Friday, October 31, 2008

Candy: The Halloween Dental Scapegoat

Halloween candy. Those words go together like, well, like tooth and decay. Many parents see the kids' Halloween candy haul and start imagining numbers of cavities. Tis the season...  We also need to be mindful of ways to prevent cavities on all of the non-candy-holiday days of the year as well.  

Sugar gets most of the headlines, but many foods can cause tooth decay.  The bacteria in our mouths enjoy carbohydrates from "healthy" foods as well. How often we eat also plays a role. Constant snacking keeps our teeth in contact with food more often and allows plaque to thrive.
It is important to brush after every meal to keep the bacteria colonies at bay. The faster food particles are removed, the better your chances of avoiding decay. Oh, and visiting the dentist regularly can't hurt either.

Go ahead, live in the spirit of the day. Just don't forget sound oral hygiene for the other 364 as well.  Happy Halloween.

Thursday, October 30, 2008

Chewing Ice--Don't Do It!

One of my employees was chomping on ice today when she saw me and said, "I know, I'm not supposed to chew ice! But what's the big deal? Besides, it's crushed ice."

The big deal is that even with crushed ice you could be causing microfractures in your teeth. These are thin cracks that travel from the crown of your molar down to the root. This means that bacteria, and possibly infection, can now pass through your tough enamel and get all the way to the root and nerve of your tooth.

The result is you are susceptible to decay without it being obvious like a cavity. If you were to shine a light from behind your teeth, you would very likely be able to see some of these cracks.

As strong as enamel is, as the hardest bone in your body, your jaws are very powerful, and your teeth aren't for crushing ice, or opening bottles or really anything except eating regular food.

Don't risk needing a root canal down the road, or worse, losing a tooth. Talk to your dentist about this. Chew gum instead. But make sure it's gum with xylitol in it, not sugar or some other non-sugar sweetener. The xylitol is actually good for your teeth. And if you don't have a dentist, time to get one, especially if you're using your teeth as an ice crusher!

Wednesday, October 29, 2008

Into the Mouths of Babes

The story of Leta's trip to the dentist is a great illustration of a story I have heard time and time again:girl fears dentist, dentist meets girl, girl loses fear, girl loves dentist.  It's as old as the hills.

Our operators at 1-800-DENTIST hear from fearful patients on a daily basis. We match them with a great dentist, they lose their fear, they love the dentist. We're not quite as old as the hills, but we have been doing it since 1986.

Whether you are a fearful adult or you have a fearful child, a visit to the dentist shouldn't be a thing of dread. Something as simple as a free toothbrush can put your child on the road to great dental health and enjoyable trips to the dentist. Download a free toothbrushing chart to make brushing at home a fun event.

If you are a fearful parent, take a deep breath and go see the dentist.  Set a good example. There may just be a free toothbrush in your future.

Tuesday, October 28, 2008

Using Up Your Dental Insurance

Many people who have dental insurance (which is not at all like health insurance--but I'll get into that in another blog) have a limit that they can use each year, and then it resets, or runs out, to put it more accurately.  Often patients don't realize that if they don't use their limit in the current benefit year, they lose it. It's a little bit like vacation time at certain companies--it doesn't accumulate.  It's a "use it or lose it" scenario.

Most insurance plans have so many different elements to them, and most insurance companies have dozens if not hundreds of variations in their plans.  And it's very hard for dentists to keep up with how their patients are covered, and so it becomes the responsibility of the patient to keep track of their coverage.

Now is the time of year when you should be looking at your plan, and if you need some dentistry, get to your dentist before the end of the year and get it done.  While I disagree with the way dental plans control your treatment, if you have coverage you might as well take advantage of it, even if it's inadequate.

If you don't have a dentist and you have coverage at work, you're neglecting an important part of your health. While it's a bit bizarre that health insurance stops at your lips, not much is going to be done about that anytime soon.  Despite this, the health of your teeth and gums is directly tied to your overall health.  Don't wait until it hurts.  That's a sign you waited to long.

Use your insurance--it's there to keep you healthy.  Find a dentist who takes it and who is also someone you think you'll like going to.  If you love your dentist, I believe you'll go as often as you should.

