Interesting article I read about the correlations between the introduction of local anesthetic for dental treatment in kids and the reduction in 3rd molar formation and ocurrence. See below.
Spear article
Thursday, May 30, 2013
Don't Run With Scissors, Don't Pour Gas On A Fire
My 3-year old daughter wanted to do some artwork last week. Upon the request to "go get some scissors," she ran to the office and ran back with the shears flailing in front of her face. Parenting Rule #856, Don't Run With Scissors, was then practiced for the umpteenth time.
There's plenty of new rules emerging in the dental world as we learn about the long-term effects of soda on teeth. My hygienist sent me a link about the wisdom of not drinking soda--'cause it's bad for your teeth--with a new twist. Not only does soda rot your teeth, it does it faster than we thought, and probably as well as meth and cocaine.
Methamphetamine and crack cocaine users suffer from dry mouth when using. Lethargy and thirst also increase, and users often turn to soda consumption to increase energy and satisfy the dry mouth. The triple whammy is that in addition to a dry mouth and acid erosion from soda, smoking the drugs will burn, erode, and decay teeth. It's like pouring gas on a fire.The photo below is pure meth mouth.
Non-drug users can suffer the same devastating results after long-term soda use. Caffeine will reduce the flow of protective saliva, and the pH of soda is so acidic, it will erode enamel quickly. This is a patient who has enjoyed Coke and Diet Coke for a decade.
There's plenty of new rules emerging in the dental world as we learn about the long-term effects of soda on teeth. My hygienist sent me a link about the wisdom of not drinking soda--'cause it's bad for your teeth--with a new twist. Not only does soda rot your teeth, it does it faster than we thought, and probably as well as meth and cocaine.
Methamphetamine and crack cocaine users suffer from dry mouth when using. Lethargy and thirst also increase, and users often turn to soda consumption to increase energy and satisfy the dry mouth. The triple whammy is that in addition to a dry mouth and acid erosion from soda, smoking the drugs will burn, erode, and decay teeth. It's like pouring gas on a fire.The photo below is pure meth mouth.
Non-drug users can suffer the same devastating results after long-term soda use. Caffeine will reduce the flow of protective saliva, and the pH of soda is so acidic, it will erode enamel quickly. This is a patient who has enjoyed Coke and Diet Coke for a decade.
The good news is that soda erosion is manageable. Neutralizing the acidity of the soda immediately after drinking it will reduce the risk of this kind of decay. Chewing sugar-free gum, drinking water, or brushing your teeth are all effective choices.
Monday, April 22, 2013
Putting A Spare on a Bad Axle?
If you haven't already given this idea some thought, wait no longer: I am a mechanic in some respects, and a doctor of the mouth in most. But Automovite specialists and I have something in common. We want to do the best job we can with any client, and minimize the liabilities for ourselves as well as the clients with any given job. We have challenges limping some clients along depending on the severity or complexity of their problems.
One example of this occurred this morning. A patient called this morning complaining of continued pain with his severe periodontal disease after we began non-surgical treatment. He elected to retain a poor tooth instead of removing it, and now I'm guessing he is hurting because the continued infection has flared up. And he prefers to have me call his pharmacist to treat his pain and infection. When I reviewed his case, I noted that the area where he was complaining has truly severe bone and tissue infection with little hope for medication to solve. In addition, he plans to transfer his care to another provider.
When your car has a problem, like a bad axle or suspension, it's tough to call the mechanic and have them send out a tow truck to put the spare tire on. Furthermore, your mechanic will have a tough time assessing the extent of the current damage without having your car up on the lift in the garage.
The same holds true for a change in conditions in the mouth. Even from week to week, periodontal disease and failing teeth are in flux. A prescription for pain control may be a poor choice for a number of reasons, both medical and dental. Some issues can't be resolved with prescriptions. Narcotic medication management is something we take seriously, and we do not provide narcotic medications without seeing patients directly. And from the medical-legal standpoint, making an assessment and treatment over the phone is risky for patients and providers.
