What's Your Dental Score?

How do you rate your finest hotels and your memorable restaurants? With a rating score, of course. You know what you're getting when you see the 5-star ratings.

Your dental health should be just as easy to identify. In the past, it hasn't been easy to understand where you stand on your health, much less how your mouth is doing. There's a lot of factors that come into play when you are talking with your doctors about your level of risk and if you have a significant level of disease--it can get pretty overwhelming.

Enter MyDentalScore.com, a new tool used to more easily identify your risk for disease. The website offers a comprehensive analysis of your dental health, by analyzing several key details about your mouth and summarizing with an easy to understand score. Your scores will guide you in making the best decisions about how to care for the three most common diseases in dentistry: cavities, periodontal disease, and oral cancer.

Give us a call or drop us some email to discuss how to address your scores today!

No concussions=Hoop Dreams

When you think dental trauma, what do you picture? A broken front tooth? A football or hockey player without a tooth in their smile?

Believe it or not, one of the most underrated aspects of dental trauma is associated brain trauma, or concussion. In contact sports, players will commonly experience brain trauma in a collision WITHOUT a protective oral sports guard. A blow to the jaw or face usually transmits traumatic forces to the head. When a sports guard is used, those forces are absorbed, and greatly reduces the risk of concussion.

When I interview patients that play sports, I have found that many of them don't use a sports guard for basketball, soccer, and baseball. There is significant risk of dental and brain trauma in these sports, but conventional wisdom has kept many athletes from investing in a sports guard.

There are many types of sports guards available in drugstores and sports stores, and those are better than nothing at all. But they often warp, distort, and lose their protective functions when they have been used for a while. The real protection from dental trauma and concussion comes from professionally-constructed sports guards. The best models keep their shape, deflect traumatic forces, and stay comfortable. They are dual-laminate, meaning they are made from multiple layers of soft and hard materials.

That being said, I feel it is important to put our hat in the ring as a dental practice who is proud of their athlete patients. Cascadia Dentistry will offer all Stanwood-Camano school basketball players a custom-made single-laminate sports guard at no cost when they come in for routine exam, x-rays, and hygiene procedures. They are normally about $175-200, but we want to make them for free express our support for the safety of school district athletes this basketball season.

Have fun this season, and stay safe!

Insurance benefits for 2010

During the last quarter of the year, we usually see insurance benefits still remain for many of our patients. And if those insurance benefits aren't used, they don't roll over to the coming year.

At Cascadia, we want to help you understand your dental insurance plan as well as possible. As a courtesy, we will review your plan benefits for you at any time. We know that insurance plans aren't going to cover all dental costs, but they are a benefit provided by employers to defray the costs of dentistry for you. We want to help you maximize the use of your benefits.

So give us a call today. You can still take advantage of 2010!

October is Cancer Awareness Month!

CANCER AWARENESS MONTH—OCTOBER, 2010

At Cascadia, we are concerned with lowering your risk for oral cancer. Because the signs and symptoms are usually missed by the naked eye, the disease is usually detected late in development, when the mortality rate is 50%. When found early, oral cancer patients have a nearly 90% survival rate. A new reason for concern has surfaced in the past few years, and it's associated with patients over the age of 17—the Human Papilloma Virus (HPV). It's the same virus that causes cervical cancer in women. It presents a 5x increase in presentation of oral cancer under the age of 40. But Dr. Rafoth has the Identafi 3000 Ultra, a new device that can detect oral cancer before it becomes apparent on a conventional examination.

During the month of October, Cascadia Dentistry will provide a free oral cancer screening with the Identafi 3000 Ultra to all patients when they receive an examination and hygiene procedures. Contact us today for an appointment!

Quality Control for Your Dental Implants

Patients and general dentists would both agree we couldn't live without oral surgeons for a number of reasons. They provide surgery with safe general anesthesia and sedation. They make the most challenging surgeries a success. Most patients know that a surgeon is important to getting implants accomplished. They are highly trained in placing dental implants. But in order to replace teeth, it's not just the oral surgeon that matters. The entire process from your tooth removal to your final implant crown determines the best results for chewing and smiling.

To get the best results with dental implants, you need to first talk with your general dentist about your goals. Dentists are the "general contractors" for implant projects. They need to have up-to-date knowledge, equipment and the skills to plan your tooth replacement with implants from the ground up. Since the standard of care for tooth replacement is with implants, dentists should be experienced with the planning and placement of different types of implants and teeth. If your implants are going to succeed, they will have to examine the bone, gums, and your teeth that need to be replaced. They will need to design a "blueprint" for your final teeth before surgery ever happens.