Monday, October 27, 2008

How People Choose a Dentist

After a couple of decades in the dental referral business, I've found that there are five basic ways that people find a new dentist. They are:
1. Ask a friend, neighbor or coworker
2. Pick one randomly from an insurance provider list
3. Look in the yellow pages
4. Call from an ad on TV, in the newspaper, or from a mailer
5. Look online

While some of these are good and some are totally random and unreliable, here are the questions you should be asking yourself.

With asking someone you know, how do you really know how they evaluate the dentist? Have they been to several, and settled on this one? Or do they just like the hygienist? What do they really know about their dentist and his qualifications versus others in the area? Usually not much.

Picking from an insurance provider list is obviously like using a dartboard, where you end up choosing by the sound of a person's name (we all do it!)

Yellow pages is almost as bad. First of all, the ad runs for a year, without changes or corrections. The dentist could have lost his license one week into the release of the book. But mostly, this is just an upgraded dartboard. You may be able to tell some of the services they offer, but my experience is the bigger the ad, the worse the dentist--that's my personal opinion, your mileage may vary.

Calling from an ad or mailer is okay, but it doesn't give you any screening feedback on the dentist. It's still just an unfiltered message about the practice.

Going online may give you more information, and that's significantly better. If the dentist has a website then you can get a feel for the practice, and see what they have to offer for services. Unfortunately only 30% of dentists have a website, and most of them are not very comprehensive.

My business is different than these other methods for several reasons: first, we check the licenses of the dentists on an ongoing basis. Second, we make sure they have adequate malpractice insurance in case anything goes wrong. Third, we find out everything about the practice and put it in our database in a searchable way.

But most important is that we're sending people to our dentists, who are independent practices, by the way, and getting feedback on the experience of seeing them. If the experiences turn out to be negative, we drop the dentist. But some of the dentists we've been referring to for 20 years without a complaint, literally thousands of people sent to their office. But no one gets to stay a member if they don't meet our standards.

And they don't get to be members just because they pay. Our screening process is harder than any other dental organization. And certainly a lot harder than the dental societies. With them, it's pay your dues and you're a member. That's not us.

Choosing a dentist can be easy if you use the right resource. We try every day to be that resource, and get better and better at it. And if you didn't experience that with us, I want to know about it.

Friday, October 24, 2008

Bleeding Gums--Not Normal!!

Proctor & Gamble recently did a survey on consumer thinking about their oral health and one of the statistics was that 33% of the people in the United States believe that a little gum bleeding as a result of brushing their teeth is normal.

It's not! It may be typical, as 50% of the population over 35 has some level of
gum disease, but it's not normal. If your hands bled a little bit after you washed them, would you think that was normal? Your gums should never bleed, not when you're brushing, not when you're flossing, or not when you're eating. Bleeding gums means that you have allowed some level of decay to occur in your mouth.

If there is infection around or below the gum line, gradually your gum is going to recede from the tooth, exposing the softer area below the tooth enamel. The result most often is you will end up needing a root canal, or possibly have to have the tooth extracted.

If you have a dentist, you should tell him or her that your teeth bleed when you brush or floss. Usually this means there will be much more bleeding when you get your teeth cleaned, so they can usually see the problem anyway. The hygienist is also going to check how much your gums are receding, and if there are any pockets of infection below the gum line. A dentist can fix this. But you should also be finding out the proper way to
brush your teeth--you may be brushing way too hard or with the wrong type of brush if there is bleeding.

If you don't have a
dentist and your gums bleed at any time for any reason, this is a clear indicator you need to see one quick before the problem gets any worse. Find a dentist that you like and then you will go as often as you should. Unless you think it's normal not to have all your teeth, then don't think it's normal to have gums occasionally bleed.

Thursday, October 23, 2008

Gum Disease and Heart Disease

An employee told me today about his grandmother, who never took care of her teeth and had lost most of them, and because of the disease in her mouth and gums, she developed a heart aneurysm and died. This is one of the reasons he feels so committed to working here, convincing people to go to a dentist and helping them to find one. This is very personal for him.

What people are gradually learning is that gum disease can put bacteria into your bloodstream, and often this bacteria is the same bacteria that causes the buildup of arterial plaque. (Odd that it forms plaque in your mouth and your arteries--or maybe it isn't so odd.) It has now been shown to possibly cause a stroke.

