Tooth Replacement Options

One of the biggest dilemmas facing many of our patients is what to do about my missing teeth.  As a dentist, the answer is not always consistent or obvious.  There are four basic choices and none of the choices are right or wrong in every instance.  It depends on the size of the space, your age, where it is in your mouth and how important the tooth is to your overall dental health.  Moving between the choices from the least to the most expensive treatment, which translates to the easiest to the hardiest (remember the dentist is like the plumbers “time is money” thus the harder the job the more time it takes).  We will start with the first treatment and that is “oh well I lost my tooth.”  Obviously wisdom teeth or severely crowded areas of your mouth often fall into this category and no treatment is necessary.   Number 2 is a removable appliance of some nature.  That can be anything from a simple tooth attached to a temporary retainer, to a chrome removable partial denture with many teeth attached.  If there are large spaces, this is often the best choice as you pay by the appliance, and not by the tooth.  So if there are a lot of missing teeth on the appliance, it isn’t more expensive.  The downside to all removable appliances is function.  It is something in your mouth that may be a little foreign to you.  The 3^rd choice is fixed bridgework in which “caps” are placed on either side of the space and a “bridge” fills in the gap.  Unlike the removable appliances you pay by the tooth and it requires modification of your teeth for it to function.  Thus there are Novocain shots and all the other issues typically associated with dental procedures.  The last options are dental implants which are artificial roots that are placed in your jaw and a cap are attached to the implant.  This has the advantage of not relying on other teeth for support, but once again you pay by the tooth.  Although we restore several teeth each week this way, a surgeon has to place the implants.  As we all know specialists are not known for being inexpensive, therefore the cost can exceed $3500.00 per tooth by the time you are all done.  Thus this process often times is above our patient’s insurance coverage limits.  Once again, all of these are just choices and there is no consistently right or wrong answer to those choices as it is based on individual needs and desires.  But in general the more expensive the process, the more it looks and functions like your natural teeth.  That being said, implants are by far the most durable and functional therefore often times are lifetime restorations and therefore are best choice if you can afford them.

The Cost of Votes

I am sure most of  you reside, like I do, in the 7^th congressional district of California and I am sure, like myself, you grew very tired of all the Ami Bera/Doug Ose ads that were on television.  Just in case you were wondering, $22 million dollars were spent on those ads.  For the number of votes that were actually counted in that election that works out to $220.00 per vote.  Obviously, a very distressing figure.  However, it is politics as we know it today and in fact nationwide if you add up all of the local statewide and national elections the total comes to slightly over one billion dollars spent in advertising for the elections on November 4^th, 2014.  That certainly seems like a very large figure, but what does that have to do with my dental blog one might ask.  Well, it has to do with what occurred the Friday before the 4^th, that would be October 31, 2014, which was Halloween.  Would anyone care to venture a guess at how much was spent on candy in the United States for Halloween this year?  I am not talking about the alcohol for parties, or for costumes, or for transportation, or little bags and other trinkets that are given away, but just the candy given to children.  Well it works out to $2.2 billion dollars.  That is over twice as much as was spent on the political campaigns.  Now one could certainly make an argument that the future of the country is more important than candy, and as a dentist I would probably agree with that.  But these figures are certainly open for interpretation and I leave it to you, my blog readers, to make your own determinations as to which one or both of these figures are in excess of what is reasonable.  I would be interested if anyone has any comments to make.