Today, the most successful plans are usually designed with the aid of a CT scan of your jaws and teeth, and the dentist uses software to create the final results before the implant surgery even begins. Once the "blueprint" is finished, the surgery can be executed more accurately and predictably.

In some cases, your dentist may be in the best position to perform your implant surgery. Not only do they understand how implant teeth need to be be built and look, they also know where the implants need to be placed at the time of your surgery. Your dentist can have complete control of the project, from design, to ordering materials, to installation and finishing of the implant teeth. Quality control can remain with your "general contractor" at every step.

At Cascadia, Dr. Rafoth has been taking this approach, providing implant surgery for his patients since 2000. He uses Simplant technology to plan their cases. And he offers a wide range of dental implants, crowns, bridges, and dentures to fit the unique situations of every patient. Call us today for a free consultation!

Happy Summer 2010

It's been a while since you saw a post from us. Dr. Rafoth has been in the mountains and on the coast all summer with his family and friends. Here's a shot of him doing what he loves best--climbing in the Cascades. He recently returned from a successful climb up the north side of Mount Adams.

We hope you have been enjoying your summer, and maintaining excellent health. We look forward to seeing you at the office for your next checkup!

Let us know how we're doing

Yelp is an excellent tool for sharing your opinions about our service. Please head to our page at www.yelp.com/biz/rafoth-chris-dds-stanwood

We do high-tech oral surgery, too!

Just wanted to let all of you know that we support space-age tooth extractions.

Implants for hopeless teeth

Patients who have failing teeth get concerned that it will be tough to chew when they lose them. Molars are like your thumbs--they are really handy for eating a proper diet of fresh foods. Without them, you're a bit handicapped.

The other part of losing useful teeth? Once the tooth is gone, the bone support atrophies, or disappears, soon after the tooth is removed unless something is done to preserve the bone.

That's where implants can help. If placed immediately after tooth extraction, supporting bone is preserved, and the process of restoring a useful tooth begins right away. Here's a case where that happened.

The tooth at center has a hopeless outlook, becasue the root has split, and an abscess is starting on the left root. The patient really wanted to chew with that tooth--it is his favorite chewing side.

We removed the tooth and immediately secured an implant in the site.

We then restored the stable implant with a crown 2 months after extraction, seen in the lower right corner of the x-ray.

Implants can really change your life. Call us for a free consultation with an exam and x-rays (Value $205) to discuss how we can help you!

One-day smile makeover--direct veneers

This patient was graduating with her doctorate in about a week, and wanted to eliminate the gaps and "the snaggle tooth" from her smile before she moved home. We recommended direct composite resin veneers. This treatment was done in a single visit, and is the most conservative aesthetic choice for improving smiles. It did not involve any cutting of teeth.

Direct composite veneers are much less expensive than costly veneer treatments which usually require cutting or trimming tooth structure. She was thrilled with the outcome, and so were we! Call us today for a free consultation (value $165) to find out if direct veneers a re the right choice for you.

Fellowship Achieved for Implant Dentistry

Dr. Rafoth recently received his fellowship degree from the American Dental Implant Association!

This advanced degree in implant surgery and implant dentistry was presented after he completed an extensive hands-on training program. Although he has been performing implant surgery since 2000, Dr. Rafoth wanted to continue his education and improve his surgical techniques with ongoing training.

Our office is providing the latest advances and procedures for implant dentistry, including computed tomography (CT) imaging, computer-aided implant placement, mini dental implants, bone grafting, and more.

We are certain that implants can change the lives of our patients, becasue we have seen the results with many patients we have treated! If you want to feel confident about eating, speaking, and smiling again, call our office today for a free consultation (value $205) to see how implants can help you.

The standard for oral cancer screening is here!

Oral cancer prevalence is on the rise. Human Papilloma Virus (HPV) has recently been recognized as a significant factor in oral cancer. Usually, the first healthcare providers to recognize oral cancer are dentists. With the increased risk in the general population, we were interested in offering our patients the best way to screen for the disease. So we now offer the Identafi 3000, a visible-light instrument that can differentiate between healthy and abnormal oral tissues.

The Identafi 3000 is easy for to use, is comfortable for you, and can better identify signs of cancer at an earlier stage than the traditional "see and feel" oral cancer screening.

