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Author: Dr. Brian

The Path To Health

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When I interview new patients during their first visit to our office I frequently find that they are not sure of what they want either from me, as their dentist, or for their mouth over the long term.  I can, however, tell you consistently what MOST people DON’T want.  They don’t want DENTAL PROBLEMS and they don’t want DENTAL TREATMENT.

Yet, most of us dentists spend our time with you looking for dental problems and offering you dental treatment.  We even market ourselves this way.  Just look at our websites and you will find many of us claim to offer the best way to solve your dental problems through the most modern dental treatments.  But, I’d be willing to bet that there is really no way to dress it up to make you want either.

If you truly don’t want either and want to reach a point free from the threat of dental problems and beyond the need for dental treatment, there is only one path to take:  the path to health.  If you don’t choose this path you will continue on the path to disease, problems, and treatment.  The recipe for health is simple:

1)      YOU must understand the causes of disease

2)      YOU must understand what causes are present for you

3)      YOU must have a long-range plan that addresses these causes in a way that fits your values and goals

The direction that you are heading is more important to your success than the speed at which you reach your destination.  Because we are more focused on building a long-term relationship with you than selling you dental treatment, we will walk with you at whatever pace you wish to go.  We understand that this may involve stopping to take a break along the way, or designing a detour when life doesn’t go as planned.  But one thing is certain, if you are ready to commit to your health, then we are ready to commit to you.

Kurt Rozek is the Grand Prize Winner of our, “Halloween Candy Buy Back” Drawing!

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Kurt Rozek is the Grand Prize Winner of our, “Halloween Candy Buy Back” drawing! Artist John Koester (right) presented his limited edition lithograph to our prize winner Kurt Rozek this afternoon. Kurt said he will be back next year with more candy.

Thank you John Koester for your generous donation to our event!winner

For more information about John check out his website at:
http://www.johnkoesteroriginals.com/

We would also like to congratulate the 6 lucky winners who won $25.00 gift cards to Toys-R-US. Ben, Adam, Ayden, Chelsea, Sarah, and Lindsey enjoy shopping at Toys-R-Us. We hope to see you again next year.

Congratulations Katelyn, and Collin. They were winners of  T-shirts and gift cards to Sweet Mimi’z.

We would like to thank our community for the wonderful turn out and the many generous donations. We look forward to working together again next year.

Howard Dental Center Announces its “1st Annual Halloween Candy Buy Back”!

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Howard Dental Center is excited to announce we are partnering with Operation Gratitude and will be participating in our “1st Annual Halloween Candy Buyback”! Tuesday,  November 5th-Thursday November 7th 8am-5pm.  Don’t miss it! Operation Gratitude annually sends 100,000+ care packages filled with snacks, entertainment items and personal letters of appreciation addressed to individually named U.S. Service Members deployed in hostile regions, to their children left behind and to Veterans, First Responders, Wounded Warriors and their Care Givers.

Trade your Halloween Candy, Letters and Drawings and you will receive a Goody Bag full of surprises and can enter to win our drawing for several great prizes.

Halloween Photo of Staff

A New Direction in Health

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Road and Arrow“The doctor of the future will give no medication, but will interest his patients in the care of the human frame, diet and in the cause and prevention of disease”                                                                                                                                          -Thomas Edison

This quote is as powerful and at the same time counter-cultural today as it was 100 years ago.  It is a challenge to health care providers as well as a recipe for true prevention of disease.  In dentistry, “prevention” is mostly limited to the recommendation of specific processes or products that are known to limit the progression of disease.  When used properly, these tools can indeed limit disease.  But, by themselves, they are limited in their ability to do so.  True prevention is a choice.  True prevention comes from understanding how our body is supposed to work, what it needs to function optimally, and what causes it to break down.

