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Things to Look For When Choosing a Dental Office

Ideally, on your first appointment to a new dental office, you should be scheduled with an appointment to see the dentist … not a cleaning appointment during which the dentist stops in for a quick check. This is BIG. If you are not given the time to discuss your concerns and your desires for your dental health, you stand very little chance of ever reaching those goals. If you have fears of being hurt, or concerns that you may lose your teeth, or feel that you are not happy with your smile, you need to be given adequate time to express those thoughts, and to make sure you are heard by the dentist.

You want to make sure that the cost of procedures are explained, and that the financial policies of the office are also explained. You should note that the fee a dentist charges reflects the value he or she puts on the treatment rendered. One way to attract patients is to charge a low fee, or to get a low reimbursement by participating with a contracted insurance company. Personal services are different from products you purchase in that they do not carry a name brand that can be evaluated easily against another brand. There is nothing wrong with getting
second opinions, but be careful not to look for low fees. You can always find those, but you may find other hidden costs along with that low price.

There is often no such thing as THE BEST treatment. We are all individuals with different values regarding what is important to us. Make sure that your values are being taken into consideration in the treatment plan that is being proposed. For example, when replacing missing teeth there are many advantages to using dental implants, but they are not the best treatment for all people in all situations. Not only is cost a factor, but in our busy world, convenience and esthetics, along with individual fears and the health history, must also be considered and discussed.

The “HOW” of Cosmetic Dentistry

When it comes to cosmetic dentistry, the dentist’s job really is to recognize what the patients want because the success or failure of the case depends not on how the dentist feels about it, but on how the patient feels about the final result. This is what differentiates cosmetic dentistry from general dentistry. In general dentistry the dentist is the one who judges whether his treatment restoration meets the criteria of success in general dentistry. In cosmetic dentistry, however, if the patient is not satisfied with the end result, there is a failure no matter how technically skilled the treatment is.

We usually start out by showing the patients some pictures of beautiful smiles, and we ask the patients to rate these smiles on a scale of 1 to 10. We then ask these patients where they want to be on this scale. Not everyone feels the need to be a 10. Millions of people who are embarrassed by their smiles, rating them a 4 or lower, simply may want to reach a 7 so that they can smile without being uncomfortable, inhibited, or self-conscious.

During this treatment discussion patients may change their minds about wanting to have a “10” smile. When they realize what treatment would entail, or how long it would take, or the costs involved, they often discover they could be happy with a smile that is a 7 or 8. If we decide on crowns or veneers, we can have a wax model made to show what the final result will look like. After the patients approve this model, we shape the teeth so that we can make the temporary crowns or veneers.

We then have a “review” of the temporaries, and we painlessly modify their shape, color, or length, without Novocaine, so that we can see the natural drape of the lips. When we achieve a result that is mutually agreed upon, we send a model of those temporaries to the dental lab so that we maintain control of the end result.

When the crowns or veneers arrive from the lab, we insert them, and only after our patients’ written approval, we cement these final restorations. We deliver our warranty, and schedule our happy patient in one week for any final tweaking.

In our office we do not believe in pressuring our patients to extend themselves either in terms of treatment or in terms of costs beyond their comfort level. It is our job to help them focus on realistic expectations so they can achieve their goals, so they are happy with their new smiles, so they feel their teeth look natural, and so they are happy with us and will refer their families and friends.

Porcelain Veneers vs. Orthodontic Therapy

Patients often ask us to help them when deciding on a course of treatment to improve the appearance of their teeth, whether to have orthodontic therapy to straighten their teeth, or to have cosmetic veneers.

Every situation is quite different, and patients who make these decisions are individuals with specific likes and dislikes. The decision is very personal, but we offer guidance and support to help them make their choice.

There are factors we look at to begin our discussion. First is the condition of the patient’s teeth. If the patient has pretty teeth, but they only need to look straighter, then orthodontics might be the way to go. However, if the teeth are not attractive or straight, then restoration with veneers or crowns would improve the appearance of the teeth and would certainly be quicker than orthodontics.

Another factor is a patient’s life schedule. Sometimes the need to accomplish dental treatment quickly because of life events like a wedding can influence a patient’s choice. A third consideration is the condition of the patient’s periodontal (gum and bone) health which is a very important factor in this treatment equation.

