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

Archive for July, 2010

Mandibular Block Injections

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

Q: After having what I thought was routine crown-work on my lower back teeth, the following day I could barely open my mouth to eat. What did the doctor do to me?!!………Phil in Tequesta

A: Chill, Phil. You’re scaring me with those two exclamation points. One I can take, but two sends me to the shrink. Often after mandibular block injections, required to anesthetize the back lower teeth, the common side effect “trismus” occurs. (In your case, it’s “trismus in July”.)

Often multiple injections are needed to numb these posterior teeth due to a tricky network of nerves that must be reached. Limited opening, muscle spasms, stiffness and pain. This is caused by inflammation of the muscle fibers, hemorrhage into the muscles of mastication or low grade infection. This will all go away.

In the mean time, your dentist might recommend warm compresses, 800mg of Ibuprofen, muscle relaxants (Flexeril, Diazepam), salt water rinses, antibiotics, and in severe cases, a steroid such as Methylprednisone. Complete recovery can take several weeks.

For a free check list that aids in the prevention of this uncomfortable condition, 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

Digital Impressions

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

Q: I recently saw a TV news program showing a very small percentage of dentists are using a new technology called digital impressions that replaces the gooey, clay- like stuff. Is this just a gadget like an iPhone or is it truly state of the art? RBJ in Boynton

A: Don’t take all your healthcare advice from Cathy Lee Gifford. Less than 10% of all dentists are using digital impressions which take 3-D scans of the teeth. I am one of them.

In the June 2010 edition of JADA (Journal of the American Dental Association), a study showed: “By examining the virtual model that can be magnified on a monitor, the dentist and lab tech can identify deficiencies and correct them without the delay that may happen when making conventional impressions. Precision improves with use of this digital technology as well as patient comfort”.

For a free consumer booklet 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

Note: Dr. Mitchell Josephs will be giving a free lecture on Implant, Cosmetic and General Dentistry and signing his latest book at the Jupiter Beach Resort on Thursday July 22nd at 2:00pm. Call 561-832-2917 to register.

Filling Keeps Coming Out

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

Q: My dentist placed a small white filling on the side of a front tooth earlier this year. Every couple of months it falls out and she replaces it at no charge. What do you suggest? “Queeny” from West Boca

A: I give you credit for the sincere loyalty you have for your doctor in letting her keep taking a crack at it. Some patients change dentists more than Joan Rivers changes plastic surgeons (and I’m just talking about the month of June!)

The key ingredient in bonding composite resin (tooth colored bonding) to tooth structure is the bonding agent. There have been 7 generations and over 23 products on the market made by over 13 companies. A recent comparison test in the Clinicians Report Newsletter showed the highest bonding strength was found in two products: Peak SE and Clearfil SE Bond.

For more info on this subject, 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

Zirconia Crowns

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

Q: I need some crowns done on my back teeth. My dentist says that I must have gold since I am a bruxer and grind my teeth excessively. I sing for a living and would prefer to show only white teeth in the back when I open wide.

A: I had a patient who was a ventriloquist who wanted me to perform dental work on his dummy. He returned the bill to me with a note saying: “Please bill my partner. He’s the one with the insurance.” The newest all-ceramic, metal-free entry for crowns and bridges is a homogenous, monolithic material called Zirconia.

Special dental labs can fabricate crowns made of this material called BruxZir; specially made for bruxers like you who demand esthetic restorations on back teeth. Although, they tend to be somewhat opaque and monotone, they still look good on back molars.

For more info, 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