2011 July Archive - Dr. Mitchell A. Josephs' Blog

Archive for July, 2011

No Need for “Fake Looking” Teeth

Posted on: July 26th, 2011 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 artificial looking teeth. How can this be prevented? Dale in Palm Beach

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 patient’s 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 crown

Note: Dr. Mitchell Josephs will be giving a lecture to the public on Less Invasive Implant Surgery, Veneers and Complex Crown and Bridge Treatment on Thursday, August 11th at 5pm at the Jupiter Beach Resort.Call 561-832-2917 to Register.

Dr. Mitchell Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts the “Tooth Talk” radio show live 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 on the Faculty Advisory Board at McGill University’s Faculty of Dentistry.
Send questions to drjosephs@palmbeachdentist.com or call 888-DRTOOTH (888-378-6684) or visit www.palmbeachdentist.com

By Dr. Mitchell Josephs

Brown Spots in Mouth after Implants; Very Rare

Posted on: July 19th, 2011 by Dr. Mitchell Josephs No Comments

Q: One month after having dental implant surgery, I noticed brown spots inside my mouth. Is this normal and is it something to worry about? Agnes in Cooper City.

A: You have heard the expression: “A red herring.” In this case, let’s call it a “Brown herring.” Both imply a rare occurrence. A recent article in the Journal of the American Dental Association reported a 63 year old white woman in Spain presented with brown spots scattered about the inside of her cheeks, hard palate and in the posterior upper jaw one month after implant surgery. Biopsies were taken to rule out any oral cancer lesions such as melanoma. The test results showed a very rare, non-threatening, benign condition called oral melanocanthoma (OMA).

Only 60 cases of OMA have been reported in the literature since 1979. Surgery could have been causal or incidental to the appearance of these lesions. What is important is for the dentist to recognize the lesions and properly test them to rule out any more serious pigmented lesions, un related to the implants. OMA’s are completely harmless and have never been proven to be related to implants.

More common causes of pigmented spots inside the mouth are lupus, Addison Disease, certain medications such as antimalarial agents, antibiotics, antiviral and antifungal agents and iron deficient conditions. However, hands down, the most common cause of dark spots in the mouth are amalgam tattoos; old silver fillings that rub against the inside of the cheeks and gums, leaching metal deposits beneath the tissues.

Note: Dr. Mitchell Josephs will be giving a lecture to the public on Hi-Tech Implant Surgery, Veneers and Complex Crown and Bridge Treatment. Send us an email, or call us, to be automatically notified of his next event.

Dr. Mitchell Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts the “Tooth Talk” radio show live 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 on the Faculty Advisory Board at McGill University’s Faculty of Dentistry. Send questions to drjosephs@palmbeachdentist.com or call 888-DRTOOTH (888-378-6684) or visit www.palmbeachdentist.com

By Dr. Mitchell Josephs

Nasal Mist Dental Anesthetic

Posted on: July 12th, 2011 by Dr. Mitchell Josephs No Comments

Q: Do you think technology in the future will eliminate the needle in the dental office?… Meg in Boca

A: I sure hope so! (Hey, I’m a patient too!) Stay tuned for needle-free dental anesthetic. St. Renatus, LLC, based out of Fort Collins Colorado, is in the process of clinically testing a drug the company believes will enhance pain control in dentistry. The company has patented the world’s first needle-free nasal mist dental anesthetic. It is administered through the nasal cavity and is suitable for use for most dental work involving upper teeth.

The benefits of this new technology include: Reducing anxiety and fear associated with dental injections. Decreasing the risk of hematomas (blood-filled, purple bruises of the face), as well as elimination of the “fat lip” feeling, post operatively until the anesthesia wares off.

A recent study showed that 96% of dentists expect to offer the new nasal mist anesthetic to their patients. With a just completed, favorable end of Phase II review with the FDA, the company expects to market the new drug product in 2012. For free consumer information on this subject, contact us.

Dr. Mitchell Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and can be reached at drjosephs@palmbeachdentist.com, 888-DRTOOTH (888-378-6684) or visit www.palmbeachdentist.com

By Dr. Mitchell Josephs

Biphosphonates and Implants

Posted on: July 5th, 2011 by Dr. Mitchell Josephs No Comments

Q: I have osteoporosis and take those drugs that doctors say you must stop if you need dental implants. Is this a real concern? Maggie in Boca

A: It seems like once a big drug TV campaign begins; half the country starts taking that “new pill”. Bob Dole and Viagra, and more recently, Sally Fields with Boniva. These drugs called Bisphosphonates as well as other brand names of the drugs: Aredia and Phosomax, have shown small incidences of jaw-bone related side effects, called: ONJ Osteonecrosis of the jaw. A decrease in circulation to localized areas of the jaw resulting in complications to tooth extractions and implant surgery was shown in a very small (4%) of people taking the above drugs.

Patients taking the drugs via injections should be more concerned and generate a dialog between their MD and their DDS. Patients taking the drug in pill form have much less risk of complications. A recent article in the Journal of Oral Implantology tested the failure rate of dental implants in patients taking bisphosphonates at S.U.N.Y.at Buffalo, NY. Although there was no statistically significant increase in implant failure in the patients taking bisphosphonates, a greater incidence of loosing small circular areas of bone where the top of the implant meets the gum line was found. This type of “peri-implant” bone loss is found on many successfully functioning implants, even years later.

Don’t let these drugs keep you from being examined by a dentists who performs dental implants and can give you the ability to have teeth like you were born with, only better! For a FREE consumer guide to implants, contact us.

By Dr. Mitchell Josephs