Today there are a number of different orthodontic options that can influence someone’s decision, from the quick Six Month Smiles that involves invisible braces, to Invisalign which uses trays and takes a little longer but doesn’t involve brackets on the teeth. I feel extremely blessed that my son does both of these forms of orthodontics so that we can, in one visit, give our patients all of the choices available to them. This includes what is involved both financially, and in the length of time needed for treatment, to help them make what is often a very difficult, and an extremely personal decision.

How important can cosmetic dentistry be to an individual?

One of our patients…I’ll call her Jane…was in her mid-60s and had been a patient of ours for over 25 years. On a 1 to 10 scale, Jane’s teeth were a five. She wanted to have teeth in the eight to nine range, but she was insistent that when we were done her teeth would not look fake and that no one would know that she had cosmetic dentistry done.

When we were completed, both Jane and I, along with the rest of the staff, felt we had achieved all her goals. Her teeth did look great, but they did not draw attention to themselves. So one day when Jane was socializing with friends, one of them came up to her and said “My God, Jane, you look terrific, what have you done? Did you have plastic surgery?” Well of course when Jane came back into the office and told me the story, we all had a good laugh over it. Yet later, when I was thinking about it, the truth was I believed that Jane was carrying herself differently. She was standing tall and proud and she was more confident.

I think this is one of the nicest compliments we’ve had about our dentistry because it showed that not only did we achieve all the goals we wanted, we even went beyond and achieved goals we didn’t originally consider. Your smile is always with you throughout life. It is one of the first things people notice about you, and one of the things you can actually change about your own body.

Another story which deals with the importance of your smile was told to me many years ago by a patient who needed extensive dentistry, and who had already invested quite a bit of money at another dental office. In order to have the treatment done, he had to sell his sailboat. Many years after that, during one of his periodic prevention visits, I said to him, “Bill, I’ve always felt badly about the fact that you had to sell your boat to get your teeth fixed. Has it ever bothered you?” He turned to me and said, “Never. Every day I smile, talk and eat using my teeth. I only used my boat occasionally. It was one of the best investments I’ve ever made.”

Why Don’t Oral Surgeons and Periodontists Place Mini Dental Implants?

As to why, I think some of it has to do with the fact that training for oral surgeons has traditionally been in wider bodied implants, 3.0 mm or wider in width, using a two-phase surgical approach. This is also the technique with which most general dentists are comfortable.

So if a general dentist refers his patient to the oral surgeon, he is expecting to work with an implant that he knows how to restore, which means the placement of a post and a crown. These techniques in dentistry have been around for quite a while now, and most general dentists are familiar with the restorative techniques involved with this wider
implant therapy.

On the other hand, if the surgeon returns a patient to a general dentist with a narrow one-piece dental implant, it is not what the general dentist expected and consequently
he may be uncomfortable about the restoration. Therefore, in the future, he may no longer refer to that oral surgeon, resulting in a potential loss of income for that oral surgeon.

Additionally, when mini dental implants first came out, they often had a polished surface which did not allow for actual integration into the bone. As a result, many oral surgeons still believe that these implants do not integrate, even though they now have similar surfaces to other implants. The truth is that there are mini dental implants that are 2.9mm in diameter and wide body implants which are 3.0mm in diameter. It is unproven if the body can tell the difference.

There is much research showing a high rate of success with narrow one- piece implants, yet there are patients for whom narrow implants are not a good choice. You need more height of bone, and often you need a greater density of bone, which is not always present. Additionally, there are situations where mini implants may be more susceptible to failure due to the fact that the patient grinds his teeth.

The fact is that when you place a mini dental implant into the bone, and there is a post, which is part of the implant itself and which sticks up ¼” into your mouth, there will be more immediate forces on the implant. This is called immediate load. This may not allow the implant to integrate into the bone as well and could result in implant failure.

These are situations which need to be evaluated and because of this we offer a no charge consultation to evaluate and discuss each patient’s individual situation. For further information please visit: http://scholar.google.com/scholar?q=Todd+Schatkin%2C+Samuel+Schatkin%2C+Benjmin&btnG=&hl=en&as_sdt=0%2C22.

