2012 July Archive - Dr. Mitchell A. Josephs' Blog

Archive for July, 2012

What Causes White Spots After Braces?

Posted on: July 25th, 2012 by Dr. Mitchell Josephs No Comments

Q: My twin daughters just had their braces removed. They now have ugly white spots on all their front teeth. The orthodontist says he does not treat this. We are all very concerned about their appearance. Please Help!! Aphrodite in Jupiter

A: After putting twins through braces, I am more concerned that you won’t have any money left to subscribe to the Post. That means no way to catch up on corrupt politicians and no way to use my column to roll up and kill Florida cockroaches the size of Buicks.

Rest assured, white-spot lesions (WSL) associated with orthodontic treatment occur in about 50% of patients. Keep in mind patients not undergoing orthodontic care show an 11 to 24% occurrence of (WSL). Under and near the brackets, patients accumulate plaque, which results in a lower pH causing acid decalcification. Prevention: Brush with fluoride toothpaste with a .01% concentration or greater, rinse daily with rinses of 0.05% sodium fluoride and placement of fluoride varnishes. Newer bracket cements called glass ionomers produce a sustained fluoride release during treatment.

To get rid of the white spots if already formed: micorabrasion, bleaching, Recaldent paste or covering with cosmetic resin bonding. For a free copy of the Hi-Tech Dental Office Check-list, contact us.

Dr. Mitchell Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts “Tooth Talk” on WBZT AM1230 (www.radiotoothtalk.com) Dr. Mitchell Josephs is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry and completed his residency at Manhattan’s Beth Israel Medical Center and Mt. Sinai Hospital.

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drjosephs@palmbeachdentist.com

44 Cocoanut Row, Palm Beach, FL 33480

888-DRTOOTH (888-378-6684)

www.palmbeachdentist.com

Why Do I Have a Racing Heart During Dental Injections?

Posted on: July 18th, 2012 by Dr. Mitchell Josephs No Comments

Q: Recently at a new dentist’s office I experienced a scary bout of heart palpitations after getting a shot for a crown. I am afraid to go back. What went wrong? Annie C. in Weston via email

A: When ordering a cheese steak in the City of Brotherly Love, one must say: “With” or “Without.” This tells the cook whether you want Cheez-Wiz or not. When I ask my dental assistant to pass the anesthesia syringe, she will ask me the same question; only this time it implies do ‘I want anesthetic “with” epinephrine or “without” ‘. Local anesthetics with “epi” used to constrict blood vessels to increase the duration of numbness, often make the heart race as adrenaline would; especially in patients taking certain heart medications. To lessen the chance of these episodes, the dentist needs to review your medical history and medication list and aspirate (pull back) on the syringe while injecting to avoid direct injection into the larger blood vessels of the jaws.

The good news is these episodes are short lived and usually not dangerous. And, again, are very common.

EDITOR’S NOTE: Dr. Mitchel Josephs will be giving a FREE LECTURE on Incision-Free Dental Implant Surgery, Digital Crowns & Veneers, Choosing a Dental Office and NEW TOPIC: Laser Dentistry, at the Double Tree Hotel, PGA Blvd. in Palm Beach Gardens onFriday July 13^th at 10:00 AM. Attendees will receive a FREE copy of his book: “Tooth Talk”. Only 16 seats remain! Call today to register at 561-832-2917

____________________________________________________________

drjosephs@palmbeachdentist.com

44 Cocoanut Row, Palm Beach, FL 33480

888-DRTOOTH (888-378-6684)

www.palmbeachdentist.com

Coronectomy; Your Surgical Option for Impacted Wisdom Teeth

Posted on: July 11th, 2012 by Dr. Mitchell Josephs No Comments

Q: My 21 year old son needs his lower wisdom teeth removed. The doctor said the roots are so long that they wrap around the nerve that runs through the jawbone, putting him at risk for permanent numbness of his lip, face and chin. What should we do? Gale in Stuart

A: First, congratulations that you have a 21-year-old son that still listens to you. (I’m 48 and still get advice from my mom. I have a sweater on as I type this.) Ask your oral surgeon if he can do a coronectomy. This removes the top part of the wisdom tooth, leaving the roots to rest, deep down in the socket left behind in the mandible (lower jaw). Removal of this “coronal” part of the tooth facilitates orthodontic tooth movement and prevents destruction of the adjacent second molars. The “entombed” roots will gradually rise up, away from the all- important alveolar nerve, which, as you mentioned, supplies sensation to the lip, chin and teeth. Occasionally, the roots over time will rise up to the surface of the gum, resulting in easy, safe removal. If not, they can stay put imbedded in the jawbone, and away from any problems.

