2010 June Archive - Dr. Mitchell A. Josephs' Blog

Archive for June, 2010

Explorer Tool Can Lead To More Decay

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

Question: 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? C.G., Hobe Sound

A: Ah, the dreaded probe. You mean the “explorer,” a 4,000-year-old instrument used by the Egyptians and many a home hobbyist in assembling those pesky plastic models for Junior.

If the instrument 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 that measures the bacteria at the bottom of fissures that are too narrow for the explorer to reach. Early diagnosis means treatment with small resin fillings. For a free 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

Pacemakers and ICDs

Posted on: June 21st, 2010 by Dr. Mitchell Josephs No Comments

Q: I’m a retired medical doctor and have an implanted pacemaker and defibrillator. I need major dental work (extractions, implants, crown and bridge work). Are there any precautions I should know about? Dr. Bob in Tequesta

A: This reminds me of that episode of the Brady Bunch where Jan (or Marcia?) picked up radio stations with her braces. A recent study at the University of Kentucky took place to determine if electromagnetic interference occurred during the use of 9 different dental electronic devices.

Of the nine, only two operatory devices inhibited heart pacing activity. The ultrasonic scaler and the battery operated composite (bonding) curing light. However, the tests were not done with patients; only on the devices on a lab bench. Millions of patients have had extensive dental work without any problems with their implanted devices. Check with your own cardiologist and dentist.

For a copy of this study, contact us. For free consumer info on this topic, 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

X-ray Determines Tooth’s Damage

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

Question: I fractured a front tooth, diagonally. The nerve is still fully encapsulated in the tooth and there is no pain. A dentist suggested to do a root canal, post and crown. Why can’t they simply slip a crown over what is left of the tooth?

Dave, West Palm Beach

Answer: Dave, I told you to turn off the ceiling fan before dusting the blades. If a tooth fractures through the enamel (outer coating) and the dentin (inner layer), but does not expose the pulp (nerve canal), you probably can reconstruct the tooth with composite resin bonding or a crown. However, even if the nerve was not exposed, an X-ray and a pulp test must be performed to evaluate the need to remove a damaged, dying nerve, i.e. root canal. If a pulp test using heat, cold, percussion and an electric pulp tester shows the nerve is dead; get the root canal. If all is OK, then restore the tooth and be prepared for a possible future need for root canal.

Dr. Mitchell 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

Implant Crown Too Bulky

Posted on: June 14th, 2010 by Dr. Mitchell Josephs No Comments

Q: I recently had an implant and crown to replace my upper front center tooth. The crown sticks out too far compared to the next one. Why?…S.V. in Jupiter Island

A: Think of the mouth as a stage in a Broadway theatre. (Complete with used gum stuck to the seats.) The lips are the curtains which rise up revealing the lead actors taking center stage: the central incisors.

It is very difficult to fix one central incisor without restoring its twin brother, sitting next to it. Fixing both will almost always guarantee that the two will match. A crown over an implant can wind up a bit out of sync esthetically compared to its brother if the implant is angled too far forward. We often compensate for this by using custom abutment posts which correct odd angulations, before the crown is made.

For free consumer info on this topic, 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

Viroxyn

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

Q: I get cold sores frequently on my lower lip. Is there any way to get rid of these ugly things once they appear?…S.S. in West Palm Beach

A: Even our creator must have had an off day when he added the herpes virus to the mix of earthly organisms. (I forgive him/her since we also got the Grand Canyon and Penelope Cruz.) Eruptions of herpes labialis often occur during periods of stress, exposure to sunlight or recent oral manipulation from dental work. A recent product comparison in the Clinicians Guide to Dental Products and Techniques newsletter showed excellent results with Viroxyn.

Your dentist rubs the ampoule’s abrasive applicator, saturated with the active ingredient benzalkonium chloride, onto your lesion. Usually, one treatment is needed. Lesions dried up in 1 to 4 days resulting in 85% of the doctors recommending this treatment. For free consumer info 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

By Dr. Mitchell Josephs

Prepare for Implants with root banking

Posted on: June 7th, 2010 by Dr. Mitchell Josephs No Comments

Editor’s note: Dr. Josephs will be giving a free lecture on dental care for cancer patients at Wellington Regional Medical Center, Friday, June 11, at noon. To register, call Sharon Cohan at (561) 775-9954 or e-mail sharon.cohan@lls.org.

Question: I am missing all my back teeth. I now need to have all my remaining front teeth removed due to gum disease. I can’t afford implants but would like to have them in the future when I am better prepared financially. Can I wait?

Answer: Remember the 1967 movie The Graduate? Career advice to Dustin Hoffman: “Plastics.” I say: “root banking.”

Once the roots are removed, the jaw bone will atrophy, lo sing the bone you will need down the line for your implants. Root banking consists of removing the nerves of the hopeless teeth via root canal, sectioning the top part of the teeth flush to the gum line and then making a new denture. You keep the roots, you keep your bone. Later, the roots are removed when you are ready for implants. For a free guide to implants and implant-supported dentures, 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 A. Josephs

Missing Teeth and Gum Disease

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

Q: I am missing all my back teeth. I now need to have all my remaining front teeth removed due to gum disease. I can’t afford implants, but would like to have them in the future when I am better prepared financially. Can I wait?

A: Remember the late 60’s movie the Graduate? Investment advice to Dustin Hoffman: “Plastics”. I say: “root banking”.
Once the roots are removed, the jaw bone will atrophy; loosing the bone you need down the line for your implants. Root banking consists of removing the nerves of the hopeless teeth via root canal, sectioning the top part of the teeth flush to the gum line and then making a new denture.

You keep the roots, you keep your bone. Later the roots are removed when you are ready for implants. For a free consumers guide to implants and implant supported dentures, 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

Editor’s Note: Dr. Mitchell Josephs will be giving a free lecture on Dental Care for Cancer Patients at Wellington Regional Hospital, Friday June 11th at noon. Call 775-9954 to register.