Tag Archive for "palm beach dentist" - Dr. Mitchell A. Josephs' Blog

Posts Tagged ‘palm beach dentist’

Adjusting Dentures at Home

Posted on: April 10th, 2013 by Dr. Mitchell Josephs No Comments

Q: I recently had dental implants to secure a full lower denture. I am back at my summer home and noticed a sharp projection cutting into my gum. Is there anything wrong with adjusting dentures with some home tools? Fred in Nantucket

A: Back in the early 90’s, I performed at an open mike night at a comedy club. I did a whole routine on the “Home Vasectomy Kit by Ronco.” “If you buy now, you get the Pocket Fisherman AND the Ginsu Knives for FREE! But wait, there’s more…..” You had to see it live. Trust me it killed.

Although adjusting dentures at home is not recommended, if you cannot get to a dentist and happen to have a small, sharp projection of metal or acrylic on the removable parts of the denture, not the implant attachments in the mouth, you could file it down with an emery board used for finger nails. Don’t take the denture to the lathe in your garage wood shop.

If you have a standard non-implant supported denture with metal clasps that seem to have loosen, only use light inward pressure with your thumbs to spring the clasp a bit closer to the teeth. Do not use a needle nose plier from the toolbox. You don’t want to risk breaking a clasp or making it so tight that it traumatizes the tooth or slips down and lacerates your gum.

Hopefully you can avoid dentures all together, which are usually made for those with limited finances or for patients who waited too long and have no bone left to install permanent teeth with implants. 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 as well as Botox and Juvederm Treatment. Join us at 10:00 AM at the Double Tree Hotel on PGA Blvd. in Palm Beach Gardens on Friday May 3^rd. Only 40 seats remain. Call 888-DRTOOTH (561-832-2917) to register today!

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.

Severe Root Decay: Implants or Root Canals?

Posted on: December 5th, 2012 by Dr. Mitchell Josephs No Comments

Q: I find as I get older, I am becoming more cavity- prone. It seems like every year more teeth begin to decay underneath crowns and fillings that were done no more than five years ago. Did my doctor do a poor job? J.K. in Boca

A: This is another fine example of: “don’t shoot your dentist.” Many patients get angry if their dental work does not last a lifetime. The body is always changing and disease can occur at any time no matter how recent the dental work was completed.

You are one of many that are suffering from this common disease facing patients 65 and older. “Root caries caused by xerostomia induced by medications and the aging process itself.” In simple terms: dry- mouth, which destroys the acid reducing, buffering capacity of the oral cavity resulting in decay of the teeth, under the gum-line, along the root surfaces. Many of these teeth are better off not being root canaled and re-crowned, but instead, extracted and replaced with dental implants which have a much better long -term prognosis. Ask your dentist for some preventive treatments for root caries such as custom fluoride trays and saliva substitutes.

EDITOR’S NOTE: Dr. Mitchell Josephs will be giving two FREE LECTURES on Incision-Free Dental Implant Surgery, Digital Crowns & Veneers, Choosing a Dental Office and NEW TOPICS: “Laser Lip and Gum Treatment” and “Why Botox at the Dental Office?”, at the West Palm Beach Downtown Library on Clematis St. on Thursday January 10th at 6:30 PM. To register, call 561-868-7701. And, on Friday February 1^st at 10:30 AM at the Boynton J.C.C. on Jog Rd. Call 561-259-3016 to register.

Attendees will receive a FREE copy of his book: “Tooth Talk”. Seating is limited; these seminars fill up rapidly; call today. Dr. 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.

The $100,000 Mouth

Posted on: October 24th, 2012 by Dr. Mitchell Josephs No Comments

Q: At a recent bridge game, a friend told me he spent $100,000 on his mouth. Was he ripped off? How is this possible? Tim in Palm Beach

A: Dear Tim: A friend of mine told me he spent $100,000 on a car. Was he ripped off? How is this possible? No “rip-off” in both cases. Both gentlemen made a decision based on what they “want” and what they “need”. Unfortunately, a $100,000 car in four years will have a trade in value of $30,000 with only 41,000 miles on it. A full set of permanent teeth can last forever and will never depreciate.

I am saddened that this country does not allow medical insurance benefits to pay for permanent tooth replacement, but don’t shoot your dentist!

How can one mouth cost $100,000? I had a patient who had gone through a tough time in his life, medically and emotionally. Due to decay and periodontal disease, he needed 18 teeth removed, 10 root canals, several bone grafts, 14 implants and 28 crowns. The fee included lab work, materials, and dozens of appointments and took 7 months to complete. With permanent teeth, he now eats steak and still drives his reliable 10-year-old car.

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.

