Dr. Mitchell A. Josephs' Blog - This is the blog for Palm Beach Dentist Dr. Mitchell Josephs and is about topics related to cosmetic dentistry, implant dentistry, root canals, and general oral care.

Avoiding Bone Grafts and Sinus Lifts Before Implants

Posted on: February 21st, 2012 by Dr. Mitchell Josephs No Comments

Q: I am missing my bottom back teeth and was told I need complicated jaw surgery and bone grafting even before the implants are placed. Is there another means to avoid this costly and aggressive procedure? Carol in Boynton

A: I would need to see digital images of your bone to properly answer this, but many times the above can be avoided by the old stand-by: The K.I.S.S rule. Keep It Simple Stupid. (Or in my neighborhood growing up, Keep It Simple Shlomo.)

“When insufficient bone exists, osseous grafting and ridge expansion are surgical options, but have serious morbidities (non-fatal complications or failures of the procedure), according to a recent article by Dennis Flanagan DDS in the Journal of Oral Implantology. A technique using a very short 6.5×5 mm implant may be placed at steep angle to successfully support permanent bridge/crown work, allowing you to “K.I.S.S.” your dentures goodbye! For free consumer info on this, contact us or attend our seminar.

EDITOR’S NOTE: Dr. Mitchell Josephs will be giving a FREE LECTURE on Incision-Free Dental Implant Surgery, Digital Crowns & Veneers and Choosing a Dental Office, at the Ross Jewish Community Center on Jog Road in Boynton Beach on Wednesday February 22^nd at 10:00 am. Attendees will receive a FREE copy of his book: “Tooth Talk”. Seating is limited. Call “Shawn” at 561-259-3016 to register.

Dr. Mitchell Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts the “Tooth Talk” radio on WBZT AM1230. (www.radiotoothtalk.com) Dr. Josephs is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry.

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drjosephs@palmbeachdentist.com
44 Cocoanut Row, Palm Beach, FL 33480
888-DRTOOTH (888-378-6684)
www.palmbeachdentist.com

Tags: bridge, bridge work, crown, dental implants, dental procedures, Dr. Mitchell Josephs, Implant Surgery, osseous grafting, ridge expansio
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Implants to Secure Loose Dentures- How many?

Posted on: February 14th, 2012 by Dr. Mitchell Josephs No Comments

Q: My dentist wants to place four implants to hold my dentures in place. To save money, why can’t I have just two like other friends of mine had? Sol in Lake Worth.

A: Trust me on this one. It’s not because your dentist needs to recoup his losses from betting on the Patriots. It is always recommended to place at least four implants to create adequate retention to secure full dentures. IF (and this is a big “IF”), you have an adequate amount of bone to accept the implant.

Four allows a back up: If one implant should be rejected, you still have three left to serve as a source of good retention. Another benefit to four is that if they are placed far enough apart on the upper jaw, the thick, bulky palate of an upper denture can be cut out, allowing you to have the luxury of feeling the roof of your mouth again with your tongue. The surface of the palate actually helps in taste sensation. The February 2012 Consumer Report showed 91% of patients had no pain or problems with implants. For a free consumer guide on Implant Overdentures, contact us or attend our next seminar.

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drjosephs@palmbeachdentist.com
44 Cocoanut Row, Palm Beach, FL 33480
888-DRTOOTH (888-378-6684)
www.palmbeachdentist.com

Tags: ask dentist, dental implants, dental procedures, dental questions, dentures, Dr. Mitchell Josephs, palm beach dentist, tooth implants
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Implant Crown to Match Veneers

Posted on: February 7th, 2012 by Dr. Mitchell Josephs No Comments

Q: I am about to get porcelain laminate veneers on my top 10 teeth, but one tooth is missing. I will need an implant, but am concerned that the crown on this tooth will not match the veneers on the adjacent teeth. Debbie D. in Lantana.

A: No worries, Ms. “Double D”. (er… I mean Ms. Debbie.) Your aesthetic scenario has challenged us tooth docs for decades. A veneer is a thin facing of porcelain that is permanently adhered to the front surface of the tooth for cosmetic purposes. Some degree of your natural tooth shining through the veneer allows for a natural looking “warmth” and translucency. To accomplish this with a tooth being replaced by a metallic, gray metal titanium implant takes some ingenuity. We are now able to select tooth colored custom implant abutment posts to anchor metal-free all-porcelain crowns to their respective implant. These tooth colored abutments act as your adjacent real teeth that have been prepared for veneers. I will be covering this topic at my next seminar.

