Patients might consider financing dental treatment... why not?

Posted by Dr. Edward Magida | Filed under , , ,

We live in a world where just about everything can be financed and paid for over time. Cars, houses, school tuition, you name it and it can be financed if need be.

Credit card offers pile up in my mailbox daily and I sleep easier at night knowing that the new sofa I just ordered wo';t have any payment due until we vote for the next president. While one must be careful not to rack up payments on frivolous things, there is one area where this type of financing can make a big difference in a person's quality of life.

I'm referring to dental treatment financing.

With this in place, a persons' dental treatment can be paid out over time and no longer do a lot of patients need to put off or cancel treatment, either needed or desired, because of a lack of funds.

Suppose you have one or more teeth that are in need of fairly extensive treatment. Maybe you finally want to replace that upper right molar that has been missing for a few years. Perhaps now that you finally lost those 50 pounds, you want to finish the makeover and get smile enhancing porcelain veneers.
Many people need or want treatment but find their pocketbooks are not quite in sync.

Well, many dental offices offer ways to pay for the procedures over time. One way that's popular is to pay for the treatment interest free for 6-12 months. Another way is to pay over several years at a reduced interest rate.

In our office, many people take advantage of these programs and are able to get their dental treatment done when they want to. Instead of having to save up for a long time, or maybe wait for a tax refund, all the while hoping the car doesn't unexpectedly need repairs, you can get dental work done when you want to.

Quality dental work does cost money; there is no question about that. However, you should consider it a good investment. If it is not done in a timely basis, sometimes it could end up costing you more in the long run. Having another option available to pay for things is something you might want to ask your dentist about.

Easy solutions to a common problem

Posted by Dr. Edward Magida | Filed under , , , ,

Do you find your co-workers offering you mints or gum all the time? Do meetings end up with you alone at one end of the table? Don't fret, you could be one of the millions of people who have bad breath. Many people don't even know they are offensive to others because most times you cannot smell your own breath.

If you were to believe all the commercials, then all you would need to do would be to use this mouthwash or that and your problems would be solved. Or would it be? Bad breath is a condition that cannot be cured - only controlled. Most breath care products don't really control the problem. They only temporarily cover things up. After about 15-20 minutes the problem starts to come back because the cause of the problem has not been addressed.

The cause of bad breath is bacteria. The oral cavity harbors millions and millions of odor causing bacteria. As the bacteria digest the foods that pass through our mouths, they give off a gas, methyl mercaptan that contains sulfur. Sulfur is the compound that gives rotten eggs their awful smell. It is this sulfur-containing gas which causes a person's breath to smell bad.

So what is a person to do? Trying to eliminate the bacteria from your mouth is impossible. The bacteria recolonize within hours. Most of the mouthwashes that are available have alcohol in them. Alcohol is a good drying agent, but not the best at killing off the bugs in your mouth. In fact, as the alcohol dries out your mouth, the bacteria tend to proliferate on the dried out oral tissues.

Good oral hygiene is a must when you want to beat bad breath. Brushing 2-3 times daily as well as flossing are needed to control bacteria and the plaque they produce. One largely overlooked area of oral hygiene is the tongue. The top of the tongue, especially towards the back, has many ridges and grooves on it. The bacteria in your mouth thrive in these grooves. What also tends to happen on your tongue is that a coating develops on it. The coating is made up of food debris, bacterial plaque, and bits and pieces of dead tissue from the inside of your mouth. If you clean off the top of your tongue on a daily basis, then most of the gas-producing bacteria will be eliminated for most of the day. There are products called tongue scrapers that will help you do this.

The last piece of the oral hygiene puzzle is to use a mouthwash and toothpaste that contains Chlorine dioxide. There are several on the market. The key thing here is twofold. Because there is no alcohol, the mouth rinse will not dry out your mouth and cause bacteria to multiply at a faster rate. The chlorine dioxide is a compound that has been proven to remove the sulfur gases in your mouth for many hours. It is much more effective at controlling bad breath than any other product on the market.

