Dr. Dave's Dental + Update

Skokie Health Department survey request.

2012-01-12T07:33:00.001-06:00

If you visit or live in Skokie, please completed this survey:

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Hello Dr. Dave,

I am writing to request that you complete the Community Health Survey in the link below, and consider sharing with others who would be willing to assist the Skokie Health Department (Rotary Members?). We are conducting the survey to establish the top health priorities for Skokie for the next 5 years, and are seeking wide community input. A blurb describing the survey is below, along with a link to the electronic version. We will publish the results of the survey later this year.

Thank you for your help, and please call me if you have questions!

Catherine

Please take a moment to answer a short "Community Health Survey" for the Skokie Health Department. The survey is being conducted to assess community health needs, as part of the state re-certification requirements. This process will identify the top health priorities for Skokie for the next five years.

The Health Department is seeking input from persons who live, work, attend school or enjoy events in Skokie. If you prefer, paper copies are available at Village Hall, or by calling ... 847-933-8252 . Here is the link:

https://www.surveymonkey.com/s/C3LSS5G

Thank you for your assistance!

Catherine A. Counard, MD, MPH
Director of Health
Village of Skokie
5127 Oakton Street
Skokie, Illinois 60077
....

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Thanks!

Tooth surface abrasion, gum recession and toothpaste.

2011-11-30T20:47:00.000-06:00

Toothpaste abrasion and brushing too hard and long have been known to cause gum recession and wear of teeth and exposed roots for years. This is now getting more attention in the media and has been researched more carefully.

Please refer to these links:

http://www.epinions.com/content_3128664196

http://www.saveyoursmile.com/toothpaste/toothpaste-d.html

http://jada.ada.org/content/135/11/1516.2.full

I definitely recommend using the lowest rated abrasivity toothpaste with fluoride and a tartar control formulation.

Please also remember to only brush your natural teeth with a soft or extra soft toothbrush. All of us should only brush 5 to 10 circular strokes along the cheek and lip sides of the teeth and the tongue sides of the teeth. The chewing surfaces can be brushed more vigorously. This will help avoid gum recession and root surface wear. Brushing harder does NOT replace flossing. All of us need to floss every 36 hours also to prevent plaque from hardening into tartar.

Remember you don't need to brush AND floss all of your teeth every day, only the teeth you want to keep!

Thanksgiving, a great holiday!

2011-11-25T10:24:00.000-06:00

It is truly one of my favorite holidays. It is nice to get together with friends and family with a focus only on enjoying one another and being reflective on the wonderful world we have to live in.

Hopefully you will be able to spend some time over this holiday weekend appreciating the world we live in, including your significant others of many different degrees of separation. According to some of the latest research for the social media, we are closer to anyone else in the world than 6 degrees of separation.

The world seems huge but it really isn't that large. Hopefully we will be mindful of that in every aspect of our lives and behave accordingly. It is truly best to think globally and act locally. All of us have a direct impact on our part of the world and our part of the world is a significant part of the entire planet.

My best to you and yours during this holiday weekend and always!

Watch for our new, totally redesigned website.

2011-11-16T21:15:00.001-06:00

We are in the process of remaking our professional office website. Fortunately we are employing some very competent help in the form of Mike Yublosky of www.diywebjem.com who is quite proficient in setting up this type of technology. He has done some wonderful work for us already.

The new website will be on a WordPress platform. We will have space for all of our Dental Family to post comments directly on the website on its blog pages. This is a very convenient way to participate and share your questions with me and the rest of our dental family at Smiles of Skokie.

I am personally very excited about this. The new design will make it very easy to communicate with everyone and update the information the website contains in a very simple fashion also. It will be a wonderful resource for all of us.

Technology provides all of us with GREAT tools!

2011-10-27T10:55:00.000-05:00

We had a patient in the other day who had a tooth fracturing under an old bridge and porcelain fracturing away on the same bridge. The tooth supporting the bridge on the other side was still bonded to the bridge. Without the proper instrumentation it can be virtually impossible to remove the bonded bridge from the still solid tooth it is bonded to. Fortunately I have in my office the ideal instrument for this and it wasn't too much of an issue. We removed the bridge cleanly and without any visible damage to the underlying tooth.

For more information on the wonderful technology we have at Smiles of Skokie, please visit our website at http://www.smilesofskokie.com/ or http://www.caredental.com/equipment.html at your leisure.

I love my iPhone too! It makes staying in touch with my 'Dental Family' much easier.

Hope all of you are having a great day!

Dental Implants are GREAT!