Thanks for understanding we dentist types want the best for your your medical health, your teeth. And your cars.
One example of this occurred this morning. A patient called this morning complaining of continued pain with his severe periodontal disease after we began non-surgical treatment. He elected to retain a poor tooth instead of removing it, and now I'm guessing he is hurting because the continued infection has flared up. And he prefers to have me call his pharmacist to treat his pain and infection. When I reviewed his case, I noted that the area where he was complaining has truly severe bone and tissue infection with little hope for medication to solve. In addition, he plans to transfer his care to another provider.
When your car has a problem, like a bad axle or suspension, it's tough to call the mechanic and have them send out a tow truck to put the spare tire on. Furthermore, your mechanic will have a tough time assessing the extent of the current damage without having your car up on the lift in the garage.
The same holds true for a change in conditions in the mouth. Even from week to week, periodontal disease and failing teeth are in flux. A prescription for pain control may be a poor choice for a number of reasons, both medical and dental. Some issues can't be resolved with prescriptions. Narcotic medication management is something we take seriously, and we do not provide narcotic medications without seeing patients directly. And from the medical-legal standpoint, making an assessment and treatment over the phone is risky for patients and providers.
Thanks for understanding we dentist types want the best for your your medical health, your teeth. And your cars.
Thursday, March 28, 2013
CPR, First Aid Update For Our Office!
We regularly see patients with multiple medical conditions, multiple medications, or other therapies. We are seeing an increase in the age of our patients, as well as seeing a greater population of patients with obstructed breathing disorders and diabetes. Understanding the complexities of these types of patients requires ongoing training and practice.
Thank you to Tara of Medic/First Aid, Inc. who led an intensive review of lifesaving and first aid emergencies. She tailored our recertification to the emergency protocols we encounter with our surgical, sedation, and general dental patients.
Dr. Rafoth is trained in advanced cardiac life support (ACLS). He is a Dental Organization for Conscious Sedation provider, mentor, and member. Our team is trained and up-to-date on the current techniques for conscious sedation care as well as CPR, AED, and first aid services.
Thank you to Tara of Medic/First Aid, Inc. who led an intensive review of lifesaving and first aid emergencies. She tailored our recertification to the emergency protocols we encounter with our surgical, sedation, and general dental patients.
Dr. Rafoth is trained in advanced cardiac life support (ACLS). He is a Dental Organization for Conscious Sedation provider, mentor, and member. Our team is trained and up-to-date on the current techniques for conscious sedation care as well as CPR, AED, and first aid services.
Monday, March 18, 2013
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.
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.
Thursday, February 28, 2013
Battling The Banes Of Our Existence: Inflammation AND Big Pharma
Inflammation is pervasive in the human body. It's likely that it is the primary cause for aging and our mortality. Hundreds of drugs have been brought to market to combat inflammatory diseases. It's likely thousands more will be introduced to treat inflammation at the genetic level, inhibit inflammatory enzymes and proteins; the list goes on.
One of the most influential drugs in the battle against periodontal disease is doxycycline. The popular brand name of this drug is called Periostat. But it is available in generic formulations. It is an antibiotic by design. But instead of using heavy-duty doses to kill bacteria associated with periodontitis, the drug has been wielded by researchers and clinicians in small amounts to suppress the body's inflammatory process, which is actually a reaction to bacterial toxins.
When the inflammatory process begins in periodontal disease, it is not the bacteria that create tissue destruction. It is the body's reaction to the toxins that trigger enzymes and bone- and gum-killing proteins to surge. So the low-levels of doxycycline suppress the enzymes released during inflammation, and the tissues are not destroyed as readily over time. The concept is called host modulation therapy.
Patients occasionally pipe up with concerns that they will not use the drug because they fear it will promote a bacterial super-infection when using doxycycline. But frankly, the doses are so small that they don't even kill bacteria, and do not promote the mutations responsible for bacteria to become more resistant to treatment. My opinion is that it should just be added to the water supply based on how effective it is for some patients with highly sensitive inflammatory reactions. It's one of the only good weapons I have seen sensitive patients use with success beyond good self-care to avoid surgical treatment and minimize the impact of periodontitis.
