Monday, March 14, 2011
Mouthwash is Overrated
If you're using Listerine or other such alcohol-based mouthwash in the hopes that you're killing 'germs', please do yourself a favor and stop. Where such products may kill 'germs' on contact, the bacteria recolonize in a heartbeat anyway. Besides, if your mouthwash is alcohol-based, it ultimately dries out your mouth which ironically leads to the bad breath you're perhaps trying to prevent.
Monday, March 7, 2011
"Adhesion Dentistry" is "Tooth-conserving Dentistry"
I'm very energized by a recent dental seminar I attended by Dr. Ray Bertolotti. Ray is a dual degreed dentist and PhD polymer chemist and refers to himself as an "adhesion dentist." Ray is at the cutting edge of understanding the best ways to bond dental materials to each other and to tooth structure. By utilizing modern chemistry that maximizes bond strengths, we can ensure that our dental restorations last longer and provide more conservative treatment options for our patients. For instance, rather than placing a more aggressive, conventional "crown" on a tooth, we can offer more conservative treatments that preserve more tooth structure and minimize the risks of complications (i.e., root canal treatment). "Adhesion Dentistry" = "Tooth-conserving Dentistry." Check out Dr. Bertolotti's website for more details..."http://www.adhesion.com/index.php?page=about_adhesion_dentistry"
Wednesday, March 2, 2011
Dental Prevention is Power
A prospective new patient called my office the other day complaining of tooth pain and urgently seeking help. He had no interest in a comprehensive exam. He just wanted to be rid of pain and move on. He said it had been about six years since he’d seen a dentist. “I haven’t had any problems until this tooth started hurting about two weeks ago,” he reported.
I’m surprised how prevalent this “mindset” towards dentistry still is. With all the expertise and technology we possess to detect dental problems early, offer more conservative treatments that preserve tooth structure and avoid painful emergencies, why would anyone tolerate the avoidable agony that this gentleman was experiencing? When he said that he hadn’t been having “any problems,” what he meant was he hadn’t been experiencing pain, but it was immediately clear that his and my definition of “problems” did not coincide. Pain is the ultimate dental motivator, but as was true in this case, symptoms often suggest that a preventable “problem” has gone way too far.
People avoid the dentist for a myriad of reasons. In their avoidance, their dental problems mount leading to more discomfort, complicated treatments with higher expenses and a higher risk of tooth loss. As a health-centered dentist, there’s perhaps nothing more frustrating than watching kids fall victim to avoidable dental disease. There’s no doubt that a parent’s initiative towards preventive dental care or lack thereof will be transmitted to their children. I’m always struck by parents who are adamant that their kids receive routine, preventive dental care and are not modeling the same level of care for themselves. They may point to their deeply entrenched dental fear from a past traumatic experience or even blame their parents for being raised with a lack of preventive mindedness.
I always commend those parents for attempting to overcome their own personal dental challenge for their children’s sake, but I also stress the importance of modeling healthy dental habits. Young children will always attempt to emulate their parents. My 1 year old son is already watching his parents and older sisters brush their teeth and attempting to mimic the behavior. There seems to be varying opinion regarding the best time for kids to first see a dentist. The American Academy of Pediatric Dentistry recommends a first dental visit by age 1. I haven’t mentioned that to anyone who hasn’t responded in surprise. The main objectives for a visit so early is to educate the parents on healthy preventive strategies, implement a healthy preventive regimen, catch any destructive habits in their infancy and get the child accustomed to the dental office as a positive, nontraumatic environment. One way to ensure a lifelong aversion to dental care is to forego a child’s first dental visit until they are 5, in pain, and have a mouth full of cavities.
Dental decay affects U.S. kids more than any other chronic infectious disease. The good news is that good oral homecare with regular fluoride, healthy eating habits and regular dental visits can virtually eliminate the risk of cavities. Many parents comment to me that they have “terrible teeth” and they assume their kids will succumb the way they have. It’s true that some people have higher risk factors and are more vulnerable to disease than others, but I have found that it’s often poor habits, not the “terrible teeth,” that are the root of the problem. With higher risk individuals, early preventive measures become even more critical. Some have deeper grooves on the biting surface of their molars than others and this genetic variant can significantly increase decay risk. Such individuals become great candidates for dental sealants that significantly reduce the chance that such teeth will succumb.
I commonly see older kids for the first time in my office that already have decalcified enamel, enamel that hasn’t formed ideally, often due to lack of fluoride. Such enamel becomes much more vulnerable to decay. An added benefit of seeing a child as young as one year old is to create a simple strategy to ensure ideal enamel formation. While I have found the benefits of fluoride have significantly reduced decay risk, frequent between-meal snacking is very prevalent and renders teeth much more vulnerable to decay. It’s not just sugary sweets that are the culprit, but any carbohydrates present in typical snack foods. Many parents in my practice seem less concerned about their kid’s “baby teeth” because they’re not permanent, but these primary teeth serve several important functions and their premature loss can really complicate a child’s dental future. A healthy primary dentition ensures proper chewing for maintaining nutrition, aids in speech development and helps maintain the space necessary for the permanent teeth to erupt.