As Thomas Edison stated, my job is to “interest” you in this path for dental health.  To do so, I must help you to achieve two things.  First, you must attain a complete understanding about the current condition of your teeth, mouth, and chewing system.  By complete, I mean not just the physical condition, but also the role of your past dental experiences and how these have served to shape your feelings, attitudes, and ideas toward your mouth and dentistry in general.  A complete understanding also entails, not just where you have been but also where your current path is leading you.

Secondly, I must teach you what a healthy mouth and chewing system look like and how health maintains itself over time and resists the occurrence of disease.  Our staff has made a commitment to study what makes the healthiest mouth healthy.  We believe that this information will be more valuable to our patients than simply studying how to clean and fix damaged teeth.

For many people their current condition is not what they thought it was, and/or the direction they are headed is not where they want to go.  With the understanding of what health is and can provide, an individual is able to make a choice in full awareness.  That choice is either to remain on the path that they are on, or to move toward health.  A real choice creates real commitment and is a driving force to help an individual create the healthy state that they desire.

True prevention is the commitment to create health in your life.  Like anything that we wish to create, it depends upon a complete understanding of our current reality and a clear picture of what we are trying to create.  When one makes this commitment, each moment becomes a choice that will either move us closer to health or towards disease.  These choices include what we eat, how we use our mouths, what products and techniques we use to care for our teeth, and what dental treatment we elect to pursue.

This is what our New Direction Program is all about.  We put the knowledge and power in your hands so that you may make your own choices according to your own values and goals.  I always tell people that it will never be my goal to sell you dental treatment that you do not want or do not need.  Instead, we will assist those that are sick of living with recurring dental problems move away from this disease cycle and create health in their lives.

Awareness, Trust and Hope

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hopeAwareness, Trust, and Hope.  These are the ONLY three objectives of our New Patient Experience.  My agenda is not to sell you treatment that you do not understand.  Instead I will work to help you gain awareness of the true present condition of your mouth, earn your trust that I am the one to give you this information, and give you hope that there is an alternative path if you do not like what you see.  The entire process is driven by your unique goals, values, and needs.  This is not a cookie-cutter approach to dental care, because you are not a cookie!  Even two people with the same goals will travel different paths to get there.  Your story of how you got to be where you are is unique only to you.  With each new patient, I take the time to hear this story, and I have yet to hear the same story twice.

However, there are two general story lines that I tend to hear more than others.  The first is that an individual feels as though they have always tried to do the right things, but they continue to have dental problems.  The other is, that because of one or more bad experiences, an individual has avoided coming into the dentist for many years.  In both cases, people have very strong emotions tied to their mouth and to their past experiences.  Understanding these feelings is equally important in helping someone, as understanding their dental condition…if not more.  The more that I understand about someone the better that I can help them understand their own values and attitudes toward dental care as well as their present dental condition.  Once people have this understanding, this awareness, the answers to the questions of what they should do about it seem to come more easily.  From this place of mutual understanding we can CO-CREATE goals and plans together that fit for each individual.  From there grows hope.

At What Age Should My Child See The Dentist?

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when should children have their first dental appointmentOne of the most common questions people ask me is: “At what age should my child see the dentist?”

A traditional recommendation has been about four years of age. This is the age that we find most children are able to comfortably participate in the normal exam and cleaning. However, several years ago, the Centers for Disease Control and Prevention released a report indicating that 2- to 5-year-olds are the only age group in the United States where the incidence of decay is on the rise. Furthermore, data shows that children seen by age 1 have significantly less dental disease throughout childhood than their peers who are first seen later in life.  So the concept of when your child should see the dentist has changed.

This information has led organizations like the American Dental Association (ADA) and Wisconsin Dental Association (WDA) to encourage parents to bring children in for their first visits sooner. Children are now being seen as early as age 1 (or within 6 months of eruption of their first tooth). The visit is meant to serve as an early screening for decay, but also to educate parents and caregivers on the importance of baby teeth.

