Fall has arrived. We can tell by the cooler nights, shorter days and even the leaves beginning to show a hint of color. For many New Englanders, this is the favorite season. As we settle into a routine of homework  sports schedules and carpools, it is important to consider that the new year will be here in the blink of an eye.

Most dental insurance plans have the beginning of the new year(January 1) as the anniversary date for benefits. The good news is that on that date, the full amount of benefits will be available for any dental procedures needed. The bad news is that any benefits not used will be lost as very few, if any dental insurance plans “roll over”. Therefore, if you have been advised by your dental team to have procedures done and you have dental benefits remaining, it would be a great time to schedule an appointment now while both you and your provider have some flexibility.

It is a frequent occurance that during December, many realize that they have benefits remaining and need procedures done and call to schedule. Unfortunately, we are often so busy with these requests appointment availability becomes very limited. This creates unneeded stress on everyone. So, think back to your last recare appointment and if there was treatment recommended, consider calling now so we can accomodate your schedule to the best of our ability.

Often patients new to our office will inform us it has been a long time since they have seen a dentist. When asked why, the most frequent response is not finances or busy schedules, it is that they are afraid of what we might find. For most of us, fear of the unknown creates apprehension. Even when we know what the correct course of action is, we are often hesitant to leave the familiarity of our current situation. The current situation might be not knowing what is going on in our mouths and as long as it doesn’t hurt why not continue.

Obviously, there are several flaws in this rationale. There are often hidden issues that can only be detected by a visit to your dental health professional. Frequently, these problems can be dealt with easily and painlessly in their early stages.Waiting for a crisis to arise often creates more anxiety and more complicated solutions.

The best solution is to sum up your courage and make the decision you know will be best. I will not deny there may be some anxious moments but you will feel better and be healthier, and hopefully wondering “why didn’t I do this sooner, it’s not so bad.”

For many, heart disease and gum disease would seem like unrelated issues. However, evidence is emerging that has established a clear connection between the inflammation of gum disease and inflammation around the heart that can cause heart disease. Periodontal disease is caused by the accumulation of bacterial plaque around the teeth. If these bacteria remain around the teeth, they colonize and invade the connective tissues that are responsible for keeping your teeth firmly in place. Several things occur when this bacterial invasion takes place. First, these bacteria release toxins that destroy the connective tissues(gum and bone) causing bone loss and the formation of a periodontal pocket which creates a breeding ground for these bacteria. Secondly, the body mobilizes its defenses to fight these bacteria. It is the bodies defenses that creates an inflammatory response(like an infected splinter). An inflammatory response is marked by pain, swelling, redness, heat, bleeding and/or loss of function. Look at the mirror closely at your gums. Might you see any of these signs?

For many years, we have been aware of a link between gum disease and heart disease. Recently ,though, a study in the British Medical Journal has reported a clear link between heart disease and periodontal(gum) disease. More sobering, is that this link is present even when other risk factors such as smoking, heredity, obesity and socioeconomic factors are considered. It is unclear however, whether the link is due to systemic bacterial invasion or the bodies immune response to gum disease.

How do you avoid gum disease? Brushing 3 times per day, frequent flossing and regular visits to your dental team for professional cleaning and evaluation.

Today I would like to discuss the wide range of treatment choices available to patients today. As I discussed in an earlier post, all treatment decisions must begin with an appropriate examination and diagnosis. After a diagnosis has been made, a discussion should now ensue between the patient and the dentist which should outline all the treatment options available , the implications of the various options, and the implications of no treatment.

One of the important aspects of treatment choices is the priority of the problem. A cornerstone of our practice is that we must treat and control active disease and/or pain. Unfortunately, dental diseases are progressive, which means they will continue to get worse without treatment. Tooth decay, gum disease and bite instability(tooth wear, jaw joint pain, mobile teeth) all get worse without intervention. Obviously, the earlier the dental team can address these issues, the easier and less costly the treatment will be. So, in our office, these areas must be addressed. It should be noted that a patient does have the right to refuse treatment but only after being informed of the problem and the implications of no treatment.

