then make your choice. And weather its at my office, or someone, else's is immaterial to me. I just want people to be happy with the treatment the get.

Wednesday, March 4, 2015

A cavity being filled. Step by Step.

One of the questions I get asked most often is ......
"What do you do when you fill a cavity?"

Well here is your answer.

This patient came in with part of the tooth missing. 
This is a fairly large cavity.
First step is to numb up the patient, remove the old filling, 
and then remove any decay and and unstable tooth structure.

In this picture we have done all of the removal mentioned above.
We then prep the tooth to receive a filling. 
We use the metal form in order to not glue the two teeth together.

The filling is placed and the form is removed. 

Just as simple as that. 

Tuesday, March 3, 2015

Dental Implants

Fantastic Implant case.
Patient came to me very frustrated with a tooth.
She had spent a lot of money on a crown, root canal, etc.
She needed a tooth in that particular spot but had been told
that the tooth that was there had to be removed.

What to do?
In a day and age where we can replace hips, knees, hearts and lungs.
Why wouldn't we replace teeth?

Tooth as it was when the patient came to my office.

Tooth now extracted and implant placed.
This all happens at the same appointment.
The implant was placed where one of the roots was.
You can actually see the outline of the other root space.
That spot was bone grafted and will fill in nicely.

Here is the Implant whit the tooth in place.
Very stable. 
No more cavities.
No more root canals.
Very happy patient. 

Thursday, January 8, 2015

What if your dental visit doesn't fix the problem?

Lets say that you go into a dentist office. 
You have a problem. 
The dentist preforms some type of procedure and
tells you that the problem should be fixed.
The problem is not fixed however, and you want to
know what to do next.

First off, dentistry is medicine. 
Medicine doesn't always work.
The birth of a baby, sadly, is not always successful. 
Fusing a spine doesn't always get rid of the pain.
A total hip replacement doesn't always restore full function.

The same is true in dentistry. 

So what then? If the treatment doesn't "work" is a patient then just out of luck?
What is the Doctor's obligation if things still aren't going well for the patient?

Here is a list of what I think a health care provider should do, IF
sufficient time has been given for the procedure to take effect and 
the desired results have not been achieved. 

#1 Re-Do the procedure.

#2 Offer the services of a specialist, if there is a specialist
that can offer an advanced alternative.

#3 Provide information and/or preform alternative procedures
that could give the same result but in a different manner.

Here is a case that was successful ...........
the second time around.

The tooth in the middle of the shot needed a root canal.

Here is the picture of the finished root canal. 
The White line down the middle of the tooth is the filling material.
The filling material is not all the way to the end of the tooth but
is within the 1.5mm margin of error that is allowable for this
type of procedure. "By the book", this should have worked.

It did not however, and the patient was still in a significant 
amount of pain.

The option that was then chosen was to Re-do the root canal. 
All of the old material was stripped out.
The inside of the tooth was prepared further down the root.
The new filling material is now all the way to the end of the root.
The result is that the patient is now feeling much better.

Now there is a chance that the Re-do wouldn't have worked either.
At that point we would have moved on to the other options.