 

Diabetes Part II

This is the second blog during Diabetes Awareness Month.  And as I promised, I am going to relate my own personal story.  My father passed away in his 80's from complications with insulin controlled diabetes and my mother had diabetes when she passed several years before.  Since diabetes has environmental as well as hereditary components, my primary care physician knew I was a candidate for type II diabetes.  Up until two years ago I was doing okay with a fasting blood sugar tested annually that was consistently in the 100 range.  Then one day I started getting symptoms of rather severe dry mouth, as well as prostate issues (you men know what I mean!).  I also suddenly developed a large cavity on the lower left 6 year molar, to put that into prospective, I had not had a cavity since 1972, so it was a little weird.  I called my primary care physician and he immediately ordered a fasting blood sugar test and my reading was 396, basically ready to die.  He immediately started two diabetes medications and now with some effort my blood sugar is consistently less than 100 and all my other symptoms have passed.  I have a new crown that Dr. Naten placed for me on that broken molar and it’s been fine.  I have lost 50 pounds and the diabetes is primarily diet controlled with regular increased exercise.  I am only on one medication that is 1/8 the dosage that I was on originally, and I feel great!  I can now keep up with my wife on all of her crazy hikes (my kids call them “MKH's” or Mom's killer hikes).  With all the potential complications of diabetes, obviously it is very beneficial to get the situation under control.   Therefore, speaking to all you guys out there, do yourself a big favor and if you have a problem get tested, get treatment and feel better.

 This is me after losing 50 pounds.

Diabetes Awareness Month

Happy National Diabetes Awareness month.  I bet you thought this was the holiday season, but in the medical world illness and disease know no seasons.  Therefore, November is Diabetes awareness month.  You may be wondering why a dentist would be blogging about type II diabetes.  Well, in my case there are two reasons.  First, I was diagnosed with type II diabetes about a year and half ago (more about that in my next blog) and second, there are substantial aspects of diabetes that affect dentistry and often the dentist is the first medical care provider to recognize diabetes symptoms with their patients.  There are two reasons for this.   First, unfortunately, as a group we are often lax at getting regular medical testing accomplished. I am speaking primarily to the men of course!  And second, more than half of the population visits the dentist at least annually therefore, we have a better chance to observe the early manifestations of diabetes.

And what is it that we see.  First, the sudden dry mouth issue that is manifested with the decreased salivary flow and more aggressive decay beyond which you would normally expect.  Second, due to the decrease in blood supply caused by the diabetes an increase in periodontal disease starts generally with gingival swelling (gingivitis) and progresses to tissue and bone loss, tooth mobility and eventual loss of teeth (periodontitis).  That loss rate can be up to 5 times greater than a non-diabetic patient.  From my own experiences do not take these early symptoms too lightly or ignore a referral to your physician for testing.  Type II diabetes is a management issue and it can be controlled with some effort. If not controlled, it can lead to blindness, loss of limbs, high blood pressure, strokes, heart attacks and obviously potentially death. 

Since I don’t really want to lose any patients, if we recommend a fasting blood sugar test with your physician just do it (the men again of course).

My First Blog!

I wanted, in my inaugural blog, to address a question I've been asked many times over the last few months.  Why the name change of our office from my name to Boulevard Family Dentistry?  The answer is really set in the past.  I've been here in this office since late 1977 and it's really an update of who I am.  In fact, at almost 40 years it's by far the oldest dental practice in Elk Grove with the same primary practitioner.  We have a  hygienist that has been with us for almost 35 years and several staff with well over 20 years of service to the community of Elk Grove. We've been through the gas crisis and drought of the 70's, the recession of the 80's, the market boom and bust of the 90's, the housing burst of the 2000's, the financial breakdown of 2008 and Obama care.  All that time we have been providing high quality care to our huge family of patients.  That's a record that I cherish and look forward to continuing for years to come.  Unfortunately, we all do get older and as I gradually approach Medicare age I have to admit that despite the fact that I have no immediate intention of retiring I have cut down to only 50 hours per week at the office.  Therefore, 20 years from now when I pass by the office, if I am going to see our patients being cared for with the same level of care that I have come to expect a name change is necessary.  As Dr. Naten and other young dentists take my place we need continuity, so that all of our patients will see that although the names of the dentists may change, the care they receive will be the same as it's been since 1977. 
For more information visit http://boulevardfamilydentistry.com/