Periodontal treatment Archive - Dr. Mitchell A. Josephs' Blog

Archive for the ‘Periodontal treatment’ Category

WANTED: Hi-Tech Hygienist?

Posted on: August 8th, 2012 by Dr. Mitchell Josephs No Comments

Q: I recently needed to have 7 teeth removed due to gum disease and yet I have been getting my teeth cleaned by the same hygienist for 15 years. Why did she not see this coming?

A: Assuming you brush and floss every day, your hygienist may not be utilizing today’s hi-tech diagnostic and treatment modalities for periodontal disease.

Remember the movie 2001 A Space Odyssey, starring Hal-9000, the talking computer? My hygienist has been using a computerized, talking probe, called the STM Probe.

A small, blunt, plastic probe placed into the pocket between tooth and gum, measures bone or ligament loss around a tooth. The computer “speaks” the measurement and records the readings on a print-out, placed in the patient’s chart. If the computer generated voice speaks of pockets of “five” or greater, these areas need treatment to prevent further bone loss, and eventual loss of the tooth. The recordings are compared from visit to visit to see if the periodontal disease is progressing.

The first and least invasive line of treatment would be a thorough scraping of toxins along the root surfaces and the inner lining of the pocket sometimes using a laser, followed by the placement of antibiotic granules, called Arestin, which dissolve over a ten day period under the gum.

Very often this will prevent you from needing extensive gum surgery and loss of the tooth.

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

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

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

Osteoporosis Drugs and Dental Treatment

Posted on: May 22nd, 2012 by Dr. Mitchell Josephs No Comments

Q: Is it true you can loose part of your jawbone if you have dental work done while taking drugs for osteoporosis? Logan in Boca Raton

A: It’s a rarity that I repeat a subject matter, but after 390 columns, this subject is worth repeating. Some new conclusions have been reached concerning the taking of bisphosphonate drugs such as Boniva, Fosamax, Actonel, Zometa, Reclast, Aredia and Alendro.

The worry is ARONJ (Antiresorptive Drug Associated Osteonecrosis of the Jaw.) Old name; ONJ. The reduction in blood supply to the jawbone can result in “dead bone” areas, becoming exposed in the mouth following removal of teeth. New studies show that special tests, including CTX tests, have yet to be reliable for diagnosis or prediction of ARONJ.

The “not- to- worry” part of the story is this: Patients taking these drugs by mouth have only a 0.1 to 0.4% chance of ARONJ. Those taking it by injections, have a 2 to 10% chance. If you take these drugs by I.V. injections and are told that you absolutely cannot stop them, diseased teeth should receive root canal treatment and /or conservative restorative treatment vs. extractions.

With proper precautions taken by your dentist, such as wound closure techniques, prescribing special rinses pre and post-op, ordering a temporary “drug holiday” (discussed with your physician.), you can have extractions, periodontal treatment and dental implants without fuss. Once on these drugs, denture patients should consider making new dentures to avoid irritation of the thin tissue that covers the jawbone, called the mucosa to prevent ARONJ. Email us for useful websites and copies of the latest studies on this topic.

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drjosephs@palmbeachdentist.com
44 Cocoanut Row, Palm Beach, FL 33480
888-DRTOOTH (888-378-6684)
www.palmbeachdentist.com

Removal of Lip Hemangiomas

Posted on: May 8th, 2012 by Dr. Mitchell Josephs No Comments

Q: For several years now, I have had a growing purplish bump on my lower lip. I had consulted with a plastic surgeon, but he said it is not dangerous and did not want to attempt to remove it. I really hate the way it looks. What can be done about it? Marge in Wellington

A: I’m with you Marge. A recent survey performed by a group of social psychology researchers showed that the first part of the human body that one human looks at upon meeting another human is the mouth and teeth. I believe it goes back to our ancestors who had to make sure a fellow cave dweller was not sporting a growling attack face. We all look at each other’s mouths first to see if we can trust that person and to see if we are attracted to that person for possible procreation and continuation of our species. (Postal workers are trustworthy and usually have decent teeth.)

You are probably describing a hemangioma, or venous lake; a pooling of blood under the translucent skin of the lip. Many surgeons are cautious to remove these due to excessive bleeding 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. Within 45 seconds the lesion will turn white and in about four weeks, your little purple friend will be gone. For some great before and after photos of these cases, contact us.

____________________________________________________________

drjosephs@palmbeachdentist.com
44 Cocoanut Row, Palm Beach, FL 33480
888-DRTOOTH (888-378-6684)
www.palmbeachdentist.com