2011-10-10T14:48:00.000-05:00

We just had a patient in a few minutes ago who has a front tooth replaced with an implant. [He is also getting one for a missing molar now.] It looks GREAT! We had to have him go to our local lab for some custom shade matching but the results are well worth it. It has been in place for a few years.

We are in the process of restoring 5 more implants now. The materials needed to start on 3 of them are ready to go and just arrived today. We will be placing 2 more on Thursday.

This is not an inexpensive process but it is the best way to do this. The surgeon's cost is in the neighborhood of $2200. The restorative process done with me is about $1600. This results in a total cost of about $3800 if only one tooth is being replaced. This tooth could very well last the rest of your life though. It is well worth it in my opinion and that of many of our patients.

Another patient was inquiring about getting dental implants earlier this afternoon also.

PerioShield is available at my office.

2011-10-07T15:46:00.000-05:00

We have it for $10 per bottle.

We will be in the office from 9am until 2pm on Saturday, tomorrow.

Patients BEWARE: Dental implant only offices with fast treatment.

2011-10-01T14:44:00.001-05:00

Unfortunately there are many examples of poorly done dental treatment from large corporate organizations. There are examples in one hour whitening, there are retailers who attempt to setup dental clinics, there are orthodontic treatment advertisers, there are porcelain veneer specialty brands and there are now large entities providing dental implants through mass advertising. There have been problems with all of these over time.

I very recently had a new patient come to me for a complete evaluation of his oral health. One of his primary complaints was in regard to a recently placed and restored molar implant. This was done at a greater fee than he would have paid through my office and our surgeon, and it was a problem. His complaint was that food was constantly accumulating in this area every time he ate. Unfortunately the only solution is to replace the slightly cheaper stock implant crown adapter [abutment] with a new one and this would mean replacing the crown also at a cost of about $1600. He is going to think about this.

He was told to return to the health care provider of this restoration to get this problem addressed. He is considering this option.

Please contact me if you have any dental questions. It is my pleasure to be of service and help to you. This is one of my major reasons for practicing dentistry.

I wish you and yours the best of health always!

Perioshield at Smiles of Skokie. Revolutionary rinse!

2011-10-01T14:20:00.001-05:00

This appears to be a very significant breakthrough for those of us with gum disease. Perioshield is a new product which is classified by the FDA as a 'dental device' and it is a rinse. It is basically a mouth wash. It is to be used twice a day after flossing and brushing.

Perioshield has been shown to reduce dental plaque and bleeding by more than one third in clinical studies. This is not a systemic drug with systemic side effects but a locally acting 'device'. In my mind this is the best way to handle health problems. Too many 'drugs' have far too many side effects and we don't need to add to the number of drugs in use today.

Here is an online link to the manufacturer's information:

http://us-professional.gumbrand.com/departments/operatory-products/gum-perioshield-oral-health-rinse/products/new-perioshield/

All of us [with our own teeth] still need to floss and brush, carefully, at least once a day but those of us with tendencies to develop gum disease may greatly benefit from this product. Those of us with gum disease susceptibility should also be very careful with our diets and perhaps take nutritional supplements to help build up our own resistance and health to be at its best to fight off this tendency.

Please tell your friends and neighbors about this if they have ever mentionend having gum problems to you or if you have ever noticed significant mouth odor from them. Bad breath is a pretty reliable indicator of gum disease.

Unfortunately Perioshield is not available through local retailers yet. We are ordering some for sale in the office for $10 per bottle because we feel this is a great product which you should be able to get as soon as possible which is why my team and I are making this available to you in our office.

Email in regard to a friend of one of our "Dental Family" & root canal treatment.

2011-09-07T18:37:00.000-05:00

Hi, _____;

Please see my response inserted into your text below.

I hope you, _____ and all of yours are well.

---
I wish you & yours the best always!
Dave McWhinnie
Text & Voice: 847-906-3202
www.SmilesOfSkokie.com
Mobile: davidmcw3@gmail.com
Blogs: http://dave-mcwhinnie.blogspot.com/
http://drdavesmilesofskokie.blogspot.com/

On Wed, 7 Sep 2011 10:56:42 -0700 (PDT), ____ _______ wrote:
> Hello, Dave.
>
> I have a question for you, please. I have a friend at work who may or
> may not be the victim of questionable dental practices. Allow me to
> explain. She had a root canal done on of her upper, center-most teeth.
> Within two days of this surgery, the color of the tooth began to
> darken. Concerned about losing the tooth, not to mention the
> appearance issue, she went back to visit the dentist. On the latter
> visit he told her that this discoloration is normal, and that one must
> wait fully six months after a root canal to see if the tooth
> recuperates its health and can be, for lack of a better word,
> “saved”.

