4 Ways Green Dentistry Can Save Green For A Dental Practice

Going green is much more than the ethically, morally, or politically correct thing to do; it is also beneficial to the bottom line of a dental practice.

4 Ways Green Dentistry Can Save Green For A Dental Practice

Eco Friendly Dentistry

Green dentistry is much more than the ethically, morally, or politically correct thing to do; it is also beneficial to the bottom line of a dental practice. It is our responsibility as health-care professionals and citizens of this planet to do our part in preserving our natural resources and minimizing the waste we produce. If we take time to reflect, we realize the average dental office produces a tremendous amount of waste each year.  Many of the going green suggestions are good, but the implementation may seem daunting and complicated, or the payback marginal at best. The biggest benefit to the environment and getting the biggest bang for the buck comes from implementing just a few time-tested and logical technologies in the office. In addition to doing our part in saving the planet, implementing these technologies has the added benefits of saving time and money, improving diagnostic ability, and increasing the safety of patient records.

The supply of fresh water on earth is not endless. It is a natural resource to be respected and used wisely. Water is not free; there is a cost for the water we use, both in buying the water and in processing the waste water in a sewage treatment plant. The amount of waste produced has increased over the years because the use of disposables has been amplified to comply with OSHA mandates, and they are convenient.

This waste must be disposed of in landfills; therefore, reducing the amount of waste we produce is a responsible thing to do. Most of the energy we use is still produced from fossil fuels that are continuing to be depleted.  Any means we can employ to reduce the amount of energy used in the office is beneficial.

The first and most obvious decision is transitioning to digital imaging in radiography and photography. The majority of dentists have made the transition on the photographic side. It allows the viewing and deleting of photographs that are not considered necessary without having to print them. Printing only the pictures desired saves ink, paper, time, and most of all, money.

Dental Digital X-Rays

The same benefits apply in the radiographic arena to an even greater extent. With dental digital radiography, there are very few reasons to ever print a radiograph and no grounds to ever have to duplicate one.  The average film processor, which uses about $66 worth of processing chemicals a month in addition to processor cleaning chemicals, is no longer needed. These processors also consume 30 gallons of water per hour they run, guzzle electricity, and generate heat and odors.  These chemicals and wastewater no longer have to be processed in wastewater treatment plants. The natural resources used to make the film, developer, and fixer are also eliminated.  The cost savings of digital radiography in time and materials as well as the increased diagnostic ability is confirmed by those who have made the switch. If you are not using digital radiography and photography in the office, making the switch will benefit the office and environment.

A second rather obvious and related way towards eco dentistry is in totally implementing the EDRs (electronic dental records) or the digital dental patient record. Although it may not be possible to be completely paperless, the use of EDRs greatly reduces paper use in the dental office.  Electronic claims submissions, and transmitting radiographs, photographs, and other documents digitally saves reams of paper, postage – and most of all – valuable time.

Electronic Dental Records

The cost of sending a quarterly newsletter to a patient approximates $1.50 in material, postage, and time. For a patient base of 2,000, it would cost $3,000 to send a newsletter, whereas sending a digital newsletter is virtually free.  Patient reminders sent via e-mail or text messaging, rather than through the mail, provide similar savings. An additional benefit of the digital patient record is the security of knowing that all of your financial and patient data is protected, even if the office is destroyed by fire, flood, tornado, or earthquake.

The third way to eco dental is the use of digital impression scanners, such as the Cadent iTero or 3M COS scanner, for acquiring dental impressions for crown and bridge, veneers, bite splints, orthodontia, and study models. Digitizing the impression process eliminates the need for disposable plastic trays and impression material.  Yet again, we save money by not buying the impression materials and are able to keep that much more out of our landfills. In addition, in-office milling systems such as the E4D or CEREC eliminate the need to even construct a working model.

Cadent iTero

The fourth and least obvious way, at least until now, is using a waterless and variable speed oral evacuation system such as the Midmark PowerVac G.  The annual cost of operating and maintaining a vacuum system is made up of three variables – the amount of water used, the amount of electricity used, and replacing the filters as needed. This may seem a bit complicated, but the following explanation should help clarify the benefits.  Most wet-ring vacuum systems use between 60,000 and 90,000 gallons of water per year. At the average U.S. cost of sewer and water of .0071 per gallon, the annual cost is between $426 and $639 per year. Adding a water recycler to the vacuum reduces the water consumption by approximately two-thirds to 20,000 to 30,000 gallons.  Besides not having to pay for this water, we do not have to pay the sewer fee to process this water. Adding an amalgam separator, which now is mandated in many areas, keeps most of the toxic amalgam waste out of the water treatment plants.

Midmark PowerVac G

In most offices, the vacuum system is turned on first thing in the morning and runs full speed until the end of the workday. The average system in a five operatory office consumes more than $300 worth of electricity per year. Wet-ring systems also require frequent filter changes, at an annual cost of more than $500.  At a minimum, the total annual cost of operation is between $1,000 and $1,500 per year, depending on if a water recycler is used or not. A dry vacuum uses no water so there is no cost for water or sewer with this one. There is also no need to change any filters. It does, however, produce much heat and consumes twice the amount of electricity as a wet-ring vacuum system. The extra heat may require additional cooling systems, especially if the vacuum system is in a confined area.