To gauge the extent of the bad breath and also to measure the effectiveness of the treatment, there is an instrument called a halimeter. This instrument is extremely sensitive to sulfur molecules and measures them in parts per billion.

Many times an initial assessment i .

Most times treating bad breath simply requires changing the way a person performs oral hygiene procedures. The problem is easily solved.

The dentist's role in eating disorder therapy

Posted by Dr. Edward Magida | Filed under , , , , , , , ,

Read any women's magazine these days and sooner or later you will encounter an article about eating disorders. Eating disorders are more widespread than ever and getting worse every year.

Often it is a dentist who is the first health professional to recognize the problem.

Dental complications of anorexia and bulimia vary in complexity depending upon the length and severity of the eating disorder and may include the following:

Enamel erosion, called "perimylolosis," is the most common problem and is caused by chronic exposure of enamel to hydrochloric acid of the purge cycle. The most common area involved are the back surfaces of the upper front teeth, but all teeth can be affected. The front teeth over time may appear shorter because the thin edges wear away first and eventually, even when a person closes their teeth together, the front teeth no longer touch.

Over time, the back teeth may become affected as their cusp tips, the pointy areas that grind the food, become rounded off.

Erosion can be accelerated by excessive toothbrushing, especially right after purging when the enamel has been softened and is more susceptible to mechanical wear.

Cavities, caused by the intake of the high caloric foods during the binge cycle and compounded by eroded and weakened enamel.

Hypersensitivity to hot, cold and sweets due to exposure of the dentin, which is the layer of tooth structure under the enamel that is in direct connection with the nerve of the tooth.

Apparent "eruption" of amalgam (silver) fillings, which happens as the enamel around the fillings erodes and makes the fillings seem to grow out of the tooth.

Salivary abnormalities, inducing enlarged parotid glands and reduced flow of salvia, causing "dry mouth" (xerostomia). If the patient is receiving treatment for depression, antidepressant drugs may exacerbate the problem.

Increased risk of gum disease related to reduced salivary flow, nutritional deficiencies, and trauma to the soft tissue in the mouth.

A patient with an eating disorder must be open and honest when it comes to answering questions about their problems. The dentist must be made aware of the person's medical history, nutritional status, previous dental treatment, extent of the binge/purge cycle and whether the person is currently in therapy, The dentist may request permission to consult with the therapist to discuss dental treatment objective, medications and issues of compliance and progress. As in any such situation, confidentiality is strictly adhered to.

Dental care for the eating disorder patient does not deviate markedly from any other patient, and includes:

Emergency treatment and pain management, thorough tooth cleaning and/or periodontal therapy, basic restorative care to restore tooth function, re-evaluation prior to cosmetic or complex treatment.

Extensive oral rehabilitation and elective cosmetic treatment should be delayed until the eating disorder had been controlled.

Cosmetic bonding, porcelain laminate veneers, porcelain crowns and bridges, as well as orthodontic treatment to correct color contour bite and spacing problems are often a powerful motivating factor in a patient's recovery.

By working closely with the psychotherapist and other members of the health professional team, the dentist can help in the intervention, treatment recovery and continued health of the eating disorder patient.

Dentistry... ENJOY!!

Posted by Dr. Edward Magida | Filed under , , ,

Over the years, I have found there to be a sort of universal saying that goes along with anything pertaining to food or eating. It used to be that I noticed it when I frequented Chinese restaurants. I would place my family's order, usually ordering way more than we needed for that meal so we could take home the rest for the next day, and then I would dig into the noodles on the table. Upon the waitpersons' arrival and serving our feast, he or she would always, and I mean always, upon placing the last dish, say "enjoy". Enjoy... as if the kitchen staff had gone out of their way to make all this food only for my family that night. Enjoy.... just hearing it being said after our meal was served made me feel great, like royalty.

