Best of Business Award.

I don't know how we were nominated or received this award but it is a nice thing to have. Please click on the title of this post or visit http://www.smallbusinesscommerceassociation.org/Default.aspx to view the web site for this organization.

Any comments about the organization granting this award would be welcome.

Saturday office hours in December.

We will be in the office on Saturday, December 6th, and Saturday, December 19th. Tuesday, December 8th, I have a study club meeting to attend and we will be closing a little earlier.

Conley Study Club last night: Digital X-rays.

Our study club met last evening. A representative from Kodak Dental Systems was our guest presenter. The Kodak sensors are very good. The wired system that they provide is excellent. The presentation highlighted many of the advantages of computer based imaging.

The system in my office is still in my mind the best conventional system. It results in less exposure to radiation than any of the others it seems. As mentioned previously, the radiation exposure to the patient is one third of that for film or conventional digital x-ray sensors like the Kodak sensor. We have the ability to take panoramic images with our system also.

It was a good meeting. It was informative and inspired some good discussion among our group. There were about a dozen of us present for this meeting.

This is a "+" update regarding computers.

This is not directly dental health related. My office is very high tech. We have more computers than team members. This is the age that we live in. As a matter of fact we could probably use another computer or two but that is another story.

Computers are essential but they can also be a big pain. We come to take them for granted when they are working well, but when we have problems with them it is quite often a major headache. My office is fortunate to have Hadi working with us. He set up the network at Smiles of Skokie. We have a server and a high speed networking switch managing our digital x-rays, digital appointment book, .... If you would like Hadi to help you with your computers at home or office he is available. Just let us know and we will get you in touch with him. He is excellent and we are happy to support him and provide all of you with an excellent resource.

Hadi works with 2 utility programs that clean out the excess data that is not needed but really slows up a PC based computer. If you do this on your own you do it at your own risk and you should be fairly knowledgable with computers. One of these programs is "Ccleaner" and the other is "Malwarebytes Anti-Malware". Both of them are free. Use them with care. You can do damage to your system if you use the "Ccleaner" software to "Fix selected issues" in your registry. Hadi doesn't recommend that you use Ccleaner to do this. Ccleaner should just be run in the "Windows" tab and don't let it work with your "Cookies" or "Autocomplete Form History". I would also not let it "Empty Recycle Bin" or do anything with the "... Shortcuts". "Advanced" should not be used at all except by advanced users in my humble opinion. "Malwarebytes" is pretty intuitive to use. If you work with computers much at all this program should be no problem to use. These two programs can help tremendously from what I have found. Thank you, Hadi!

The other program that I have found very helpful is Uniblue's "Registry Booster". This program will analyze your system and do very limited cleaning of the registry unless you pay to register it. Once you have paid for it [less than $30] it will clean all of the problems and back up your registry in the event that it makes an error. I have never had a problem using this software. Hadi doesn't like making changes to the registry but I have found that this helps my computer performance tremendously in conjunction with the other 2 programs mentioned above.

Again, use these 3 suggestions totally at your own risk. If you have other suggestions or would like to contact Hadi for help please get in touch with the office. All of us at Smiles of Skokie know Hadi and appreciate his help and, most of all, we are happy to be of help to you!

Office News. Minimally Invasive Dentistry.

This month's office newsletter is updated. Please check it by clicking on the title of this post.

We have more information about xylitol at the office. We also have some xylitol products.

Minimally invasive dentistry is discussed in the newsletter. I have been using air abrasion for years and it is the best way to remove small areas of decay and prepare surfaces for bonding.

Please visit our web site for more information or do your own Google search.

Best always and have a happy Labor Day weekend!

Digital x-rays and sharing information.

You should be very interested in this subject. As a patient, digital information enables you to have your records taken and maintained extremely efficiently. The digital x-rays that my office takes, expose you to only one third of the radiation that the more conventional other types of digital systems need. We use a phosphor plate system which is also more convenient and comfortable. The plates that we use are sealed in plastic envelopes and then processed in a few seconds. This allows for the images to be read almost immediately and, if needed, be retaken to get the best image possible. If an x-ray needs to be retaken, then you are still exposed to 1/3 less radiation than one image would require with a totally electronic system. From my perspective this is something that is taken for granted due to the fact that we have been using our phosphor sensor system for close to 3 years now.