The annual cost of this technology is between $500 and $600 for electricity, plus any costs associated with the increased heat production.  The newest system being introduced by Midmark, which will eventually be followed by other systems, is the PowerVac G system. This is a variable speed unit that increases and decreases the speed/volume of the vacuum system as needed.  This eliminates the vacuum system running at full speed all day, every day. The savings in energy costs is substantial and minimizes the use of fossil fuels. The annual cost of this system should normally be less than $200.

There are many more things we can embrace in our attempt to do our part in being environmentally responsible. The four ideas presented here are a start in the right direction. The long-term payoff is not only a benefit to future generations, but also to the bottom line of the practice.

I am a member of the Eco-Dentistry Association. The cost is about $300 dollars per year, which is extremely reasonable. If you want more information about eco-dentistry and how to make your practice green, I suggest you either visit there website, or you can read a few of my previous blog. If you enjoyed this article on green dentistry, there is a good chance you will also like the following articles:

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2 Responses to “4 Ways Green Dentistry Can Save Green For A Dental Practice”

  1. I have a suggestion for you. Instead of sending post cards by mail as appointment reminders, which both use paper and cost 50 cents per mailing, instead use automated call reminders which cost much less, are much more trackable, and have a much smaller carbon footprint.

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Periodontal Plastic Surgery Techniques

Recent advances in oral plastic surgical techniques have significantly improved the ability to restore damaged periodontal (gum) tissues.

Periodontal Plastic Surgery Techniques

Oral Plastic Surgery

Recent advances in periodontal plastic surgery techniques, such as periodontal regeneration, root coverage procedures with gum graft surgery, and procedures combined with dental extractions or post extraction for dental implant site development, have significantly improved the ability to restore damaged periodontal (gum) tissues.  Early diagnosis is critical to periodontal disease management and offers a patient the best chance of preserving their natural teeth.

Gum Recession- Diagnosis And Treatment Planning

One of the challenges of diagnosing gingival or gum recession is determining the appropriate timing of intervention with corrective periodontal plastic surgery.  The clinician must determine the key anatomic factors that influence the evaluation of the need for therapeutic intervention versus the option of monitoring and providing ongoing periodontal health maitenance.  Critical decision factors for gum recession treatment include:

  • Extent of gum recession
  • Abscence of keratinized gingiva
  • Less than 2 mm attached gingiva
  • Evidence of progressive recession
  • Compromised access for oral hygiene due to high frenum position or decreased vestibular depth
  • Need for full coverage restoration
  • Site of dental implant planned treatment

Options for gum graft surgery continue to increase as new technologies advance in the marketplace.  It is important to assess the evidence of newer therapies in comparison to well-documented procedures such as the free gingival graft for gingival augmentation, and the connective tissue graft for root coverage.

Free Gingival Graft: Before and After

Alternative therapies today include allogenic donor graft biomaterials (Alloderm Graft), biologic amelogenin-like proteins and growth factors combined with coronally positioned flaps, biomaterial membranes to scaffold new tissue formation and cell therapies.

Alloderm: Cadaver Graft

Alloderm: Cadaver Graft

The Gold Standard- Connective Tissue Graft

Langer and Langer introduced the connective tissue graft for root coverage procedures in 1985.  When the treatment goal for gum recession is a combination of providing root coverage and augmenting the zone of attached gingiva, the connective tissue graft is the gold standard procedure.

The added vascular supply available utilizing a connective tissue graft allows for successful, predictable root coverage procedures,a s it is a layered procedure with the primary flap advanced coronally over the graft to achieve partial or complete primary closure.  In comparison to the connective tissue graft, a free gingival graft has only a periosteal blood supply and is therfore more limited in achieving root coverage.

Connective Tissue Graft: Before and After

Connective tissue grafts can be harvested from either the maxillary palate or the maxillary tuberosity.  A variety of successful incision designs have been developed over the years that, depending on the tissue thickness of the palate, are indicated to allow adequate graft thickness and potential primary closure of the donor site wound.

In general, connective tissue graft donor sites heal uneventfully with limited discomfort compared to a free gingival graft donor site from the surface of the palate. Advanced surgical techniques such as modified double pedicle techniques can allow for optimal healing by:

  • Repairing clefting of the marginal gingival tissues
  • Increasing the width of keratinized gingiva at the site of the cleft
  • Strengthening the marginal gingival tissue
  • Improving surface tissue contours associated with coronally advanced flap

Biologic Agent In Longevity Of Therapeutic Result

To promote longevity of the therapeutic result recent breakthroughs in combining the application of biologic agents such as Enamel Matrix Derivative (Emdogain) or recombinant human platelet-derived growth factor (Gem 21S) to stimulate healing with advanced surgical techniques have been shown to improve early wound healing.

Emdogain: Enamel Matrix Derivative

Gem 21S: Platelet Derived Growth Factor


These biologic agents have been documented to provide regeneration of the periodontal attachment apparatus with human histologic studies.  These biologic agents tip the healing process toward regeneration with new connective tissue attachment, rather than reliance only upon repair with long junctional epithelial seal.

Cervical Restorations

Root coverage procedures are not recommended over composite or porcelain restorations.  Treating the site of a planed root coverage procedure first with surgical therapy is recommended with the understanding that if there is incomplete root coverage and a restoration is needed for caries control or esthetic reasons this can be provided after the healing is complete.

Class V Dental Defects: To Graft or Not To Graft

Where class V restorations are present, they can be removed at the time of surgical intervention and replaced after the healing is complete, adjusting to the new level of the marginal gingiva as needed.  If a crown margin extends onto the receded root surface, this can also be altered prior to surgery to allow for esthetic correction.  If a cavity preparation is shallow, it can be root planed or smoothed with high speed instrumentation, but a deeper preparation may pose a challenge for a root coverage procedure.

