How many of us brush our teeth and notice blood on the tooth brush? What happens when your gums bleed during a routine cleaning at the dentist’s office? Are you dismissed after hearing a lecture about the importance of flossing or told to return sooner for your next cleaning? We know that three out of four adults are unaware that they have some form of gum disease. Healthy gums DO NOT bleed. Is the bleeding from lack of care, a genetic predisposition to periodontal or gum disease or bacteria in the body taxing the immune system? Many times the dental team with unpredictability relies on traditional approaches.
We now have two revolutionary molecular tests that help periodontists and general dentists identify patients with and at risk for periodontal disease. MyPerioPath® detects the presence and quantity of specific bacteria associated with periodontal disease, while MyPerioID PST® (which the company licenses from Interleukin Genetics) provides a means of quickly and accurately assessing an individual’s genetic risk for periodontal disease.
MyPerioID PST—Determines the cause and depth of periodontal infection and identifies individual genetic susceptibility to periodontal disease. This test enables the clinician to establish which patients are at increased risk for more severe periodontal infections due to an exaggerated immune response.
Patients with a family history of periodontal disease and compromised immune systems should consider MyPerioID PST. Adolescents, patients who continue with disease activity despite therapy and who have lost, or will lose teeth to periodontal disease are also candidates for the test.
MyPerioPath identifies the type and concentration of specific perio-pathogenic bacteria that are known to cause periodontal disease. This test helps support the clinician with better risk assessment and personalized treatment options for more predictable patient outcomes.
This test can be used as a “baseline” for any patient who may be at increased risk for periodontal infections including those with signs and symptoms of a periodontal infection and those who are not responding positively to their current treatment. Patients who test positive for genetic susceptibility (with the MyPerioID PST test) or have Type I or Type II diabetes, a history of cardiovascular disease and tobacco use are also candidates, along with women of child bearing age.
Both tests are very simple and require the patient to spit into a vile which is sent off for analysis. A detailed report is generated for you and the dental team in order to provide a treatment plan tailored directly to you with the specific answers we have been missing in dentistry in the fight to save teeth.
Many situations can occur that may require us to find a new dentist such as moving, having a dentist retire, or needing special services our dentist can’t provide. Although we all know that proper dental care is vital to good health, most of us do not know how to choose a good dentist. It canbe difficult to know what questions to ask and what things to observe in the process of choosing one. As a patient it is very difficult to discern quality. Most of the time it is thenon clinical tangibles such as office hours, staff interactions, location, insurance constraints, etc that will help sway your decision.You will want to know both how the dentist treats you as a person and how he treats your mouth. Following are some key questions to ask and observations to make in the process of making your choice.
1. What is your philosophy for performing dentistry? Example: When do you recommend replacing a silver filling?
2. What continuing education have you had during this past year? Example: Are you current on the newer more conservative time saving techniques?
3. Do you comply with OSHA and American Dental Association guidelines for infection control?
4. Do you maintain a DMF (Decayed,Missing, and Filled) record? This is a detailed record of ALL treatment and diagnosis including periodontal charting to screen for gum disease?
5. Does the dentist consider you in the treatment planning process? Does the dentist and staff spend the time educating you and supporting you in your overall dental health? Is there a long term vision to get there?
6. Does the dentist focus on finding the cause of the problem versus continuing to fix and repair the same issues? Unfortunately, dental insurance has created a barrier formany patients when it comes to choosing a dentist. You only get one set of teeth as an adult. The relationship between the dentist and the patient will always dictate dental health. The insurance companies have tried to turn dentistry into a commodity. Dentistry is a service-based profession. You are not buying a filling or a crown!
Dentistry is rapidly changing today. Techniques taught in dental school as little as 10 years ago are now antiquated. The average shelf life of dental education and advancementstoday is three to five years. People understand how quickly technology is changing.While we now live longer and have a better appreciation for health and beauty, wehave more compact schedules and less time.