EDITOR’S NOTE: Dr. Mitchell Josephs will be giving a FREE LECTURE on Incision-Free Dental Implant Surgery, Digital Crowns & Veneers, Choosing a Dental Office and NEW TOPIC: Laser Dentistry, at the Double Tree Hotel, PGA Blvd. in Palm Beach Gardens on Friday July 13^th at 10:00 AM. Attendees will receive a FREE copy of his book: “Tooth Talk”. Only 16 seats remain! Call today to register at 561-832-2917

____________________________________________________________

drjosephs@palmbeachdentist.com

44 Cocoanut Row, Palm Beach, FL 33480

888-DRTOOTH (888-378-6684)

www.palmbeachdentist.com

Easy Removal of Ugly Purple “Lip Bumps”

Posted on: July 4th, 2012 by Dr. Mitchell Josephs No Comments

Dear Readers: Due to an overwhelming response from a recent column, I am repeating a topic for the first time in six years and 300+ columns.

Q: For several years now, we have had a growing, ugly purplish bump on our lower lips. What can be done about it? Michelle and Sol in Wellington

A: There is no doubt that the lower third of the face: teeth, gums, lips and chin, show one’s age the most. This happens to be the first area that one human focuses on another human. (And on some sub-humans, like my cousin Herb.)

A hemangioma, or venous lake; is a pooling of blood under the translucent skin of the lip. Many surgeons and dermatologists are cautious to remove these due to excessive bleeding, pain and possible scaring from incisions and sutures. The fastest, least invasive way to remove these puppies is with a diode laser, which many dentists already use in the mouth on a daily basis for periodontal treatment and just before crown and bridge impressions along the gum line. Dentist are the best trained to give injections inside the mouth to numb the area. (Many times topicals like Emla cream are not effective). Within 45 seconds the lesion will turn white and in about four weeks, your little purple friend will be gone. I will be covering this at my next lecture (see below).

EDITOR’S NOTE: Dr. Mitchell Josephs will be giving a FREE LECTURE on Incision-Free Dental Implant Surgery, Digital Crowns & Veneers, Choosing a Dental Office and NEW TOPIC: Laser Dentistry, at the Double Tree Hotel, PGA Blvd. in Palm Beach Gardens on Friday July 13^th at 10:00 AM. Attendees will receive a FREE copy of his book: “Tooth Talk”. Only 20 seats remain! Call today to register at 561-832-2917

Dr. Mitchell Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts “Tooth Talk” on WBZT AM1230 (www.radiotoothtalk.com) Dr. Josephs is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry and completed his residency at Manhattan’s Beth Israel Medical Center and Mt. Sinai Hospital.

____________________________________________________________

drjosephs@palmbeachdentist.com

44 Cocoanut Row, Palm Beach, FL 33480

888-DRTOOTH (888-378-6684)

www.palmbeachdentist.com

Non-Surgical Laser Periodontal Treatment

Posted on: July 3rd, 2012 by Dr. Mitchell Josephs No Comments

Q: I was told I need gum surgery by my periodontist and my general dentist. I see a lot of information on the web about the use of the laser vs. surgery, yet both my doctors do not use this procedure. Is it proven? Daniella in Boca

A: Allow me to let you in on a little personal secret. I had an itchy tush problem a while back. A real pain in the ass. I didn’t just get a second opinion, I got four. Problem solved. (Now half the medical community has seen a side of me they have never seen before. Some send me Holiday cards.)

L.A.N.A.P (Laser Assisted New Attachment Procedure) is fairly well studied since 2004 as a less invasive, less painful alternative to the “ole scalpel and stiches” technique. After numbing, a glass fiber laser tip encircles the teeth, under the gum line, destroying the diseased inner lining of the periodontal pocket. Then ultrasonic scalers and hand instruments are used to remove the calculus (tarter) from the root surfaces. The laser then goes back in for a final “victory lap” to sterilize the pocket.

I will be covering this at my next lecture (see below) with some great videos and slides.

EDITOR’S NOTE: Dr. Mitchell Josephs will be giving a FREE LECTURE on Incision-Free Dental Implant Surgery, Digital Crowns & Veneers, Choosing a Dental Office and NEW TOPIC: Laser Dentistry, at the Double Tree Hotel, PGA Blvd. in Palm Beach Gardens on Friday July 13^th at 10:00 AM. Attendees will receive a FREE copy of his book: “Tooth Talk”. Only 39 seats remain. Call today to register at 561-832-2917

____________________________________________________________

drjosephs@palmbeachdentist.com

44 Cocoanut Row, Palm Beach, FL 33480

888-DRTOOTH (888-378-6684)

www.palmbeachdentist.com