Treating Multiple Teeth

Multiple adjacent teeth can be treated with a single surgical procedure to alleviate the need for multiple surgeries.  The palate donor sites available and the thickness of the palatal tissue will limit the extent of therapy at one time.  Although some clinicians prefer the use of alternative techniques for multiple teeth such as allogenic acellular dermal matrix the predictability of root coverage should not be compromised and in most cases adequate donor tissue can be harvested atraumatically.

Pre-Graft of Multiple Teeth

Post Graft of Multiple Teeth

In closing, perioodontal plastic surgery can reduce further recession and bone loss. In some cases, it can cover exposed roots to protect them from decay. This may reduce tooth sensitivity and improve esthetics of your smile. Whether you have a soft tissue graft to improve function or esthetics, patients often receive the benefits of both: a beautiful new smile and improved periodontal health – your keys to smiling, eating and speaking with comfort and confidence.

If you enjoyed this article on periodontal plastic surgery,  there is a good chance you will like these posts from my blog as well:

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New Tooth Chip Stores Your Medical History

A newly developed chip can be implanted into a person’s tooth and can store a person’s unique identification number linked to his or her entire medical history.

New Tooth Chip Stores Your Medical History


Dr. Kevin Brunski wants to put an implanted chip your tooth.  More specifically, the Crown Point dentist, who has a patent pending on his invention, I-Denti-Fied, hopes to one day see every person in the United States wearing the device — a chip about the size of a grain of rice that stores a person’s unique identification number linked to his or her entire medical history.

Kevin Brunski, D.D.S., of I-Denti-Fied Inc., demonstrates how a field scanner could scan a dental-implant transponder in his home Friday in Crown Point.  The tooth chip is implanted where it can neither be felt nor rejected by the body.  Brunski gave up his nearly 20-year dental practice a couple of years ago to devote all his time to market the I-Denti-Fied.

He got the idea four years ago after an Amber Alert had just appeared on television, notifying the viewing audience to keep an eye out for a missing child.  “I was disgusted with that. I went to pet my dog and felt this lump.”  It was his Australian shepherd Chesney’s microchip that Brunski felt.  “I said, ‘Wait a minute, why can’t we do this for our children, not like a Big Brother type of thing, but if they are lost or stolen?’ ” Brunski said. His first thought was to implant a chip into a tooth to help in identifying missing children, but he realized it could also hold critical health information in case of an emergency.

Brunski turned to the Internet to see if any such device was already on the market, but the ID chip at that time were larger and wouldn’t fit inside a tooth.  Brunski tabled the idea, but kept researching to see if anyone had a smaller chip.  Finally, in fall of 2007 Brunski found a company in Luxemburg that manufactured a transponder 1 mm by 5 mm, the size of an uncooked grain of rice. He began benchtop studies with a denture and extracted human teeth in his office.  The chip, transponder, or “tag” holds a 16-digit code that unlocks a person’s personal health record. Brunski partnered with a company that stores such records online.

Tooth Technology

“They are fully HIPAA (Health Insurance Portability and Accountability Act) compliant,” Brunski emphasized, to protect client’s health information privacy. The information can’t be stolen because it isn’t in the chip, and the code can only be read by a special “reader,” a gun, produced by the same company, aimed at the client’s mouth.  “No other reader can read it,” Brunski said.  Because the product is so new and not yet universal, clients are also given a USB device that can be carried on a keychain. They also receive a wallet card and a sticker to be placed on their driver’s license.

“It allows first responders and caregivers to have critical access to their information, especially for those with a chronic disease like Alzheimer’s disease and dementia or special needs like autism and Down syndrome,” said Brunski.  Even X-rays, allergies, family member contact information, insurance information and Do Not Resuscitate orders can be included.  A 24-hour call center can pull up the information and fax a patient’s profile to any emergency department, Brunski said.  Brunski also sees potential use for the chip id in such diverse applications as football players’ mouth guards and disasters like the recent earthquake in Haiti.

Rocio Alcantar, who moved to Michigan from Whiting, had her East Chicago dentist Dr. Lawrence Adams install the device in her tooth in November.  “I always lived blocks from my family,” said Alcantar, a diabetic who has had two kidney transplants. “It gives me and my family peace of mind.”  “I’ve had handfuls of surgeries and I’m on so many medications, when my husband is at work and my son is in school, I’m completely alone with zero acquaintances,” Alcantar said.  Alcantar likes the fact that she can control the information that goes into her personal health record, which can change weekly.  “They provide you with a Web site and USB port. You put in your password and you have access to edit your info. When I go to a doctor for the first time I can take the USB with me.”  The implant process was painless, Alcantar said.  “It was less invasive than having a cavity filled,” she said.

Currently those like Alcantar who have the device implanted into live teeth do so knowing it has not yet received FDA approval.  The cost is $150, including one year of membership on the Web site, Brunski said.

Currently, only three dentists in Northwest Indiana implant the devices. Dr. Annette Williamson, who practices in Crown Point, implanted one in her assistant Kristy Green’s son’s tooth.  “He’s a senior at Valparaiso High School this year and he’ll be going away to college,” Green said.

“They don’t have the readers yet, but his information is on the thumb drive and he has a wallet card. When I heard about it I immediately said, ‘It’s cool. I want my son to have that. It gives me peace of mind because if he’s by himself and something happens, number one, they’ll be able to get in touch with me.”

