Archive for September, 2010

Claspless Partials

Posted on: September 29th, 2010 by Dr. Mitchell Josephs No Comments

Q:  I need to have a tooth pulled and a new partial denture made, but the ugly chrome clasp will now be visible as it engages my canine tooth. What else can be done to hide this clasp?… Dan the CPA

A: Many of us have memories of an older relative running their partial under the tap to “freshen up a bit.” (My grandfather, Pappa Jimmie Josephs once displayed his on a Passover Seder plate!) When patients have insufficient bone for implants, the partial route may be needed. It is always better to go clasp-less. Special attachements called Locators and ERA’s allow partials to clip to crowns or roots that have been purposely cut to gum level, without the shiny metal clasps. New age plastic allow for tooth-colored clasps as well. Your relatives will be none the wiser.

Editor’s Note: Dr. Mitchell Josephs will be giving a free lecture on Implant, Cosmetic and General Dentistry and signing his latest book on the Island of Palm Beach on Friday October 15th from 11am to 12. Call 561-832-2917 for registration and info. Seating is limited.

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

 

Pain-free tooth still can be abscessed

Posted on: September 22nd, 2010 by Dr. Mitchell Josephs No Comments

Q: My dentist insists I get a root canal on a tooth that is pain free, but “looks abscessed on the X-ray.” He even went as far as to tell me I could “wind up in the hospital” if I ignore it. Is this just to scare me into paying him more money? – Louie in Delray

A: Hey, Uncle Louie. When Dr. Sal my Gastroenterologist begs me to undergo a colonoscopy, even though “nothing hurts,” I am sure he can find better ways to make a buck than explore my better side with his “body-flossing” camera. Many root canals are needed to save a tooth that suffers from a chronic (painless) abscess vs. an acute abscess. These are often identified upon X-ray or by a series of pulp tests which determine whether the nerve has died in a tooth. Almost 8,000 patients are hospitalized each year for dental abscesses with an average hospital bill of $13,590.

by Dr. Mitchell A. Josephs

Editor’s Note: Dr. Josephs will be giving a free lecture on Implant, Cosmetic and General Dentistry and signing his latest book in Palm Beach on Oct. 15 from 11 a.m. to noon. Call (561) 832-2917 to register.
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

‘OAC’ common in removal of upper molars

Posted on: September 15th, 2010 by Dr. Mitchell Josephs No Comments

Question: My dentist recently took out an upper back tooth and left me with a hole into my sinus cavity. I had to be treated by an oral surgeon to fix the problem. What went wrong? – Mr. L., Lake Worth

Answer: A famous oral surgeon with whom I shared the lecture circuit once told me: “If this has not happened to one of your patients yet, you either just graduated dental school or you are lying!”

The fact is that upper back molars, especially ones that stand alone without a neighboring tooth, have roots that practically penetrate the sinus floor. Removal of these teeth often results in an “OAC” – oro-antral communication. (Sounds like an e-mail between two dentists.)

Not to worry. A dentist or oral surgeon will put the patient on antibiotics, nasal sprays and a decongestant and see him or her once a week until uneventful closure is realized. Occasionally, larger OAC’s require a small surgical procedure under local anesthesia using a rotating flap of tissue or synthetic membranes to close the defect.

For a free booklet on tooth extractions, contact us.

By Dr. Mitchell Josephs

 

'OAC' common in removal of upper molars

Posted on: September 15th, 2010 by Dr. Mitchell Josephs No Comments

Question: My dentist recently took out an upper back tooth and left me with a hole into my sinus cavity. I had to be treated by an oral surgeon to fix the problem. What went wrong? – Mr. L., Lake Worth

Answer: A famous oral surgeon with whom I shared the lecture circuit once told me: “If this has not happened to one of your patients yet, you either just graduated dental school or you are lying!”

The fact is that upper back molars, especially ones that stand alone without a neighboring tooth, have roots that practically penetrate the sinus floor. Removal of these teeth often results in an “OAC” – oro-antral communication. (Sounds like an e-mail between two dentists.)

Not to worry. A dentist or oral surgeon will put the patient on antibiotics, nasal sprays and a decongestant and see him or her once a week until uneventful closure is realized. Occasionally, larger OAC’s require a small surgical procedure under local anesthesia using a rotating flap of tissue or synthetic membranes to close the defect.

For a free booklet on tooth extractions, contact us.

By Dr. Mitchell Josephs

 

Dentures can accelerate bone loss

Posted on: September 8th, 2010 by Dr. Mitchell Josephs No Comments

Q: I have worn partial dentures for years with no major problems. My friends are all egging me on to get permanent teeth with implants. Why should I change? – Mildred in West Boca

A: A patient once said: “Why should I stop smoking; I made it to 70 so far?” Unfortunately, he did not make it to 75 to see his grandson’s wedding. Although dentures are not life-threatening, their clasps hasten the loss of adjacent healthy teeth. They also accelerate bone loss needed for implants in the missing-teeth areas and trap food, funguses and bacteria in the mouth. Dentures are often chosen due to financial limitations, specific (but few) medical contra-indications and insufficient bone to support implants.
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

 

Novocain in ocular nerve is culprit

Posted on: September 1st, 2010 by Dr. Mitchell Josephs No Comments

Question: Recently I had several back teeth crowned. After I was given the Novocain, my right eye suddenly went numb, preventing me from being able to close my eye for more than two hours. This frightened and angered me and forced me to stay home in bed for the rest of the day. What went wrong? – Sue-Ellen, Palm Beach

Answer: This brings us to another installment of “Don’t shoot your dentist.” (I have often thought of a reality show about a dental office called: As the Tooth Turns.)

The fifth cranial nerve exits the base of your skull and splits into three branches: maxillary, mandibular and ocular. Very often in attempting to numb the sometimes difficult teeth of the posterior mandible (lower jaw), a bit of local anesthesia bathes this ocular branch causing temporary numbness of the muscle that closes the eyelid.

It is best to go home and place a wet towel over the eyelid to keep the eye moist. I also recommend the use of OraVerse, an anesthetic reversing agent that your dentist can inject in the mouth which cuts the numbness time in half.

For free consumer info on OraVerse, contact us.

by Dr. Mitchell A. Josephs
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

 

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