Nowadays, it seems like I hear it being said all the time. Whenever we eat out, the server emphatically states "enjoy", before departing our table. I would like to think that the establishment is proud of the food they serve and are grateful that we want to spend our hard earned money there. I feel like my presence is recognized by this saying..."enjoy". Recently, while buying groceries at a local supermarket I had the same type of encounter. After loading all the goodies into my cart, the cashier looked up and stated a sincere "enjoy". The interesting thing is that now some of the individual food manufacturers are placing this on their foodstuffs. I was opening a can of peaches for a snack when I noticed that it said on the top of the can "Enjoy by 7/9/04". By this point I'm sure all of you are wondering why a dentist is writing all this stuff. Well, there is a reason for my madness, so to speak.

I stated before that the saying "enjoy" goes with things associated with food and eating. While it is possible to eat some foods without teeth, having them surely improves the process. I would like to group all kinds of things dentists see and do on a daily basis into one sentence, and then follow things with my new favorite word. For the person who finally gets the willpower to have all his hurting teeth taken care of... for the person who finally finds out that replacing your missing teeth makes your life better... for the person who has lost her self esteem because of an accident that knocked her front teeth out, and has finally decided to get some implants and crowns to get her beautiful smile back... to the elderly person in a nursing home whose denture keeps dropping out and has finally decided to have a new one the people that have all their life not smiled a lot because they had teeth that were too dark or crooked or chipped or any combination of these, and have finally had a beautiful set of porcelain veneers or crowns placed... ENJOY!!!

Dental Insurance 101 ---A patient primer

Posted by Dr. Edward Magida | Filed under , ,

I am writing this article as a last ditched effort for people to try and understand just what it means to have and use dental insurance benefits. Please be aware that dental benefits have not changed much for decades, meaning that the amount an insurance company will pay is still the same it was 25 years ago, even though the cost of dental treatment has gone up like everything else.

I am going to list a bunch of things people have done or tried to do with their insurance as told to me by people in the dental profession. Sometimes things were done out of being ignorant of things. Other times things were done out of frustration. Hopefully, by reading about this topic you can get a handle on just what dental benefits you do have….or don’t have!

Here are things patients have done, or tried to do

  1. Not paid their co-pay for a procedure.- Very few procedures are paid in full by the insurance company.
  2. Not paid their deductible.- This is a once a year payment that is due to the dental office.
  3. Not paid because their insurance “maxed out”.- If you need a lot of treatment, and you use up your benefits, you still are obligated to pay your balance for the treatment you needed and authorized your dentist to do.
  4. Not pay for a procedure if the insurance company “downcodes” a procedure, and therefore pays at a lesser amount.-Insurance companies are not known for always paying for better quality materials used in many dental offices today. They will pay for what they consider “adequate materials”. Do you want your mouth to be “just adequate”?
  5. Play ignorant about their policy benefits.- If you do not understand just what is covered, call the company and ask them. It’s your plan.
  6. Play ignorant about their yearly maximum benefits.-At some point, if you have much treatment, your policy will max out and you will owe the entire treatment bill yourself.
  7. Get upset because “their dental office doesn’t keep track of all aspects of their policy”.- There are hundreds of policies out there. It is not possible to expect your dental office to know everything about all the policies.
  8. Get upset with their dental office because insurance is messed up, when in reality, the patient gave the wrong policy information to the office.-Make sure we have your correct birthday, social security number, insurance company address.
  9. As the office to falsify dates of service in order to collect benefits.-I’m not losing my license for anybody!
  10. Get upset when their dental office doesn’t keep absolute track of a person’s remaining benefits.-It’s much easier for you to keep track of your remaining benefits, than for your dental office to keep track of the benefits for several thousand patients.
  11. Get upset when their dental office does not know to the absolute penny, how much of a benefit is to be expected.-Many times we do not know exactly how much will be paid until the check arrives.

C’mon folks. Get real. Whose benefits are these anyway? They are not the dentist’s. The dentist is just trying to do what’s best for the patient. You the patient absolutely need to understand your own benefits. You need to know what procedures get reimbursed at what percentages. You need to know that certain procedures, although deemed necessary by your dentist, might not be covered. It is not the dental office’s fault if your coverage is lacking!

