Dental Info

According to the dictionary a serf is "a servant or laborer of olden times who was treated as part of the land worked on and went along with the land if it was sold"  and now a days it seems that healthcare workers are being bought and sold by large corporations and this analogy seems more and more apropos. I read an article today in the Wall Street Journal about CVS negotiating buying a chain of Doctor clinics from Oak Street Health. According to the article  "CVS's deal would be the latest in a series of moves by a range of players, including health insurers to acquire clinics and doctors focused on primary care. Of special interest to the buyers are clinics that manage and treat patients with chronic health conditions such as diabetes, whose care can be costly if not managed closely" It is clear that the hope is that through "greater efficiency" managing and preventing worsening conditions may save money and lead to greater profits for the own...

Lately I've seen an uptick in new patients entering our practice.   It seems that an increasing  number of my contemporary dentists (baby boomers) have chosen to retire and some of their patients were not particularly happy with their younger replacements.  Boomer  dentists are defined as those born between 1946 and 1964 and many are retirement age.  When I queried these new patients as to why they left their previous dentist,  many were unhappy with the dentists who took over a prior dentist who retired and they implied that either they didn't feel like they were getting the same "personal attention" and/ or the new dentist was finding problems that their previous dentist didn't mention. Over the years I have had the good fortune to take over a number of dental practices when collegues have chosen to retire. I can attest that this is both an opportunity and a challenge. While I feel flattered that these dentists have chosen me to be t...

  Often patients come in with the hope that the solution to their dental problem will be a simple fix, especially if their tooth problem is not associated with any painful symptoms. Sometimes they are right but sometimes they are not. Unfortunately, pain is not always a good indicator of a dental problems severity. some extremely decayed teeth do not cause a lot of discomfort, but tooth structure can be so compromised by the amount of missing tooth structure, that refilling the tooth may not be an option.  Often salvaging a tooth with advanced decay is not always feasible and when it is possible, multiple costly procedures may be required to save the tooth (root canal, crown lengthening, post and core). Sometimes the most predictable solution is to remove an extremely decayed tooth and to arrange for its replacement with an implant and implant restoration.  This involves multiple steps and can be costly, but often the implant option offers a more predictable long term...

  retentive crown preparation for all zirconium crown I was asked this question by a frustrated dental student. She explained that she tried in a zirconium crown and it had no real retention. She asked me why this had happened. I asked her to show me the crown and the model it was made on. Now truth be told, zirconium crowns can have more relief between the prep and the crown than some porcelain fused to metal or full metal crowns, but all types of crowns can have a problem with being non retentive due to a number of circumstances. I explained the following reasons for a poorly retentive crowns to result from our efforts: 1) the degree of taper. In theory crowns can be fabricated on preparations with miniumal taper (3 degrees), but many practitioners are unable to make this sort of preparation without producing undercuts. In their effort to make a preparation without undercuts, it is not uncommon to end up with preparations with greater than a 10 degree taper. These ...

 There are a number of different possible answers to this question. Teeth that are bothered by drinking cold liquids or breathing cold air could be suffering from "cracked tooth syndrome, a loose filling, gingival or occlusal erosion, deep decay, or a pulpitis. If you are experiencing discomfort when dealing with cold liquids or air it's best to see your dentist so he can try to diagnose why. When a patient comes in to a dental office with this complaint , the dentist should  interview them about when they have this symptom. (drinking cold or hot liquids or breathing cold air). Also do  they have intermittent pain on chewing food sometimes (cracked filling or cracked tooth)? In my office, after this brief interview I have my assistant take a periapical and bitewing radiograph and I examine the tooth or teeth in question specifically  looking for signs of a crack in a tooth or filling, decay approaching the pulp and/or dentin erosion. In addition I tap gently on the...

  I like shopping at Ikea. The prices are great and the furnishings are good looking, but I have some traditional furniture that I inherited from my mother or purchased from crate and barrel that has held up extremely well and I expect it to serve me well for many years to come. My Ikea purchases have  not always held up as well. I have thrown out all the rugs I bought there after several years and I do not purchase any upholstered furniture there.  There are some parallels that can be drawn with dentistry. Are crowns and other restorations the same regardless of which dentist we choose to help us? After all, all dentists we see are licensed and have received the same training in dental school? Also if I see a dentist with a well maintained dental office and busy practice, (with lots of nice google reviews) they must be pretty good? Sometimes yes, sometimes no, since the test of quality dentistry is how it holds up over time. Also the ability of a dentist to treatmen...