Yesterday, our surgeon general officially endorsed community water fluoridation. According to the American Dental Association, ”Every surgeon general for the past 50 years has endorsed community water fluoridation of community water supplies as a safe and effective weapon in the war against tooth decay.”
Dr. Regina Benjamin was quoted as saying, ”Fluoridation’s effectiveness in preventing tooth decay is not limited to children, but extends throughout life, resulting in fewer and less severe cavities.”
She further noted, “each generation born since the implementation of water fluoridation has enjoyed better dental health than the generation that preceded it.”
We realize that there are many people who opposed community water fluoridation for a variety of reasons. But if you look at the entire body of scientific evidence, the overwhelming majority of it supports fluoridation as safe and effective. According to Dr. Benjamin, water fluoridation is ”one of the most effective choices communities can make to prevent health problems while actually improving the oral health of their citizens.”
Dr. Steve
Roseville Family Dentist
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Many people with prosthetic hips and knee joints have been taking antibiotics before dental treatment on the advice of their Orthopedic Surgeons. They were afraid that the bacteria in the mouth could get into the bloodstream and infect the artificial joints, which could lead to having to replace the joint. Some people were told to premedicate with antibiotics before dental visits for two years after their joint surgery. Others were told they must do it for the rest of their lives. If dental work leads to infected prosthetic joints, then it would surely be wise to take antibiotics before dental visits. But does it?
The American Dental Association (ADA) and the American Association of Orthopaedic Surgeons (AAOS) completed a systemic review of the literature last month and came up with the following recommendations:
1- “The practitioner might consider discontinuing the practice of routinely prescribing prophylactic antibiotics for patients with hip and knee prosthetic joint implants undergoing dental procedures.”
2- “We are unable to recommend for or against the use of topical oral antimicrobials in patients with prosthetic joint implants or other orthopaedic implants undergoing dental procedures.”
3- “In the absence of reliable evidence linking poor oral health to prosthetic joint infection, it is the opinion of the work group that patients with prosthetic joint implants or other orthopaedic implants maintain appropriate oral hygiene.”
HUH? What does this all mean? Here’s my interpretation:
1- There is no evidence that dental treatment causes joint infections, but they’d like to see more studies done before they stick their necks out and actually say it doesn’t. So, doctors might not want to give patients antibiotics before dental work unless/until they hear otherwise.
(If you read the fine print, there is only one good study which explored the “association between dental procedures and orthopaedic implant infection”. It concluded, “dental procedures are not risk factors for subsequent implant infection and furthermore that antibiotic prophylaxis does not reduce the risk of subsequent infection.”
They go on to state that we know dental treatment causes bacteria to get into your bloodstream, but there are no studies at this time that show that bacteria infects prosthetic joints.)
2- We’re not really sure if rinsing with antibacterial mouth rinses right before dental work would be helpful, since there’s not much evidence either way and it doesn’t look like dental work causes joint infections anyway, but it wouldn’t hurt so if you want to keep doing it, then go ahead.
3- We think you should floss and brush well if you have artificial joints. (Glad to know the ADA and AAOS agree on this!)
For both of the first two recommendations, they also state, “Patient preference should have a substantial influencing role.” Translation- “whatever the patients want to do is fine with us”.
So do you need to take antibiotics before dental treatment if you have an artificial hip or knee? Well, here’s the title of the article the AAOS put out in December- “Evidence Insufficient to Recommend Routine Antibiotics for Joint Replacement Patients Who Undergo Dental Procedures”. Many surgeons will probably continue to recommend it. I would recommend not to. But it’s up to you!
Dr. Steve
Roseville Family Dentist
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August 22 is National Tooth Fairy Day. (Apparently, so is February 28.) And it would seem our fabled colleague has a rather long history.
According to Spear Education- “Centuries ago in Europe, the tradition of “hiding” a child’s primary tooth that fell out began. Some of the earliest practices included burying a tooth in the garden, known as tooth gardens, to prevent an “evil witch” from stealing it and casting a spell on the child… Over time, the tradition in America went through many phases. For instance, up until the late 1800s, many people believed that swallowing the tooth was the best way of preventing evil from getting ahold of it. Some people even believed that if an animal swallowed the tooth, the new tooth growing in would resemble the tooth from that particular animal. A common belief during this time was to force a mouse or rat to eat the tooth to ensure the teeth growing in would be sharp and strong.”
The Straight Dope writes, “The tooth fairy as we now know her didn’t make an appearance until the early 1900s, as a generalized “good fairy” with a professional specialization. The child loses a baby tooth, which is put under the pillow at night, and the tooth fairy exchanges it for a present, usually money but sometimes candy. Exchanges of this sort are common in many rites of passage (like an exchange of rings at a wedding, say).