Dental insurance should be looked at as a possible bonus towards treatment you need. It should not be looked at as the reason to get or not get treatment.

If you have dental benefits, that’s great. It will definitely help with paying for your dental treatment. All I’m asking is for you to be part of the picture. It’s your plan and you should know what it does or does not do for you.

Cosmetic dentistry – The changing of our lives

Posted by Dr. Edward Magida | Filed under , , , , , ,

"Nothing personal, Doc, but I don't like coming here!"

As a dentist, I have to say that this statement is the one that I hear most often. I don't take it personally because I know that down deep, most people appreciate the care given to their mouths by dental professionals. Still, day in and day out, that "nothing personal Doc" statement is something that I have learned comes with the territory.

However, the territory is changing constantly. Cosmetic dentistry is one aspect of dentistry that is in permanent overdrive. Bleaching, all porcelain single crowns and bridges, bonded esthetic fillings and onlays and a myriad of other procedures have left the patient with a lot more choices than ever before. The old silver filled teeth and chalky looking crowns are being replaced by many new and exciting options. Once people are educated about what cosmetic dentistry can do for them, their attitudes about good dental treatment and its proper maintenance change drastically.

Suppose a woman had discolored, chipped or misshapen front teeth. Perhaps she doesn't smile very often due to being embarrassed about the look of her smile. Once esthetic porcelain restorations are placed in her mouth, there was a tremendous boot in her self-esteem. Patients have mentioned how they used to talk with their hands in front of their faces all the time. Other people say that replacing old, ugly crowns in the front of their mouth brought them peace of mind. No longer are they afraid that others are staring at their teeth. Instead, people ask if their hair is different or whether they've lost some weight. The effect of beautiful and natural dental work is that of illusion. Something is different, but because everything looks so natural, nothing stands out. Gone are the days of yesteryear when the white chicklet "Hollywood" look was the norm after someone had "caps" done.

Please don't think that cosmetic dentistry is only for the front teeth. New and exciting options are available for the back teeth, too. Tooth colored ceramic restorations can eliminate the silver look of the past. Tooth shaded ceramic onlays can be placed to strengthen a broken down tooth that in the past could only be fixed with a crown. These onlays are much more conservative because much more tooth structure is left intact. If a crown is needed there are several new types that are incredibly lifelike and vital looking. Many of these esthetic looking crowns are very difficult to detect.

If you have been walking around with some "old" dentistry, and do not like how it looks anymore, you owe it to your self to investigate the new alternatives.

Consider Changing Your Toothbrush

Posted by Dr. Edward Magida | Filed under , , , ,

Does your toothbrush look like you’ve been cleaning all the statues in New York City?

Do the bristles go in every direction, like a cartoon depicting someone’s hair while they get shocked by electricity?

Does the receipt for your toothbrush show it actually was purchased many years ago at a 5 and 10 cent store for only a dime?

Maybe it’s time to consider starting fresh and tossing your old friend and replacing it with a new toothbrush.  Studies have shown that the germs in your mouth easily contaminate the bristles, and get spread around as you brush your teeth.

It is wise to rinse the brush after using, and allow the brush to dry out first before using it again, since this will help control the spread of these germs. The use of two brushes, alternating between them, will help this process.  In a healthy person, you should replace the brush every three-four months.

Patients who have colds (or flu virus) should replace the toothbrush when the cold is over.  People with chronic conditions as well as those with oral inflammatory conditions, i.e. gum disease, should replace their toothbrushes more frequently as well as immersing their brushes into an antimicrobial mouthwash for 15-20 seconds when done using them.

Toothpastes containing triclosan appear to significantly reduce the microbial contamination on the brush.  Do not store toothbrushes in a room that has a toilet as it has been shown that flushing sends up a large amount of tiny droplets, which could contaminate the brush.

