Archive for May, 2010

Thinking of Having Cosmetic Dental Work?

Posted on: May 31st, 2010 by Dr. Mitchell Josephs No Comments

Q: I am thinking of having some cosmetic dental work (veneers and some crowns), but I am afraid they will look fake. I see a lot of people with very artifical looking teeth. How can this be prevented?

A: Nobody wants to look like they swallowed a piano or a box of Chiclets. Many of the techniques we use in cosmetic dentistry to create natural looking veneers and crowns involve the artistic communication between the doctor and his dental lab technicians.

Firstly, the shade that one chooses should be appropriate for their skin, eye and hair color. Olive skin patients should not pick a ‘refrigerator’ white shade of porcelain, but those patients with fair skin, blue eyes and light blond hair can often get away with “Regis Philbin” white teeth.

Secondly, when we design a case, we don’t like a bowling ball surface texture. We prefer an irregular, pebbled surface to break up the light for a more natural appearance. We call these subtle “waves” in the front surface of the porcelain: facial lobes or flutes. Natural teeth have these irregularities that form during the embryonic development of the adult teeth.

And thirdly the shape of the teeth is paramount in creating a natural smile and is dependent on the patients age, personality and facial contours. A square face, a heart shaped face and a round face might dictate a completely different shape and contour of the veneers or crowns.

Mitchell A. Josephs D.D.S., P.A.
Cosmetic, Implant and General Dentistry

Replace The Whole Bridge?

Posted on: May 27th, 2010 by Dr. Mitchell Josephs No Comments

Ask the DDS

Q: I have a long five-tooth permanent bridge that has come loose above just one of the support teeth. Can it be saved or do I need to replace the whole bridge?

A: You are lucky that I stopped watching TV after the Seinfeld went off the air. Instead, I took up this “kooky” hobby called “reading”. My folks always wanted me to take it up.

In this month’s JADA (Journal of the American Dental Association) A Utah dental researcher, Dr. Gordon Christiansen, addressed this dilemma. If the X-ray and clinical exam show no decay, a small hole can be drilled through the loose abutment, followed by a flushing out of the old cement with a bleach-like solution called Dakins solution. Then, while the doctor exerts a pulling force on the loose end of the bridge, he  expresses a special cement called Glass Ionomer into the hole, followed by the patient biting down as the cement dries.

Dr. Josephs practices in Palm Beach and can be reached at drjosephs@palmbeachdentist.com , 1-888-DRTOOTH or visit www.palmbeachdentist.com

Diagnodent vs. Explore

Posted on: May 25th, 2010 by Dr. Mitchell Josephs No Comments

Q: I recently read an article in the AARP magazine that said when a dentist probes a soft spot on a tooth he could augment the decay process by spreading bacteria further into the tooth. Is this correct? CG in Hobe Sound

A: Ah, the dreaded probe. You mean the “Explorer”. A 4000 year old instrument used by the Egyptians and many a home hobbyist in assembling those pesky plastic models for Jr. If the explorer is pressed too hard into a decalcified pit or fissure on the biting surface of a tooth, “cavitation” can occur, making the lesion more susceptible to decay.

A better way to diagnose pit and fissure decay is with the Diagnodent; a laser decay detector which measures the bacteria which lie at the bottom of fissures that are too narrow for the explorer to reach. Early diagnosis means treatment with small resin fillings, before they wind up requiring root canals.

For a free consumer guide on this, contact us. Dr. Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and can be reached at drjosephs@palmbeachdentist.com (888-378-6684) or visit www.palmbeachdentist.com

Reversing Numbness

Posted on: May 24th, 2010 by Dr. Mitchell Josephs No Comments

Q: I need some urgent dental work, but leaving the dental office with a numb face and lip will ruin an important speech I need to make. What can I do to get rid of the numbness?

 

A: Every day I eat lunch with three items: a tuna melt, a car magazine and a dental journal. Last Monday in the JADA (Journal of the American Dental Association), a study of a recently approved drug called Ora Verse was approved by the FDA to help reverse the numbing action of dental local anesthetics when it is no longer desired.

 

It was shown that the duration of anesthesia was shortened by as much as two thirds. This could eliminate the occurrence of patients accidentally biting their lips, cheeks and tongues. (And could prevent you from drooling your way through your speech)

 

Mitchell A. Josephs D.D.S., P.A.
Cosmetic, Implant and General Dentistry

 

 

Ask the Dentist: D.I.Y. Dental Emergencies

Posted on: May 20th, 2010 by Dr. Mitchell Josephs No Comments

Q: How do I get emergency dental treatment when the power is out from a storm?

A: A few years ago I was interviewed on a morning news program in Westchester, N.Y. The topic was: “The Dental Emergency Travel Kit.” What to pack in your luggage in case you don’t wish to see the local “island dentist” who practices out of a grass hut and has an iguana as his dental assistant.

This kit can be used as a “Dental Emergency Natural Disaster Kit”. Many items in the dental isle of your local pharmacy are designed for dental emergencies, such as replacing lost fillings, re-cementing crowns and bridges, and repairing broken dentures.

Other items I recommend to put in your kit are a bottle of peroxide, and an empty prescription bottle to store any dental work until you see your DDS.

Always ask your dentist to give you a paper copy print-out of your digital X-rays to keep with you. Should you wind up in another dental office on a trip or if your dentist does not have a generator during outages, the X-rays will be very helpful.