But there is now a greater challenge for patients to get access to this drug because of the decisions pharmaceutical companies and medical insurance companies are making. Not only are many drugs being taken off the shelf due to discontinuation of drug manufacturing, but insurers are also implementing increases in co-payments for patients who want to use drugs that are in short supply. So if you or others want to know the status of your drug of choice in the marketplace, go to the site managed by the American Society of Health Pharmacists.
One of the most influential drugs in the battle against periodontal disease is doxycycline. The popular brand name of this drug is called Periostat. But it is available in generic formulations. It is an antibiotic by design. But instead of using heavy-duty doses to kill bacteria associated with periodontitis, the drug has been wielded by researchers and clinicians in small amounts to suppress the body's inflammatory process, which is actually a reaction to bacterial toxins.
When the inflammatory process begins in periodontal disease, it is not the bacteria that create tissue destruction. It is the body's reaction to the toxins that trigger enzymes and bone- and gum-killing proteins to surge. So the low-levels of doxycycline suppress the enzymes released during inflammation, and the tissues are not destroyed as readily over time. The concept is called host modulation therapy.
Patients occasionally pipe up with concerns that they will not use the drug because they fear it will promote a bacterial super-infection when using doxycycline. But frankly, the doses are so small that they don't even kill bacteria, and do not promote the mutations responsible for bacteria to become more resistant to treatment. My opinion is that it should just be added to the water supply based on how effective it is for some patients with highly sensitive inflammatory reactions. It's one of the only good weapons I have seen sensitive patients use with success beyond good self-care to avoid surgical treatment and minimize the impact of periodontitis.
But there is now a greater challenge for patients to get access to this drug because of the decisions pharmaceutical companies and medical insurance companies are making. Not only are many drugs being taken off the shelf due to discontinuation of drug manufacturing, but insurers are also implementing increases in co-payments for patients who want to use drugs that are in short supply. So if you or others want to know the status of your drug of choice in the marketplace, go to the site managed by the American Society of Health Pharmacists.
Wednesday, February 13, 2013
New Beginnings
Old School is a favorite movie of mine. For some reason, Will Ferrell's voice resounded in my head as I was getting my day started with a dental assistant for a working interview. To me, "new beginnings" mean that my team gets a chance to find a great asset to add to the mix. And the theme of new beginnings are also important when any of our team is welcoming a patient into the practice.
One of the major tenets of our mission is as follows:
"Our patients are supported by a personable, approachable team concerned with building their trust and confidence. We provide a relaxed, open forum where you can consider or express a new desire for dental care."
I have always been associated with activities an interests that include people having fun together; making and performing music, hosting uniquely themed parties, skiing with a group, mountaineering, playing Scrabble and other games around the table with my family. So naturally I want to get to know somebody before I launch into dental care. And that's what I decided my team should be great at. Inviting guests into our house means we hang their coat, give them a tour, and sit down for a bit to share about each other. Then we can take the steps to plan treatment people want to pursue. Until that relationship is made, we don't do dentistry.
So call us! You can come in to meet us for a cup of coffee and a no-cost consultation, or book a visit for a cleaning and examination to get your dentistry done.
One of the major tenets of our mission is as follows:
"Our patients are supported by a personable, approachable team concerned with building their trust and confidence. We provide a relaxed, open forum where you can consider or express a new desire for dental care."
I have always been associated with activities an interests that include people having fun together; making and performing music, hosting uniquely themed parties, skiing with a group, mountaineering, playing Scrabble and other games around the table with my family. So naturally I want to get to know somebody before I launch into dental care. And that's what I decided my team should be great at. Inviting guests into our house means we hang their coat, give them a tour, and sit down for a bit to share about each other. Then we can take the steps to plan treatment people want to pursue. Until that relationship is made, we don't do dentistry.
So call us! You can come in to meet us for a cup of coffee and a no-cost consultation, or book a visit for a cleaning and examination to get your dentistry done.
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