When a root canal is done on a tooth there shouldn't be much discoloration. A root canal treated tooth [in particular an upper front tooth] needs to be sealed with a temporary filling material which should prevent it from discoloring and help prevent the root canal treatment from failing. The discoloration I don't understand at all. A tooth treated in this manner should also be restored with bonding material within a few to 6 or so weeks after the root canal. Then it should be restored with a crown within a year of the completion of the root canal treatment. These are standard practices within dentistry. Root canals in these teeth almost always work. The success rate is in excess of 95%.

>She also is thinking that if the tooth is this dark after
> a few days, what will it look like after six month?

This is a good question.

>The worst case
> scenario, the dentist says, is for the tooth to die, in which case he
> says the optimal step would be replacement with a tooth implant.

The tooth is already devitalized and thought to be dead after a root canal. Failure entails an infection which won't heal or usually redevelops within a relatively short time after the root canal is completed. Root canals can, however, fail years after the treatment is completed.

>
> Does this sound like standard and proper practice to you, please?

Perhaps there is something lacking in the communication but it does sound questionable to me.

> Does it sound as if a second opinion may be needed here?

I think that would be a good idea. I would be happy to assess the situation. I do a lot of this type of treatment.

>
> I appreciate your time and trouble, whenever you may have the
> opportunity to answer this.

It is my pleasure and honor to be given the opportunity to express my professional opinion here. I appreciate your concern and efforts on behalf of a friend of yours.

>
> Thanking you kindly in advance,
>
> ____

Please let me know if I can be of further help.

Sincerely yours,
Dave

Good day yesterday.

2011-07-06T16:09:00.000-05:00

We saw one patient I did some veneers for a year or so ago. I couldn't tell which teeth they were on without doing a close examination. It is great to have such wonderful materials and labs to work with that this is possible. Cosmetic/aesthetic dentistry sure is FUN!

We also started a crown for another patient which should work out very well. We delivered a whitening system for another patient and thanks to my wonderful team everything went well. It is a great feeling to know we are helping our 'Dental Family' as well as is possible at this point in time.

I am always looking for better ways to help all of our 'Dental Family'.

We had an 8 year old and an 11 year old in yesterday who are brother and siter. They are both flossing all of their teeth daily. This is GREAT! Once the habit is formed and a patient gets accustomed to a healthy, clean mouth they are much more likely to maintain this healthy routine for life. These two will have minimal dental problems and as a result better overall health throughout their lives. How about you?

It is nice to be back in the office after a long holiday weekend. I did have fun though in a number of ways. It was a nice holiday weekend. My wife also arrived home from the Philippines yesterday. It is wonderful to have her home.

We could be busier. We would like to keep our entire team comfortably busy. Michelle, our hygienist, would like to be working more hours. If you can think of any friends, relatives or neighbors, who have teeth, and who might benefit from our help, please refer them to us. We appreciate this vote of confidence when you refer new patients to us very much.

Medications to prevent heart attack or stoke from blood clots.

2011-06-09T07:47:00.002-05:00

There are some major changes in the way we handle your medications if you are taking this type of medication. We will not be suspending anti-clotting medications nearly as much as we have in the past.

The American Dental Association has a very good article which includes very recent research which I would recommend you discuss with your physician if this pertains to you. There are 2 versions of the newest recommendations at the following website link, one of which is for patients and the other for dental professional. Please read it if you are taking this type of medication.

http://www.ada.org/2526.aspx?currentTab=2

We are fortunate to live in an environment where improvements in health care are always progressing through research and clinical evaluation of all of our treatments. There are always improvements in the way we treat and medicate our 'dental family' which is our professional promise to you.

We also treat handicapped patients.

2011-06-01T15:00:00.002-05:00

We are handicapped accessible. We recently joined www.jjslist.com to allow us to be more easily found by future, new, challenged members of our dental family. We enjoy taking care of all of your friends and neighbors. We take special pleasure in helping those with more difficult circumstances. After all, we are in the oral health care field to care for and help all of our friends and neighbors. We take great pride in our work of helping others.

Toothpaste and abrasion.

2011-06-01T14:56:00.001-05:00

Toothpaste abrasion and brushing too hard and long have been known to cause gum recession and wear of teeth and exposed roots for years. This is now getting more attention in the media and has been researched more carefully. Please refer to these links:

http://www0.epinions.com/content_3128664196

http://www.saveyoursmile.com/toothpaste/toothpaste-d.html

http://jada.ada.org/content/135/11/1516.2.full

I definitely recommend using the lowest rated abrasivity toothpaste with fluoride and a tartar control formulation.