Dr. Mitchell Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts the “Tooth Talk” radio on WBZT AM1230. (www.radiotoothtalk.com) Dr. Mitchell Josephs is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry.

____________________________________________________________

drjosephs@palmbeachdentist.com
44 Cocoanut Row, Palm Beach, FL 33480
888-DRTOOTH (888-378-6684)
www.palmbeachdentist.com

Tags: cosmetic dentistry, dental implants, dental procedures, Dentist, Dr. Mitchell Josephs, palm beach dentist, porcelain veneers, tooth talk, translucency
Posted in dental, Dental Implants | No Comments »

General Surgery and Dental Damage

Posted on: January 31st, 2012 by Dr. Mitchell Josephs No Comments

Q: I am scheduled for open- heart surgery and am concerned about damage to my dental work. A friend of mine had a bad experience, which cost him thousands of dollars in repairs. How can I avoid this? Arthur in Boynton Beach

A: Firstly, I wish you only the best outcome of your surgery. I am impressed you are thinking of your teeth and your ticker! Dental damage caused by trauma from the anesthesiologists’ intubation process accounts for one-third of all medicolegal anesthesia claims, acceding to the Mount Sinai Journal of Medicine (now stuck between my front car seats.) These accidents are usually caused by the anesthesiologist using the upper front teeth as a fulcrum for their laryngoscope while placing the breathing tube.

To avoid damage, loose teeth can be tied with suture material which would prevent dislodgement into the air way or esophagus. I take impressions on my patients pre-operatively and have a specialized custom mouthpiece fabricated, which will prevent all possible damage to their teeth and dental work.

Dr. Mitchell Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts the “Tooth Talk” radio on WBZT AM1230. (www.radiotoothtalk.com) On staff at Good Samaritan Medical Center, Dr. Mitchell Josephs is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry.

____________________________________________________________

drjosephs@palmbeachdentist.com
44 Cocoanut Row, Palm Beach, FL 33480
888-DRTOOTH (888-378-6684)
www.palmbeachdentist.com

Tags: anesthesiologist, ask dentist, breathing tube, custom mouthpiece, dental, dental damage, Dr. Mitchell Josephs, laryngoscope, open-heart surgery
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Second Opinion on Gum Surgery

Posted on: January 24th, 2012 by Dr. Mitchell Josephs No Comments

Q: A dentist told me I need gum surgery, which will involve thousands of dollars of treatment, stitches and many appointments. I already had this done back in the 80’s. Should I seek a second opinion?…Mel in West Palm Beach.

A: Every year a poll is taken on what are the most trust worthy professions. The top three, year after year, not necessarily in this order, are clergy, pharmacist and (you guessed it) dentists. A second opinion might be in order after a trip to the confession booth, or when the pharmacist recommends a jock itch cream or when a dentist recommends full mouth periodontal surgery. Second opinions are a fact of life. See both a general dentist and a periodontist for their take. It might be possible to perform more conservative treatments such as non-surgical root planning and curettage with the injection of sub-gingival (under the gum) antibiotics such as Arestin for pocket depths of 5 millimeters or less. Pockets over 5 millimeters with bleeding and/or advanced bone loss may benefit from extraction of the tooth and implant placement for a long-term prognosis. For a free consumer guide on this subject, contact us.

EDITOR’S NOTE: Dr. Mitchell Josephs will be giving a FREE LECTURE on Incision-Free Dental Implant Surgery, Digital Crowns & Veneers, Choosing a Dental Office and NEW TOPIC: Oral Care for Cancer Patients, at the Boynton Beach Jewish, Ross J.C.C. on Jog Road on Wednesday February 22^nd at 10:00 am. Attendees will receive a FREE copy of his book: “Tooth Talk”. Seating is limited. Call today to register at 561-740-9000. Ask for the Adult Lecture Series.

Dr. Mitchell Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts the “Tooth Talk” radio show on Fridays at 11am and Tuesdays at 8:30am on WBZT AM1230. (www.radiotoothtalk.com) On staff at Good Samaritan Medical Center, Dr. Mitchell Josephs is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry.