Williamson, who attended dental school with Brunski, said she thinks the device is “a great idea.  “I used to service nursing homes for 15 years. Sometimes the residents leave and just wander,” she said. “If they’re injured and paramedics try to administer medication, their allergies and other information would be at their fingertips. Often, it’s a matter of saving a life when time is of the essence.”

Even if a patient is not sick Williamson said she sees the I-Denti-Fied as a time saver.  “In the dental field patients need to update their history every six months and people hate filling out paperwork,” she said. “If they have all this information on a thumb drive they can just hand over. I can put it in my USB port, call it up and print it out.”

“It’s a safety issue as well,” Williamson said. “We have so many health-care providers and specialists. Not one person has your complete record. It’s a great way to cross reference.”
Community outreach

Brunski has been working for more than a year with many home healthcare services in Lake County.  “We’re a start-up company, so we’re taking a community-based approach,” he said.  Brunski is targeting fire departments and EMS personnel who are frequently in harm’s way.

He’ll give a presentation on I-Denti-Fied at the Crown Point Fire Rescue Department which will host the Feb. 17 meeting of Indiana Volunteer Firefighters Association’s Districts 1 and 2 meeting.  “It takes dentistry out of the post-mortem era and brings it into the lifesaving era,” Brunski said.

“My ultimate vision is that this would become a unique patient identifiers, even as President Obama is supporting electronic medical records,” he said.

If you enjoyed this article on the tooth chip id, there is a good chance you will like these articles from my blog as well:

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The Ugly Truth About British Teeth

Ricky Gervais is the first to admit that his teeth are neither white nor straight – and Americans mistakenly think he wears bad false teeth for comedic purposes.

The Ugly Truth About British Teeth

Austin Powers Teeth

Ricky Gervais is the first to admit that his teeth are neither white nor straight – and Americans mistakenly think he wears bad false teeth for comedic purposes. Why the dental divide?

Do the British have bad teethBritish teeth are not like American teeth.  Hollywood smiles are pearly white paragons of straightness. English teeth might be described as having character.  So much character, in fact, that Ricky Gervais says one US journalist complimented him on being prepared to wear unflattering false teeth for his role as an English dentist in his latest film, Ghost Town.

Only he didn’t.  “I was horrified that I could have such horrible real teeth. It’s like the biggest difference between the Brits and the Americans, they are obsessed with perfect teeth,” says Gervais.  Unlike many British stars hoping to make it big across the Atlantic, Gervais hasn’t bought himself a Hollywood Smile.

But what is it about the bright white and perfectly straight teeth of Los Angeles that Americans love – and expect of their public figures?  “Americans have the idea uniformity is equivalent to looking good. The British character is more free-spirited, more radical,” says Professor Liz Kay, dean of the Peninsula Dental School in Exeter and Plymouth.  She says Americans aspire to a row of teeth which are absolutely even and white.

Artificial smile

Whiter than white, it transpires. Teeth naturally vary in color and the palette can tend closer to cream than white.  “US teeth are sometimes whiter than it is physically possible to get in nature – there is a new reality out there. The most extreme tooth bleaching is terrifying, it looks like it’s painted with gloss paint and has altered what people perceive as normal,” says Professor Jimmy Steele, of the School of Dental Science at Newcastle University.

The British traditionally prefer “a nice natural smile – natural in color”, he says, and have had a more functional view of teeth and dentistry, whereas Americans have always seen teeth more aesthetically, hence the rise of the artificial smile in show business and pop culture.  Cue jibes such as The Bumper Book of British Smiles which cajoles Lisa Simpson into having a brace, and Mike Myers’ mockery of buck-toothed Brits in Austin Powers. Conversely, in the UK the snide remarks are saved for those who have had obvious work done, such as Simon Cowell or glamor model Jodie Marsh.

Simon Cowell

When it was widely reported that Martin Amis had secured a book advance in 1995 to help “do his teeth” – which the author denied – he was lampooned by critics. And more recently there has been much speculation over whether Gordon Brown has had a smile makeover.  Until now it has been considered rather un-British to go for an upgrade, says Professor Steele.  He now performs cosmetic dentistry on a wide spectrum of patients, from an 82-year-old woman with overlapping teeth who finally wanted to “do something for herself”, to a 17-year-old worried that fluoride had given her mottled teeth that were whiter than normal.

But the main difference is that Brits tend to go for more conservative treatments.  “Dental tools can do an awful lot of damage if used inappropriately. Crowns can mean a perfectly good tooth has to be cut down, which can weaken the tooth or damage nerves in the long run,” he says.

Metal mouth

While it is starting to be more common to see braces on adults, most people opt for quicker solutions, says Martin Fallowfield, a cosmetic dentist and executive board member of the British Dentist Association.  “Quite often teeth whitening is a 40th or 50th birthday present,” he says, a procedure that can be done in a dentist’s chair in two hours for about $900. A more intensive “smile makeover” – perhaps involving veneers, crowns and reconstruction work – can take months and cost anything from $2,800 to $14,000.  Dentistry in the UK is a £5bn market, and Mr Fallowfield expects this to rise to £15bn within 10 years, largely fueled by private cosmetic dentistry. While NHS dentists are in short supply in parts of the country, the number of dentists registered with the General Dental Council is up from 31,029 in 2000 to 35,419 in 2007.