After we have addressed our active disease issues, we now get into areas that allow more choices to treat an individuals concerns. If a patient is unhappy with their smile, a number of options are available usually. Some might be simple, such as bleaching and/or cosmetic bonding and others may be much more comprehensive such as essentially rebuilding  a dentition that has been severely damaged. The most important point that I would like to conclude with is that any treatment decision should be made only after the patient is educated about their particular problem so the patient can make the proper treatment decision for themselves.

Today, I would like to discuss the varioud types of dental examinations that we use to aid in appropriate treatment. The first examination that I will discuss is the comprehensive oral evaluation. As the name implies, this is an examination that should involve the entire oral complex. This exam is done most frequently with a patient who is new to a dental practice or who has not been seen by their dentist for a number of years. During this exam, we will review the patients current and past medical history as well as the patients current and past dental history. There is often much to be learned before even looking in the patients mouth. A patients expectations, past dental treatment and anxiety level can all be discussed to aid in making the patient more comfortable and informed. Once we begin to examine the patient we will look at much more than teeth. We will also look at the patients periodontal(gums)health. This is accomplished by measuring the space between the teeth and gums.Excessive tooth wear or mobility of teeth should also be noted.  The comprehensive exam will also include an oral cancer screening and a review of any bite or TMJ(jaw joint) issues. After a visual examination, often a complete set of dental x-rays will be imaged. A complete radiographic series should be accomplished every 3-5 years depending on the patients condition. Occasionally, diagnostic molds of the teeth will be taken as well as photographs of the mouth. All of this information will be used to determine the level of health and potential need for treatment.

The next exam to discuss would be the periodic exam. This is accomplished during the patients recare visits. A review of the medical and dental histories will be accomplished. Since the patient is known to the practice the depth of the exam is lessened but still involves evaluation of entire oral cavity. This exam can be done by the dental hygienist or dentist, and commonly both. The need for current x-rays will be evaluated depending on the patients condition. The patient should have the results of the exam discussed, as well as any recommendations for  necessary treatment.

 The most obvious dental examination is the problem focused, or “emergency” exam. This type of exam would take place when the patient realizes that they have a problem and need to seek dental care. Commonly this would occur with the fracture of a tooth or filling or  the occurance of pain or trauma. As you would imagine, a diagnosis will need to be made before treatment is rendered , and arriving at the correct diagnosis can be quite obvious, or it can be quite a challenge. Visual examination, past dental history, and appropriate dental xrays are all tools to aid in arriving at a correct diagnosis.

Hopefully, this discussion will help our patients understand that not all dental exams are the same. Each is critical to optimal dental health to the individuals that we treat.

Welcome to my blog. It is my intention to post information two or three times a month that you will hopefully find interesting and relevant. Today, I would like to discuss some reasons why teeth break.  Obviously, trauma that occurs during sports or an automobile accident can fracture teeth. Also, if you have a tooth that has decayed sufficiently enough to undermine one or more of its surfaces, this can cause your tooth to break as well. Another less known reason is that your tooth can fracture due to the size of the fillings they comtain and the existence of cracks in them. Fillings, especially silver amalgam, due nothing to strengthen teeth, in fact they weaken them.

If the fracture is slight, the tooth may be simply smoothed and polished. If the fracture is more significant, it will require a bonded tooth colored  filling .  In more severe situations, a filling may not be adequate to restore the shape of the tooth, and a crown may be required to restore function.

Anticipating problems before they occur is more predictable, less stressful, and certainly more cost effective. I can not over-emphasize the importance of regular periodic examinations  as this will enable us to identify teeth that are at risk for fracture. Dental x-rays are also an important tool that we use in conjunction with visual examinations to guide us in making sound treatment decisions. So we look forward to seeing you in the near futures, and will welcome the opportunity to discuss any concerns that you might have.

Consider this blog your news resource for information about oral health, dental procedures and technology, and what’s happening at your dentist’s office. We believe communication is key to building great doctor-patient relationships, and this dental blog is intended to keep us in touch with you. The best part is, you can simply bookmark this page in your browser, then visit whenever you like! Stay tuned for regular posts that will keep you informed.

If you need to schedule an appointment or are “interviewing” us as your potential new dental provider, call today! You may also want to review information about us here.