New High Tech Cone Beam 3D Imaging Comes to Morrison Dental Care

We are one of only a half dozen offices in the area to have this new technology, which allows in-office 3D images to be available instantly. With specialized software, we can see in a three-dimensional way where we want to place implants. We can place these implants digitally on screen first, before we perform the physical procedure, which gives us greater visualization, control, and accuracy.

If desired, we can construct a plastic device that sits in the mouth and directs the placement of the implants. In certain difficult situations, where we need to be particularly precise in implant placement, this type of guidance has significant benefits. In periodontal therapy, we can actually see the bony defects within the jaw, which gives us more specific information to help us decide what type of therapy would be most effective.

When diagnosing teeth that need root canal therapy, and during the root canal procedure, we are able to see the number and direction of the canals so that we can increase our success rate. When making a diagnosis for orthodontic care, we can see the amount of bone present to help us make decisions concerning which teeth we can move first, so that we don’t disturb the precious bone that we are going to need later.

When we are trying to diagnose whether a tooth has a fractured root, we can look at the tooth in a three-dimensional way and are better able to see a fracture. Previously we have had to send the patient to a specialist, who may have had to start root canal therapy, only to determine if there was a fracture by investigating the tooth under a microscope, the patient having been anesthetized and the root canal started.

This is tremendously exciting for the whole staff as well as for patients. Not only can we diagnose treatment more accurately, but the incredible three-dimensional visualization actually helps our patients see what’s going on, so that they can be more comfortable about making decisions regarding desired treatment.

Another wonderful benefit of this machine is the routine panoramic x-rays that are now digital and this means decreased radiation to our patients. In addition to this, the equipment is so sensitive, and the software so excellent, that the images we receive from this technology are far superior to anything previously seen. Another boon for patients who have problems with gagging, and who find the digital sensors in the mouth uncomfortable, is that we can actually take bitewing x-rays without putting anything in the patient’s mouth. So as you can see, David and I are very excited to be able to offer this new cutting edge imaging technology to our patients.

Routine Dental Visits Twice Per Year

Everyone knows they should see their dentist twice a year for their cleanings and check-ups.  Although public perception invariably turns to the cleaning, it is the exam that is just as important, if not more so. The real reason is that most dental problems do not hurt. Therefore, it is important to have your teeth examined before any problems get serious, and before you feel pain.

Neither decay nor periodontal disease usually cause pain, until the problem is fairly serious. A patient can walk around with periodontal disease, experiencing only very mild discomfort, a lousy taste, and bad breath. However, by that time the disease can be so bad that it will result in the loss of numerous teeth. It is also not unusual for a patient who has been avoiding the dentist to have the first actual sign of pain occur only when the decay has gotten into the nerve of the tooth, and by that time the tooth needs extraction or root canal therapy.

Several years ago we saw an educated, knowledgeable patient, who had put off dental visits for about seven years because he had no discomfort whatsoever, and his teeth looked and felt fine. When he finally did come in, due to a minor problem, x-rays revealed a significant tumor in his jaw. The removal of the tumor necessitated the removal of over ten teeth. Thankfully, this is an uncommon occurrence, but one that needs to be avoided by thorough exams and routine x-rays.

I do want to stress that it is important to have your teeth cleaned twice a year, and some people need cleanings even more often.  The buildup of tartar that most people have is a great breeding ground for bacteria, which causes periodontal disease. Once the bacteria has calcified and formed a little coral reef around the tooth, it is just about impossible for it to be removed, except by a licensed professional hygienist. During the cleaning, the hygienist will also be able to safely remove stains from the teeth, caused by the many habits we have, such as drinking coffee or smoking.

As for young children, it is important to watch their growth and development in order to see dental problems as they are developing. It is better to take care of these problems at the earliest opportunity, with the least amount of intervention. As children get older, it is certainly important to see what is happening with their wisdom teeth. If there is a probability that the wisdom teeth will need to be extracted, it is better to schedule the procedure when children are younger, as there will be less chance of complications, and quicker and easier healing.

The Importance of Dental Health During the Senior Years

I will never forget the time a patient about fifty-eight years old came into my office, and as we were talking about what treatment would be necessary to improve his dental health, he said to me, “I don’t think it’s worth it to spend any money on my teeth.  After all, I’m almost sixty and I don’t know how much time I have left.”

