The changing face of Dentistry

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Dentistry Then, Dentistry Now
 
Then: Dentists would not allow the patient to take an active role in planning their own treatment, nor would would they take into account the patient’s individual wishes and demands.

 

Now: Dentists nowadays have a much better understanding of patient psychology. Modern dentists realize that if the patient is involved in the care they are receiving, then they will understand it better and the final outcome will be better as well. What patients really want is to be understood by their dentist, and to have their needs addressed in a way that is realistic, and that fits their budget, lifestyle, etc. In fact, this is what any human being would want. It would be hypocritical for us dentists to ignore the personal aspect of patient treatment. Modern dentists really emphasize patient participation in their own care, customer service, and seek to take away the negative stereotypes surrounding dentistry.

 
Then: Dentistry in the “old days” was a lot more painful.
 
Now: with modern anesthetic techniques, dentistry really does not have to be painful at all. Occasionally there may be discomfort, but it should never be “painful.” In fact, one of our philosophies is to never work on a patient until they are 100% numb, even if it means waiting an extra hour and getting behind in our schedule. We have new tools which make injection pain thing of the past. The patient comes first!
 
Then: In the old days, dentists had limited hours of operation. They were usually open 3-4 days a week, from 8-4. Weekend and evening hours were almost unheard of.
 
Now: Ever since the economy went down the toilet, Americans have had to work longer hours to maintain their standard of living. This meant that they may only have time to see the doctor or the dentist in the evening or on weekends. The modern dentist understands this, and seeks to accommodate this shift in work hours. Thus, we are open on weekends and in the evening because we are in tune with the fact these hours are more convienient for a significant portion of the American population. As a husband and a father myself, I’m all too familiar with being too busy to see the doctor, dentist hair stylist, etc., and am very appreciative of evening and weekend hours when available. 
 
Then: In the past, dentists had the ability to charge high fees because patients could afford it. Dentists would charge their high fees, and if a patient couldn’t afford it, they would be politely told to go somewhere else.
 
Now: As I alluded to above, with the economy the way it is, it really is unrealistic to expect the average person to pay 1400$ for a crown out of pocket. Modern dentists (hopefully) are in touch with this reality and are able to accommodate their patients, either with in-house membership plans that offer significant discounts, or payment plans, etc. The attitude of “these are my fees, take it or leave it” has been fading in these difficult economic times. 

Teeth Whitening- Part 1

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William Rounseville Alger (1822-1905) once said “Even pearls are dark before the whiteness of his teeth.” Sure that must be some white teeth there. The history of dental care goes way back in history, it was recently reported in a reputed newspaper, that our ancestors around 3000B.C used something known as “chew sticks” to maintain dental health and whiten their teeth. However, we have come a long way in dental care since the age of our ancestors. Today in 21st century, you can find endless number of advertisement regarding teeth whitening. Every product claiming to be better than the other, and every product giving an excuse of saving a trip to your friendly neighborhood dentist. 

Now the question arises, how important are your teeth to you ? Its a vital part of our body and an important part of your persona, makes you look more attractive. Everyone wants white and healthy looking teeth and for that they need to be cared for… by professionals. Imagine, one day there will be a product that would treat your heart ailments without necessitating a visit to your doctor, would you take that gamble? 

Having said that, let me give you an insight about teeth whitening. Teeth Whitening done right does not harm the teeth or gums. The key to that it has to done in a professional manner to be effective and safe. You will be surprised to learn how affordable a professional teeth whitening can be at your neighborhood Queen Anne Dental.

The ingredient we use to whiten teeth breaks down the  stains on the surface of the teeth and makes the color of teeth lighter. Whitening ingredient does not affect or lighten the color of the fillings, crowns etc. There are different strength and different type of ingredient which can be use for teeth whitening. With our state of the art technology at Queen Anne Dental, we can even whiten severely stained teeth. The key to it is using the correct technique and ingredient. 

