Your Path to Healthier Dentistry: A Holistic Approach to Keeping Your Teeth for a Lifetime

2013 by Dr. Alex Shvartsman. All rights reserved.

The information in this book has been obtained from authentic and reliable sources. Although great care has been taken to ensure the accuracy of the information presented, the author and the publisher cannot assume responsibility for the validity of all the materials or consequences for their use. Before beginning any dental treatment or therapy, please consult with a licensed dentist and/or physician.

No part of this book may be reproduced, stored in a retrieval system, or transmitted by any means without the written permission of the author.

Published by AuthorHouse 05/22/2013

ISBN: 978-1-4817-4118-7 (sc)

ISBN: 978-1-4817-4119-4 (e)

Library of Congress Control Number: 2013906745

Any people depicted in stock imagery provided by Thinkstock are models, and such images are being used for illustrative purposes only.

Certain stock imagery © Thinkstock.

Because of the dynamic nature of the Internet, any web addresses or links contained in this book may have changed since publication and may no longer be valid. The views expressed in this work are solely those of the author and do not necessarily reflect the views of the publisher, and the publisher hereby disclaims any responsibility for them.

CONTENTS

1.   DIAGNOSIS

2.   PREVENTION

3.   TOOTH DECAY

4.   BIOMIMETIC DENTISTRY

5.   AMALGAM FILLINGS

6.   TOOTH COLORED FILLINGS

7.   CROWNS

8.   BIOCOMPATIBILITY TESTING

9.   GUM DISEASE

10.   TOOTH WHITENING

11.   ROOT CANAL THERAPY

12.   TOOTH EXTRACTION

13.   DENTAL IMPLANTS

14.   THE MODERN DENTAL OFFICE

15.   UP KEEP

16.   THE FUTURE

17.   DENTAL GLOSSARY

18.   GRATITUDE

19.   DENTISTRY WITH A PURPOSE

20.   ABOUT THE AUTHOR

21.   FURTHER READING AND REFERENCES

*In the future revisions of this book this chapter will see the most change. I look forward to moving the following sections to the previous chapter and fill the upcoming pages with new exciting advanced we can all look forward to.

For my son, Logan

May you find a career as fulfilling

and rewarding as I have.

INTRODUCTION

Today dentistry is changing at a rapid pace. It is a truly exciting time to be a dentist. However, it is an amazing time to be the patient. New advances in all disciplines of dentistry have made it possible to provide comfortable, esthetic, long lasting and healthy dental care.

It is also a scary time to be the patient. Globally and in the USA tooth decay and gum disease are on the rise. The impact of oral disease on the total heath of the body can no longer be denied or ignored.

Unfortunately the responsibility for your health falls on no one but you. Neither the government, insurance companies nor dental organizations have your best interests in mind. Do not fear, for in the following pages you will gain the knowledge of how to keep your teeth for a lifetime and become your own dental health care advocate. This book may make you laugh, shock you, anger you but most importantly it will empower you with knowledge to help you make better decisions about healthier dental care for you and your family.

DIAGNOSIS

In dentistry as in medicine, there is only one right diagnosis and many treatment options. With today’s rapidly evolving technology, new dental diagnostic methods are available to improve our identification of oral disease. This chapter will explore this in further detail so you, the consumer can learn what to expect and ask for.

TOOTH DECAY DIAGNOSIS

Laser Cavity Detection

Traditionally dentists use a sharp-pointy pick to check for cavities. You may have had this instrument stuck in your tooth in the past. Not only can this be painful, but also a sharp-pointy instrument coming at your face is not a comforting experience if you are already nervous at the dentist. In addition, the sharp metal pick can damage weakened enamel and potentiate cavity formation. The fact is that cavity detection with this technique is at best only about 60% accurate; many small cavities go unseen and can become large cavities if left untreated. This can lead to unnecessary root canal treatment, crowns or extractions.