There are really two approaches to healthcare: treating disease as it arises or preventing it from occurring in the first place. The traditional medical model focuses on treating symptoms of disease, and generally, much less emphasis is placed on prevention. The majority of dental practices in the U.S. practice similarly. Our society is moving at a feverish pace and seems geared toward instant gratification and “quick fixes.” Some dental practices are so busy treating disease that there’s little time spent on education, to prevent the disease from occurring in the first place. Empowering people with prevention education surely takes time, but educated patients are likely to spend much less time and money in the dental chair over the course of their lives. Arm yourself and your loved ones with the power of prevention.
I’m surprised how prevalent this “mindset” towards dentistry still is. With all the expertise and technology we possess to detect dental problems early, offer more conservative treatments that preserve tooth structure and avoid painful emergencies, why would anyone tolerate the avoidable agony that this gentleman was experiencing? When he said that he hadn’t been having “any problems,” what he meant was he hadn’t been experiencing pain, but it was immediately clear that his and my definition of “problems” did not coincide. Pain is the ultimate dental motivator, but as was true in this case, symptoms often suggest that a preventable “problem” has gone way too far.
People avoid the dentist for a myriad of reasons. In their avoidance, their dental problems mount leading to more discomfort, complicated treatments with higher expenses and a higher risk of tooth loss. As a health-centered dentist, there’s perhaps nothing more frustrating than watching kids fall victim to avoidable dental disease. There’s no doubt that a parent’s initiative towards preventive dental care or lack thereof will be transmitted to their children. I’m always struck by parents who are adamant that their kids receive routine, preventive dental care and are not modeling the same level of care for themselves. They may point to their deeply entrenched dental fear from a past traumatic experience or even blame their parents for being raised with a lack of preventive mindedness.
I always commend those parents for attempting to overcome their own personal dental challenge for their children’s sake, but I also stress the importance of modeling healthy dental habits. Young children will always attempt to emulate their parents. My 1 year old son is already watching his parents and older sisters brush their teeth and attempting to mimic the behavior. There seems to be varying opinion regarding the best time for kids to first see a dentist. The American Academy of Pediatric Dentistry recommends a first dental visit by age 1. I haven’t mentioned that to anyone who hasn’t responded in surprise. The main objectives for a visit so early is to educate the parents on healthy preventive strategies, implement a healthy preventive regimen, catch any destructive habits in their infancy and get the child accustomed to the dental office as a positive, nontraumatic environment. One way to ensure a lifelong aversion to dental care is to forego a child’s first dental visit until they are 5, in pain, and have a mouth full of cavities.
Dental decay affects U.S. kids more than any other chronic infectious disease. The good news is that good oral homecare with regular fluoride, healthy eating habits and regular dental visits can virtually eliminate the risk of cavities. Many parents comment to me that they have “terrible teeth” and they assume their kids will succumb the way they have. It’s true that some people have higher risk factors and are more vulnerable to disease than others, but I have found that it’s often poor habits, not the “terrible teeth,” that are the root of the problem. With higher risk individuals, early preventive measures become even more critical. Some have deeper grooves on the biting surface of their molars than others and this genetic variant can significantly increase decay risk. Such individuals become great candidates for dental sealants that significantly reduce the chance that such teeth will succumb.
I commonly see older kids for the first time in my office that already have decalcified enamel, enamel that hasn’t formed ideally, often due to lack of fluoride. Such enamel becomes much more vulnerable to decay. An added benefit of seeing a child as young as one year old is to create a simple strategy to ensure ideal enamel formation. While I have found the benefits of fluoride have significantly reduced decay risk, frequent between-meal snacking is very prevalent and renders teeth much more vulnerable to decay. It’s not just sugary sweets that are the culprit, but any carbohydrates present in typical snack foods. Many parents in my practice seem less concerned about their kid’s “baby teeth” because they’re not permanent, but these primary teeth serve several important functions and their premature loss can really complicate a child’s dental future. A healthy primary dentition ensures proper chewing for maintaining nutrition, aids in speech development and helps maintain the space necessary for the permanent teeth to erupt.
There are really two approaches to healthcare: treating disease as it arises or preventing it from occurring in the first place. The traditional medical model focuses on treating symptoms of disease, and generally, much less emphasis is placed on prevention. The majority of dental practices in the U.S. practice similarly. Our society is moving at a feverish pace and seems geared toward instant gratification and “quick fixes.” Some dental practices are so busy treating disease that there’s little time spent on education, to prevent the disease from occurring in the first place. Empowering people with prevention education surely takes time, but educated patients are likely to spend much less time and money in the dental chair over the course of their lives. Arm yourself and your loved ones with the power of prevention.
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