Distinctive Smiles of Dublin Blog

I don’t consider myself old, but I do have several years of practice in this career we call dentistry. So I hear the fears of my patients quite often. Whether it was a bad childhood experience of a dentist not using anesthetic or their dentist standing on the chair while they “yanked out my tooth”. I still can’t imagine a dentist doing either of those. However, the most common two things that patients fear the most are “the dreaded shot” and “the awful noise the drill makes”. Well many of you know that we have an anesthetic machine called the “Wand”. Instead of using the big silver syringe that you see in most dental offices, the Wand using a small plastic holder with a very fine needle. It controls the rate that the anesthetic goes in (pushing the fluid in too fast is what usually causes most of the discomfort). After we numb a patient, many say they didn’t feel anything. So many of our anxious patients are no longer fearful of getting numb. You can check out this youtube video that will show you what it looks like.

We just recently addressed the noisy drill issue. Older style handpieces or drills use air from a compressor to turn the bur. The loud pitched whirring noise that is heard is the air pushing again a turbine inside the handpiece. Well that noise is not only annoying for the patient, but for us as well. Not to mention that it’s hard on all of our ears. So we did some research and decided that it was time for something different. Electric handpieces have been out for several years and quite popular in Europe. But there were some drawbacks such as heat buildup which could damage soft tissue and lack of speed control in which it may take the operator longer to fine tune the tooth preparation. After researching the different electric handpieces systems, we decided to go with ones that not only address those issues, but provide minimal noise. The power and torque of these handpieces also allow us to remove decay and prepare a tooth in a faster, more efficient manner. There’s less vibration and fiberoptic lighting that allows me to see better. And did I mention that they are very quiet (I think I’ll be able to hear my grandchildren when I retire). You basically will hear the suction tip more than the drill. Check out this video which will show the difference between air and electric handpieces.

We’ve been using these for a while and patients have had very positive experiences. Obviously, we promote prevention and we only drill on your teeth in order to make you healthier. And when we do, our goal is for it to be as comfortable an experience as possible. So between the Wand and our new electric handpieces, we’re moving even closer to that goal.

As we draw toward the end of 2011, our practice makes it a priority to make sure patients realize what dental benefits they have remaining for the year. We’re always trying to explain dental insurance with patients throughout the year. The insurance companies try to make it as hard to understand as possible so patients are less likely to get the full benefit from their plans, in my honest opinion. And we fight with insurance companies to get every dollar the patient should get from their plans. Resubmitting x-rays and claim forms, writing narratives to justify reasons for sound, recommended treatment, and writing appeals for when insurance companies don’t pay what they said they would. Let’s face it, the insurance companies don’t make money by paying for claims so they do everything in their power to not pay. I could go on bashing the insurance companies, but after we jump through these hoops, they do subsidize some of the treatment costs and allow some patients to be healthier. But I still don’t like them…
The funny thing is that we (ie dentists) invented dental “insurance”. First, let me digress a little…it’s not really insurance. The definition of insurance is “to protect against catostrophic loss in which a third party payor guarantees coverage”. So if you wreck your car, the insurance company gives you a check for the totaled car. If your house burns down, your home insurance provides a check to build you a new home. Many of you know that most employers sign up most employees for dental “insurance” plans that give a maximum of $1000-$1500 per year. And if your in need of rehabilitative treatment (something beyond a couple fillings and a couple cleanings), your costs can be in the high four figures to 10’s of thousands. So the term insurance is not correct. Around here, we call them dental benefits because they subsidize the cost of most treatment.
So back to the story of dental “insurance”. We invented it back the late 1960’s and it was designed to provide coverage for the dental catostrophic event (accidents, trauma, extensive breakdown of the teeth, etc.). The coverage in the 1960’s was a yearly maximum of $1000-$1500, just as it is today. However, if we adjusted for inflation, today each patient would receive about $8700 each year in dental insurance. Notice I didn’t put that in quotes, because that could actually cover a castostrophic dental event.
Moral of the story is that an employee spends a certain amount out of their paycheck each pay period to have dental benefits. You might as well use them. We’re coming up on the end of the year so use ’em or lose ’em. Oh, by the way, that’s another way insurance companies make a bunch of money – people not using the benefits that they paid for throughout the year. I love dental “insurance”!