Please also remember to only brush your natural teeth with a soft or extra soft toothbrush. All of us should only brush 5 to 10 circular strokes along the cheek and lip sides of the teeth and the tongue sides of the teeth. The chewing surfaces can be brushed more vigorously. This will help avoid gum recession and root surface wear. Brushing harder does NOT replace flossing. All of us need to floss every 36 hours also to prevent plaque from hardening into tartar.

Took a short trip to Florida the end of last week.

2011-05-13T12:00:00.002-05:00

Here is a link to the photos I took:

https://picasaweb.google.com/davidmcw3/2011May57BeachBlastPanamaCityBeachFlorida?authkey=Gv1sRgCKyH296NrKWNzwE#

It is always nice to get back too though.

Radiation worries are now on everyone's mind.

2011-04-04T13:16:00.002-05:00

Dear All, I have been letting you know about our minimal radiation exposure dental x-ray system somewhat regularly but it bears repeating in light of the disaster in Japan. There is no level of radiation which is desirable. However, until we have a better way of checking for your health or lack of it in regard to medicine or dentistry we are stuck with it.

Our phosphor sensor plate system requires the least exposure to radiation of any x-ray system available. It actually requires 33% of the radiation which other electronic sensor systems need to produce a good image.

I actually had to replace one of our x-ray machines when we bought this system for you and our office. There was no way to set the old machine to a low enough exposure to get a good image.

Please do a Google search if you would like. You will find there isn't a more sensitive system available than what we have for you at Smiles of Skokie.

Your health is our primary concern. We are interested in keeping you as healthy as possible dentally and medically.

We thank all of you for letting us help you as members of our 'dental family' at Smiles of Skokie!

It is best to take good care of 'baby' teeth.

2011-03-07T10:28:00.002-06:00

http://www.todaysparent.com/baby/article.jsp?content=5890&page=1

This article makes a lot of sense.

I see children at times with numerous cavities. Today this is more rare thanks in large part to better patient awareness and fluoridation.

It is a good idea at times to intervene early with minor orthodontic treatment to help direct growth. This can actually lessen the cost of orthodontic treatment in the long run.

Bike paths in Skokie. Please help!

2010-12-01T17:47:00.001-06:00

I have forwarded this to some of my biking friends and would like to request that any of you who can support this plan do so. It will be a wonderful addition to our community.

This is a proposed plan in need of voices to back it.

>>>

Hello Dr. Dave!

Nice speaking with you a few moments ago! I write to request your help with obtaining community letters of support for the Village of Skokie Model Communities grant application. The Model Communities grant program is a federal program providing funds to "Change Policies, Systems and Environments to Promote Healthy Eating and Active Living". The Village is applying for funds to develop engineering and landscape design plans to complete a segment of multi-use (biking, walking, etc) path along the old Union Pacific Right-of-Way between Oakton and Jarvis.

The proposed portion of the path will provide access to the new CTA station at Oakton Street(construction begins in January 2011), and will link north to the new multi-use path between Oakton and Dempster (construction set for 2011), as well as south into Chicago through Lincolnwood. A map showing the proposed route is attached (in green). Clearly, completion of the new path will significantly benefit Skokie residents, and those of neighboring communities, by improving access to alternative forms of transportation, such as the CTA, and providing additional opportunities for recreation.

We are very excited about the opportunity to complete the biking/walking path from Jarvis to Dempster (and beyond). It would be helpful to have a number of letters, including those from residents (perhaps you?), describing the potential benefits of the project. I have attached a draft letter for your review, although it is more applicable to larger entities than regular citizens.

Thank you very much, and please do contact me if you have any questions!

Catherine

Catherine A. Counard, MD, MPH
Director of Health
Village of Skokie
5127 Oakton Street
Skokie, Illinois 60077
Phone: (847) 933-8252
Catherine.Counard@skokie.org

<<<

Link to bike map in Skokie area:

>>>

http://www.egovlink.com/public_documents300/skokie/published_documents/Community%20Development/Bicycling%20in%20Skokie/Bikeway%20System%20Plan%20201000630%207-10.pdf

<<<

[Please copy and paste the above text lines into a browser window.]

Template:

>>>

[Letter of Support Template]

December [___], 2010

Albert J. Rigoni, Village Manager
Village of Skokie
5127 Oakton Street
Skokie, Illinois 60077

Re: Letter of Support – Model Communities Grant Program

[Organization name] is pleased to support the Village of Skokie in its efforts to apply for Model Communities grant funds to connect Downtown Skokie to Lincolnwood, Chicago, and beyond, via the Village’s Community Connections project, a multi-use path corridor from the Oakton Street CTA Station to Lincolnwood’s municipal boundary.