____________________________________________________________

drjosephs@palmbeachdentist.com
44 Cocoanut Row, Palm Beach, FL 33480
888-DRTOOTH (888-378-6684)
www.palmbeachdentist.com

Tags: antibiotics, Arestin, dental, Dr. Mitchell Josephs, Free Lecture, general dentist, gum surgery, palm beach dentist, periodontist, sub-gingival
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Franchise Discount Dental Offices

Posted on: January 17th, 2012 by Dr. Mitchell Josephs No Comments

Q: I tried getting a refund for faulty implant and denture work I had done at a franchise dental office. The doctors told me they “do not own the business” and I must “deal with their corporation’s headquarters in another state”. What’s up with that? “Angry Al” in Boca
A: Let me begin by telling all the angry dentists who will read this and send me hate mail that I am only the messenger and will be merely quoting my source. At the last meeting of the county dental society, an expert in dental practice transitions, Dr. S. Auerbach stated: “ According to The Florida Department of Health, Board of Dentistry, Division of Medical Quality Assurance, statute 466.028(1)(h) states that ‘being employed by any corporation, organization, group, or person other than a dentist(s) is illegal in Florida. Three popular outfits are Gentle Dental, Aspen Dental and Affordable Dentures”.
EDITOR’S NOTE: Dr. Mitchell Josephs will be giving a FREE LECTURE on Incision-Free Dental Implant Surgery, Digital Crowns & Veneers, Choosing a Dental Office and NEW TOPIC: Oral Care for Cancer Patients, at the Double Tree Hotel, PGA Blvd. in Palm Beach Gardens on Thursday January 19th at 4:00 pm. Attendees will receive a FREE copy of his book: “Tooth Talk”. There are only 9 seats left. Call today to register at 561-832-2917
Dr. Mitchell Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts the “Tooth Talk” radio show on Fridays at 11am and Tuesdays at 8:30am on WBZT AM1230. (www.radiotoothtalk.com) On staff at Good Samaritan Medical Center, Dr. Mitchell Josephs is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry.
____________________________________________________________

drjosephs@palmbeachdentist.com
44 Cocoanut Row, Palm Beach, FL 33480
888-DRTOOTH (888-378-6684)
www.palmbeachdentist.com

Tags: Board of Dentistry, dental implants, dentures, Digital Crowns & Veneers, Dr. Mitchell Josephs, Florida Department of Health, Incision-Free Dental Implant Surgery, Oral Care for Cancer Patients, Palm Beach Dentists
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Pre-Cancer Treatment Dental Treatment, a Must

Posted on: January 10th, 2012 by Dr. Mitchell Josephs No Comments

Q: My husband is about to undergo cancer treatment and his doctor says he might have severe dental problems during and after treatment. What can he do to prevent this? Jill in Lake Worth

A: Many physicians, including oncologists, are not aware of an important publication written by the N.I.H (National Institute of Health), entitled “To Fight Cancer Best, your Cancer Team Should Include a Dentist.” I have recently re-written a version of this booklet with easier verbiage for the general public. This publication will be distributed for free at my next seminar, listed below. I will be covering this important topic as well.

Important pre-cancer treatment needs: Digital X-ray examination, minimizing radiation exposure, fabrication of custom fluoride trays to prevent massive root decay from chemo and/or radiation, removal of un-restorable teeth that could abscess during cancer treatment, possibly resulting in the suspension of the treatment, and relining or re-making ill-fitting dentures.

EDITOR’S NOTE: Dr. Mitchell Josephs will be giving a FREE LECTURE on Incision-Free Dental Implant Surgery, Digital Crowns & Veneers, Choosing a Dental Office and NEW TOPIC: Oral Care for Cancer Patients, at the Double Tree Hotel, PGA Blvd. in Palm Beach Gardens on Thursday January 19^th at 4:00 pm. Attendees will receive a FREE copy of his book: “Tooth Talk”. There are only 15 seats left. Call today to register at 561-832-2917

drjosephs@palmbeachdentist.com
44 Cocoanut Row, Palm Beach, FL 33480
888-DRTOOTH (888-378-6684)
www.palmbeachdentist.com

Tags: dental, Dr. Mitchell Josephs, pre-cancer, x-rays
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Less Implants Can Achieve Same Result

Posted on: January 3rd, 2012 by Dr. Mitchell Josephs No Comments

Q: I am missing three molars. My dentist wants me to have three implants and three crowns. If I did two implants and three crowns, this would save me $2600. Is this safe to do? Melvin in Boynton

A: Let’s compare kiwis and pomegranates here. If your bone is super dense and plentiful as verified by digital imaging, you can get away with two implants to support three crowns, HOWEVER these three crowns will be connected to each other, like a permanent bridge, with a floating tooth in the middle that can trap food and will require the use of a floss threader. If you are OK with this and have great oral hygiene and see your hygienist regularly (at the dental office, not at Starbucks.) then, you are OK with the two implants. The ideal treatment would be three implants.