We perform an annual screening with the Identafi 3000 for all our patients. There is a reasonable cost associated with this service. But the value of early detection outweighs the cost of treatment and rehabilitation associated with advanced-stage oral cancer.

Call us today to schedule an examination that includes the Identafi 3000. For more about the instrument, visit http://www.trimira.net/.

Medical Evaluation for Periodontal Disease

When you have a major illness or injury, think about what has to happen to get better: you go to the doctor, the doctor may take some blood, orders specific tests. Those tests identify certain facts about your problem. Then the doctor uses these facts to decide how to help you.

The same methods are now being applied in dentistry for periodontal disease. Specific tests are important for identifying the presence of infection, the effects of infection on your body, and the presence of genes that put you at greater risk for the disease.

In our office, we see many patients have medical complications as well as conventional dental problems. But when we review their medical history, and find risk factors for periodontal disease, we work with the patient's doctors to run specific tests. These tests can detect harmful bacteria, identify abnormal inflammation, find the gene for gum disease, or identify when other medical conditions are liable to cause problems with oral health. With that specific information, we can treat them using the proper procedures. We also use medical testing to confirm that patients are recuperating after we treat them.

There is a service, called OralDNA Labs, that is now doing many of these tests for patients at the dental office instead of going to their physician. For more information about these tests, visit www.oraldnalabs.com. To discuss how we can help you treat periodontal disease or medical evaluations for your oral health, call us today!

How We Decided to Offer Sedation Dentistry

Before I started practicing in 1998, I had the unique privilege to learn oral surgical procedures at a local hospital. The differences between hospital-based dentistry and general dentistry were numerous. The biggest difference was how patients were cared for comfortably with respect to their level of anxiety and their medical conditions. In many cases, comfortable treatment meant sedation or general anesthesia was used. From that point on, I knew I should position our practice to offer sedation dentistry.

Before we offered sedation to patients, there were a number of steps we had to take. First, I wanted my team well-educated and trained to administer safe sedation to patients. We took an extensive amount of time at several continuing education facilities. And I make sure that they receive regular reviews of all sedation procedures and emergency protocols. Being a part of the Dental Organization for Conscious Sedation (DOCS) keeps me and my team up-to-date about all aspects of sedation dentistry.

Next, I made sure that we were prepared with the right equipment and medications to monitor patients, and manage their needs. And I made sure that we arranged to focus on one patient's care at a time while they were under sedation.

I know many patients who want sedation are also in need of high-level rehabilitation--in a lot of cases, that means significant amounts of dentistry. So I prepared my practice to provide comprehensive care. That means we are trained to perform the standard of care not only for fillings, crowns, and cleanings, but also for oral surgery, root canals, dentures, gum surgery, and implants.

Finally, offering a comfortable environment that provides "TLC" and high-level customer service is necessary to work out details for people who require sedation or comprehensive care. This means we spend the time it takes to listen to a patient's specific needs and desires. We discuss how we can realistically and reasonably offer sedation dentistry to get them what they want.

It has been really rewarding for me to know that we have treated so many patients with sedation dentistry that would otherwise never be able to improve their dental health. The preparations to offer sedation have really paid off, because we know we are providing safe and effective ways to keep them comfortable during care.

Another Bleaching Success Story

After using the Kor Deep Bleaching procedure for tooth whitening in our office for several years, we still find it incredibly satisfying to hear how Deep Bleaching changes patient's lives.

A recent article illustrates how patients who have had lifelong tooth staining can get excited when tooth whitening is accomplished.

Treating darkened teeth in 2 simple visits at our office with the Kor procedure can give you a whiter smile than any other professional whitening system available. I know, because not only have I performed bleching procedue for patients with the lasers, lights, and super-concentrated bleaches, I have also been a patient!

Call us today to schedule a free consultation for Deep Bleaching.

Periodontal Disease is a dangerous medical condition!

Several years ago, I realized the impact periodontal disease has on overall health. It is connected to several of the top ten causes of death in our country: heart disease, stroke, diabetes, and a few others. Oral bacteria from periodontal disease is the link in these killer diseases.



The good news? We developed a successful program several years ago for treating periodontal disease. We work with your physicians and medical specialists to make sure this disease is managed the right way.



Periodontal disease is also a chronic inflammatory disease. And inflammatory diseases can complicate several other diseases, including chronic pulmonary disease, arthritis, pneumonia, and diabetes. Not only is periodontal disease a confirmed factor in these problems, but there is current research being conducted to prove how it can trigger or influence more diseases, like pancreatic cancer and Alzheimer's.