I remember saying to him that I was approximately his age, and I was not ready to pack it in yet.  I said that unless he knew something about his health that he was not telling me, it would be best to keep his teeth in great health for as long as he could.  I told him that research has indicated that excellent dental health improves life expectancy.

You may be a happily married, or happily single, seventy-year old, who says I do not care what my teeth look like as long as they function fine.  However, you have to know that in our society, your family, particularly your grandchildren, are significantly affected by the way your teeth look.

I recall having one patient come into the office solely because her five-year old grandchild had started calling her “ugly teeth Grandma.”  The proud smile this patient had following treatment had her grandchild telling her she was now “beautiful Grandma.”

Excellence in cosmetic dentistry does not mean overly white teeth that look fake.  In our office, we believe that properly restored teeth should look healthy and natural.  You should not walk into a room and hear, “What did you do to your teeth?”  Instead, you should hear, “You look great.  What did you do?”  However, we will be happy to provide the smile of your dreams if that is your desire.

Another unpleasant, but important, thought is that there is a time in life when many people’s health becomes such a problem that rendering dental care can be difficult, if not impossible.  Proper dental care for nursing home patients, or patients on multiple medications, or for those with severe general health issues, can be complicated or even out of the question.  My mother was one of those patients, and I regret delaying certain treatments when she was younger.

It is extremely important to keep your teeth healthy as you age, for proper nutrition.  It is important to keep your mouth, and accordingly your body, free from infection.  If you have periodontal disease, it should be treated, to keep your gums healthy and to prevent tooth loss.  In addition, you should be aware that there is a correlation between periodontal disease and heart disease.  A healthy mouth is also important for proper social interaction, which has been shown to play a significant role in mental health, and therefore in overall physical health.

How To Deal With Dental Fear

First, do not be embarrassed or feel inadequate in any way for not being able to go to a dentist.  Almost invariably you were hurt by a dentist who said, “I won’t hurt you”, and when you said it did hurt, your feelings were either dismissed or you were ignored.

It is only reasonable that you do not want to go back and subject yourself to the same injustice – not only reasonable, but intelligent.  It is smart not to put your hand back on the stove after you have burned it, but in truth, that is what you have to do.  You need to have a “healthy fear” to function in life.  Find a dentist who understands and does not belittle your concerns.

When I was 10 my father (the dentist) did hurt me, and when I asked him to stop, he said, “I’ll be finished in a minute.”  It hurt! From then on I was afraid of dentists, and I would even jump out of the chair and force him to chase me through the office – “quite a scene.”

One of the most difficult aspects of dental fear is that once you have been hurt, the emotional reaction to a dental office never goes away.  Our patients with dental fear trust we will not hurt them.  They know they can say STOP.  We will do whatever it takes to control any discomfort they are having, but emotionally we know they are feeling anxiety and we will not belittle them.

Talk to your dentist about your concerns, or come to our office and meet us.  Schedule a short appointment to experience the office without treatment.  The benefits of dealing with your fear are huge.

Remember it is not dental phobia.  It is real.  You have been hurt, but today you have the right to painless treatment.  Look for it, request it, and then require it.

Painless Dentistry

It is not the needle that causes the majority of the discomfort when getting Novocaine, but the fluid expanding the tissues that is unpleasant.

This discomfort can be minimized, or eliminated, by the dentist simply taking his time and injecting slowly. So …why do dentists not do that?  I don’t know the answer. At Morrison Dental Care WE DO INJECT SLOWLY.  It takes more time, but…do unto others that which you want done to your self.

Painless dentistry is practiced routinely in our office. How?? We give painless injections, then reinforce the Novocaine, and after that if anyone has discomfort (either physical or mental), we STOP.  Next, we take whatever steps are necessary to eliminate the problem BEFORE we continue. It sounds simplistic, but it works.  Again, I don’t know why it is not done routinely if it is that simple. All I can tell you is that my dentist growing up was my father, who used to tell his patients to raise their hands when it hurt. Then when I raised my hand, my Dad would say.. ” I am almost done”, and not stop. So I know what dental pain feels like…not good. I will not do that to my patients. The good news is that my mother would yell at him when we got home. Thanks, Mom.

Contact Us

Morrison Dental Care
1524 Route 9
Clifton Park NY, 12065
Phone: 518-371-3400

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