The most common side effect of whitening is teeth sensitivity and irritation of the gums , which most of the time is temporary and subsides in few days after stopping the whitening treatment. In my next blog post I will go over various option and techniques for teeth whitening, so stay tune for more…

Invisalign and short term braces

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What are some of the types of orthodontic procedures we offer here at Queen Anne Dental?
6 Month Braces (“Powerprox”): Many adults love this. As the name implies, patients are in braces for an average of 6 months. The purpose of this is cosmetic correction in order to give the patient the appearance of a great smile. The reason why treatment is so rapid is because the patient’s bite is unaffected, as bite correction is not the focus here. If bite correction was the focus, then the patient would need to be in conventional braces for anywhere from 2-3 years. We give our patient’s the option of 6 month braces versus conventional braces, and many adults opt for the 6 month braces, as they do want to be in braces for too long.

Invisalign: These are basically clear plastic trays. or aligners, that function as braces, and are custom created for the patient. Aligners are made of smooth, comfortable and virtually invisible plastic. Wearing the aligners will gradually and gently shift the teeth into place, based on the exact movements that we treatment plan. There are no metal brackets to attach and no wires to tighten. The patient just has to pop in a new set of aligners approximately every two weeks, until treatment is complete. When I say these aligners are virtually invisible, I mean just that! As a dentist, I sometimes don’t notice when people are wearing them, which says a lot, since I would know what to look for!
There you have it. See you next time!
 

Teeth Whitening-Part 2

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Welcome back friends, this would be an eagerly awaited continuation of my previous blog on teeth whitening. Today, I will shed some light in the various techniques used in this process…

Let’s start with the basics, as many of you would already know, for any whitening system to be effective, apart from your dentist’s expertise, it needs time, strength of the solutions and intimate contact with the teeth surface. It works with simple logic, a higher strength solution would take less time to whiten the teeth but in process, can cause increase in teeth sensitivity, gum irritation etc. and a lower strength solution would need more time to act but are gentler to your teeth and gums. Solution contact with the teeth is very important, and all the effort is made that it does not get diluted with saliva or potentially irritates your gum. 

Now the question arises, why not use numerous over the counter teeth whitening system available in the stores and avoid a visit to you friendly neighborhood dentist. They do advertise a lot, it must be good, right ? …

Regarding over the counter products, there are hundreds of over the counter products that we can find these days such as strips, trays, gel, pens etc. How do we decide which ones are good and which ones to avoid? Remember the two important things while choosing a solution – strength of the solution and the intimate contact with the teeth. In addition, make sure that the solution is fresh, does not leak, become diluted by saliva or cause any sensitivity or gum irritation. 

Over the counter products are mass produced, they are not custom made for you. Your teeth alignment would be very different from your best friend and this requires your dentist to give you an effective whitening treatment, just designed for your teeth, that lasts longer,  without causing any discomfort of gum irritation or giving you extra sensitive teeth. It’s an art to use a product that best fits your need and in the right concentration to give you THAT lasting smile which you had always longed for…

Shopping malls- we have all seen the teeth whitening booth at shopping malls. The offer quick whitening options and we wonder how they work. What does they do is shine very bright light for some time it causes teeth to dehydrate temporarily. When teeth are dehydrate they became  lighter in color and we see the instant results. But teeth rehydrate after few hours and the color goes back to the original. They also uses a chemical which you get at store but the actual contact time with teeth is short so not very effective.

Now let me give you a little insight about the teeth whitening process, as done by a professional… 

First, there is take home whitening trays- This is consider to be the gold standard in teeth whitening. In this a very well fitted custom whitening tray is fabricated by your dentist according to the shape and alignment of your teeth. The dentist provides you  with the whitening solution which you can put in tray and apply on your teeth. The good thing is that you can control the time which you want to wear the tray and the result you want. Remember longer you will wear the tray whiter your teeth will get. So be careful what you wish for.. 🙂

Second, is at office teeth whitening- done by your dentist at the office under close supervision where in a high strength gel is carefully applied to the teeth, it is most useful for people who feels the application too cumbersome with take home tray or those who need instant result for that special occasion in life. 

Lastly, there is a method that is the combination of the two, especially for those whose teeth are severely stained and discolored… and yes.. we do take care of those teeth as well.. This method does provide a long lasting result. 