Mitchell A. Josephs D.D.S., P.A.
Cosmetic, Implant and General Dentistry
44 Cocoanut Row #206
Palm Beach, FL 33480
tel. (561) 832-4675
fax (561) 832-7018

Options for Bleach-Free Teeth Whitening

Posted on: May 17th, 2010 by Dr. Mitchell Josephs No Comments

Q: Due to personal finance issues I cannot afford porcelain veneers ($14,000!) and yet my teeth are too sensitive for bleaching. What other options do I have?…B.G. in Boca

A: As Captain Stubing would say on the Love Boat: “Your ship has come in.” (Or in this case, your smile has come in.) Over the past twenty years, many patients have asked me: “Can’t you just put some kind of white paint over my teeth; like Liquid Paper correction fluid?” Finally, we can now say YES!

Bleach-free whitening made by Denmat, the company that brought you Lumineers, has come out with a “paint-on” whitening material. The dentist applies a super thin layer of an opaque resin that is hardened with a UV light, followed by a glaze. For under $1000, your whole mouth can be done in one visit with no sensitivity and more predictable and longer lasting results compared to bleaching. However, you cannot change the shape of the teeth or correct any crookedness as in veneers.

How Hi-Tech Is Your Hygienist?

Posted on: May 13th, 2010 by Dr. Mitchell Josephs No Comments

Q: I recently needed to have 7 teeth removed due to gum disease and yet I have been getting my teeth cleaned by the same hygienist for 15 years. Why did she not see this coming?

A: Assuming you brush and floss every day, your hygienist may not be utilizing today’s hi-tech diagnostic and treatment modalities for periodontal disease.

Remember the movie 2001 A Space Odyssey, starring Hal-9000, the talking computer? My hygienist has been using a computerized, talking probe, called the STM Probe.

A small, blunt, plastic probe placed into the pocket between tooth and gum, measures  bone or ligament loss around a tooth. The computer “speaks” the measurement and records the readings on a print-out, placed in the patient’s chart. If the computer generated voice speaks of pockets of “five” or greater, these areas need treatment to prevent further bone loss, and eventual loss of the tooth.

The first and least invasive line of treatment would be a thorough scraping of  toxins along the root surfaces and the inner lining of the pocket, followed by the placement of antibiotic granules, called Arestin, which dissolve over a ten day period under the gum.

Very often this will prevent you from needing extensive gum surgery and loss of the tooth.

Written by Dr. Mitchell A Josephs DDS

Dr. Josephs practices cosmetic, implant and general dentistry in Palm Beach and hosts Tooth Talk on WBZT, AM 1230. For more info visit palmbeachdentist.com, email  drjosephs@mindspring.com, or call 1-888-DRTOOTH

Gentle Clean Ultrasonic Tips

Posted on: May 10th, 2010 by Dr. Mitchell Josephs No Comments

Q: I have a mouth full of implants and very sensitive natural remaining teeth. I am dreading my next cleaning visit. What can my hygienist do with a complex mouth like mine? Mrs. C. via email

A: Mrs. C., Mr. C., Richie and Joni: Listen to the “Fonz” and please keep your hygienist appointment. Today’s hygienists are well equipped with the latest in periodontal maintenance equipment, materials and techniques.

Special ultrasonic scaling tips have recently been created for cleaning around implants and sensitive teeth. GentleCLEAN TM uses a technology called a magnetostrictive, polyetherthermide resin tips that are designed to remove plaque and soft calculus from metal and teeth without damaging implants or the gum- line edges of your dental work. This greatly reduces pain and prevents scratching of implant surfaces, making the implants resistant to plaque formation.

For a free copy of the “Hi-Tech Hygienist Checklist”, contact us. Dr. Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and can be reached at drjosephs@palmbeachdentist.com (888-378-6684) or visit www.palmbeachdentist.com

by Dr. Mitchell Josephs

Teeth Like a Celebrity

Posted on: May 6th, 2010 by Dr. Mitchell Josephs No Comments

Q: A friend of mine told me she was able to get the “same teeth that Hale Berry has” from her dentist. Is this really possible?

A: Did she promise to return the teeth to Ms. Berry before the weekend? I hope she sterilized them!

I think what your crony means is that she had some porcelain laminate veneers that copied the shape, color and style of the celeb in question.

Over the years, I have had patients bring me smiling photos of Demi Moore, Cindy Crawford, Julia Roberts and Sara Jessica Parker. We send these to our lab to aid in designing the veneers, crowns or bridges to mimic these “famous” smiles.

As long as your teeth are not way out of whack, like actor Hugh Grant’s teeth which resemble a rotting mummy, you can get some nice results.

Implant Overdentures – Messy Plate Syndrome

Posted on: May 3rd, 2010 by Dr. Mitchell Josephs No Comments

Q: My husband (age 64) is frustrated with his plate; food gets underneath. We thought about implants. Are they prohibitively expensive? TJ in Boca

A: Millions suffer from “messy plate syndrome”: more food is found under your “plate” than on your plate. Solution: implant supported overdentures which will allow his existing denture, if in decent condition, to be securely anchored to his jaw bone to prevent food from rushing underneath.

Two to four implants do the job with special attachments embedded into the dentures called Locators. Costs range from $4500 to $10,000+ depending on the available bone. The longer you wait for treatment, the less bone you will have to work as “empty” bone will atrophy.

For a free consumer guide on implant overdentures, contact us. Dr. Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and can be reached at drjosephs@palmbeachdentist.com (888-378-6684) or visit www.palmbeachdentist.com

by Dr. Mitchell Josephs

44 Cocoanut Row, Palm Beach, Florida 33480 | P: 561.832.4675
F: 561. 832.7018 | Email: info@PalmBeachDentist.com
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