Just yesterday we had a patient in our office that needed to be sent to a specialist. We took a couple of x-rays and then emailed those directly to the specialist for review before the patient even arrived in spite of the fact that he left our office and went directly to the other doctor's office. What a wonderful benefit!

We can transfer these images to other continents or provide them to patients who are traveling. They can easily be attached to emails just like photos. The images can be stored in a patient's home computer or on their thumb drive. We typically send the images as 'jpeg' files which are the same as your digital photos. This means that they can be viewed on your home computer if you wish.

We also backup all of the office data on a daily basis and have the data, when taken, stored on a computer server at our office which has a dual hard drive 'RAID' system built into it. 'RAID' means literally, "Redundant Array of Inexpensive Drives". If our computer server has a hard drive failure then it notifies us of the problem and still has a good copy of the data on the 2nd drive. The backup that we make daily is a placed on a portable drive that goes home with me daily. We rotate 5 drives from home to office in order to have multiple copies for the ultimate in safety.

This discussion was prompted by one of our patients that was in on Monday. If you have something that is of interest to you that you would like to see me discuss here, please let me know.

Implant Restorations & Longevity.

I have been restoring implants for many years. Of the implants that I have restored there was one that was restored about 20 years ago on which the crown and support structures loosened. There is a key component which is designed to hold indefinitely. It in essence 'cold welds' the tooth portion of the replacement to the root portion which is the surgically placed implant. This technology has improved to the point where the implant manufacturers no longer recommend placement of crowns for implant restorations with remvable or temporary cement. All of the crowns placed in my office on implant restorations done recently are secured with bonding materials and resin based, virtually insoluble cements. They should not come loose or have any degradation for 2 to 3 lifetimes according to scientific research.

Recently we saw a patient of ours [who is new to our office within the last 2 years] who has many implant restorarions. Within a couple of weeks he had 2 crowns come loose from implant replacements. Both of these crowns are now secured with resin based bonding materials and he shouldn't have this problem any longer.

It is best to follow the manufacturers recommendations and I believe in keeping up with the latest technology and refinements in dental treatment. I attend many continuing education courses and do a lot of professional journal reading as well as follow my profession in other ways. Our relatively new patient should not have any more problems with the 2 most recently secured crowns on his dental implants.

Growing new teeth in mice.

Mike Melnick sent me this link to an interesting article.

http://health.msn.com/blogs/daily-dose-post.aspx?post=1215105

Research is moving ahead on many fronts.

Things keep getting better and better!

Fighting decay with 'sweets'.

We have recently seen a couple of patients who had developed some pretty thoughtless habits that nearly caused some very serious problems. One person was having some digestive problems and was consuming sugary mints quite regularly and the other was developing a dry mouth in the middle of the night and quenching his thirst with a sugary energy drink.

The individual with the energy drink habit is a senior high school student. He wanted to drink something that had a cap on it so that when he was thirsty in the middle of the night he wouldn't need to get up to go get something to drink. Unfortunately he chose an energy drink that had quite a bit of sugar. Apparently this didn't give him a sugar rush of energy that disturbed his sleep. Perhaps he was just drinking small sips from time to time in the middle of the night. Regardless, this nice young man came in for a check-up and noticed that his upper back teeth were feeling a little rough. On examination his back upper teeth both had large, deep cavities. When the decay was removed, one of them had decay just barely touching the nerve. When this happens there is about a 50% chance of this tooth needing a root canal in the future. I used the most sedative procedures possible when restoring this tooth and so far the root canal isn't needed. We are both hoping it won't be necessary in the future. There were 3 other cavities in his mouth that needed fillings that fortunately weren't nearly as deep.

The other patient is a 60 year old friend of mine from the area who was having some sensitivity with his last tooth on the lower right. It was so sensitive that it required much more anesthetic than is usually necessary. It was also decayed fairly deep below the gum line making the filling of this tooth much more difficult. Fortunately in this case the nerve was not touched/exposed by removal of the decay. However, the tooth was still quite sensitive for some weeks after treatment. It seems to be growing less sensitive with time which is an excellent sign. This patient had a total of 9 teeth with cavities in them. We are still finishing the cavities that aren't as deep as those that we had to deal with on an emergency basis.