One of the things that I enjoy the most is taking someone’s smile that they have not liked for years and creating a whole new smile that functions well and the patients can be proud of. Patients have told me that this change has increased self worth, enhanced their professional lives, and given them the confidence to ask someone out. We take pride in the cosmetic dentistry that we can provide in our practice and our patients take pride in the new smiles that we have provided for them. These cases take a lot of work from my team and the lab not to mention the courage and investment from the patient to have such a change take place. Things such as porcelain veneers and crowns to long span bridges replacing several missing teeth can all contribute to creating a whole new smile.

Yesterday I had a junior in high school ask if I enjoyed what I do and if I would become a dentist all over again. Without hesitation, I emphatically said yes. You see I was the cliche that said I wanted to go to college to become a doctor, more specifically an orthopedist (fixing broken things has always fascinated me). Well the more I discovered about medical school and the healthcare system from doctors I shadows at the local ER, the more I wasn’t so sure. I came from a family in which my dad was a factory worker and my mom was a teacher and while they were very supportive, I didn’t have any family members that could mentor me in a healthcare career. I enjoyed science/health classes and I enjoyed working with my hands through woodworking, model building, and playing sports so a family friend told me to check out dentistry. So I volunteered at a couple dental offices, went to school and the rest is history.
So back to the teenager from yesterday. He was interested in a dental career so we talked about some of the things that may help him move toward that goal. I thought posting them here might be helpful to others looking toward that career path. One thing we discussed is visiting or working at a local dental office. Gaining first hand experiences will always allow you to discover and learn about a future career. It also allows you to network and get the word out that you are interested in this field. This is especially important when you are applying for dental school or looking at associate dental positions after dental school. There are many dentists out there who know each other through continuing education, discussion boards, and study clubs. The other suggestion is an obvious one. You have to focus and be driven to do well in school. Take opportunities to take AP classes especially in math and the sciences. Separate yourself from your classmates by getting good grades and being active in extracurricular activities. In college, whenever I felt I lost focus to get into dental school, I would go shadow the local dentist. I would watch the cool stuff he did and he would tell me how he actually liked coming to work each day. That would give me the motivation to push forward and achieve my goals.
Some people say they hate coming to the dentist and to them the dentist represents pain and discomfort (our practice puts a huge focus on minimizing any pain or discomfort so hopefully our patients don’t feel quite as cynical). However, the ability to make people healthy and proud to smile is what drives me each day. I’m not saying that it’s all flowers and rainbows every minute of each work day. But I have an opportunity to provide for my family while going to work each day with the anticipation that I can help someone feel better or improve their quality of life. That is why I would do it all over again. And I hope to have a long, fulfilling career with challenges and successes. So if you know a young person who is interested in a dental career, have them contact us. My staff and I love what we do and are happy to show a perspective dentist, hygienist, or dental assistant a real world dental experience.

Ok, so very few of us are as excited as the title may say, but you should be. When partnered with good brushing, flossing will keep you out of my chair more than anything else you do in your mouth. The problem is that we all know that we should floss each day, but many of us are doing it wrong. Before dental school, I would try to floss at least a few times a week (maybe not during those late nights at college when I was…studying). The problem was that I was doing it wrong or rather I was not doing it effectively. So here you are, a step by step method of flossing. Because if you’re going to do it, you might as well do it right.
1. First, choose a floss that works with you teeth. There are a bunch of different types out there so you need to find one that you can get in between your teeth with shredding or breaking. Also, for those with dexterity issues, there are floss holders that can help you.
2. BEFORE brushing your teeth, measure approximately 18 inches of floss, and wind each end around your middle fingers. Grasp 1 to 2 inches of the floss with your index (pointer) finger and thumb.
3. Gently guide the floss between the teeth without snapping it so you don’t damage the gum tissue.
4. Angle the floss so it hugs the tooth in a “c” shape. Gently slide the floss up and down the surface of the tooth making sure it goes slightly below the gumline. When complete, angle the floss to hug the tooth in the opposite direction, and repeat this step.
5. Floss all the teeth moving from upper right to left, then lower left to right. Rewind the floss after each tooth so you are using a clean, fresh part of the floss.
6. Always follow up with brushing (preferably an electric toothbrush) and you can rinse with mouthrinse or fluoride rinse at that time.
*Thanks to ADA.com
*Check out this youtube video to demonstrate the proper technique How to Floss