EDITOR’S NOTE: Dr. Mitchell Josephs will be giving a FREE LECTURE on Incision-Free Dental Implant Surgery, Digital Crowns & Veneers, Choosing a Dental Office and NEW TOPIC: Oral Care for Cancer Patients, at the Double Tree Hotel, PGA Blvd. in Palm Beach Gardens on Thursday January 19^th at 4:00 pm. Attendees will receive a FREE copy of his book: “Tooth Talk”. There are only 30 seats left. Call today to register at 561-832-2917

drjosephs@palmbeachdentist.com
44 Cocoanut Row, Palm Beach, FL 33480
888-DRTOOTH (888-378-6684)
www.palmbeachdentist.com

Tags: bone density, bridge, crown, dental implants, Dr. Mitchell Josephs, implants
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Don’t Short Cut the Number of Veneers

Posted on: December 27th, 2011 by Dr. Mitchell Josephs No Comments

Q: I would like to have veneers on my uppers. I just wanted six, but my dentist insists I do eight to ten. What do you think? Lisa in Wellington

A: Lisa, get to the nearest computer or smart phone and email me. I will respond to the email by attaching a photo of what happens when patients try to cut corners and only treat their front four or six teeth. The photo is of a fashion model in a magazine, believe it or not! Ninety percent of patients show 10 teeth in a full smile. If you don’t treat the full smile, you can wind up looking like you are missing back teeth or reveal the unsightly transition of a veneered tooth adjacent to an un-veneered tooth. For free consumer info on veneers, contact us.

EDITOR’S NOTE: Dr. Mitchell Josephs will be giving a FREE LECTURE on Incision-Free Dental Implant Surgery, Digital Crowns & Veneers, Choosing a Dental Office and NEW TOPIC: Oral Care for Cancer Patients, at the Double Tree Hotel, PGA Blvd. in Palm Beach Gardens on Thursday January 19^th at 4:00 pm. Attendees will receive a FREE copy of his book: “Tooth Talk”. There are only 33 seats left. Call today to register at 561-832-2917

drjosephs@palmbeachdentist.com
44 Cocoanut Row, Palm Beach, FL 33480
888-DRTOOTH (888-378-6684)
www.palmbeachdentist.com

Tags: ask dentist, cosmetic dentistry, dental questions, Dr. Mitchell Josephs, palm beach dentist, porcelain veneers, veneers
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Dentists Can Now Give Botox and Dermal Fillers

Posted on: December 20th, 2011 by Dr. Mitchell Josephs No Comments

Q: I have seen in my travels that many dentists are doing Botox and Juvederm. Is this safe?

A: I know this concept is a little hard for many patients to swallow. (Look, believe it or not, 50% of the population is afraid to even get their teeth cleaned by us!)

Many health professionals are providing injectable cosmetics: plastic surgeons, gynecologists, internal medicine doctors, dermatologists and allied health care providers such as physician assistants (PA’s) and estheticians. None of these practitioners learned these procedures in school unless they graduated after 2004. Therefore, they (and myself) learned these skills during recent continuing education courses.

Like anything else, the importance is training. The American Academy of Facial Esthetics trains both dentists and medical doctors on how to use these drugs. Each doctor must know his limitations. One of several advantages of having these procedures performed at the dental office is that they can be combined with your four month check-up and cleaning visits, as most of these drugs wear off in four months. I will address this topic further next week.

EDITOR’S NOTE: Dr. Mitchell Josephs will be giving a FREE LECTURE on Incision-Free Dental Implant Surgery, Digital Crowns & Veneers, Choosing a Dental Office and NEW TOPIC: Oral Care for Cancer Patients, at the Double Tree Hotel, PGA Blvd. in Palm Beach Gardens on Thursday January 19^th at 4:00 pm. Attendees will receive a FREE copy of his book: “Tooth Talk”. There are only 37 seats left. Call today to register at 561-832-2917

Tags: American Academy of Facial Esthetics, Botox, dental, dental procedures, Dr. Mitchell Josephs, Juvederm
Posted in dental | No Comments »