Tag Archive for "dental work" - Dr. Mitchell A. Josephs' Blog

Posts Tagged ‘dental work’

Unsightly “black on gumline” bothers patients

Posted on: April 17th, 2013 by Dr. Mitchell Josephs No Comments

Q: I notice my friends dental work at lunch the other day shows an ugly tinge of color that I can only call: black on gumline, for lack of a better term. What is this? Anne F. in Boca

A: Apparently lunch did not go so well for your friend, I take it. (If you broke the news to her.)

The most common reason one would see black at the gumline would be gum recession above a PFM (porcelain fused to metal) crown. This type of crown has metal that can be visible at the gumline with age or in patients with genetically thin gingiva. Many doctors like myself use all-porcelain, metal-free crowns in the esthetic zone to prevent this occurrence.

Another possibility is minor gum recession around dental implants, exposing the metallic, abutment post that connects the crown to the implant, imbedded in the bone. The use of metal free, ceramic abutments can prevent this in some, but not all, cases.

For a short video preview of my next FREE seminar to the public (info below), contact us and I will email you the video.

Editor’s Note: Dr. Josephs will be giving a FREE seminar to the public: “Teeth for Life”: A hi-tech update on the latest techniques in Implant, Cosmetic and General Dentistry. Join us at 10:00 AM at the Double Tree Hotel on PGA Blvd. in Palm Beach Gardens on Friday May 3^rd. Only 38 seats remain. Call 561-832-2917 to register today! Free copies of his latest book will be given to all attendees.

Dr. Mitchell Josephs practices Implant Cosmetic and General Dentistry and hosts “Tooth Talk” on WBZT AM123.0 Dr. Josephs is on staff at West Palm Hospital (Formerly Columbia Hospital) and 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.

Bridge Decay Redo

Posted on: April 5th, 2010 by Dr. Mitchell Josephs No Comments

Q: I have a three tooth bridge that needs to be re-done for the third time over a period of about twenty years. The dentists all say that I keep getting decay underneath. Is this normal? Aunt “B” in Delray

A: All of us tooth docs wish that all dental work could last forever. (I thought the roof on my house would last forever; boy was I wrong. That was some bill!)

The common treatment to replace a single missing tooth by crowning the adjacent teeth and stringing three crowns together has its limitations. Only a pair of dextrous hands can snake a floss threader underneath the fake tooth to clean out bacteria. The area missing the tooth will continue to resorb, creating an increasingly larger gap that traps food leading to tooth decay. Some reports state that these types of bridges have an average lifespan of 7 years.

If you have enough bone in the area missing the tooth, discuss with your dentist the implant option. This will stop the bone resorbtion and provide you with a single, floss-able crown that better mimics a natural tooth.

For a free consumers guide to implants, contact us.

Dr. Mitchell 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

Canker Sores- A Pain in the Mouth

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

Q: I frequently get canker sores inside my mouth. My dentist just says: “wait 10 days and they will go away.” What can I do?….. … JHC Palm Beach

A: You and me both, kiddo. Every time I have dental work or slip with the toothbrush and scratch my gum, bite my cheek or tongue, I wind up with what is known in the “biz” as an apthous ulcer. These are caused by unknown viruses floating around in the normal flora of our mouths. (Personally, I think the city should evict them!)

Apthous ulcers look like a white moon crater, surrounded by a red, inflamed border. Spicey and citris foods make you want to punch a hole in the wall. These are not to be confused with the herpes labialis cold sores on the lip; these are inside the lips, cheeks, tongue and near the gums.

Your dentist just does not have the right “goo”. I have been using a product called Debacterol for years that instantly chemically cauterizes the pesky canker in five seconds. The pain stops immediately and within a day or two that puppy is history.

Medications Plus Dental Work

Posted on: November 25th, 2009 by Dr. Mitchell Josephs No Comments

Q: I take a lot of medications, including Zocar for lowering cholesterol. I am about to have extensive dental work including implants, crowns and root canals. Should I be concerned?

A: I remember my old pharmacology professor, Howard Katz BS, DDS, MS, PHD (He had more degrees than a thermometer in Phoenix!) He once said that patients today are walking “pharmacopeias”, or “drug soups”. All health care professionals need to be on top of their game in knowing which drugs don’t mix.

After placement of an implant, we put patients on antibiotics for a week to ward off infection. Patients who are allergic to Penicillin are often prescribed Erythromycin. EXCEPT IF YOU ARE TAKING ZOCAR! This can result in a bad reaction called myopathy (muscular weakness) and rhabdomyolysis (muscle breakdown). There fore these patients would best be prescribed a “Z”-Pack (azynthromycin) or a cephalosporin.