Electric toothbrush heads should be changed just as often.  If the person has braces on, then change the head every two-three months.

Toothbrushes are a vital element in maintaining good oral hygiene but they do need to be cleaned and replaced on a timely basis to be as effective as possible.

A dental check up…It's not a pit stop

Posted by Dr. Edward Magida | Filed under , , ,

It is very interesting to me that for some people, setting up an appointment for dental treatment is synonymous with ordering a pizza. They want it quick and easy and many times don't really care about how good it is, since after all, it's only a pizza. Consider the person who had not seen the inside of a dental office for many years. I'll call him Mr. Jones.

Upon calling the office for an appointment, Jones explains that his last check-up and cleaning were done "awhile ago." He's calling because he would like to have his teeth cleaned as soon as possible. His teeth do not bother him, he says, except for the food that keeps getting stuck in a big hole in the back somewhere. Jones says he tries to keep up with brushing most days, and if it were not for the persistent nagging of his wife about his bad breath, he would not have called at all. He would have waited until something really started to bother him.

What is interesting about Jones is that he recently bought himself the sports car of his dreams. A real beauty. He washes it religiously every weekend, wouldn't think of putting anything less than premium gas into it and has the oil and filter changed every 3,000 miles without exception.

When it comes to his dental health, however, it's a different story; Jones thinks sporadic dental office visits ought to be sufficient. He wants someone to give a quick look-see, and then give a quick buff and shine to his teeth. These are the very teeth, which unlike his car, get used all day, everyday of his life. The teeth, that if lost, would be sorely missed.

The receptionist asks what type of cleaning Jones needs. Does he need a simple above the gum prophylaxis or polishing? Or, perhaps the two to four longer visits with the hygienist for quadrant scaling and root planing to take off the years of tartar deposits that have covered Jones teeth and gone below the gumline, now causing him periodontal disease.

Jones is taken back. He now has to stop and think about something he has never really thought about before. Unlike the careful thought he gives to the car that he probably will trade in for the latest model in several years, the question of his teeth is disconcerting.

The question about the kind of cleaning he needs will hopefully get him thinking about his teeth and their proper care. Unlike his car, his teeth are the only ones he will get. A change in attitude about them is called for.

When a patient comes in for hygiene or "recare" appointment as it is now called it is not like he is bringing his car into a quick-lube garage. A lot of thought and skill goes into the appointment.

Here are some of the services performed by the dentist; all good reasons for continued routine dental treatment.

Your dentist should:

  1. Review medical history and modify treatment as needed.
  2. Perform a blood pressure screening. Many times the dentist sees the patient more than the physician, so a problem might be detected sooner.
  3. Perform oral cancer screening.
  4. Screen for periodontal disease.
  5. Perform cavity and tumor detecting x-rays.
  6. Examine existing fillings and detect new cavities.
  7. Evaluate your bite and the consequences of missing or crossed teeth.
  8. Re-check fit of dentures.
  9. Remove tartar, plaque and stain.
  10. Provide fluoride treatment and other medicaments.
  11. Plan treatment for your present and future dental needs.
  12. Evaluate total dental needs and make referral to a specialist if needed.
  13. Talk to you about cutting edge dental technology and treatment available.

The old adage "floss only those teeth you want to keep" holds truth. So much is known today about dental disease and how to control or eliminate it. A person owes it to himself or herself to take care of his teeth properly. The next item you seek out the services of a dentist or hygienist, or you receive your reminder card that says it is time again for the dentist to see you, be assured the dentist is there to help. Use your dental professional as a resource. Ask questions about your mouth and problems that your are experiencing.

For dentists, a patient with a beautiful smile and a healthy mouth is what it's all about.

If your dentist doesn't answer your questions to your liking or doesn't seem to really care, it's time to find a new one. Healthy teeth are part of the equation for good quality of life. The dental profession is trying very hard to educate people that their teeth can very easily last a lifetime, if cared for properly.