This has been the focus of the recent “Baby Teeth Matter” ad campaign of the WDA. This campaign is designed to counter the claim that is sometimes made that baby teeth are not important because they just fall out anyway. According to the WDA, baby teeth are important because they:

  • Foster good nutrition through proper chewing.
  • Aid in speech development.
  • Build self-esteem by providing a beautiful smile.
  • Enable a child to pay attention and learn in school without the distraction of dental pain.
  • Save space in the jaw that is needed for proper development of adult (permanent) teeth.

Clearly, healthy baby teeth should be preserved by preventing early childhood caries.

By providing screenings and education prior to the key 2- to 5-year-old age group, we are making greater efforts to do just that. Aside from the dental office visits, the WDA also recommends the following tips for preventing cavities in baby teeth:

  • Mothers and pregnant women should make sure their own mouths are healthy by getting a professional dental exam and necessary care, and by practicing good daily oral hygiene (brush, floss, healthy diet). This reduces transmission of cavity germs from mothers to infants.
  • Use breast milk, formula or water in baby’s bottle; never put juice, soda or other sweetened drinks in a baby bottle. Do not put an infant or toddler to bed with a bottle unless it contains only water. Wait until 12 months to give juice and then limit consumption to meal and snack times.
  • The American Academy of Pediatric Dentistry (AAPD) encourages parents to have children drink from a cup by their first birthday.
  • If a child uses a pacifier, do not dip it in anything sweet like sugar or honey. If it falls on the ground, do not “clean” it in your own mouth as this can transmit cavity-causing germs to the child. Clean with hot water and soap and rinse thoroughly before returning to baby’s mouth.
  • Provide healthy snacks, such as meat, peanut butter, milk, yogurt, cheese, fruits and vegetables. Limit sweets in quantity, portion size and frequency.
  • Before baby teeth appear, gently wipe gums and inside of the mouth every day, especially after feedings and before bed, with a clean, warm cloth.
  • Beginning with the appearance of the first tooth, brush baby teeth twice a day with a soft, age-appropriate sized toothbrush and “smear” of fluoridated toothpaste according to the AAPD. For 2- to 5-year-olds, use a “pea size” amount of toothpaste and perform or assist your child’s tooth brushing.

As with anything, the earlier good habits are established, the better the chances that a child can enjoy good health for the rest of their lives.

What Causes Tooth Sensitivity

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One of the first questions that I will ask someone during an exam is: “Are you having any sensitivity to temperature, sweets or any biting pain?” One of the primary reasons I ask is because these can be symptoms of a cracked tooth. If you are experiencing tooth sensitivity localized to one area, particularly if it comes and goes, then you may very well have a cracked tooth.

Why do cracks cause pain?

The outer layer of tooth, the enamel, does not normally transmit sensitivity or pain. However, when the underlying tooth structure, dentin, is exposed, sensitivity will occur. This can be the result of a cavity, a leaking filling, tooth wear or a crack, among several other causes.

When do cracks occur?

Most commonly, a crack will occur adjacent to a larger filling that has been in the tooth for many years. When tooth structure is removed, a tooth is weakened. Most fillings do little to strengthen the tooth and leave it very vulnerable to cracks. This is most commonly the case with the older silver fillings, which do not bond to the tooth and tend to be larger than today’s bonded, tooth-colored fillings. Over many years of service, weakened tooth structure surrounding a filling will begin to crack. If the crack remains only in the outer enamel, it is unlikely to be a problem. However, if that crack begins to penetrate deeper, under the filling and into dentin, sensitivity will ensue and the risk of further problems increases greatly.

Beyond sensitivity, why are cracks a problem?

Though cracks can be very small and difficult to see with the naked eye, they are large enough to allow bacteria to travel into the tooth and form a cavity. This can be true even for those people with a low susceptibility to decay. As the crack travels deeper, it can create inflammation within the pulp of the tooth, where the nerve and blood supply are. This can lead to a severe toothache and the necessity for a root canal. Should the crack progress further, the tooth can break. If the break is severe enough, the tooth must be removed. To prevent root canals and tooth loss, it is always best to treat a cracked tooth as early as possible.