Well guess the above information should be good for you all. If you have more questions, and we at Queen Anne Dental understand that, and are here to help you in every way possible. Please feel free to give us a call to clarify your doubts or schedule an appointment with us. We will make sure that its a comfortable experience for you.. 

Till next time.. Adios…. 

Dental insurance in nutshell

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Many people think that dental insurance is the same as medical insurance, and are shocked when they find out it isn’t. How does dental insurance work? We can think of it as a coupon or a voucher that allows the patient to receive a limited amount of dental services. And when I say “limited,” I really do mean “limited” when compared to the coverage that one receives through medical insurance. Dental insurance providers have all kind of limitation on how this amount can be used. Sometime they put 6 months to 1 year waiting period . Many time they severely limit the procedures which can be done.
 
Most dental insurance plans give the patient a 1000-2000$ a year maximum.It is the same amount which they first started offering in late 60s. There is often a deductible. What this means is that before insurance starts paying, the patient needs to pay deductible out of pocket first.
“Preventive” procedures such as exams, x-rays, and basic cleanings are usually covered at 80-100%. 
“Basic” procedures such as fillings, extractions, root canals, and deep cleanings are covered at 50-80%.
“Major” procedures such as crowns,bridges and orthodontics are covered at 0- 50%. 
These categories esp. Basic and Major are different with different insurance carriers and more push nowadays to move the treatment in major category
 
Now, if you happen to need a lot of dental work, the 1000-2000$ yearly maximum may not be enough. And this is when the comparison to medical insurance really shows: with medical insurance, if you have several health problems, most insurance plans will pay significant portions of the treatment costs, sometimes upwards of 50,000$. Now when these same patients expect their dental insurance to do the same, they are in for a nasty surprise. Imagine that you need significant of dental treatment, and your insurance plan was only going to pay 1000$, and you’d have to pay the remaining amount out of pocket. This is the reality of the health care system,
 
Now, it has always been our philosophy to never let money be an obstacle in obtaining the dental treatment you need. That is why we offer patients several options for financing their dental treatment:
1) They can sign up with a third party credit company like Spring Stone or Care Credit.
2) If they don’t have insurance, or if their insurance has been maxed out, they can join our membership plan and save 20-40% off dental treatment.
3) They can pay for their treatment in monthly installments that are realistic for the patient’s unique financial situation. 
 
So there it is, dental insurance 101, until next time

How to save money at the Dentist

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In the last blog, we discussed how dental insurance works and how the benefits provided by dental insurance are sometimes not adequate in dealing with the dental problems. Getting good quality Dental care is further complicated by the rising healthcare cost. In light of these facts, it is becoming more and more important to learn about ways to save money at the dentist. In this blog entry I intend to highlight a few points which I believe will help you rein in the cost of dental care.

1. Prevention is the key
As the old saying goes – An ounce of prevention is better than a pound of care. This could not be more true in today’s world. Not only it will save you tons of money in the long run but also save you time, potential discomfort, loss of function etc. Here are a few things to help prevent dental issues and hence the cost –
Regular brushing, flossing and using mouthwash
Regular dental checkup
Avoiding too much of acidic, sugary drinks (energy drinks, soda) – Acid and sugar are lethal combination that can rapidly destroy the teeth.

2. Taking care of small problems 
“I don’t have any pain, why should I go to a dentist?”
Many of us think that if there is no pain, it might be okay to wait. Majority of the dental problem do not hurt in the initial stage. You may not feel any pain, sensitivity for prolonged period of time. Most of dental problems are silent in nature. It is like having high blood pressure which do not interfere in day to day function unless it is out of control. Small cavities and the onset of gum infection are often painless and present no symptoms. At this stage, treating them is often easy, quick, painless and cheap. Treating disease or dental condition like cavities and gum infection in early stages can often save the teeth and the gum structure.
Waiting for it to hurt or cause problems like sensitivity, pain, fracture  is often an indication that problem has gone too far and may require more advance procedure to save the teeth which may be expensive and time consuming. Again, regular dental checkups is the key to help identify issues in a timely manner and avoid expensive treatments.

