Dental caries (cavities, decay) is still very prevalent in today’s society. There are many factors that contribute to dental decay. In addition, there are some people who are more susceptible to decay than others. In a recent article in the Journal of the American Dental Association (JADA), sugar-sweetened beverages, one of the main culprits for dental decay, was discussed.

Dental decay is a multifactorial disease characterized as an infectious process during which carbohydrates are fermented by specific oral bacteria at the tooth surface. This results in acid production and enamel breakdown. It should be noted that the beverages described in this column are not the only things that lead to dental decay. Anything rich in… (Read More)

In a recent study published by the American Dental Association (ADA), visits to the emergency room (ER) for dental related issues have doubled nationwide over the last decade. Last year, over 2.1 million people visited the ER for a dental “emergency”, most of which could have been prevented with regular dental visits.

In another recent collaborative study between the Rutgers School of Dental Medicine and the Rutgers Center for State Health Policy, they confirmed that most of these ER visits were for dental pain and infections that were not related to trauma. This is an increasing burden on the taxpayer and the healthcare system. ER visits can be 10 times more costly than if the… (Read More)

Over the course of my 22 years in dentistry I have witnessed some significant changes in the materials that are used to restore teeth. In fact, most of the materials I use today were not in existence when I started to practice. The demand for materials that are tooth-colored have taken over. There are very few patients who ask for gold or silver fillings any more. And, while some of these newer materials are white, there are many factors which need to be considered in determining what material is appropriate for each individual situation.

As I said last week – The best dentistry is NO dentistry. Prevention of decay and other factors that require teeth… (Read More)

Here are a few answers to questions asked by readers:

Jim H:  I was recently told by a dentist that I need a root canal, a post, periodontal crown lengthening surgery and a crown. The total cost of treatment is $3500! Do I have any alternatives?

That is a difficult question to answer without seeing the specific case but here are some thoughts. There are quite a few things to consider. The first is the general condition of the teeth. If you have numerous other dental problems that need to be addressed, you must prioritize these and decide if the cost of doing them all is something you can afford. The last thing you want… (Read More)

Head and neck surgeons are knowledgeable about the human papillomavirus (HPV) and show generally positive attitudes and beliefs about HPV education and vaccination, according to a new study in JAMA Otolaryngology–Head & Neck Surgery. However, 68.9% reported that their daughters had received or would receive the HPV vaccine, while 55.8% reported that their sons had received or would receive the vaccination.

The relationship of HPV to oropharyngeal cancer is now well-established, with 40% to 80% of cases of oropharyngeal squamous cell carcinoma (OSCC) in the U.S. estimated to be related to HPV, noted the U.S. team of researchers. The incidence of OSCC has been increasing over the past 30 years in many parts of the… (Read More)

As I discussed last week, dentistry is full of old, new, and emerging technology. For example, the different ways to use dental implants over the last 30 years has been a major game changer in the field of dentistry. Likewise, CAD/CAM technology (computer-aided design and manufacturing of dental restorations) has seen steady growth over the same 30 years. Here is a little background on the some of the reasons this technology is here to stay.

Let me start by saying that the best dentistry is NO dentistry. Prevention of decay and other destructive things that happen to teeth is the best line of defense. Having said that, the fact of the matter is, there are… (Read More)

Many people avoid technology as long as possible and others embrace it early. For many of us, it’s not easy to decide when, how, and even if, to incorporate different technological advances into our lives. My dilemma is often whether the cost and learning curve will be worth it in the end. How do we know whether the investment in time and money is really any better than an “older model”? Technology is great, but there is no arguing with historical success.

Technology does come at a cost. While we would all love to have unlimited resources to purchase everything that catches our eye and try it out, this is not reality for most of… (Read More)

It is amazing to think that a short time ago we didn’t have pocket cell phone computers or the internet to gather information. Today, everyone searches the internet to get information about everything. That includes where to eat, where to travel, who to see for a doctor, diagnosing conditions, and even treatment options. The information out there is overwhelming and constantly growing.

I have had four patients this past week who presented with issues in which they came armed with self-diagnosis and/or solutions. Much of the information people came with was good. An informed patient can make better decisions on treatment that meets their needs. However, there was also some misguided information. Although it does… (Read More)

A couple of weeks ago I discussed the different types of materials that are being used today to “fix” teeth. I broke them down into two main categories – direct vs. indirect materials. Direct materials are things like silver amalgam and tooth-colored resin/composite that are placed directly into the tooth after the tooth is prepared. Indirect restorations are things like crowns, gold and ceramics in which the tooth is prepared and a manufactured restoration is cemented or bonded to the tooth.

Whatever your feelings are on amalgam, there is no disputing that it proved to be a very successful material over a long period of time. Despite this, it has not been used in most… (Read More)

One of the most important things you do when visiting a new physician or dentist is to fill out a medical history form. Many patients balk at filling out these forms, and in my experience, a high percentage of patients fill them out incompletely. There are many risks involved with not including all prescribed and self-prescribed medications.

The most frequently prescribed medications by therapeutic category are anti-hypertensives (blood pressure), cholesterol regulators, antiplatelet and anticoagulant agents (blood thinners), respiratory agents, antiulcer drugs, antidepressants, hypnotics, and anti-diabetic medications. In addition to including any of these medications on your history form, it is also very important to include any over-the-counter (OTC) drugs, as well as vitamins and supplements.