Adults should floss at least once a day, preferably twice, morning and night. Kids should try to start flossing as early as possible to develop good flossing technique and dexterity along with good oralcare habits. And yes, we all know it’s a hassle to take the time to floss each day, but think of the time and money you’ll be saving by not getting those cavities in between your teeth. As the saying goes, “You only floss the teeth that you want to keep.”

I know you’ve heard those commercials that say “dental professionals recommend blah, blah”. Well any company can tweak the data to get those numbers. Each day, we get questions about what kind of toothbrushes, toothpastes, floss, and rinses are best. I love questions like this because it shows that we are driving home the point that home care is very important and our patients want to use the most effective tools to keep their teeth healthy. P&G and Colgate probably don’t want us dentists saying this, but it really doesn’t make a whole lot of difference what toothpaste or floss you use, just use something. Unless directed otherwise, use a toothpaste with fluoride. Most of the whitening, tartar control, flavored, etc is just marketing (however sensitivity toothpastes do have ingredients that can help with sensitive teeth). And floss…I don’t care if you use a piece of twine…I’m just happy if you are getting in there once a day with the floss. NOTHING can remove plaque between teeth like floss.
However, I do believe there are differences between toothbrushes. The biggest difference is manual versus electric. And any electric brush is going to be much more effective than a manual. The electric brushes take the work out of brushing and are more efficient. They range in prices from $10 to $200. The more expensive ones have more features such as timers and power settings plus are usually rechargable and will last longer. FYI, we sell the Sonicare brushes and I’ve been using one of those for about 9 years so that’s what we normally recommend.
If you have some dental work that has been done over the years that you’ve invested in, I think it’s smart to invest in a good electric toothbrush. If you’ve been healthy or just want to try an electric toothbrush, then go a little less expensive. My advice however is to toss the manual and get some sort of electric toothbrush.
Just like a manual toothbrush, you need to brush for at least 2 minutes (it’s really not hard to take 4-6 minutes from your day to brush, you have 1,434 minutes left in your day) and you need to change the brush head every 3-6 months depending on how hard you are on the bristles (stop scrubbing your teeth and your brush head will last longer). Check out the videos down below and if you have any questions, we’re always available to help out.
Best BrushSonicare Technology

You’ve probably heard the cliche that Hollywood deaths come in threes. For some reason, around our office, one thing seems to always come in threes. ROOT CANALS! I’m sure just reading those two words makes you cringe and think about Steve Martin in “The Dentist” or some other movie or TV show that makes this procedure seem worse than putting bamboo shoots under your fingernails. Well dentistry has come a long way and I’d like to squash some root canal myths that are out there (by the way, I’m really not sure if leprechauns can have root canals). So here’s my own Root Canal Top 10…