We are recommending xylitol containing products for people that are consuming sweets. Xylitol should be the first ingredient listed when you are shopping for one of these products as Heidi our hygienist points out. Xylitol has been shown to help dramatically reduce decay when added to one's diet. This ingredient can actually help heal small cavities that have already started in teeth. Xylitol is naturally occurring in our bodies and is contained naturally in many foods. Up to 15 grams a day is safe for everyone. It also tastes great in contrast to many artificial sweetenters. The recommended amount to be consumed daily is 5 to 15 grams.

Sweets can be good for you too! You just need the right kind of sweets!

Vacation next week & flying last weekend.

I hope that all of you are doing well. It has been wonderful weather lately. Hopefully you have been enjoying the fresh air and getting out.

The office will be closed for oral health care from this coming Saturday [July 18th] and for the next full week. We have appointments scheduled again starting Monday, the 27th. Our last day in the office will be this coming Friday the 17th, before the vacation.

Lori will be in the office for limited hours next week. Please call the office and speak with her or leave us a voice mail if you would like. I have already arranged to have 2 local dentists in my study club to help with any emergencies that may arise during my absence. As always, information will be available by calling the office at 847.675.3002.

I am making a trip across Iowa with a smaller group [ www.ragbraicubs.org ] among approximately 10,000 other bicyclists. My daughter, Erika, will be making the trip also. There are 62 bicyclists in the smaller group and a support crew, Erika is a member of the support crew for this trip.

During this trip, I will be riding my bicycle during the day and flying my powered paraglider in the mornings and evenings when conditions are right. Yesterday there was a profile in the Des Moines Register newspaper at http://www.desmoinesregister.com/article/20090713/LIFE/907130301/1039
mentioning this.

This last weekend was very good weather for flying. I was at the Kankakee Regional Airport for an ultralight flying event. Photos that I took during this event can be viewed at http://picasaweb.google.com/davidmcw3/PPG090711KIKKFlyIn?authkey=Gv1sRgCLfXjoeJ6Yz7BQ# at your leisure.

Again, I wish you the best, and look forward to seeing you, your friends, family and neighbors in the office and around town.

Newer Anesthetic

Having a 'dental family' is fun. It is truly a pleasure to work with all of you. Stress comes into the equation due to the nature of the treatment which can be uncomfortable. The nature of teeth is that they are sensitive. They have 'nerves' that are usually quite sensitive when teeth need to be treated even with small cavities.

Novocaine is what most of us call the local anesthetic that is used in dentistry. Novocaine hasn't been used by most of us for years. It was replaced by lidocaine before I started dental school. I have never given a patient actual novocaine. Lidocaine has recently been replaced by a more comfortable and more dependable local anesthetic called articaine.

Articaine is much better than lidocaine [and thus novocaine] in a couple of signicant characteristics. It penetrates tissues much more effectively. It also doesn't hurt as it is injected nearly as much as lidocaine.

I have been using articaine at my office for a number of years. Many other offices are finally switching to this more comfortable anesthetic.

Implant restorations made easier and esthetics.

This morning I attended a continuing education meeting that presented restoration techniques for esthetic dentistry in general and implants in particular. It was given by Dr. Rob Ritter of West Palm Beach, FL.

The program touched on esthetic dentistry techniques, materials and resources. Much of it was review but there were some interesting different perspectives which will help me refine my practice even further. The cosmetic dentistry discussion was helpful.

We then discussed the Biomet Encode system for restoring implants. This is something that results in faster and easier visits for the patient without compromising the results. Actually, it results in a more esthetic restoration through the use of a custom abutment [understructure] for the implant restoration. If you are interested in learning more about this please contact me. We are now offering this in our office.

It was a good meeting and fun!

"Diagnodent" helps find smaller cavities.

This is a relatively new piece of equipment. We have been using it for years. We use it for virtually all of our patients. It is a pretty costly piece of equipment but we feel that you are worth it.

The Diagnodent allows us to find decay when it is much smaller than can be found by other diagnostic methods. This means that instead of tiny areas of decay going undetected they can be found earlier and a much smaller filling will be needed or perhaps just a sealant to restore the tooth after the decay is removed.

When smaller fillings or sealants are needed it is much better for the patient. There is less tooth destroyed by the decay. There is less irritation to the nerve within the tooth. There is less of a need for anesthetic. The remaining tooth is stronger because there is more of it. The filling will last longer because it is smaller. All of this makes the use of this advanced diagnostic device very beneficial.