3. Doing it in stages
Sometime it is possible to do dental treatment in stages. Taking care of any active infection and pain is the first priority. After that, sometime it is possible to divide the treatment in stages – this can ensure that you don’t incur significant expenses upfront. It  helps in planning with regards to time and finances.

4. Alternative treatment
Ask if there are any alternatives available to the recommended dental treatment. Most of the times the proposed treatment is the ideal one but sometimes there are alternatives available. The alternative options may have some drawbacks or shortcoming but they can work at a more affordable cost.

5. Ask questions
It is very important that you get involved in the care. The more informed you are about your dental health, the better it will be for you in long run. Ask for a plan from your dentist. Think about what are your immediate and long term goals with respect to your teeth. Ask your dentist how they can help you achieve your goals.

Contact us at Queen Anne Dental at 206-486-8600 for any questions or concerns.

When should your child first visit the dentist?

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One common question we get asked is whether or not we see kids. The answer is yes! We love to see kids. We see kids of all ages. Our approach towards kids in general is to make the experience fun and not scary. We have several ways of doing this, for younger kids, after their appointment, they get to pick a toy out of our treasure chest. In fact it’s not uncommon for kids to look forward to coming to see us just so they can get a prize! We have also found that many kids react quite well to magic tricks, as this can put even the most scared child at ease. Our emphasis when we see kids is always on prevention, as we truly believe that for a kid, the less dentistry the better. So we are very careful to review good hygiene care habits with the parents. Many oral health problems can be prevented with the proper mindset!

When should parents bring their kids in? Our recommendation to parents is to bring their kid in not too long after the first tooth erupts. Our goal at this point is to not do any elaborate procedures on them, but to get them used to coming to a dental office and to be comfortable in such an environment. We want to shape the child into an adult who understands the value of good oral health, and it starts from a young age. Not instilling these values early on has dire consequences for the child, such as future pain and suffering and tooth loss, all things which could have been prevented with the proper mind set.

For a very young child, the first appointment often involves just taking a very cursory look (as much as the child will allow us to look), with no x-rays. We call this a lap exam, because the child will usually be sitting on the parent’s lap. We will introduce a tooth brush, and try to make the experience fun for the child. Afterwards, our recommendation is to see the child for an exam twice a year. Usually at the age of two or three, they will have a full set of baby teeth. Baby teeth can be thought of as space maintainers for the permanent teeth. Prematurely losing a baby tooth can result in shifting and migration of the remaining teeth, leading to future misalignment of the child’s bite. This often requires expensive orthodontic treatment to correct. That’s why it is of utmost importance to make sure that your child’s baby teeth are healthy. 

In summary, if you have kids, feel free to bring them! and we actually enjoy interacting with them, and helping them attain the level of oral health that they deserve!

 

Root Canal treatment: Common misconceptions

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The purpose of this month’s post is to talk in depth about a commonly misunderstood procedure, the Root Canal!

1) “When you do a root canal on my tooth, I will be left with a dead tooth, right?” 

This belief about a “dead tooth” resulting from a root canal is a very common belief. However, it is not true. According to Clifford Ruddle, one of the leading authorities in the dental world regarding root canals: “anybody that’s even been remotely involved in dentistry, would know that any “dead” tooth would be exfoliated and rejected by your own immune system. An endodontic tooth is a vital tooth because the body perceives it as vital because there is a PDL attachment, a suspensory ligament that slings the tooth from the cementum to the surrounding bone.  So, the tooth is vital, interpreted as an integral member of the arch, and it can function in complete health.”

So, a properly root canal treated tooth is still a functional and living tooth, because the body doesn’t reject it, and because it can still sense pressure sensations, but not pain sensations.

2) Aren’t root canals needed before you do crowns?

I get asked this by patients at least a few times per month. The answer is that if a tooth needs a crown, that doesn’t mean it a needs a root canal automatically. However, the reverse is true sometimes. If a tooth (a back tooth in particular) needs a root canal, it will sometimes need a crown.