It doesn't seem that neglecting your teeth could be fatal, but it is possible. The gums lead directly to the bloodstream--it's why heart patients put nitroglycerin under their tongue when they feel a heart attack coming on. The body absorbs it very quickly. The same is true when you don't control the bacteria in your mouth.

Crazy stuff, but true. Being afraid of the dentist is potentially life-threatening.

Wednesday, October 22, 2008

Invisalign-The Best Alternative to Braces Yet

Sometimes modern technology actually does make things better. What I've seen in the past few years is that the Invisalign system for orthodontics is a radical improvement in moving teeth. First of all, they are removable. Secondly, they are clear, not metal. Third, because they are smooth and not metal, they are not shredding your tongue and lips.

Adults who would never consider braces are using Invisalign to straighten their teeth, sometimes just a few skewed teeth who have wandered from the herd, but occasionally the full mouth. And the way Invisalign works is simple and brilliant.

First, an impression is taken of all your teeth. Then your dentist works with Invisalign advisors to design the proper movement of all your teeth, and then software plans the gradual movement of the teeth, and designs a series of retainers that are then made by the company and sent in batches to the dentist. Usually you wear a retainer for around two weeks and move on to the next one.

Very often Invisalign cases are finished in a year. This is also fairly appealing, but even if it were longer, then it wouldn't be as bad as metal braces. Not everyone is a candidate for Invisalign, though. The more extreme cases may require metal braces first, or some extractions, but they are getting better and better at the effectiveness of Invisalign all the time.

Also, it was not recommended for teenagers, because their mouths are still forming, but that has also improved. There are now many more younger people who can use Invisalign. The greatest challenge with Invisalign is that, because they are removable, people leave them out too long and slow their treatment down. Teenagers are the worst at this, as you can imagine.

Straight teeth are a good thing, not just because they look better but because, in the end, they are also healthier. Tight, crowded or crooked teeth are very often traps for food and decay, and also are at greater risk for gum disease. And it all gets worse from there.

Modern technology, it can be a beautiful thing!

Tuesday, October 21, 2008

Do Electric Toothbrushes Make a Difference?

People ask if these various types of electric toothbrushes are worth buying.  Let me first say that a dentist friend of mine, Dr. Shah, starts with every new patient by explaining how to brush their teeth. He estimates that 90% of people don't brush their teeth properly.

I use the Sonicare Pro Health toothbrush.  What I've seen is that there is a significant benefit to using an electric brush, and ideally a sonic one.  There is no way you can move your hand fast enough to replicate the action of these brushes, and people have found that they have much easier dental cleanings when they use them.  This was my experience when I switched to a sonic toothbrush.  And easier cleanings is reason enough.

There is an adjustment period with these brushes.  The first time you touch your tooth with the vibrating plastic rather than the bristles is a real eye-opener.  But you'll quickly learn to manipulate the brush properly and the result is a great, clean feeling.  They are also excellent for brushing your gums and tongue (which you should.)  You also need to wrap your lips around them in a very specific way, not the wide-mouthed approach that you can use with a regular toothbrush, otherwise you will have toothpaste spray all over the bathroom mirror.

My particular Sonicare has a special feature that disinfects the brush portion with an ultraviolet light (I'm a bit germ-phobic.)  I have tried various Oral B brushes, and am less impressed.  Their Triumph felt like a jackhammer.  And the Ultreo, the most expensive of all, designed by the former Sonicare inventors, is not as impressive as its price.  And I can't figure out what the rubber block in the middle of the bristles is for.  And three of them went defective on me in a row.

Don't forget to change the brush every three months or so.  If the bristles are starting to bend, it's time.


Monday, October 20, 2008

Healthy Teeth Equals Quality of Life

I was just reading one of my favorite blogs, from the author Daniel Pink, who wrote "A Whole New Mind," which is a very astute book about how design is essentially taking over every element of our lives, and the people who create those designs will "rule the world". His new premise is that "frugality will be the new ostentation." In other words, spending money wisely will now be more respected than bling.

My take on this is that healthy teeth is more than just a hygiene issue, it's a quality of life issue. If the average 30-year-old is going to live well past 100, as scientists tell us, then you are going to want to be eating. In fact, it may be one of your primary pleasures when you hit your next century.

