General

Some electronic flossing aids offer great technology and potential, but you should make sure you have tried manual flossing before going to these. They remove large debris stuck between the teeth, but not the fine layer of plaque that traditional floss can get. I find the best use for these electronic flossing appliances is for people who cannot manually floss on their own – such as people with a past injury, or those in nursing homes. Not discussing exceptional circumstances, traditional flossing with physical contact on the tooth is the way to fully cleanse the surfaces in between the teeth.

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Beware of marketing pitches. The before and after pictures shown to you as an example of what can be done for your teeth may not be the work of the actual dentist offering them. They can represent the work another provider completed that the dentist is presenting as something they are CAPABLE of, or the work the PRACTICE is capable of. Some practices have many doctors come through, likely with different skillsets. Be sure to verify the source of the work, and don’t be afraid to ask for it in writing.

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Dentistry is a “treatment” profession, more than a “cure” profession. Dentists treat, but not as many things can really be cured back to their original state. The work we do will at some point fail. Nowadays, things are made to be increasingly fast, streamlined… disposable and replaceable. But I don’t think it is good to do this when it comes to teeth. Procedures on a tooth are irreversible, and every time a filling needs to be redone, more tooth structure is lost. A tooth gets a filling, then later a bigger filling, then a crown, a potential root canal, and so on and so forth until a patient loses the tooth and needs an implant. That’s a lot of treatment and a lot of money for one tooth. Avoiding the filling stage is the best option, but when it has to happen, choosing the option with the best lifespan can add decades of performance and literally save the tooth. Repeat work is great for business, not so much for a patient.

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Bisphosphonates – A quick google search can determine the various names of this medication. It can be used in the treatment of osteoporosis. This drug can be very beneficial, but it can have serious complications in dentistry. When used for long enough periods of time, it can impair the ability for the jaw to heal. Once this point is reached, it may no longer be possible to remove an injured tooth, because the socket may not be able to heal. Medication-Related Osteonecrosis of the Jaw (MRONJ) is the condition. Although rare, make sure your dentist and physician put together a plan for how this will relate to your long-term dental treatment and health.

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It can help to get an endodontic consultation before an implant. Implant technology has improved greatly, but so has endodontic therapy. The experience has also become more comfortable. Implants are great for replacing missing teeth, but root canals can be very good (and a fraction of the cost) for treating existing teeth.

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Implants are increasingly popular. In the USA alone, more than 150 implant companies now exist. An implant is not like a filling where any dentist can readily treat it. Implants are brand-specific with their own unique parts, tools, and designs. An internet search will show you the dominant names in implant manufacturing. Less established companies can appeal with various methods, such as lower prices. If the company goes out of business, discontinues its production line, or the dentist who provided the implant is no longer available, parts and tools to service the implant may become difficult or impossible to find. So research the suggested implant before you receive it, and don’t be afraid to get a second opinion!

In addition to USA-based implant companies, other countries have their own vast array of implant manufacturers and designs. All these implants can have specific parts, tools, and protocols. Another dentist may not have the equipment to service your implant should something go wrong, especially if you are leaving the country, have a less common implant, or if you get a new dentist that uses a different system. You may consider purchasing some service parts for your own implant from the manufacturer. This would primarily include retention screws and the driver kit (the “screw drivers”). Your dentist may advise some other specific parts. It may cost more up front, but if you find yourself in a circumstance where providers don’t have the parts or tools to service your implant, the dentist that agrees to fix it will likely have to charge you for the equipment they order, the treatment, and an hourly rate, which can come close to, or exceed, the cost for buying the parts yourself up front. The tools will likely remain in the dentist’s ownership once you’re finished as well.

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The specific type of implant someone has can be difficult or impossible to identify without documentation (do you know what type of implant you have?). With the numerous brands of past, present, and future implants on the market, it can be very helpful to keep a personal record of your implant’s specifications should it ever be needed in the future.

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Sustainability is becoming increasingly important. Many goods today are single use, throw away items. That is fine if the material can break down in nature, but for things made out of plastics that do not readily degrade, accumulation becomes a problem. Now, non-plastic dental alternatives exist. Dental floss can be found in the form of silk, or other organic materials, toothbrushes can be made out of wood with environmentally friendly bristles, and there are toothpastes that come in the form of tablets that once chewed, foam into toothpaste. There are also toothpaste powders, or toothpastes that come in metal tubes (Some toothpastes have fluoride, some don’t, so check). This can make a huge difference over the course of a lifetime, and in my opinion, takes very little getting used to. See what you can find!

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Dentistry is still an incredibly unregulated profession. Advertising for low-cost dentistry is increasingly common. Dental companies will tell you they can afford this because they buy in bulk. Not true. The primary way this is done is with lower cost, lower quality materials: fillings, implants, crowns, etc.; A lot of crowns can be made in China and other countries for pennies on the dollar and imported to the USA. These labs have little to no oversight or quality control. Even in America, lab technicians are “Unclassified Labor” with no barriers to entry. This means ANYONE can technically make your crown. So a dental office using a tested, quality lab that costs a little more is essential for the long term predictability of your work. It never pays to cut costs up front, especially for your one set of adult teeth.

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Most people don’t think of the mouth as an organ, but it indeed is the first organ that makes up the digestive system. Just as the kidneys clean the blood and the liver detoxifies the body, Teeth allow us to chew food that takes care of the rest of our body. Interestingly, teeth are the only organ in the human body that are incapable of healing on their own. A dentist has to place a filling in a tooth to restore it from a cavity. And there is nothing as good as the original, natural tooth. So treat the teeth like the essential organ they are, and make sure to care for them so they can continue performing the job they do.

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Have you ever thought how a water-flossing device compares to traditional floss? There is a great degree of marketing behind this new technology. It is important to know these are flossing “alternatives”, not necessarily something equivalent. Water flossing devices were originally intended for people who were unable to manually floss their teeth – such as those in assisted living facilities, or the injured. The goal was to have a device that would at least shoot greater debris worth of food out. Fast forward many years and water flossers have become a mainstream product on almost all department store shelves. With that being said, these electronic water-flossing devices will leave a layer of plaque behind which can only be removed by manual, physical floss. What I see in dentistry is a lot more people relying on these devices to replace flossing. As a result, their teeth become dirtier, and their gums inflamed due to a greater degree of plaque being present. If you don’t floss often, you have a high risk for cavities. If you use a water-flossing device, you have a high to medium risk for cavities. Manual flossing is the only way to get the cavity risk down to low. Floss manually 6-8x each tooth surface, and dental disease will be much harder to set in.