How is a crack diagnosed?

It is not always easy to diagnose a crack, and as a result they are often missed. Cracks are not visible on x-rays and because the deep (dentin) cracks most often occur under fillings, visual inspection is very difficult as well. Also, since the symptoms tend to come and go, it is very common that they may not be present by the time a person comes in for an exam. Therefore, diagnosing a crack is the result of putting all available evidence together. The key things that we look at are the size of the existing filling, the presence of any superficial cracking, and pain to temperature, sweets or biting. An intraoral camera is used both to track these problems over time as well as to show patients teeth that may be at risk for cracks.

How is a cracked tooth treated?

If the crack is severe enough, a root canal or even extraction may be necessary. This is why it is important to catch the crack early. Traditionally, these early to moderate cracks would be treated by placing a crown over the top of a tooth to strengthen the tooth and reduce the stresses that cause the crack to progress. In cases of early cracks, modern materials and techniques allow us to repair a crack more conservatively with a bonded tooth colored “biomimetic restoration.” “Biomimetic” means life-like, and compared to a conventional crown, they certainly are. This is because they require a minimal amount of tooth structure removal and are customized to each situation to act more like a tooth. The result is a tooth that is less prone to further problems, such as root canal issues, at a significant cost savings over the conventional crown.

What’s The Best Way To Clean My Teeth?

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What’s the best way to clean my teeth?

This is a question we hear quite often, and its an important one.  So let’s just talk a bit about the best way to clean your teeth.

Gum disease and decay are caused by bacteria. That’s why the goal of proper home care is to keep the number of bacteria in your mouth below harmful levels.

In most cases brushing, flossing, and tongue scraping are very effective in removing bacteria – if they are done correctly. But since studies show that up to 75% of the adult population has some level of gum disease that may be increasing the risk for many diseases, I think we can assume there is a problem here that needs to be addressed.

Let’s run through some weapons you can use in your daily battle against the bacteria that are causing decay, gum disease, and inflammation in your mouth.

Brushing
Brushing with a soft brush is the most effective plaque removal system for accessible areas. Brushing mechanically removes bacteria and plaque from your teeth and gums. The biggest problem is not taking the time required to do a thorough job. Get a timer and make yourself brush for at least two minutes twice a day.

Tongue scraping 

The tongue can harbor huge populations of bacteria. So if you are cleaning the gums and teeth, but not the tongue, then bad bugs living on the tongue have an easier time repopulating the gums.

Tongue scrapers come in a wide variety of forms and most are roughly the same effectiveness. Brush your tongue whenever you brush your teeth, and you should use a tongue scraper at least once a day. Start doing this TODAY!

Flossing
Brushing cannot reach the areas between your teeth, and that’s why flossing is essential for removing bacteria between the teeth.

There are many types of floss and it doesn’t matter much what kind you use, as long as you use it. As with brushing, the main thing is to slow down. Simply going around your mouth and snapping floss between your teeth isn’t going to cut it. Make sure you get the floss gently all the way up under the gums on each tooth.

Flossing is typically the biggest problem area with oral hygiene. Some people do it faithfully, some people do it occasionally, some people won’t do it, and some people can’t do it because of limited manual dexterity, large hands, arthritis, etc.

If you simply can’t or won’t floss, if you have extenuating circumstances like gum pockets deeper than 3 mm, or or for whatever reason simple brushing and flossing aren’t working for you, then you need to add other weapons to your arsenal.

If what your doing isn’t working, then don’t spend your entire lifetime using the same failed strategy over and over. Don’t spend your entire life with bleeding gums and the associated health risks. Do something different!

The bottom line is you either have to floss, or you have to do something different. The following are some other strategies you can use.