Which means smoking isn't a good idea. Along with the thousand other things that it does to shorten your life, it increases the risk of cavities in your teeth. And don't leave missing teeth missing. Get a dental implant, or your teeth will spread out and you'll keep losing them, and eventually need dentures, or a lot more implants. It's cheaper to keep 'em, as they say.

Teeth are actually a great investment. Feeling better, looking better, eating better all add to the quality of your life. And the more you take care of them now, the less you'll spend on them in the future. The new frugality, remember?

That means finding a dentist you love and going to them. If you don't love them, you won't go as often as you should. And that is a cascading problem.

And if you follow Dan Pink's advice, find a dentist will a well-designed office. I agree with that too!

Friday, October 17, 2008

The Fearful Patient

I just talked one of my employees, who admitted to being an extremely fearful patient, and told her she had to get to the dentist. Angel kept insisting that she needed someone gentle, that everything hurts, and expressed the usual fears. I explained that she should go to this specific dentist, Dr. LaBounty, because I know how gentle both he and his hygienist are. I also told her she should ask for nitrous oxide for any treatment she has.

She told me she had a root canal a while ago but never put the crown on--that there was just a hole there--but it didn't hurt. I said, "Angel, you're not going to grow a new tooth. You're not a shark. That's not what happens in humans." She laughed. I think she realized that her procrastinating was only going to make things worse.

I stood there while she called and made an appointment. Her heart was actually racing. It reminded me how afraid many people are, and how important it is for dentists to realize this and make the extra effort to put their patients at ease, use the best comfort-conscious technology, and do their best to educate their patients. It made me even more resolved to make sure that the dentists that we recommend to people at 1-800-DENTIST are compassionate, caring, and use the latest technology.

Angel has an appointment on Monday. I'll bet she goes, and it changes her whole experience of the dentist.

Thursday, October 16, 2008

The Successful Smiles Blog: Let Your Kids Enjoy Their Halloween Candy

This is a well-known Boston dentist's take on eating candy.

The Successful Smiles Blog: Let Your Kids Enjoy Their Halloween Candy

Halloween--the dentists' holiday!

What an amazing holiday. We keep a giant bowl of candy in the house for about a week, and then distribute more candy in a night than anyone should eat in a year. The worst thing you can do for your teeth is eat candy all through the day, or worse, right before you go to bed. And not to sound like a mom, but you need to brush your teeth after you eat candy. Sort of ruins the taste, I know.

But here's the problem: the bacteria in your mouth love sugar. The devour it like a ten year old devours candy, and then the bacteria secrete acid which causes the teeth to decay, first as cavities, more typically in children, and then also as gum disease in adults.

So what do you do? Some simple rules:
1. Have specific times when you or your kids eat candy, and limit the quantity.
2. Brush soon after, or at least rinse with water.
3. Avoid the stickier, gummier candies. They adhere to the teeth and provide a much more sustained sugar supply to the plaque bacteria.
4. Don't let your kids have a "stash" of their new booty. If they see it, or know it's there, they'll eat a lot more of it. This goes for adults too. Probably even more.

A friend of mine gives out candy and toothbrushes at the same time on Halloween. Don't try just toothbrushes or you'll get a trick for sure!

If your kids have eaten a lot of candy around this holiday, make sure they see a dentist soon after. The best time to treat a cavity is early on, when it has done little damage to the enamel.
If they don't like to go to the dentist, find one with a better chairside manner. The right dentist can be the authority figure with your children (taking you out of that role for at least one thing!) and at the same time help your kids learn to appreciate good oral hygiene.

Wednesday, October 15, 2008

How to Choose a Dentist

I have one basic rule when it comes to finding a dentist, and that is if you love the dentist, then you'll go as often as you should, and that will help you save your teeth and give you the best smile. But to be more specific, here are some things to check out:

Is the staff friendly? If not, why bother going there? There are plenty of dentists, and many of them have great staffs.

Does the dentist offer a wide range of services? Dentistry has changed a lot in the past 20 years.
There are dentists who do Zoom whitening or some other in-office system.
There are dentists who have same-day restorations, which means you don't need to get a temporary. The machine they use is called a CEREC.
There are dentists with dental lasers, some using them for root canals and even cavities.
There are dentists who do same day dental implants.
There are dentists who do no-preparation veneers, like Lumineers or Vivaneers.
There are dentists who offer Invisalign, which are invisible braces.