There are several tooth decay detection devices now available, the most widely used is the Diagnodent: the laser cavity detection system. This decay laser is over 90% effective in painlessly finding even the smallest cavities early, when they can be treated conservatively with a small filling.

Digital 2-D x-rays

There are many advantages of digital dental x-rays over conventional film x-rays. Digital x-rays use an electronic sensor to capture the image. Studies estimate that radiation exposure can be reduced by about 90% with digital dental x-rays. The best systems can reduce radiation by about 98%.

The image can be refined to improve and aid in dental diagnosis. The zoom-in feature allows dentists to see more detail. Contrast changing ability can help detect the smallest cavity as well as hidden tartar under the gums. Many current software systems have decay finding features to help point out small cavities. The image appears in a few seconds and can be displayed on a TV screen so patients can see their x-rays better. An additional benefit of this technology is that there is no environmental waste from chemicals, plastic and lead as there is with conventional dental film x-rays. A draw back to all 2-D x-rays is that they area two dimensional representation of a three dimensional object and are subject to interpretation. Decay is always bigger in real life than how it appears on 2-D x-rays.

Digital 3-D x-rays

Cone Beam Computed Tomography (CBCT) is a recent addition to dentistry’s armamentarium. It is a powerful diagnostic tool, which allows dentists to finally look inside teeth and accurately evaluate the depth of cavities. Although currently not as sharp as 2-D dental x-rays this innovative diagnostic technology will improve with time and will someday replace 2-D x-rays.

Transillumination

Traditionally, decay between teeth (interproximal decay) is diagnosed by the use of dental x-rays. However, a new device to identify tooth decay in between the front teeth has become available. It uses a light instead of x-rays, allowing modern dentists to minimize their patients’ radiation exposure. The transilluminator uses a strong beam of focused light to illuminate the front teeth. Since the front teeth are flat, they allow light to go directly though them. Transillumination used by an experienced dentist can pick up even small cavities between the front teeth.

GUM DISEASE DIAGNOSIS

Very little has changed in the way dentists evaluate patients for the presence of gum disease. Although the standard of care is a full gum disease evaluation once a year, according to the American Academy of Periodontics few dentists actually do this routinely. The periodontal exam consists of x-ray evaluation to see the level of supporting bone around the teeth and measuring the space between the gum and the tooth with a round-ended ruler called perio probing. As well as evaluating the color, shape, quality and recession of gums and noting areas of heavy bleeding. In addition, some dentists use a phase contrast microscope to assay the type and amount of bacteria under the gums. This helps dentists to custom tailor treatment based on the microorganisms infecting the gums. This leads to more effective gum disease treatment.

ORAL CANCER DIAGNOSIS

Every hour of every day, one American dies of oral cancer. The mortality rate associated with oral cancer has not improved significantly in the last 40 years. More than 30,000 Americans will receive an oral cancer diagnosis this year. In five years, only 57% will still be alive. 27% of oral cancer victims do not use tobacco or alcohol and have no other lifestyle risk factors.

Oral cancer is one of the most curable diseases when it’s caught early. Several new non-invasive oral inspection tests have been developed to screen for oral cancer. Lights of different wavelengths are used with special filtering glasses to identify and further evaluate suspicious areas of the mouth. Similar technology has proven successful in identifying soft tissue abnormalities in other areas of the body. One device in particular combines all the available lights and provides a comprehensive oral screening procedure for patients at increased risk for oral cancer. The Trimera Identifi 3000 exam is painless, fast, and helps dentists to see abnormal tissue that is not visible to the naked eye during a routine exam.

A brush biopsy-screening test is another useful tool. Suspicious areas of the mouth can be lightly brushed with a specially designed stiff bristle brush to collect cells. The specimen is sent to a lab to look for pre-cancerous or cancerous cells.

Minimally invasive oral cancer technologies can help identify early mouth cancers without the need for invasive biopsies, which require cutting, stitching, and discomfort for several days to weeks.