Investing in planning efforts for a multi-use path will not only provide a future connection to Downtown Chicago, but it will benefit [Organization name] as well. Our mission is [mission statement]. This mission benefits the residents, employers, employees, property owners, business owners, and visitors of the area by [list benefit(s)].

[Organization name] will support the Village of Skokie with participating in community planning events and partnering with community leaders to make Skokie an active and healthy community.

[Organization name] has successfully collaborated with the Village of Skokie in the past by [list past collaboration effort(s)], and intends to be a strong partner in this and future opportunities.

We look forward to collaborating with the Village of Skokie on this Community Connections initiative.

Sincerely,
[Organization name]

[Name]
[Title]

<<<

The letter above is a template.

Congratulations to our patient, Alexis Yusim!

2010-12-01T16:31:00.002-06:00

Alexis Yusim is a senior at Niles West High School. She is an academic and swimming all star. She is considering attending Swarthmore, Lake Forest College and a number of other fine schools. Lake Forest has offered her a scholarship.

She finished her high school swimming season recently and according to an article in a Pioneer publication she now has swimming records 500 free, 200 medley relay, 200 free relay and 400 free relay events.

Again> Congratulations, Alexis!

My office and x-ray radiation.

2010-12-01T16:17:00.003-06:00

There have been some news stories recently in regard to the amount of radiation patients are being exposed to via dental x-rays. The first mention of this was in the Wall Street Journal. The current interest in this subject was probably brought about by the new airport screening methods prompting a closer look at radiation exposure in general.

X-ray radiation is a very serious concern for all of us. This is something that I have focused on for years. My office has used the most sensitive x-ray film available for years prior to switching to an all computer based system about 4 years ago. We minimize the number of x-rays we take and customize our approach for each patient. The system that I chose for my office when we moved, was and is the most sensitve x-ray system available. This means that for each x-ray image that we take we are exposing our patients to the least amount of radiation possible to get that image. For a given amount of radiation we can take 3 images in our office and a conventional digital x-ray, electronic sensor would only get one image for that same amount of radiation exposure for a patient.

The x-ray image on this page is from our phosphor sensor plate dental x-ray system of one of our patients within the last year [with his permission of course]. In the past, we used film badge dental team radiation monitoring for years. With the technology and systems we used prior to our even more sensitive systems now, we didn't ever register any significant exposure for any of our team so our regulators agreed to let us stop monitoring ourselves. It was simply a waste of time and money to continue monitoring services when nothing was recorded for years.

The system which we have now is very versatile but expensive. It allows us to take minimal radiation individual x-rays as well as panoramic x-rays. The individual x-rays are more detailed and clearer due to their low radiation, very short exposure time. Movement of the film or patient is much less of a problem with short exposure times. With increased sensitivity there is however a 'grain' problem. This is similar to the pixel problem in digital photography when very low light photographs are taken. When greatly enlarged individual grains [or pixels] are seen making the image more 'fuzzy'. In my mind this is a very good trade-off for exposing my dental family to the least amount of radiation possible and still having good diagnostic images. I think you will agree. As a matter of fact, we had to replace one x-ray machine when we switched to this dental x-ray system because it couldn't be set to give a low enough exposure to get properly exposed x-ray images.

Unfortunately there are some artifacts visible on most of the x-ray images which we take in our office. [There is a faint white line across the image of the x-ray near the bottom.] Artifacts virtually never interfere with the diagnostic use of these images. If we can use 1/3 of the radiation that conventional dental digital x-rays require we should all be happier. Again, the phosphor sensor plates we use only need 1/3 of the x-ray exposure to produce a good image compared to other fully digital dental x-ray sensors which are used in most other dental offices. There are still today many film based x-rays taken in other dental offices which require much, much more radiation than Smiles of Skokie uses for our dental family. We have your overall health in mind at my office in many different and widely varying ways.

We are restoring many implants. Some of the recent news articles were specifically addressing the newer cone beam computerized tomography [cbct] x-ray technology which is very useful for implant placement and other denal uses. Implant placement can be critical for success of the final implant restoration. There is more information in regard to this technology from an online article by a team of dentists headed by Dr. Martin Palomo of Case Western Reserve Dental School, which discusses the advantages of this system and the amount of radiation exposure . According to this article, cbct exposes the patient to, 'up to 4 times less radiation than a conventional' CAT scan. It is on the order of the same exposure that a patient gets from a conventional, film based, panoramic x-ray [which is at least 3 times what our patients receive from panoramic x-rays] and about 1/3 of the radiation dosage passengers receive on a round trip airplane flight from Paris to Tokyo.