10. Root Canals Hurt
The perception of root canals being painful began decades ago when root canal treatments were painful. Today, with modern technology and better anesthetics, root canal treatments are no more painful than having a filling. Many of our patients fall asleep during the procedure. Knowing what to expect while having a root canal can help ease a lot of anxiety. Trust me, I won’t proceed if a patient is having discomfort during a root canal.
9. Root Canals Require a lot of Visits to the Dentist
With today’s cutting edge technology, most root canals can be performed in one or two office visits.
8. Crowns Cause Teeth to Need Root Canals
Many people believe that having a crown on a tooth means that the tooth will eventually need a root canal. Crowns do not cause the need for root canal therapy. If a crowned tooth does require a root canal, it could be that the tooth has abscessed or that decay has gotten underneath the crown and reached the pulp of the tooth.
7. Root Canals Cause Illness
There is no evidence to support that root canals cause illness. However, there is evidence to support the fact that people who have had root canals are no more at risk for developing illness than people who have never had root canals. It’s a lot more dangerous to not have the root canal and leave the infection/abscess around the tooth.
6. Root Canals Involve Removing the Roots of the Tooth
When the dentist or endodontist performs a root canal treatment, he or she remove the pulp from inside of the tooth. The roots of the tooth are not removed.
5. Pregnant Women Can’t Have Root Canals
Pregnant women can and do have root canals. Having a root canal does require a small x-ray, but the radiation exposure is very minimal and the x-ray is aimed at the mouth, not the abdomen area. If you are pregnant and your dentist needs to give you an x-ray, he will use a lead apron to cover your belly. The anesthetics that dentists use are also safe for pregnant women. Be sure to let your dentist know beforehand if you are pregnant. It’s much more dangerous for the baby to leave infection associated with the tooth that can get into the bloodstream.
4. Even With A Root Canal, The Tooth Will Come Out Eventually
If you have your tooth properly restored, maintain good oral hygiene and visit your dentist for regular checkups, your natural tooth could last for the rest of your life.
3. If the Tooth Doesn’t Hurt, There is no Need for a Root Canal
While a throbbing toothache usually results in the need for root canal treatment, many times a tooth can require root canal treatment when there is no pain present. Dentists and endodontists are specially trained to test a tooth to see if the pulp has been infected or damaged. If this is the case, a root canal would be necessary to save the tooth. Many times a long-standing chronic infection may not cause pain, but it is hard on your body to continually be fighting an infection.
2. Pulling the Tooth is Better than Getting a Root Canal
This would be like cutting your finger off because you have an infected hangnail. Keeping your natural teeth for as long as possible is very important for proper eating and chewing functions. There are several options available for missing teeth, such as dentures, partial dentures, dental implants and fixed dental bridges, however, these alternatives can be much more expensive than saving your tooth with a root canal treatment.
1. After Having a Root Canal, My Tooth is Completely Restored
After having a root canal, it is extremely important to make a follow-up appointment with your dentist to have the tooth permanently restored. After the pulp of the tooth has been removed, the tooth can become very dry and brittle. Having a permanent restoration will help protect your tooth from fracturing.

So as some of you know, my wife and I had the opportunity to go to Greece a couple weeks ago (first trip we’ve taken since Logan was born 4 yrs ago). It’s a beautiful country with friendly people, great scenery, and fantastic food. We were on the islands of Mykonos and Santorini then went to Athens (I added a few photos below).

As my wife and I toured the country, ate the wonderful food, and chatted with the locals, it put things in perspective. The Greeks really enjoy life and appreciate the opportunties they have. They lead a simpler life than we do in the States and are not as fast-paced and digital as we are (trust me, it was hard finding a working wi-fi signal to check on sports scores).
In Greece there are many people that have crooked and crowded teeth, metal fillings on front teeth or even missing teeth in their smile. I asked some of the locals of Greece about the dental care they have in Greece. Most indicated that it’s not for lack of money that their dental condition is not ideal. It’s the fact that dental care is not a big focus in their youth and that dentists do not offer esthetic options. One man said that he had only seen a dentist once in his life a couple years ago to get a tooth pulled. He said it was a painful process because the doctor charged for anesthetic and the gentleman did not want to pay for it. Can you imagine not being numb for an extraction or even a filling? From what I understood charging for anesthetic is pretty commonplace in Greece. Most Greeks do not have access to dental insurance or patient financing either. And everything is paid up front before any work begins.
Those conversations made me realize how lucky we are to live in this country and have access to the medical and dental care available to us. Of course we have our problems with the economy and rising healthcare costs, but we also have the opportunity to get great care. If a person living in this country wants a great looking and healthy smile, then we can make that happen. Granted there are several variables or even barriers such as finances or time that can keep people from the smile they’ve always wanted, but the opportunity is there. And I appreciate the fact that I have access to great equipment, a wonderful lab, comprehensive continuing education, and a terrific staff that allows me the chance to create a smile they’ve always wanted (check out the smile below). That, to me, makes all worth it and makes me realize how fortunate we are.