The advancements in modern dentistry address many of these issues. Lasers replace traditional surgeries which allow for reduced patient chair time and post-op discomfort. Tooth decay can be found BEFORE it evershows up on a digital x-ray. Silver fillings are a thing of the past. We can treat patientswith the strongest porcelains in one day that would normally require two to three visits and multiple injections. Most traditional porcelain crowns which radically destroy good tooth structure can be treated conservatively with onlays, causing less destruction of the natural tooth.
Teeth replaced with dental implants help eliminate bone loss and facial collapse, and can restore appearance and function in as little as two visits. Patients who have esthetic and functional issues with traditional dentures can have life-changing results. Crowded teeth in adults can be corrected in as little as four to six months using clear brackets and a toothcolored wire. A major cause of tooth loss—gum disease—can be detected in its earliest stages. Products on the market today can stop decay in its tracks with no drilling involved.
Modern dentistry can stop the agingprocess. Prevention, coupled with conservative approaches through early diagnosis andadvanced technology is the new paradigm shift. What do you envision your dentalhealth to be in 20–30 years? The choices we make TODAY will impact that outcome
Many people are faced with the decision to replace a tooth. A three unit bridge is commonlyrecommended. Usually reimbursed by insurance, it can be completed in two officevisits. However, very few patients understand the long term ramifications of their decision.
What we now know is that there is a 33 percent failure rate at 10 years out and a50 percent failure rate at 15 years. The two most common complications are nerve death or pulpal necrosis and recurring decay. The chance of nerve death for a single tooth crowned is three percent. With the three unit bridge the chances of pulpal necrosis goes up to 25 percent for each tooth. Once an abutment tooth requires root canal therapy it is more susceptible to fracture. The stresses in the system go up when teeth are used as supports.Recurring decay occurs from flexure,cement failure and lack of adequate hygiene
The advances in dental implants no longer require enamel destruction to replace teeth. A tooth can be restored with a dental implant in as little as two to three office visits; sometimes the same day. Depending on the location in the mouth, the patient can leave with a temporary tooth attached to the implant.
Dental implants have become the gold standard. Some insurance companies are starting to cover the procedure. The cost is very similar to the three unit bridge and the success at 10 years is 98 percent. The advantagesof the dental implant are that there is no nerve to deteriorate and titanium does not decay.
NOVEMBER is American Diabetes Month and healthcare providers across nation are dedicating this month to creating awareness and education on early detection,prevention and treatment. According to The Centers for Disease Control, in addition to the 24 million with diabetes, another 57 million people are estimated to have pre-diabetes, a condition that puts people at risk for diabetes.
Studies indicate a link between systemic health and oral health. An estimated one-third of people with diabetes have severe periodontal disease. According to the American Dental Association, periodontal disease is often linked to the control of diabetes. Your dental professionals can often detect symptoms and aid in controlling diabetes.
In addition to periodontal disease, diabetes can have other effects on your oral health including; tooth decay, fungal infections, dry burning mouth, mouth ulcers, changes in the way teeth come together and acetone breath. Be aware and inform your doctor if you experience these symptoms. Keeping your dentist updated on any medications you are taking will allow a proactive approach to detecting or preventing diabetes.
Diabetes impairs the body’s resistance to infections. A patient with diabetes can also experience a longer healing time. The LANAP therapy for treatment of periodontal disease uses laser technology to treat the gum infection without the need for traditional scalpel surgery, with significantly reduced healing time and dramatically healthy results. Along with regular checkups, self evaluations and advancements in technology, we can be a part in helping patients control and detect diabetes.