But Brits haven’t embraced the full Hollywood makeover – yet.  “Americans don’t mind this unnaturally white look. It’s a new phenomenon, like buying a Rolls Royce and telling the world. They are wearing a smile as a badge,” says Mr Fallowfield.  Nor do aspiring actors and actresses need to get a new and very expensive set of pearly-whites, says Sylvia Young, of the eponymous theater school. “A trip to the orthodontist can be a good idea, to get the teeth straightened if need be.”

As for the likes of Ricky Gervais, it makes sense to stick to his guns, says Mr Fallowfield.  “A lot of people in his place would have had their teeth fixed in this day and age. But for comedians, it’s good to look unique.”

If you enjoyed this article on english teeth, there is a good chance you will like these articles from my blog as well:

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One Response to “The Ugly Truth About British Teeth”

  1. Dr. Todd, so interesting that you wrote this article about British teeth. I have two friends in England with extremely crooked teeth and off bites. They are always complaining and upset that oral health and appearance was never emphasized in their families. In the US first thing parents do is get their kids braces!


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Red Wine Types Are Good For Your Teeth

When you pop open that bottle of red wine, consider toasting its benefits to your teeth. After all, compounds in red wine can prevent cavities and plaque build-up.

Red Wine Types Are Good For Your Teeth

Red Wine Good For Your Teeth

When you pop open your favorite type of red wine, consider toasting its benefits to your teeth. After all, compounds in red wine types can prevent cavities and plaque build-up, researchers say.

The compounds — called polyphenols — block a molecule made by the bacteria streptococcus mutans, which are found in all our mouths, said researcher Hyun Koo, a microbiologist at University of Rochester Medical Center in New York.  Normally, these bacteria break down sugar we eat and make sticky molecules called glucans, which let bacteria to cling to our teeth and damage their surfaces.

These bacteria also produce an acid that leads to tooth enamel erosion, which in turn leads to dental cavities.  But the fermented grape stems, seeds and skins left over from wine production contain high amounts of polyphenols. The polyphenol antioxidants can block the ability of S. mutans to make glucans, letting the good bacteria in the mouth thrive, while disabling the bad bacteria from sticking to the teeth.

“The oral cavity is a very rich microbial environment, so you can’t just smoke [the bad bacteria] out,” he said. “There are beneficial and pathogenic organisms.”  Koo, who was a dentist for two years before becoming a microbiologist, also found that compounds in cranberries work similarly — they block the molecules that enable the sticky surface to form on our teeth.

Red Wine and Cranberries

When researchers fed rats the cranberry compounds, called A-type proanthocyanidins, they found that the bacteria’s production of acid and glucans were reduced by 70 percent, and cavities were reduced by 45 percent, according to a study Koo published in March in the dental health journal Caries Research.

But Koo warned that eating heaps of cranberry sauce or downing glass after glass of red wine won’t help you reap the dental benefits of these compounds. Cranberry products, such as cranberry sauce or cranberry juice cocktail, contain a lot of sugar and aren’t good for the teeth, and red wine can stain the teeth, he said.

Instead, Koo and his colleagues hope to find a way to add these compounds to mouthwashes, toothpastes or chewing gum to combat plaque and cavities. He hopes to test the findings in a clinical setting in the next four years.

If you enjoyed this article on red wine types, there is a good chance you will like these articles from my blog as well:

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Difficult Tooth Pulling: The Root Of The Problem

Removing teeth, while not a particularly pleasant experience, is a routine and uncomplicated procedure in the hands of an expert.

Difficult Tooth Pulling: The Root Of The Problem

Simple vs. Surgical Tooth Extraction

From a procedural or professional standpoint, a simple tooth extraction refers to removing a tooth in which the shape of the root or roots lends to easy removal. This usually involves teeth that have a single and straight root shape, which allow for a more or less straight path of tooth pulling.

In the case of an upper front tooth the root is generally cone-shaped, so there is not too much resistance to removal. One source for this particular procedure’s name is from the dental insurance code ascribed to it, “simple uncomplicated extraction.”

Removing teeth, while not a particularly pleasant experience, is a routine and uncomplicated procedure in the hands of an expert. What keeps a tooth in place in its native bone is a membrane or ligament that surrounds the tooth root called the periodontal ligament (“peri” – around; “odont” – root). The main fibers of the ligament surround the tooth at a slanted angle similar to a hammock and attach it to the bone. By carefully manipulating the tooth, these fibers can be fairly easily dislodged, allowing the tooth to be removed quite simply. Believe it or not, there is a real art and “feel” involved in tooth removal, making it both uncomplicated and relatively simple. It is certainly easier in experienced hands and therefore inconsequential for a patient on the receiving end.

To ensure the extraction is “simple” in the professional sense, involves proper assessment and diagnosis beforehand, in particular of the shape and status of the tooth or teeth to be removed, and the surrounding bone in which they are encased. Routine radiographic (x-ray) examination will allow that determination. In addition the dentist, periodontist or oral surgeon will also take a thorough medical and drug history, to both ensure that you are healthy enough to undergo this minor surgery, and that you have normal blood clotting and wound healing mechanisms.

It may also be likely that the surgeon will fill the socket (the space formerly occupied by the tooth), with a bone substitute or other bone grafting material if it is necessary. Most grafting materials today act as scaffolds upon which your body builds or replaces the grafting material with bone. This ensures that any existing bony defect is reconstructed and the original bone mass or volume is reestablished. This is particularly necessary if a dental implant is contemplated to replace the tooth root. However, your oral surgeon, periodontist or dentist should let you know whether or not your socket(s) will require grafting prior to your treatment.