This problem is a double-edged sword--problems with oral health can create problems with your medical health, and vice-versa. But we have experience solving these issues directly with your physician. And that results in reducing your risk.

Open this link for more information on the medical importance of good oral health. Contact us for an appointment today!

Referral Awards!!!

We want to thank our patients for spreading the good word about our office. To celebrate, we are promoting a referral awards day on June 1, 2010.

The person who refers the most patients to our practice between now and 6/1/10 will receive a gift package. It includes a dinner for 2 in Stanwood (value $120) and a movie package to Stanwood Cinemas for 2 (value $30). We will personally deliver the gift to your door on June 2, 2010!

You can refer friends or family members through our website, or call us at 360.629.7229.

Oral Cancer Update

Oral cancer is becoming more prevalent in non-smokers and non-drinkers. And the growth rate for oral cancer has jumped considerably in the past few years.

Exposure to human papilloma virus (HPV) is the fastest growing factor in acquiring oral cancer. It is the same virus that is responsible for cervical cancer in women.

HPV presents a 5x increase in the risk for oral cancer under the age of 40.

HPV can be acquired through sexual contact.

What does this mean? All patients over the age of 17 should be screened every year for oral cancer by their dentist. The detection of oral cancer with the naked eye is important, but by the time it is detected visually, the mortality rate is about 50% The technology is improving so that it can be diagnosed earlier, and treated more successfully--with an almost 90% cure rate.

Two types of technology are available for dentists now, the Velscope and Identafi 3000. Both use special wavelengths of light to identify abnormal oral tissue.



The other important part of reducing oral cancer risk is making appropriate lifestyle changes. Eliminating tobacco use, reducing alcohol intake, and eating a diet rich in fresh vegetables and fruits are important. And having a doctor or health professional provide screening, testing, or treatment women at risk for HPV is also essential to reducing oral cancer risks. Learn more about HPV at the CDC website.

Six Month Braces Case

Here is a case that was just completed. This gentleman was unhappy with the appearance and position of his upper teeth. We proposed three phases of treatment: tooth realignment with 6 Month Braces, whitening with Deep Bleaching procedure, and replacing the discolored and leaking bonding in his front tooth. The benefits of this approach were a cost savings compared to conventional veneer treatments, as well as avoiding the irreversible cutting or veneering of teeth in order to straighten, whiten, and keep the smile balanced.

Before treatment began.

Results after just 4 months of braces, Deep Bleaching and replacement of the failing filling on the upper left front tooth.

Spring is Coming!

Cascadia Dentistry's blossoms are arriving. Always a great reminder to check up on your hygiene visit schedule for springtime. Give us a call or book online!

Dr. Rafoth and his dad, Dr. Rafoth

My dad, Richard Rafoth, MD, is a gasteroenterologist at the Everett Clinic in Everett, Washington. He has published 2 editions of a book. It's focused on nutrition and cycling. He has also created a blog and website devoted to cycling performance, called Cycling Performance Tips. He is the absolute best long-distance rider I know, has tons of street cred in the nutrition department, and has inspired me to ride for the rest of my life.

I thought I would share an older post from his website. I contributed an article about the research and management of tooth decay when you are a high-performance cyclist.

Happy riding!

"I don't need toothpaste to get clean?"

Toothpaste is not the most important part of cleaning your teeth--it's time.

Researchers are unified in the fact that excellent plaque removal is based on the length of time you brush. In fact, a dry brush is more effective, say some researchers, because patients can actually feel when the plaque is being removed. Toothpaste masks the truly clean feel your tongue can detect.

So brushing for 2-3 minutes is the most ideal time it takes to remove the most plaque and bacteria.

Don't ignore the power of today's toothpaste products, though. The best toothpastes contain ingredients that remineralize and protect the enamel surfaces, as well as desensitize your teeth. The notion that toothpaste is needed as an abrasive is outdated. The older toothpastes on the market may contain pumice, silica, and other abrasives that can speed up tooth erosion or abrasion. Contact us today for the best recommendations on the right toothpaste for you.

Cascadia's Weekly Prescription

Root surface cavities happen at the gumline of teeth. Older patients typically get these cavities because of their tendency to have gum recession and exposed roots. But another population of patients is on the rise: those who routinely drink soda, energy drinks, or sport drinks. The acid from the drinks corrode tooth enamel, and the cavity pattern is similar to root cavities in older patients.