As we all buckle down and become more discerning with our resources, we must not forget the bigger picture. Right here in our own back yard we have poverty! The Covington Food Bank has taken an active stance in the fight against poverty. Thirty-three percent of the Food Bank’s clients come from Washington Parish where 27 percent of the total population and 36 percent of the children live in poverty. Washington Parish ranks 59th out of 65 Louisiana parishes compared to St. Tammany, which ranks 10th and Orleans which ranks 50th. In 2010 the Food Bank distributed over 700,000 pounds of food representing a retail value of over $900,000. This is a 44 percent increase over the 2009 demand. The Vincentain Center Ministry distributed $48,000 to over 400 families for emergency needs. The Dental Clinic Ministry performed over 1,800 procedures valued at over $350,000, on the “working poor,” disabled and the elderly population without insurance. The Thrift Store Ministry sells gently used clothing and household items for 10 to 20 percent of their retail value. All profits are used to purchase food and many items are given free of charge to victims of fire, domestic abuse, homelessness and countless other dire circumstances. These valued ministries are made possible by over 22,000 volunteer hours that were donated. For all those have contributed in any way—Thank you! The Food Bank and its ministries are in constant need of donations—not only of commodities but also skills and services. Please help us in the fight against poverty. For all those have contributed in any way—Thank you! Dental Clinic Ministry: A Bigger
Check out our new 3 minute feature on NOLA Marketplace on WGNO.
Date Station Advertiser DayOfWeek Air Time Program (Placed*)
10/25/11 WNOL Mandeville Center For Dental Excellence Tuesday 12:30:40 PM NOLA MARKETPLACE
10/26/11 WNOL Mandeville Center For Dental Excellence Wednesday 12:46:45 PM NOLA MARKETPLACE
10/30/11 WNOL-THIS Mandeville Center For Dental Excellence Sunday 1:38:40 PM THIS Daytime Programming
Over the years many patients have commented on their dental care being tied to the insurance benefits. Many have not seen a dentist for years until they or a spouse changes jobs and a dental benefit is offered. For many the dental insurance is their dental budget. The longterm oral health is quite different for many of the patients we see. Is it luck? Is it strong teeth? Is it the dental insurance? Is it the home care? Who is in control?
For many patients their dental care has been a reactive experience. The patient has pain which prompts a visit to the dentist. For others their dental care has been dictated by the benefits of the dental insurance. As many have discovered this “dental insurance” leaves a lot to be desired. The only true winner is the insurance company!
The patients I have seen who appear to be the healthiest are the patients whom have taken control of their oral health. These patients have received a comprehensive exam,full set of stays and a consultation whereby the dentist has layer out a long range plan focused on the underlying reasons that their mouth is breaking down and aging. By educating the patient, the patient is now empowered to take control. The patient can then take this treatment plan and incorporate it into something that will fit in their budget. For many just stabilizing the deterioration can be a life changing event. Provided with the right information and choices the patient will ultimately be the winner!
Occlusal disease is one the most destructive and neglected elements in dentistry, and plays a major role in reducing the longevity of dentistry’s finest restorative efforts.
It can present itself in the form of painful, clicking TM Joints, sore facial muscles, headaches, tooth wear, tooth looseness, sensitivity, and migration. Often times patients are completely unaware of clenching or grind g of the teeth. It is a dominant factor in the fracture of restorations on posterior teeth and if handled early can avoid much unnecessary dental treatment.
Although a dentist may understand the cause and effect of these destructive forces, explaining these concepts to patients and their families can be very difficult. It is much easier to discuss the solution for caries or fractured teeth than it is to describe how excess wear is caused by a movement of the mandible from their “acquired bite” , in and out of it’s proper position in the TM Joints. Likewise understanding how interferences on the back teeth from side to side movement is difficult enough for dentists to see and detect, this difficulty is only compounded when we try to explain these problems to patients.
Difficult or not, we are obligated to offer a treatment plan for the resolution of all disease categories which fall within our scope of health care service. Without addressing this destructive disease, bruxism may cause patients to have repeated dentistry only to later have the tooth or teeth extracted.a proper examination and bite analysis should be performed as part of the initial and periodic examination. After practicing dentistry for 16 years now that is not a day gone by whereby a majority of patients exhibit some signs of occlusal disease without symptoms!