BAD BREATH DIAGNOSIS

While there are many causes of bad breath, one major contributor are Volatile Sulfur Compounds (VSC’s). Two sulfur-containing amino acids, cisteine and methionine, found in protein are the main source of VSC’s. Patients with high levels of VSC’s tend to get very bad breath. A machine called the Halorimeter can be used to detect the presence of these compounds. Recently, a product has been developed that looks like a q-tip and can be used to detect the presence of VSC’s in a few seconds by swabbing the gums.

New technologies are emerging that will make dental diagnosis better and help improve the care of patients.

PREVENTION

Prevention of disease is the key to continued good health. This is the most important chapter in this book. So pay attention!

The old saying an ounce is prevention is worth a pound of cure rings true to this day. Except in cases of trauma, every crown, root canal and tooth extracted because of tooth decay all began as a tiny cavity. Had that cavity been diagnosed early, it could have been treated in a conservative, minimally invasive and least expensive manner. Since small cavities and gum disease are typically painless, people are initially unaware of any problems in their mouth.

People who avoid the dentist for professional cleanings and exams are really short changing themselves. Years can go by without any symptoms. Finally when a tooth breaks because the cavity has undermined and weakened the tooth or pain sets in because the decay has reached the nerve, the amount of tooth destruction can be massive. The cost associated with restoring the tooth is now 10 to 20 times more than it would have been had the cavity been diagnosed when it was tiny. Worse, however is the actual tooth destruction that has occurred. As advanced as dentistry is today, nothing is as good or as strong as your own natural teeth. The key to keeping your teeth for a lifetime is to keep as much of your own natural, healthy teeth for a lifetime. Nothing man-made is better than nature.

The college syndrome

When young people leave the protective nest and go away to school, typically their dental health suffers. Late nights of studying are usually accompanied by coffee, soda and energy drinks (more on that later). Junk food made with processed and refined carbohydrates becomes the norm and not the exception. Gone are the parents who nag them to brush their teeth before going to bed. Combined with a lack of flossing, results in an increased tooth decay rate. It is not uncommon to see kids coming back from college with a mouth riddled with cavities.

To make matters worse, going to the dentist for a professional exam and a cleaning becomes and after thought when they return from college during vacation. Typically, a college student comes in at the very end of their break and not at the very beginning. When problems are diagnosed, there is usually no time to treat them because the student is leaving for college within a few days or the next day! Months can go by until they return for treatment. By then the cavities are much bigger, more costly to treat and have destroyed more of the natural healthy tooth. If you do nothing else, please make sure to see the dentist at the beginning of the college break and not the end.

The no insurance syndrome

Many people avoid the dentist because of a lack of dental insurance. This is common with young adults when they come off their parents insurance and do not have a job that provides dental coverage. By avoiding regular professional cleanings and exams, small cavities and early gum disease silently progress and do their damage. By the time the person finally sees a dentist the amount of tooth destruction and the cost of treating it may be daunting. The money saved by not going to the dentist for exams and cleanings pales in comparison to the cost of treatment. It is not only cost effective to invest in regular check-ups, but it is less tooth destructive as well.

TOOTH DECAY PREVENTION

Diet

You may not realize this, but tooth decay was virtually non-existent over 10,000 years ago. Tooth decay is a human made disease. Our pets and us are the only animals on this planet that develop tooth decay. In fact, tooth decay is a relatively modern disease, first seen in the archeological record with the advent of grain consumption, which led to farming. Tooth decay as well as many other diseases are what used to be called diseases of civilization, until it became politically incorrect. However, it is a very fitting name and it includes cardio-vascular disease, strokes, heart attacks, many cancers, obesity, high blood pressure, diabetes, food allergies, and autoimmune diseases such as Lupus, Alzheimer’s, multiple sclerosis, Type I diabetes, vetiligo, psoriasis, etc.

After about 250,000 living as hunter-gatherers, approximately 10,000 years ago humans began transitioning to a life of farming. Agriculture has turned out