Another important factor in making a tooth extraction procedure “simple” is recognizing what to do if there are any minor complications. For example, if a tooth root is brittle it may fracture due to previous trauma and/or a root canal treatment. This may require some surrounding bone removal to access and remove the fractured tooth root fragments. While this complication may sound dramatic, it is not—and is routinely encountered and planned for by an experienced dentist, periodontist or oral surgeon.

Immediately after tooth removal it is normal to place sterile gauze over the socket for 10-20 minutes with gentle pressure to control bleeding while a clot forms. Some small sutures (stitches) may also be placed over the socket to help control bleeding. As for your after surgery care, you will receive instructions for cleaning and caring for the extraction site. You may also be provided with any or all of the following: antibiotics, anti-inflammatory (swelling control) and analgesic (pain control) medication, usually of the aspirin/ibuprofen family of drugs as well as saline or antibacterial mouthrinses.

Tooth extraction is usually carried out with local anesthesia, numbing the teeth to be removed together with the surrounding bone and gum tissues. In addition oral sedation medication, nitrous oxide and/or conscious sedation can be used to render the experience anxiety free, relaxing and amnesic (“a” – without; “mnesia” – memory). This is usually required for more complicated or multiple tooth extraction. By the time the sedation medication has worn off you won’t even know it has been done.

It is important that all the potential risks, benefits and possible outcomes of tooth removal are reviewed with you beforehand, so you know what to expect.

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Oral Sex Increases Risk Of Oral Cancer

Here’s a crucial message for teens: Oral sex increases the risk of oral cancer and carries many of the same risks as sexual intercourse.

Oral Sex Increases Risk Of Oral Cancer

Oral Sex Increases Risk Of Oral Cancer

Here’s a crucial message for teens: Oral sex increases the risk of oral cancer and carries many of the same risks asoral sexual intercourse, including human papilloma virus, or HPV.  And HPV may now be overtaking tobacco as the leading causes of cancer in America in people under age 50.

“Adolescents don’t think oral sex is something to worry about,” said Bonnie Halpern-Felsher professor of pediatrics at the University of California, San Francisco. “They view it as a way to have intimacy without having ‘sex.’”

Here are some interesting statistics:

  • “Some 36 percent of teens ages 15-17 admit to having had oral sex.  These numbers increase among teens and young adults ages 15-24.”
  • “About 75 percent of teens ages 15-17 who have had intercourse have also had oral sex, while 13 percent of teens ages 15-17 who have never had intercourse have admitted to engaging in oral sex.”
  • “Nearly 25 percent of 10th graders in an upper middle class school district in New England reported having multiple oral sex partners within the last year.  The females reported having three to four partners.”

While tobacco was the prime cause of oral cancer in the past, recent studies have attributed the steady increase of the disease to the human papillomavirus (HPV). HPV are common viruses that cause warts. There are approximately 130 versions of HPV but only nine cause cancers, and the HPV16 version causes almost half of the oral cancers in the U.S.

Tobacco is no longer the only bad guy,  HPV16 is increasing in incidence as the causative etiology, and if it continues on this trend line, it will replace tobacco as the primary cause of oral cancers.

The latest data suggest that 64% of oropharynx cancer– growing in the middle part of the throat – in the United States are caused by HPV, which is more than tobacco causes, said Maura Gillison of Ohio State University. And as the number of partners on whom you have performed oral sex goes up, the risk of oropharnyx cancer goes up.

About 37,000 people per year receive a diagnosis of oral cancer, according to the Oral Cancer Foundation.

The media heavily influences the way kids act, feel and respond to sexually related issues. The messages communicated by the media are that sex outside of marriage is okay (and expected!), oral sex is not as big a deal as intercourse, and exploring multiple sexual partners and experiences should be encouraged. And these messages are becoming more common and explicit in relation to oral sex.

Another factor is the varied perceptions that teens have about oral sex.  A study in Seventeen magazine revealed that half of all teens ages 15-17 do not believe that oral sex is ‘sex.’ And why should we expect anything different? Teens are bombarded with the message that it’s okay, yet where are the voices telling them otherwise?

Parents should have honest conversations with their teenagers about oral sex. Tell them that the consequences of HPV may not happen right away, and while the risks may not be huge, they are significant. Potential long-term outcomes of cancer are quite concerning.

Dentists are usually the first to notice subtle signs and symptoms of oral cancer in a simple three to five minute visual and tactile exam. It is extremely important that the dental community continues to be involved in oral cancer screenings.

Of the 37,000 new cases of oral cancer diagnosed each year in the U.S., 25% of those people will die of the disease. Only 57% of all diagnosed oral cancer patients will be alive five years after their diagnosis.  Approximately 100 people in the U.S. will be diagnosed with oral cancer every day, and one person will die every hour from it.  In short, oral sex increases the risk of oral cancer.

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Charlie Sheen’s Two and a Half Teeth

While professionals seek to finally prove to him that he is in trouble, the Sheen teeth images have had no problem convincing the rest of the country of what drugs can due to your teeth.

Charlie Sheen’s Two and a Half Teeth

Charlie Sheen’s Teeth

Charlie Sheen appears to have had his porcelain crowns replaced with gold crowns.  The Two And Half Men star was recently released from rehab after going on a 36 hour drug binge with porn stars.  But his continued drug use has meant that it appears his porcelain crowns and/or veneers have had to be replaced with gold crowns.