These root surface cavities are hard to restore, because they are at or below the gumline. Conventionally, dentists removed the cavity and restored it with a filling. But this can create unhealthy gum tissue at the restoration in many cases.

Today, the best first line of treatment is to remineralize teeth and stop the cavity process. Numerous studies are revealing that professional-strength topical fluoride arrests root surface decay. When combined with excellent home care and professional dental visits, routine use of topical fluorides can prevent unneccessary restorations and reduce your costs. For complete information about the disease of tooth decay, visit our website.

Stabilizing Loose Teeth

Teeth can become loose for several reasons: Traumatic injuries, severe periodontal disease, or tooth grinding. In many cases, those problems become terminal, and the loose teeth have to be removed.

We can stabilize teeth and increase their lifespan. If we can anchor loose teeth successfully, and treat the source of the loose teeth, those questionable teeth can survive longer.

One method is splinting. We can unite or bond several teeth together. We can use metal wires or non-metallic fibers to unite the teeth with adhesive dentistry.




We also make clear acrylic splints called biteguards so you can reduce the traumatic forces of grinding.



Combining splinting with treatments for bite problems or treating periodontal disease can prevent premature tooth loss.

Cascadia's weekly prescription

Over the years, I have become increasingly aware of which patients have higher risks for obstructive airway disorders (OAD), also known as sleep apnea. What was at first a suspicion has now turned into an important screening procedure at every patient examination for my patients. I routinely examine the airway and offer a brief medical survey to patients who appear to be at greater risk for the disease. In collaboration with their specialists, we have treated patients with OAD to improve their quality of life.

I have been reviewing literature and websites for several years, and feel that the Academy for Dental Sleep Medicine is a decent resource for learning more about diagnosis and treatment for the disease. This site also offers you a self-test to determine if you should visit a doctor to determine if you can be treated for this debilitating disease. You can also visit our site to take the self-test.

Precision Implant Surgery

We are entering another amazing era in dentistry. Just 10 years ago, I thought our patients were experiencing an one-time renaissance in incredible dental technology and lifelike dentistry. But it's not over. The next technological evolution has arrived. We provide computer-guided, 3-D implant surgery in our office! We now replace teeth with digital precision.



We are now a certified SimPlant office. Using 3-D SimPlant technology, We can plan implant surgery with digital precision, and perform your implant surgery with confidence AND digital accuracy. We work with CT scan specialists to plan your surgery before you even enter our office for treatment.

Cascadia's weekly Prescription

Check out this dental information site from ToothIQ. It does a decent job of combining text with visual explanations of many dental procedures. www.toothIQ.com

Many of the services we offer at Cascadia can be researched at this site.

Preventing Bone Atrophy

When teeth are lost, the supporting bone starts to dissolve. This is called bone atrophy. This creates a number of difficulties for patients. Dentures become loose and painful. Bone support is lost for existing teeth. Losing bone causes the smile to collapse, and makes it hard to restore a natural-looking smile. It also creates problems with tooth replacement near sinus areas, because the bone becomes very thin. The video below shows more about this issue.


We have become experts at preventing bone loss when teeth are lost. We now perform bone grafts when teeth are extracted, which preserves bone needed for tooth replacement and prevents collapse in that area. We also offer dental implants to prevent long-term bone loss. Implants have been proven to maintain healthy bone without atrophy.

Preventing atrophy means you retain bone for secure dentures, maintain your natural smile, and improve the outcome when replacing your missing teeth. Call us today for a consultation to see if grafting or implants could help you!

Inaugural Blog!

Welcome to the first post on our new blog feature!

Our primary website is http://www.cascadiadentistry.com/.

I'll be dedicated to adding pages and links to information about high-quality dentistry, health, and general wellness on a regular basis. It's important to discuss not only the services we provide , but also let you into our personal lives every now and then. You can go directly to each of our main pages here:

Patients are saying great things about our office! Read testimonials about our care.
Our Services. We are proud to offer 6 Month Braces, implant dentistry, peridontal surgery, root canals, and sedation dentistry for our patients, as well as routine fillings and cleanings.
Our Team. We have set the standard for customer service. Contact us today to set up an appointment online!
Patient Resources. Book your visit online, access patient information and forms, find easy financing for dentistry, and be a part of our referral rewards program.
Contact Us. We love to meet new patients! Book your appointment online, leave us an email, or give us a call. Access directions and maps for your convenience.

It would mean a lot to me if you would leave comments on the blog posts, or drop me an email at chris@cascadiadentistry.com.