Find the one that does what you want, and has what you would like. They should have technology that makes your experience more comfortable, and gives you the best, longest lasting results.

Does the dentist have a good chairside manner? Dental visits are seldom fun. But many dentists are very aware of that, and do their best to put patients at ease.

Is the office clean? Basic, but this is your mouth we're talking about, not your shoes.

Is the dentist well-trained? He or she should be getting ongoing training every year, and you should be able to see certificates of that training displayed in the office or on the website.

Has the dentist been sued for malpractice? This is really hard to check on your own. At 1-800-DENTIST, the only dentists that we refer are ones whom we've done a background check on for a history of malpractice, and we check their license as well.

You can search for all these criteria online at, or you can call and find a practice that does what you want, knowing that 1-800-DENTIST has sent hundreds of patients to the dentist without a complaint. To find out more about dental technology, visit

But either way, find a dentist that you love. Otherwise, you'll put it off, and that's not good.

Tuesday, October 14, 2008

The Myth About Cavities

I hear adults all the time saying, "I haven't had a cavity in years. I don't need to see a dentist." Sorry. The fact is that after your 20's your greatest risk isn't cavities, it's gum disease. Brushing and flossing (even if you did it daily) aren't nearly enough to prevent gum disease as you get older.

Here's what's happening. There are millions of bacteria in your mouth, and some of them get organized into little colonies, and they love to eat sugar and secrete acid. This acid might give you cavities, but it most likely will travel between your teeth and gums, and gradually separate the gum from the tooth, until you are, as they used to say, "long in the tooth."

Receding gums are bad, and very hard to fix. They expose the tooth below the enamel, which is the hardest bone in the body, and allow decay to reach the softer tooth area below.

But that's not all. Gum disease means that the bacteria have been allowed to travel deep below the gum line, and create pockets of infection. This means you could eventually lose the tooth. Symptoms are bad breath, bleeding when you floss, redness instead of a healthy pink color to your gums, and sensitivity at the gum line.

The only solution is to see a dentist and get cleaned regularly, at the very least every six months. Some people should go even more. (The cleanings are also a lot easier if you go more often.) This removes the plaque, which are the little bacteria villages secreting acid. And if you have gum disease, a dentist can start a program to treat it and allow you to keep your teeth.

50% of the population over 35 has some level of gum disease. My advice is find a dentist you love, and that way you'll go often. Call 1-800-DENTIST or visit, and they'll help you find one. If you suspect gum disease, don't wait until it's too late and you need a root canal or lose the tooth. It won't heal itself, not with some mouthwash or by brushing harder. Get yourself to a dentist. Preachy, I know, but teeth are important.

Monday, October 13, 2008

Why Get a Dental Implant?

Most people don't realize the impact of a missing tooth on their overall tooth health, but two very serious things happen, and they start to happen quickly. First, the surrounding teeth start to space out. This will make them looser, and also more susceptible to gum disease. Second is the jawbone starts to recede from the area where the tooth was. This is because having a tooth stimulates the bone, and without that stimulation the body assumes it doesn't need bone tissue in that area. You can see where, the more teeth that are missing, the more these two problems would increase.

For the past few centuries, all you could do was put a partial bridge in to fill in the area, or if there are many missing teeth, dentures. Now there are dental implants, and they are drastically better. Everyone knows the problems with dentures, and even though they're better than no teeth at all, eating is restricted, your appearance changes, and you just plain feel old. Implants , on the other hand, are as strong or stronger than regular teeth, and last a long time, while keeping the jawbone stimulated.

Essentially dental implants are porcelain crowns that are fixed to a screw that is placed directly into the jawbone. Sounds a little strange, but very effective, and the jawbone grows very quickly around them to hold them in place. It's not a particularly uncomfortable procedure, especially if a dentist uses a dental laser to prepare the gum tissue.

Implants are relatively expensive, but generally a great investment, since most likely you'll be eating for many years to come. And now many times implants can be placed in a single appointment, which is vastly different than it was even five years ago, when it would take up to six months to complete. Also, a handful of dentists are using a 3D cone-beam scanner in order to place the implants in exactly the right place. I think this is a fantastic innovation, and I hope a lot more dentists will get one soon.

To read more about dental implants and find a dentist who does them, go to To read more about 3D cone beam scanners, go to