The pictures taken of Charlie Sheen’s teeth during his bender look interesting, to say the least.  While the troubled star was busy with rehab, photos and videos of his last bender were being released online. In one of the photos, he looks more out of it than usual, with a wide smile showing that a lot of dental work has been done.  Yet Sheen’s problems began years before this latest breakdown, according to one of his porn star girlfriends.  TMZ received a video from the actor’s now infamous 36-hour party binge. In it, he is seen dancing with three of his many girls, at the home of friend George Santo Pierto. But it is a picture from that night which seems to reveal more about his condition.  Beforehand, Sheen’s teeth looked flawless, as he appeared to maintain his smile despite all of his drug use. Yet last week, he was caught smiling with his eyes closed, and with a good portion of his teeth broken and filled with gold.

Charlie Sheen on a bender

The mystery over this image was quickly solved by one of his porn star contacts. Kacey Jordan went on Howard Stern to explain that past drug use rotted out Sheen’s mouth. But since he didn’t like his porcelain crowns, he had gold crowns fabricated instead.  At the least, the Charlie Sheen teeth pictures aren’t a result of his latest drug induced spiral. Yet it confirms just what his previous benders did to him, and that his most recent binges obviously didn’t help any. Anyone could easily guess that this was the case, but it is another thing to see the effects.

Therefore, if the Sheen teeth photos are that bad from his past drug use, it stands to wonder how much more damage he’s done over the last few benders. But even in spite of that, he needed a lot of convincing to voluntarily check himself into rehab, and still may not think he has much of a problem.

While professionals seek to finally prove to him that he is in trouble, the Sheen teeth images have had no problem convincing the rest of the country of what drugs can due to your teeth.


How Drugs Can Cause Dental Problems


There are a number of things that cause drug induced dental decay. Part of the reason that the drugs themselves contribute to the breakdown of the teeth, according to the American Dental Association, due to the acidity of the drugs. The extreme acidity, along with the kinds of contaminants present in drugs, contribute to teeth that decay relatively rapidly. But that’s not the only reason. Here are some more reasons that drug induced dental decay can develop:
  • Cracked teeth: One of the signs of drug induced dental decay is cracked teeth. This happens when drug users grind and clench their teeth. This can happen both while under the influence of the drug and in the aftermath while experience withdrawal symptoms.
  • Dry mouth: Xerostomia, which is known more commonly as dry mouth, results when there is a reduction in the saliva that is formed. Saliva provides natural protection for teeth and gums. The use of drugs reduces the production of saliva, and that means that there is lower protection. This condition can be exacerbated by the fact that many drug users sometimes sleep for more than 24 hours at time – often with the mouth open.
  • Indifference to oral hygiene: One of the hallmarks of an addiction is an increasing indifference to matters of hygiene. This includes oral hygiene. Many drug users do not bother to brush or floss their teeth, or eat foods that can help strengthen and protect them. This leads to a situation in which the mouth is vulnerable to weak teeth, gum disease and other problems.

It is important to note that the problem of drug induced dental decay can be enhanced by tobacco use, consuming sugary drinks, and the fact that drug users rarely eat (many drugs are appetite suppressants), meaning that there is less of a change for saliva to be produced and used in the mouth.

Early Stages of Drug Induced Dental Decay( Not Charlie Sheen

Late Stage of Drug Induced Dental Decay (Not Charlie Sheen

You should also realize that drug induced dental decay can result from the use of many different drugs.  Even though it is called typically know as “meth mouth”, those who are addicted to other substances, including cocaine and even alcohol, may experience a similar oral condition. Additionally, those with problems related to saliva production – even if drug abuse is not an issue – can exhibit the signs of drug induced dental decay. Children, teenagers and adults who do not properly care for their teeth can also, over time, develop what appears to be meth mouth, even without going anywhere near drugs. However, in drug abusers, the characteristic signs of drug induced dental decay generally develop much fast.

If drug induced dental decay is not addressed, and the situation is allowed to continue, it can lead to a number of serious problems. It is possible for gum disease to develop, and for teeth to begin falling out. Additionally, oral cancer is a possibility. Another concern is that disease in the mouth can spread to other parts of the body. Also, poor oral hygiene can weaken the immune system, leaving someone with cavities more vulnerable to colds and the flu, and other attacks on the respiratory system.

I truly hope Charlie Sheen gets his life back on track. The point of this blog was not to bash Charlie Sheen, it was to educate the public of what drug use can do to your oral health.

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Top 6 Dangers Of An Abscessed Tooth Infection

A tooth abscess is a collection of infected material (pus) resulting from a bacterial infection in the center of a tooth.

Top 6 Dangers Of An Abscessed Tooth Infection

Tooth Abscess

You woke up in the morning, put your clothes on and went to eat breakfast. Everything seemed to be the same except an unpleasant feeling in your mouth accompanied by a general discomfort. You went to the bathroom, found a mirror and opened your mouth.

You then realized it was your tooth that was hurting.  Your tooth hurt when you bit down, you had a bitter taste in your mouth, you had hot and cold sensitivity in the area of your pain and you noticed an unpleasant smell coming from your mouth. More than likely you are suffering from an abscessed tooth infection.

A tooth abscess is a collection of infected material (pus) resulting from a bacterial infection in the center of a tooth.

Causes, Incidence, and Risk Factors

A tooth abscess is a complication of tooth decay. It may also result from trauma to the tooth, such as when a tooth is broken or chipped. Openings in the tooth enamel allow bacteria to infect the center of the tooth (the pulp). Infection may spread out from the root of the tooth and to the bones supporting the tooth.