I think that this is enough detail in regard to the x-ray radiation subject for now. It was recently in the news and I thought you might like to know more about my dental office and our attention to your health in every possible facet. If you have more questions, please contact me for more information in regard to radiation or any other oral health related topic. It is always good to hear from you!

Excellent dental implant meeting last Thursday.

2010-11-21T13:30:00.002-06:00

The meeting was held at Dr. Bob Bressman's office near the Westfield, Old Orchard shopping mall in Skokie.

Straumann is a company that has been producing excellent dental implants and materials for them for years. Their SLActive surface, morse taper and Roxolid [titanium and zirconium formulated] implants seem to be significant steps forward in dental technology which will benefit us doctors helping patients with implants and our patients.

There are many good implants on the market and most of them are very good. The FDA protects all of us by certifying these products for dental use.

We restore a good number of implants in our office and are looking forward to taking advantage of this new technology to serve our patients even better.

Thanksgiving is a special time of the year. [Wednesday evening]

2010-11-21T08:58:00.004-06:00

We are all fortunate to have wonderful friends and family. This is a special time of the year to take our blessings into consideration. I am thankful for all of you.

This Wednesday evening in our area there will be a multi-religiious gathering at a local Jewish 'Synagogue'. It is sponsored and organized by the Niles Township Clergy Association. My Roman Catholic parish of Saint Joan of Arc and pastor Father Kehoe are active in this group. This year it will be held at the Ezra Habonim Jewish Congregation at 4500 Dempster Street at 7:30pm in Skokie. This gathering will include: Catholics, Baptists, Bahai, Sikhs, Buddhists, Methodists, Jews, Muslims, Lutherans, .... It is a general prayer gathering with music and short thoughtful sermons/speeches which is inspirational and thought provoking.

It usually lasts about an hour. There are snacks served afterward and a mingling of those in attendance. I just found the details for this particular event via Google. There is a sign in front of the Jewish Congregation site on Dempster announcing this event.

There are similar gatherings in many areas. If you or yours are not going to be in the Skokie area at this time you can probably find a similar event close to your home. I highly recommend this type of service and usually attend this particular gathering annually. This type of event is traditionally done on the evening before Thanksgiving and it will be the 40th annual gathering of this type by the Niles Township Clergy Association.

I am thankful for all of you and our dental care team at Smiles of Skokie. It is a pleasure and honor to be able to care for all of you and help you with your health!

It would be nice to see you at this event if you can attend. It is a busy family/friend time and many of you will be too involved in holiday preparations to attend but all of you will be in my thoughts and prayers.

I wish all of you and all of yours the best always!

Last week was busy. Seeing patients, dental meetings, biking and flying.

2010-11-07T19:17:00.000-06:00

It was good and busy. A busy week of work with patients a couple of dental meetings, flew and biked too! And, ... it started with Halloween.

We had a good week in the office. It is great to be helping patients with their dental problems. Our team at the office is excellent. We helped a number of patients with a variety of problems. We dealt with a number of implant restorations, denture patients, patients with gum problems and helped a number of children. It was satisfying to be able to help and make a difference for all of these members of our dental family. We could be a bit busier. We are still trying to help Michelle work on Thursdays too.

We had a number of new patients recently too. One lady is a native South American from Guyana. We have had a large family of patients whose heritage is from India but their parents and grandparents were raised in the South American country of Guyana in the capital of Georgetown. Apparently there is a fairly large contingent of the Guyana population originally from India. It is very interesting how our country is a magnet for such a large variety of people all adding to our diversity and enriching our culture.

The meeting on Tuesday evening was given by Dr.s Marty Rogers and Matt Davis. It addressed the most recent thoughts on cracked teeth and root canal treatment. They did an excellent job.

Wednesday was a meeting of the Northern Illinois Dental Specialists at which I was a guest. Dr. Burgess formerly of New Orleans [before hurricane Katrina] and now of the University of Alabama dental school is a well know restorative dentistry expert. His presentation was outstanding. It is good to keep up on the latest technology in order to be able to serve my 'dental family' as well as possible.

I biked a few mornings last week and was able to fly last evening. The flight with 5 of my powered paragliding friends near Kankakee was a great way to end the week.