Continuing Education... It is a must for your dentist

Posted by Dr. Edward Magida | Filed under , , ,

When I graduated dental school 18 years ago, I remember being told by some of the faculty that finally I was going to learn. That was a little disheartening to hear since I had just spent the hardest four years of my life supposedly "learning" to be a dentist. I couldn't appreciate what they were saying at the time.

Today, I understand what they meant.

Dental school is only a beginning. It teaches the basics. A new dentist needs to practice what he or she has learned. The new dentist needs to gather tips and tidbits from more experienced dentists. The new dentist needs to take classes on subjects that are not offered in dental schools, for it is only when dentists routinely enroll in continuing education courses that they learn the cutting edge stuff.

Relying on only what was learned in dental school, a dentist will soon find him or herself terribly outdated. State-of-the-art procedures are constantly evolving, and it takes a concerted commitment to continuing education to keep on top of things.
Most of the procedures I do on a day to day basis, for example, are procedures that I learned after I graduated.... Things such as tooth-colored fillings, implants, porcelain veneers, orthodontics and orthopedics were all learned from other dentists who were considered masters of their craft.

Other techniques such as root canal therapy are now performed differently than was ever envisioned back in dental school days.

There are new materials to use that weren't even around four to five years ago. There are new and improved versions of older materials that need to be tried out. Equipment design changes are constant, with the introduction of better, faster technology almost every week.

With all the movement in the profession, it is imperative that your dentist read as much as possible about what is going on. The next step is to take courses on the topics that interest him or her. In this way, a dentist can bring new knowledge about the latest techniques back into the office.

Last month, at a dental conference held in Toronto, I became a Fellow of the Academy of General Dentistry. It is an award given to dentists who complete hundreds of hours of continuing education in various dental topics, and who also pass a comprehensive written examination. I was proud to achieve this award because it signifies my continuing commitment to be my best.

Require the same from your own dentist. It will result in much better care for you and your family.

Dentists Beam in on Cavities

Posted by Dr. Edward Magida | Filed under , , , ,

Captains log, stardate 2002: We're rounding Alpha Caninigus and heading towards a rendezvous with Starship Incisorus. The reason? We recently acquired a new instrument, one whose origin seems right out of science fiction.

Its name is the Diagnodent and when I use it I feel like the doctor on Star Trek. Remember how he could diagnose a problem by passing a wand-like instrument over a person? Diagnodent is a new technology that can help diagnose dental cavities in a similar way.

One time-honored way to detect dental decay in teeth has been to stick a sharp dental explorer into the nooks and crannies on the chewing surfaces of a person's teeth. If there was a 'stick", meaning the explorer got wedged inside one of the tiny grooves of the tooth, this was considered a cavity and the tooth needed a filling. In addition, the dentist took x-rays to help look for the classic signs of decay, which are dark shadows on the films. Between x-rays and poking around with the explorer, most cavities were found.

There are several problems that can make cavity detection difficult. Fluoridation, which has been shown to help prevent cavities by "hardening" the enamel of teeth, is not 100 percent perfect. It has, in some circumstances, made the detection of small, subsurface cavities difficult, because the 'hardened" enamel remains intact, but the subsurface decay develops through tiny fissures and microcracks. The decay hidden beneath the surface is inaccessible to probing with the dental explorer. To further make things difficult, x-ray diagnosis of early has been shown to be inaccurate if the decay has not developed to a certain depth.
This is not good since the best time to treat a cavity is when it is small so that it has not destroyed much tooth structure and has not come close to the nerve of the tooth. By the time some cavities can be detected, a significant amount of tooth structure is lost and sometimes the nerve has been affected.

Beam me up, Scotty... well almost. The Diagnodent uses a laser beam that measures changes in fluorescence levels within tooth structure to quantify decay progression. When the laser shine onto an area of decay, even if that area is not detected on an x-ray or with the tip of an explorer, it will register that decay is present. The dentist can remove the small cavity and place a very conservative filling in the tooth. Conservative is the name of the game, since you want to find and treat cavities as soon as they develop.