3) Just when exactly are root canals needed? Only when there is pain?

Root canals are needed for the following reasons:

  • When the tooth has severe nerve pain that shows no signs of improving
  • When there is evidence of an abscess forming around the root as seen on an x-ray or in the mouth
  • When there is a large cavity that looks like it is right up against the nerve, as seen on an x-ray.

Of the three reasons above, the first one involves pain. There may or may not be any pain associated with the second and third reasons, although those reasons are just as equally valid as the first one. A way to think about it is this, sometimes heart surgery is needed because a patient is feeling pain, and the doctor finds out that this is being caused by heart disease. However, sometimes a patient will need heart surgery even if he doesn’t feel any pain, especially when his cardiologist finds that he has severe heart disease. Pain is not the only indicator of when something is wrong.

4) My tooth has a large cavity that is close to the nerve. The other dentist says I need a root canal. I don’t understand why I can’t just have a filling. After all, it doesn’t hurt.

Again, pain is not the sole indicator of whether or not to do a root canal. When you have a cavity that is right up on the nerve, there is a significant chance that during the filling procedure, the nerve may get irritated irreversibly. Whether or not this will happen cannot be predicted, although we can say that the chances of it happening are significant. If it doesn’t happen, then you are lucky, as the filling will be enough for the time being. But if the nerve does get irreversibly irritated, there will often be immense pain that doesn’t go away, and, a root canal will be the only cure (besides extracting the tooth). So you will end up paying for a filling, a root canal, and a crown, as opposed to just a root canal and a crown.

5) I’ve been told that root canals take a long term and are extremely painful. Is this true?

Root canals can take anywhere from 1-2 hours. True, it is one of the longer procedures we do. But stories of root canals taking 5, 6, 7 hours are greatly exaggerated. Furthermore, with modern anesthetic techniques, there is no reason for you to be in pain during the procedure. In fact, modern root canals are painless.

After the root canal, you may have some pain and possible swelling, but we often prescribe medication to deal with these issues if needed.

6) Aren’t root canals expensive?

Most insurances cover Root canal procedure so that your out of pocket expense is low. We at Queen Anne Dental also offer flexible payment plans to help our patients get the treatment that they deserve. We have helped out many patients who do not have insurance, who otherwise would have chosen to have their teeth extracted due to not being able to afford root canals. If you need a root canal, but are not able to afford it, call our office at 425-947-2727 and ask about your options.

 

Chew gum to prevent cavities?

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Is Xylitol Really the Ultimate in tooth Decay Prevention?

The effectiveness of Xylitol products (such as gum and candy), in preventing tooth decay, has now been commonly accepted by the public. Very often I get patients telling me “I should never again get a cavity because I chew Xylitol gum.” But how effective is Xylitol at preventing decay?

It’s important to understand that in the realm of science, belief does not always coincide with reality. An example: my mother used to tell me as a young child not to play in the cold, as the cold weather will cause me to get sick. We now know that it’s the Rhinovirus that causes the common cold, not a drop in temperature. It’s always important to re-examine our beliefs, no matter how deeply ingrained, and to cross check them against what the current research says.

So what is the conclusion regarding Xylitol? According to this recent scientific article (linked below), the following conclusions were made:

http://www.ada.org/en/publications/ada-news/2015-archive/march/new-research-shows-clinical-evidence-unclear-on-effects-of-xylitol-products-preventing-dental-carie?nav=news

1) There is insufficient high-quality evidence to prove that xylitol prevents tooth decay, 

2) The best evidence for preventing tooth decay is still brushing with fluoride toothpaste and eating less sugar,

3)  There are side effects for Xylitol that are often not reported such as bloating, diarrhea and laxative effects.

The upshot is that brushing, flossing, and proper use of fluoride is still the gold standard for preventing decay. The study is not saying that Xylitol does not work, but merely stating that so far, the research and statistics are insufficient, and more investigation is warranted. So the next time your friend tells you that she quit brushing and flossing because she now chews Xylitol gum, you will now know what the proper response is!