This is how a good friend of mine trains powered paraglider pilots near Christmas, Florida:

http://vimeo.com/16502027

The above is an excellent video showing the training process in summary. Bob is an excellent student and Eric Dufour is an excellent instructor [perhaps the best in the country]. It doesn't always go as smoothly as depicted here. There are some good instructors in the midwest too.

My photos from last evening's flying:

http://picasaweb.google.com/davidmcw3/PPG101106Koerner#

It was a bit late when we launched and the light wasn't as good as I would have liked for photography. My camera regularly let me know that the battery was dying in spite of it being fully charged just before leaving home. Apparently the camera didn't like the cold. It was about 40 degrees or a little less as we flew. Colder weather is definitely making its way into our too near future.

My best to all of you and all of yours always!

My real pilot friend on Fox News.

2010-10-12T08:40:00.000-05:00

I fly a powered paraglider and ride a bicycle. I now have a number of friends met through these two activities who are great people and wonderful friends. Scott Clark is one of these people. We have traveled to a number of local and not so local sites to fly paragliders with and without power. We have had many great times together.

We flew Sunday evening and he mentioned to me that Fox News Chicago was going to interview him for his Blue Sky Taxi service for which he is the chief pilot.

Here is the link:

http://www.myfoxchicago.com/dpp/good_day/blue-sky-taxi-new-flight-way-planes-scott-clark-pilot-20101011

He did a great job! Check it out.

Volunteer/travel opportunity for a great cause.

2010-07-21T17:16:00.001-05:00

We had an interesting speaker this week at our Skokie Valley Rotary Club meeting. Patti Vile is a very interesting and caring lady. She has been organizing trips to New Orleans to help hurricane Katrina victims by bringing groups there. She organizes all of the logistics.

Please visit her web site at www.volunteerexpeditions.org for more information.

The office will be closed 7/24/10 until 8/2/10.

2010-07-21T16:24:00.002-05:00

All of us need a vacation from time to time. Your team at Smiles of Skokie is no exception to this rule. The office will be closed as noted in the title of this update. No one will be available to answer your calls to the office during this time. Dr. Susan Doroshow [847-677-2774] has agreed to help our 'Dental Family' with any emergencies that might occur during our absence. We thank her very sincerely for helping all of us in this capacity if the need should arrive.

Lorraine will be traveling to California. Lori is in Arizona with her children spending time with her mother. I will be traveling across Iowa with the www.RAGBRAICUBS.org group doing the RAGBRAI [www.ragbrai.org] bicycle ride. This is my 9th year doing this event. We will again be raising money for Camp Courageous in Monticello, IA, for handicapped children. This is a very worthwhile charity. Their web site is http://www.campcourageous.org/ if you would like more information.

Dr. Doroshow's office is located at 3901 Howard Street, in Skokie, which is just a block east of Crawford on the south side of the street. She is a wonderful dentist, a member of the study club that I am in, a good friend, and a fellow dog lover. You will be in good hands if you have an emergency while I am gone.

Hopefully you will have time to get some rest and relaxation this summer too.

Thanks for your understanding.

Your team at Smiles of Skokie wishes you the best always!

Amalgam issues. We have been safe for years!

2010-06-03T13:05:00.002-05:00

There is a movement in the federal govenment to mandate mercury amalgam separators for dental offices. We have portable, self contained units [which we have had for over 12 years] and they are not only more sanitary [no waste lines running in the floors or ceilings] but they also have amalgam separators built in to them as they are produced.

The stand alone unit is the best for sanitation and safety in a dental office. We are very happy to have these units. They are more expensive but well worth the cost.

Our summer schedule.

2010-06-02T11:29:00.002-05:00

The office will be closed this coming Saturday. We don't see patients on holiday weekends. Your oral health care team needs time to regenerate with longer weekends too.

The office will be close from July 24th through the 31st. This is our summer vacation week.

Losing weight without starving.

2010-05-01T10:40:00.003-05:00

There is a new approach to losing weight by eating foods that control craving. Dr. Leslie Van Romer has done a lot of research into this subject. She has many years of experience. The only ones that won't like what she has found are the large corporate interests that have a vested interest in hooking you on their products!

Please visit www.gettingintoyourpants.com for more information.

This is common sense, non-hype information!

Implants, new young patient, ....

2010-04-23T09:13:00.002-05:00

It has been an interesting week. We had a patient very recently with 3 new implants restored in on upper right, lower left and lower right. We had another new patient who is only 2 1/2 years old fall out of a stroller and do damage to upper front teeth. Another patient had some nasty, viral ulcers that needed laser treatment. Another patient who has only come in for emergent care hopefully will come in to get 'caught up' very soon.