Power brushes
There are numerous power brushes on the market that may be of benefit, especially if you have dexterity problems that make it difficult to brush and floss.

Water Flossing
Devices like that Water Pic use a concentrated stream of water to clean the teeth and gums. Water flossing is particularly effective if you have gum pockets since often these cannot be cleaned thoroughly with normal brushing and flossing.

If need be, mouth rinses can be used with the irrigator as a further step to eliminate inflammation. Understand that water irrigation devices are not a substitute for brushing. We use irrigation as an adjunct for people who won’t or can’t floss properly, or when there are areas in your mouth that are not cleanable any other way.

You should consult a dentist about proper use of the water flossing devices so as to not cause damage.

Tooth picks
These can be effective if you have spaces between your teeth. Care should be taken because overuse or being too aggressive with toothpicks may cause loss of gum tissue between the teeth. The key is to be gentle!

Plaque Discloser
People are often confused as to why they get decay even if they brush and floss regularly. This happens because they are not cleaning the teeth as well as they think they are.  Disclosers contain a harmless dye that makes plaque on the teeth visible.  After you clean your teeth, take the disclosing agent and see all the plaque remaining on the teeth. Brush and floss again and then recheck with the discloser. Do this for a few days and you will easily train yourself to be very effective with your home care. Buy some plaque discloser at your pharmacy today!

The bottom line is that you have to do whatever it takes to stop decay and gum disease. If you can’t do it with just brushing and flossing, then use other tools that are cheap and effective.

What are implants?

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As Dentists, our primary goal is always to help our patients keep all of their teeth for a lifetime.  It is not uncommon, however, that due to the cumulative effects of dental disease, one should lose a tooth.  In fact, approximately 70% of adults in the U.S. are missing at least one tooth.  Unfortunately, the loss of a tooth will many times lead to more tooth loss.  This is because the rates of gum disease, decay, and tooth fracture increase in teeth adjacent to a missing tooth.

Traditional options for tooth replacement have been inadequate to mitigate the risk of further tooth loss.  Removable partial dentures are often cumbersome and difficult to wear.  In fact, about half of patients are able to chew better without their partial denture.  Furthermore, partial dentures wreak havoc on the supporting teeth leading to greater plaque retention, tooth mobility, increased decay and increased gum disease.

When it comes to long-term health, a permanently cemented bridge is only marginally better.  Only about 30% survive the first ten years, and only 50% the first fifteen.  Decay and root canal problems are the most common causes of failure and many times will lead to the loss of one of the supporting teeth.

Over the past two decades, fortunately, we are seeing many people abandon both partial dentures and fixed bridges in favor of dental implants.  A dental implant is a man-made root replacement for a missing tooth.  An implant does not depend on support from the adjacent teeth and, therefore, helps to promote the long-term health of those teeth.  A single tooth implant is a stand-alone solution to the missing tooth problem.  Dental implants also boast the highest long-term success rates of all tooth replacement options.

In the majority of cases, the transition from a failing natural tooth to a dental implant takes about 6-8 months.  When a tooth is unable to be saved, it is removed as gently as possible.  This is to assure that there is no damage to the surrounding bone or gum tissue that will eventually support the implant.  Many times graft material is placed in the tooth socket to help support the healing of the site and assure that there will be an adequate volume of bone remaining for successful implant placement.  After 3-4 months, the bone and gum tissue have healed, and the root portion of the implant is placed.  The root-form is a small cylinder made of titanium which is gently inserted through the gum tissue and into the underlying bone.  This is done very gently, in such a way that there is typically minimal discomfort after the procedure.  Sometimes, the implant can be placed at the same time as the removal of the tooth, shortening the total treatment time.  After another 3-4 months of healing, a new crown can be affixed to the implant, thus completing the treatment.  In the case of a front tooth, a temporary replacement is usually provided during healing to fill the space and preserve a natural appearance.  The end result is a tooth replacement that feels, functions, and lasts like a natural tooth.