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

____________________________________________________________

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

Crowns Over Implants, Connect Them or Not?

Posted on: June 26th, 2012 by Dr. Mitchell Josephs No Comments

Q: I recently had two implants with bone grafts placed on my lower left missing molar area. The dentist who placed them said he placed 10 mm long implants, but wish he had “placed longer ones”, but could not due to the location of an important nerve at the bottom of the jawbone. He recommended that my regular dentist make the two crowns connected to each other. My regular dentist told me, ask the implant dentist!

This worries me as I once had a bridge that was three teeth all connected, preventing me from flossing, resulting in my losing two teeth due to decay and gum disease. My question is should I have two single floss-able teeth, or play it safe and have two connected crowns? Stanley in Palm Beach Gardens

A: Let’s not allow “too many cooks to spoil your dinner.” Both doctors are asking the other one to “make the call” on splinting the two crowns or fabricating two single unit crowns. Splinting crowns together is usually done if less implants are placed then the number of teeth needed in the final result. Or, natural teeth that have loose roots due to severe bone loss from periodontal disease. If the dentist who placed the implants has tested them three months after the surgery, and they seem well integrated into the bone, then I say create single crowns for easy flossing.

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”. There are only 40 seats left! 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

Dental Laser Often Means No Need for Shots

Posted on: June 19th, 2012 by Dr. Mitchell Josephs No Comments

Q: I recently needed a crown on a tooth that already had a root canal. Why did the dentist still have to shoot me all up with shots of Novacaine all over again, even though the tooth had its nerve removed? Doris in Stuart

A: Recently I visited my favorite optometrist for an eye exam. (The guy is a dead-ringer for sounding and looking like actor Vince Vaughn). I was worried I was going to have my pupils dilated for the glaucoma test which would render me useless and looking like I was on drugs. Thankfully, his new technology measured my eye pressure with a blast of air with a really cool machine.

Traditionally, many dentists need to have you numb to either pack chords of thread or burn the tissue with an electrosurgery unit to retract the gum away from the tooth and stop any bleeding for an accurate impression. Many of my colleagues and myself now use a diode laser that performs the same task (called: laser troughing.), but without a need to anesthetize the patient. For a link to a video that demonstrates this, contact us.

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”. Seating is limited to 50 attendees. 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

Loved the Temporaries, Hated the Permanent Ones

Posted on: May 30th, 2012 by Dr. Mitchell Josephs No Comments

Q: I recently had porcelain veneers done. I loved the temporary ones that I had for three weeks, but I hate the permanent ones that were just put in; they don’t look like the temporaries at all! What happened?!…..P.O’ed in Vero

A: I had this nutty dental professor in school 25 years ago named Dr. Woolhouse. He looked and acted like David Lederman; dry sense of humor and sounded just like him. He had a blue collar, French Canadian practice in Montrealand told us: “Don’t make the temporaries too nice; the patients won’t come back for their permanent work!”

“Oh contraire mones amis!” (check French spelling) Not the best advice. The temporary crowns or veneers in aesthetic cases that are hand shaped by the artistic talent of the dentist must be approved by the patient before the permanent work is made. Patient should return to the office on a day when they are no longer numb from the anesthesia to evaluate the temporaries. Once the temporaries look good, we take photos and moulds of the temporaries and send them to the lab to “copy” the design in the final porcelain work. This leads to the permanent veneers or crowns having the same shape as the temporaries that you had come to love.

For some photos of actual cases showing patients in their temporaries and their final permanent work, email us.

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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

Problems with Posts

Posted on: May 15th, 2012 by Dr. Mitchell Josephs No Comments

Q: Two years after I left my old dental office, my new dentist took some check-up X-rays. He pointed out that a tooth my former dentist worked on two years ago showed an incorrectly placed post, perforating through one of the roots. I remember this tooth had a root canal, so I have not felt any pain. I now need to have the tooth removed and replaced with an implant and crown. Is this malpractice? I.M. Shyster

A: Another subject for my book’s chapter: “Don’t Shoot Your Dentist.” A poor outcome is not necessarily malpractice. If the doctor’s chart notes show that he followed all the proper protocol in treating the tooth, but due to the pre-existing, frail condition of the tooth, the tooth fractures or the post perforated through a curved root, than most likely, no negligence was committed. Most dental offices have patients sign an informed consent, not to eliminate the ability to litigate, but to make sure the patient knows all the risks and possible negative outcomes to a procedure.

There are numerous dental journal studies that show that root perforations and fractures are “common complications” on teeth that have had root canals; especially on neglected teeth that were full of decay before the treatment was rendered. My suggestion is to speak to your former dentist, as he might be willing to reimburse your fees that were invested in that tooth.

____________________________________________________________

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