The patient with the new implants is doing very well. The lab did a beautiful job. They look good and are feeling good according to the patient too. They do feel different because the porcelain has a slightly different quality than tooth structure. He just needed a minor fine-tuning of his bite on Monday.

The young patient fell out of a stroller and displaced her 2 front teeth. There is also swollen gum around these teeth and a swollen lip. She is a sweetheart and doing well. She was seen in a hospital emergency room on Tuesday when this accident happened and then seen in the office on Friday morning. She is still sore. X-rays were taken in the hospital. We took a couple of photos with our intraoral camera this morning. Displaced teeth in young children will usually reposition themselves normally without intervention by a dentist. We will just need to observe and check for infection or nerve death in the future. We may need to take more x-rays to follow up in the future.

The patient with the viral ulcer problem was treated with our dental laser. He has had this treatment a couple of times before. He relies to some extent on other medications but finds that the laser is much more effective and provides almost immediate relief. We also find that when this type of infection occurs and is treated with the laser it doesn't recur as much or usually not in the same location.

It has been a good week!

Vacation: March 29th through April 4th.

2010-03-31T17:13:00.002-05:00

The office is closed for the time period above. Most of us are going out of town. We are observing some holidays as well as wishing and praying for the best for all of you, our dental family.

There are two highly qualified dentists who are kind enough to help you with emergencies if the need arises while we are gone. They are Dr. Doroshow & Dr. Sodini.

Dr. Doroshow is a colleague of mine and we are in the same study club and members of the Chicago Dental Society. Dr. Doroshow's office is near Howard and Crawford in Skokie and the office phone number is 847-677-2774.

Dr. Sodini's office is about a block east of my office on Oakton and the phone number for his office is 847-676-9292.

It is a relief for me to know that my dental family will be in good hands while I am on vacation.

CDS meeting

2010-03-12T12:52:00.004-06:00

We have been fairly busy at the office. Our usual assortment of patients needing a variety of care has been a little on the light side due to the economy but we are doing pretty well.

The Chicago Dental Society Midwinter meeting was good. There were about 32,000 attendees. I managed a large meeting on Saturday as the Chicago Dental Society representative.

The Smiles of Skokie team went to the meeting as a group on Thursday. We updated our infection control knowledge and added a new hand cleanser system to the office thanks to Dr. Molinari's course. Dr. Roger Levine helped us with our office management skills and provided valuable information to our entire team. It was a good day! [Traffic was terrible in the morning. We drove down in 1 vehicle.]

I was at the meeting on my own on Friday. Dr. Carl Misch's implant lecture was very good. He had some excellent research data and provided a good scientific basis for bridge and implant restorations of a variety of types. He is a very knowledgable and opinionated lecturer.

Saturday, Heidi & I attended separate courses. Mine was on health and stress given by Dr. Uche Odiatu from Toronto, and Heidi took part in a course on dental instrument sharpening and maintenance. Both of us learned a lot. We try to be your positive, health-optimizing resource and Dr. Uche's material will help us serve our patients even better.

It was a good meeting as usual. This year it was held in McCormick Place West for the first time. This venue meant that this huge meeting wasn't scattered over as large of an area as it usually is.

A recent porcelain veneer case.

2010-01-04T11:02:00.004-06:00

I firmly believe in only doing the most conservative, best option for my patients. This patient has done a lot of whitening. He wanted a better smile but a natural appearance. We were both happy with the results.

There are more expensive, brand-name veneers. There are also very high strength, extremely well done porcelain veneers fabricated by less well known excellent laboratories. This case was done using the services of the latter type of lab.

Whenever doing veneers or implants for a patient the patients bite and habits need to be evaluated carefully. This patient elected to have a nightguard made and is using it every night to protect his investment in his smile.

Best of Business Award.

2009-12-21T11:49:00.003-06:00

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.

2009-12-01T15:40:00.002-06:00

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.

2009-10-07T17:42:00.002-05:00

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.

2009-09-09T17:43:00.005-05:00

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.

2009-09-02T13:18:00.002-05:00

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.

2009-08-26T13:38:00.003-05:00

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.

2009-08-19T10:48:00.003-05:00

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.

2009-08-13T10:12:00.002-05:00

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'.

2009-08-11T16:34:00.003-05:00

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.

2009-07-15T12:18:00.002-05:00

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

2009-07-04T15:35:00.004-05:00

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.

2009-06-24T15:12:00.004-05:00

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.

2009-06-17T19:15:00.003-05:00

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

2009-06-07T19:57:00.004-05:00

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,....

2009-06-07T19:22:00.003-05:00

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

2009-06-07T14:54:00.004-05:00

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.