Infection results in a collection of pus (dead tissue, live and dead bacteria, white blood cells) and swelling of the tissues within the tooth. This causes a painful toothache. If the pulp of the tooth dies, the toothache may stop, unless an abscess develops. This is especially true if the infection remains active and continues to spread and destroy tissue.


The main symptom is a severe toothache. The pain is continuous and may be described as gnawing, sharp, shooting, or throbbing.

Other dental abscess symptoms may include:

  • Bitter taste in the mouth
  • Breath odor
  • General discomfort, uneasiness, or ill feeling
  • Fever
  • Pain when chewing
  • Sensitivity of the teeth to hot or cold
  • Swollen glands of the neck
  • Swollen area of the upper or lower jaw — a very serious symptom

An abscessed tooth must be treated. If it is ignored then tooth abscess complications are inevitable. Here are some of the dangers of tooth abscesses:

1. Loss of the tooth

  • Many times a tooth becomes non-restorable (not able to be fixed) because of an abscess and requires a dentist to pull the tooth. It can be a painful process and you need to avoid it.

2. Spread of infection to the jaw bone

  • Mandible (lower jaw) or maxilla (upper jaw) are strongly effected by abscessed tooth infection.

3. Spread of infection to soft tissue

  • Ludwig’s angina is a type of cellulitis that involves inflammation of the tissues of the floor of the mouth, under the tongue. It often occurs after an infection of the roots of the teeth (such as tooth abscess) or a mouth injury.

4. Sinusitis (Sinus Infection)

  • Any infection or inflammation of the sinus cavities behind the nose and eyes. Symptoms vary according to which sinus cavity is infected.

5. Brain abscess

  • This very important organ is situated close to the infected area. Tooth abscess and abscesses in and around the nasal sinuses, face, ears, and scalp may work their way into the brain.

6. Blood infection

  • The blood flow increases to the trouble area. If the abscess ruptures into neighboring areas or permits the infectious agent to spill into the bloodstream, serious or fatal consequences are likely. It is called blood poisoning – a term commonly used to describe an infection that has spilled into the blood stream and spread throughout the body from a localized origin. Blood poisoning, known to physicians as septicemia, is also life threatening. In this case important organs are affected like heart, for example.

Now you know that an abscessed tooth can result in a serious problem.  The next time when you feel uneasiness and dental pain you should not ignore it and pay a visit to the dentist.  Doing so in a timely manner reduces the risk of tooth abscess and eases you from its dangers.

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3D Digital Dental Scanning Of Teeth May Soon Replace Plaster Models

Cadent iTero is one of the first systems with powered by proprietary imaging technology, enabling the dentist to take a powder-free digital scan of the patient’s teeth.

3D Digital Dental Scanning Of Teeth May Soon Replace Plaster Models

Cadent iTero

Using current technology, dental technicians typically make dentures, removable partial dentures, and dental crowns using a bite impression. The silicone template for this plaster model is made by the dentist, in a procedure which is unpleasant for the patient. In the future, a 3-D  dental scanning provide the teeth contours – without a plaster dental model.

When a toothache makes a visit to the dentist unavoidable this often marks the start of a time-consuming treatment marathon for the patient. If the tooth cannot be saved and a dental prosthesis is necessary, the dentist first has to make a silicone dental impression for the dental laboratory. The patient is sent home with a provisional repair and dental technicians set to work on modeling a plaster impression.

The intricate and laborious route from bite impression and plaster mold in the laboratory is now becoming a thing of the past.  The three-dimensional coordinates of the tooth surface can now be determined on the basis of measurements taken in the patient’s mouth and digital dental impressions fabricated.

Dr. Peter Kühmstedt, an expert team at the Fraunhofer institute developed an 3D digital scanner which scans the oral cavity and captures three-dimensional data of the teeth using camera optics. A complete picture of the individual tooth is created from several data records. After an all-round measurement, it is even possible to represent the complete jaw arch as a virtual computer image. The measurement conditions in the confined oral cavity are, however, unfavorable.

To obtain precise results, the scientists use fringe projections in which a projector shines strips of light on the tooth area to be measured. From the phase-shifted images the evaluation software determines the geometric contour data of the tooth. Two camera optics provide the sensor chip with image information from different measurement perspectives. After the pixel-precise comparison of various camera images, the evaluation program recognizes any image faults and removes them from the complete image.

It is problematic if the patient moves while the images are being taken in the oral cavity. The scientists have therefore made sure that the process takes place quickly. “The image sequence for each measurement position is captured in less than 200 milliseconds,” explains Kühmstedt.

Cadent iTero is one of the first systems with powered by proprietary 3D scanner software, enabling the dentist to take a powder-free digital scan of the patient’s teeth and bite, make any necessary adjustments in real-time, and then transmit the file via a wireless Internet connection to a Cadent-partnering laboratory for further processing. From there, the digital file is transmitted to Cadent where a precision milled model is created and shipped to the laboratory within 48 hours. The laboratory also can import the iTero STL file into its lab-based CAD/CAM milling system for direct production of copings and full coverage CAD/CAM restorations. With significant benefits such as increased patient satisfaction, improved clinical outcomes, and enhanced office efficiencies, iTero is making an impression…125,000 of them and counting.

Straumann, a global leader in regenerative, restorative, and replacement dentistry will begin marketing Cadent’s iTero’s digital impression system as of February 1st, 2011.

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