Fixing it BEFORE it breaks

It's been a while since my last posting. 

My wife and I celebrated my 20th wedding anniversary.

We traveled out of the country for a minute or two. 

Anyway, I'm back. 

Today we need to talk about getting regular dental visits so that 

you can catch things BEFORE they get out of hand. 

When people come into my office we use a digital camera to take 

pictures. These pictures allow us to see more more detail then normal. 

In the above picture we can see a metal filling in a molar. 

The margins of the filling look decent enough. 

What doesn't look decent is the cracks in the tooth that appear 

to be extending in several directions. 

In the above picture you can see what we did to rectify the situation. 

We removed the old filling and the cracked enamel. 

We then placed a filling. 

There was no need for a crown because we caught it early. 

I have no doubt that had we waited the cracks in this tooth would have progressed

and the tooth would have fractured. 

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Which floss is the best?

People ask me which type of floss is the "best" type of floss. 

Thin Floss

Thick Floss

Waxed......

Unwaxed.......

Floss on a handle

etc.

etc.

etc.

The answer to this is easy. 

The best floss is ........whichever floss you will use. 

The percentage of people who will floss daily is around 40%.

And the number of people who will never floss is around 20%.

So the "type" of floss you use is not nearly as important 

as actually "using" the floss.  Because it really doesn't matter.

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My child hasn't lost any teeth yet. Should I be worried?

I get lots of anxious parents coming into my office asking me

if they should be worried about their child who hasn't lost any teeth yet.

We live in a society built on comparisons. 

We can't help it. 

You think your home is big .... until the neighbors build one bigger. 

You think your car is awesome ...... until the new model comes out.

Etc Etc Etc

So that is what is happening with most of these parents. 

They think that their kid is normal ..... but then they see the neighbor's

kids loosing teeth and they start to question their kid's normalcy. 

Well parents, just relax. 

In about 97.625% of cases your kid's teeth will fall out on their own

and everything will turn out totally okay. 

In a few cases, not many, your child may need help getting their teeth out. 

Here is a chart to give you the AVERAGE age a child will lose their teeth.

Remember this is a AVERAGE (see how I am typing it in caps ; )

That means that half of kids will be older then the graph suggests

and half will be older.

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Broken Tooth ..... Now What?!

Most people break a tooth and think the worst. 

Crowns, Root Canals, Bears, oh my. 

In many cases however, a filling is all that is needed. 

This is a great case in point. 

Patient came in today with a corner broken off.

We matched the color, filled it, and finished off with

a nice polishing. 

And here is the after. 

The patient was very happy. 

The moral of the story is that when things break just

get into the dentist. 

It's probably not as bad as you think.

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Should I cover my toothbrush at night?

There is a decent debate, among the general public, as to 

whether or not you should cover your toothbrush when you are 

done using it, or simply let it air dry.

Those who say it needs to be cover will state that every time you

flush your toilet, germs come hurdling up out of the bowl

and cover everything in site. Thus, if your toothbrush is 

uncovered the bristles will get caked in these germs. 

Well, I sure hope this isn't the case. Because my towels, handles to 

my faucet and soap dispenser all all uncovered all the time.

It would be a shame if I was drying off with a poop germ 

covered towel every morning. 

So I did some research. I looked to see if there were any studies

done on the matter of toothbrushes being less germy in, or out

of a toothbrush head cover. 

And it turns out that the American Dental Association says:

"Do not routinely cover toothbrushes or store them in closed containers. A moist environment such as a closed container is more conducive to the growth of microorganisms than the open air."

 So, according to the ADA, placing your moist brush in an 

enclosed environment actually is MORE conducive to the 

brush getting germy then leaving it out to air dry.

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"I'll fix that cracked tooth later."

I tell people, on many occasions, that they have a crack in their tooth. Some people choose to fix the cracks asap. Others choose to put it off. Some people put it off for financial reasons, which is totally understandable. But some will simply say, "I will just wait till it breaks then you can fix the break". And sometimes that works. Other times it ends up like this tooth. There was a crack in the tooth. The crack progressed until the tooth broke. The brown line represents the gum line of the patient. The tooth fractured below the gums, below the bone, and almost all the way to the end of the tooth. So what can be done about a crack that bad?! Well, there is a reason the tooth sitting on my desk on a piece of gauze. Get the cracks fixed!

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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.

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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. 

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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.  

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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.

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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.

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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.

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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.

Etc.

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. 

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"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.

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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.

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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. 

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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?

Implant.

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. 

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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.

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How does an implant work?

Many people are still nervous to get an implant. 

One of these factors is that they don't know how an implant works.

Here is a step by step of what the process is like. 

#1 A patient comes to the office with a tooth broken off to the gums. A bridge is possible, but that would mean shaving down the teeth on either side of the broken one. They are great teeth and that doesn't make a lot of sense. So an implant is chosen.

#2 After the tooth is removed a drill is placed into the hole. This is very important. No new hole is drilled. There is a hole there already. We simply shape the hole to fit the implant. Extraction is more stress on patient then the shaping of the hole.

#3 The implant is placed in the hole. A temporary tooth was glued into the empty space. No on ever leaves with a hole in their smile ; ) After 12 weeks of healing the new, permanent, tooth will be placed on the implant and all will be well.

Implants are an amazing way to simply, that's right I said simply, replace missing teeth. If you have concerns I have plenty of patients that have been through this procedure that could tell you all about it. Let me know if you have any questions.

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Re-growing teeth from stem cells

There has been a lot of news lately about stem cells and the

re-growth of new teeth.

In this short video clip I discuss what is going on with that.

Dr Ellis discusses regrowing teeth from stem cells.