I realize that’s a silly question because most people want to look beautiful. We’ve been providing beautiful smiles for many years in our practice. But now my team and I can provide another level for you to rediscover your youthful appearance by smoothing out or filling in some fine lines and wrinkles. I’ve recently become certified to provide facial rejuvenation using Botox and dermal fillers.

Botox® is a procedure which was developed to treat the visual signs of aging by reducing or removing wrinkles. It is considered a safe, effective way of treating aging skin. Common areas for injections include horizontal forehead furrows, vertical lines between the eyebrows and “crow’s feet” around the eyes. It has proven to be the best non-surgical form of facial rejuvenation and is capable of producing phenomenal improvements in your appearance.

Also, as we age, our skin volume diminishes causing wrinkles and folds to form especially in the delicate facial skin. Juvéderm® or Restylane®, both dermal fillers, are made of a naturally occurring substance in our skin called hyaluronic acid. This substance simply restores your skin to its more youthful volume, smoothing wrinkles away. The ultra smooth consistency of Juvéderm® and Restylane® provide a more natural look and feel to help correct facial wrinkles such as the “parentheses” (line between your mouth & nose), “marionette lines” (the downward turn at the corners of the lips), and can plump your lips for a fuller look.

Here’s a couple examples of what can be done. The first example is how Botox can relax the upper facial muscles and smooth out the lines that develop as we age. The second is one that demonstrates how the folds between the nose and corners of the lips can be removed. The lips have also been slightly enhanced as well. Click on the thumbnail to see the full photo.

Although here in Ohio it looks like Siberia with all the ice and snow, it will be spring and summer someday soon. I’ll be chasing the little white ball around the course, but for many kids, the nice weather also means the opportunity for injury increases. We were all kids at one point jumping out of a tree, swinging on the monkey bars, fielding ground balls at third base, etc. Well we’re coming up on a time when we see more dental injuries as well. So I thought I’d discuss what to do if your child has the unfortunate luck of busting a lip or breaking a tooth.
My first piece of advice is to put your child in a plastic bubble and do not let them out of the house. If you cannot follow that advice, then read on. If your child cuts their lip or has a facial laceration, clean the wound and try to see how severe the injury is. If you can’t see the bottom of the cut, then it’s off to the professionals because it’s probably stitches time. If you can see the bottom of the cut then use a cool to cold compress and put pressure on the wound. If the bleeding persists for more than an hour, you need to see a dentist, oral surgeon, or ER doctor.
A injured tooth is a little more complicated. If the crown (the portion above the gums) is fractured, save the piece and see your dentist as soon as possible. While it’s unlikely it can be bonded back on, it is possible sometimes. It also gives the dentist a perspective of what it looked like before the fracture. If the crown and the root are fractured out of the mouth and in one piece, try to re-implant the root into the socket then call your dentist. If you cannot re-implant it or the socket is fractured, then place the tooth in one of the following mediums. Below is the order of things to put the tooth into based on the best prognosis of tooth survival.

1. The tooth socket
2. Hank’s solution (found in many first aid kits)
3. Milk
4. Saliva (place in the side of the cheek)
5. Water (not good for the survival of the root cells)

The key to a tooth surviving is keeping the little root cells alive so the will integrate with the socket bone. Notice that keeping it dry is not an option. If it is left dry, the cells die in minutes and re-implantion is next to impossible. You have about an hour in any of these mediums for a good prognosis.
So keep your dentist’s phone number in your wallet or purse so when those kids decide taking down the trampoline net was a good idea, you’ll be prepared.