The Diagnodent uses a safe optical laser with a light sensor that detects the changes that decay causes in the light that it reflects back [technically: "laser fluorescence"]. Unfortunately it also reacts to calculus or tartar on the tooth and to healed [remineralized] very small areas that were once starting to decay. There are some significant false positives that your dentist [me!] needs to sort out.

We plan on using this wonderful piece of equipment for the foreseeable future!

The Best Materials for White Fillings in Back Teeth

We use a special combination of materials when placing white fillings in one of our dental family member's teeth. There are a wide variety of tooth colored materials available for filling teeth. Most dentists use one of these materials to fill anterior teeth for appearance and another one of these materials to fill back teeth for wear resistance and secondarily, appearance.

I use a combination of materials to restore back teeth. There are materials which are quite wear resistant but they also contain, absorb and release fluoride to help minimize the possibility of decay occurring on areas adjacent to these fillings and on neighboring teeth. I use this type of material for the surfaces in between the teeth below more wear resistant materials on the chewing surfaces.

Fortunately, the more wear resistant materials placed over the high fluoride containing materials bond solidly to the underlying material as if it was one solid filling material. The wear resistant material wears in a similar manner as natural tooth enamel does. This material is very compatible with natural enamel.

This combination of filling materials leads to the most decay resistant, strongest, longest lasting fillings that I can place for you. There is the high fluoride content between the teeth and the wear resistance on the chewing surface. This technique has been recommended by one of the most respected 'dental gurus' in dentistry but is not done by most dentists. It does require a little extra effort.

I am doing the best I can for you when filling teeth for my dental family and helping you in other ways.

Bonding Crowns, Implants, Bridges, Inlays, Overlays,....

In my office we very rarely have dental restorations come loose if we have placed them permanently in our office. We don't use conventional dental cements, everything that we place that is meant to stay in place long term is bonded, not cemented, to place. There are occasions when there is so little left of the tooth that we stretch the limits of the materials that we use in order to avoid the need to do root canals. Root canal treatment can allow rebuilding of teeth to allow for better retention of crowns and other restorations.

Many dentists still use dental cements. Most dental cements, even the so called permanent cements, are usually slightly soluble in saliva over a period of years. Restorations placed with these cements often will loosen and leak in about 5-10 years. Often these restorations can be recemented or bonded to place again if there hasn't been too much leakage of bacteria and food debris under the crown. At times there is too much decay and breakdown of the underlying tooth structure and the old restoration can't be used any longer. If you have bonded or cemented restorations in your mouth and you feel a change in these restorations contact us at your earliest convenience and we will be happy to assess the situation for you and help you with your problem.

I have been using bonding, resin materials rather than cements to place permanent restorations since graduating from dental school. Unfortunately many dentists are too conservative and most didn't change to the better bonding technology until years after I started doing this.

If you are in need of having permanent restorations placed and you are not one of my patients, ask to have these restorations bonded. Implant restorations, fixed bridges, crowns, ... should all be placed this way if they are meant to stay in place long term.

Please contact me if you have any dental related questions. It is always good to hear from you.

Fosamax, Jaw Surgery & Other Osteoporosis Drugs

Dr. Bob Bressman hosted a group of dental professionals at his office to review and discuss current research being done at the University of Southern California San Diego. I was happy to attend. Parish Sedghizadeh, DDS, MS, has been involved in multi-disciplinary research studying the effects of nitrogenous bisphosphonates on oral surgery. Fosamax is one of these drugs which is being used by many of our patients. We reviewed a video lecture of his during this meeting.

According to preliminary research being done at USCSD, there is about a 4% risk of developing osteo necrosis of the jaw [ONJ] when nitrogenous bisphosphonates have been taken for a long period of time [many months or years] when there is at least one other factor compromising the patient's health [diabetes, periodontal disease, ...]. Dental extractions are the primary procedures which can lead to ONJ. This seems to be a problem primarily associated with nitrogenous bisphosphonates and not with non-nitrogenous bisphosphonates.

I attended another meeting last October, sponsored by a drug company, which led me to believe that this was much less of a problem than the independent research noted above is now indicating.

If you are taking drugs to treat osteoporosis please let your dentist know.