Complicated Care Plans Require Flexibility in Treatment

Lately I have had several consultations regarding large-scale, complicated treatment plans to care for complex decay and periodontal disease. It's been pretty trying for me as I discuss the large costs of these treatments; my patients have developed these conditions over many, many years. To recommend the right kind of care for them, I have to walk a fine line between cost and care with them all. Most of the involved plans have a sticker price that is akin to a new car.

In order to make things affordable in dentistry, I have to find a way to create steps in care. I'm always using the simple (albeit sometimes oversimplified) analogy of building a house. At times I am proposing a remodel. Other times I am proposing a bulldozing and total rebuild. And when a house gets work done, it can happen in phases. No different in my line of work.

The reason it's important to share this?  Twofold. First, everything in dentistry is expensive. It's important for me to keep that in mind as I propose care plans, because it's a real world we live in with lots of expenses from all angles in our lives. If I can create a situation where patients can start a project, have stability in the interim, and finish it within a reasonable time frame while on a budget, then I feel good about that.

Secondly, dentistry done right is time-consuming. I actually feel steps HAVE to happen in many of these cases. "Teeth InAn Hour" is bandied about these days, and I don't think that fits the majority of patients; it's practically unfair to doctors and patients alike to push that same-day tooth replacement option.  Oral health doesn't blow up and fail in a day. So there's little chance that a quality result occurs in the same time frame.

Lastly, with financing, things can happen in steps with a flexible payment plan.

Give us a call to talk about your involved or complex care. I know we can find a way to make it happen in steps.

Please Get Educated about the 2010 Healthcare Act

A decent summary of the Affordable Healthcare Act (ACA) as it impacts dental patient care was released recently.

The ACA has inadvertently developed many complicated twists and turns for patients and providers on the long road to a successful, comprehensive care horizon.

My thoughts:

1) Dentistry isn't about to get cheaper or easier to access with the advent of the ACA activity.

2) Maintain great communication with your employers and human resources representatives. Do your best to communicate the continued need for dental insurance policies.

3) Consider a health savings account or a flexible spending account and talk with your employer or HR about matching or funding those accounts for dental care. These types of accounts allow flexibility in how and where you get care. They can also help you and your family break through dental insurance limitations for where, when, and how you get care.

4) Educate yourself on how you can keep your children healthy under the ACA provisions. Odds are there is a state-funded program for kids in need, wherever you may live.

5) The ACA will create better access to medical insurance for our country's patients. Keep in mind surgical care in a dental office (tooth extractions, periodontal surgery, grafting, dental implants) and treatment for sleep apnea in a dental office can be submitted to medical insurance.

Building Momentum

I took care of a patient a few months ago who was sweating bullets in my conference room when she saw me for the first time. She couldn't imaging treatment without being "put under."  Now, I don't put anybody to sleep in my clinic, because I simply don't want to assume responsibility for their breathing. But I provided moderate sedation for her, and I have seen her twice for surgeries to replace a tooth with an implant.  Last week, she asked me if I would discuss how to improve her facial esthetics with Botox and Juvederm. WITHOUT sedation.

I thought her progress was interesting, because I have seen a similar pattern in fearful patients. I truly believe that past experiences of traumatic dentistry never fade; those events are hard-wired into the patients' processes of fear and/or anxiety, kind of like a deeply rutted road that is traveled thousands of times. But when I can create a visit that is free of the triggers for that psychological cascade of behaviors, I could swear that a new pathway is created for patients to travel that has a totally different context for them as they sit in my office for consecutive visits.

It's pretty fascinating and rewarding to talk with this patient about how I am going to stick her with a needle, and she is significantly more relaxed. And I proceeded to inject her without anesthesia!!!! Yes, I engineered some trust between us. But that is quite a positive trend she has displayed.  I anticipate she will see me for dental care in the future without the need for sedation, because I see that evolution in other patients too. I like not having to sedate patients. And I like it even more when I know that they can build momentum in a positive way to eliminate that need for sedation care.

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.

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.