The tooth fairy grew slowly in popularity over the next few decades. The Tooth Fairy, a three-act playlet for children by Esther Watkins Arnold, was published in 1927. Lee Rogow’s story “The Tooth Fairy” appeared in 1949 and seems to be the first children’s story written about the tooth fairy. She became widely popular from the 1950s onward, with a veritable eruption of children’s books, cartoons, jokes, etc., including more focus on children’s dental hygiene. Parents cheerfully bought into the idea and the tooth fairy became part of family life. The 1980s saw the commercialization and merchandising of the tooth fairy, with special pillows, dolls, banks, etc.”
According to Delta Dental’s Tooth Fairy Poll, the Tooth Fairy’s giving habits tend to follow the stock market.
And Visa’s 2011 Tooth Fairy Survey findings include:
- 10% of children receive no money from the Tooth Fairy.
- 7% of children receive less than a dollar.
- 29% of children receive exactly $1.
- 18% of children receive between $2 to $4.
- 18% of children receive $5.
The Tooth Fairy is an American tradition with European and superstitious roots. And since she brings joy (and money) to children all across the country, easing the emotional pain of losing a tooth, we are proud to celebrate her National Day.
Dr. Steve
Roseville Family Dentist
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Let’s face it, dentistry is not cheap. While you’re likely to spend far more on cars than you do on your teeth and mouth during your lifetime, it takes more than pocket change to get your teeth fixed. So how can you save money at the dentist?
First and most importantly, an ounce of prevention is worth way more than a pound of cure. Here’s how to prevent the two most common diseases in the world (tooth decay and gum disease). The bottom line is this:
- Don’t feed the sugar bugs between meals!
- Floss daily, especially at the gumline
When you come in to see the dentist, consider spending a little on preventive measures to save a lot in the long run. Examples include:-
- sealants to seal off the grooves where sugar bugs hide and most decay occurs
- fluoride treatments to harden the teeth- gels and foam are good; varnish is better
- splints (aka- nightguards) to prevent “occlusal disease”, which occurs when clenching and grinding your teeth at night causing cracked/broken teeth, worn/failed dental restorations, sensitive teeth and TMJ problems
If you already have lots of decay or gum disease, remember the four goals of dentistry, which are listed somewhat in order of priority:
- Remove/manage dental disease- tooth decay, gum disease, occlusal disease
- Replace what’s missing
- Preserve what’s left
- Cosmetic dentistry
Make sure to treat dental disease early. All dental disease is progressive! The longer you wait, the worse (and more expensive) it gets. Here’s what can happen when you wait to fix your teeth. When it comes to fixing your teeth, you will usually have options. Weigh pros/cons of each restorative option. You can sometimes save money if you don’t mind a little silver showing, or if you choose a removable denture versus crowns or implants.
Will going to a dentist with lower fees save you money? Well… maybe. If two dentists recommend the same treatment, then of course the one with lower fees will cost less, at least initially. But sometimes dentists with lower fees recommend more treatment. Or sometimes the quality of work is not as good, so the work needs to be redone sooner, costing more money in the long run. How do you know if a dentist may be treatment planning aggressively? If you are ever unsure of recommended treatment, get a second opinion. A dental exam costs far less than dental treatment which may not be necessary. How do you know if the dentist does good work? Ask friends who’ve been seeing them for a long time. Or check out the testimonials on their website.
Dentistry is not cheap. But there are many things you can do to keep your dental costs down, while still maintaining healthy teeth and gums. As always, feel free to contact me if you have any questions.
Dr. Steve
Roseville Family Dentist
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“Yamamoto and Lee is a family dental office dedicated to providing top quality dentistry and overall service to our patients.” (from our mission statement)
We take our mission very seriously and always do our best to live up to it. Yet despite our best efforts, we know we will never please everyone. So when a patient leaves our practice, we like to find out why they’re leaving so that we can hopefully learn from our mistakes and improve our service. But then, some of them come back!
We understand that there are many reasons why people leave a dental office to go see another dentist. What we fail to realize is that people don’t always leave because they are unsatisfied. Sometimes people leave because their insurance changed and they now have a list of dentists they must see if they want their dental work to be covered by insurance. Or sometimes they leave because finances are tight, and they think they can save money by going to a dentist with lower fees (and there’s always someone with lower fees). One returning patient this past week said that even though his insurance changed, he’d rather come here and pay out of pocket because the dentist he saw under his plan tried to get him to agree to treatment which wasn’t covered, and it would have cost him more than what we had recommended. Another returning patient came back because the “cheaper” dentist wanted to replace all his fillings and do full mouth deep cleanings, which we didn’t think he needed. (In my next post, I will discuss the best way to save money at the dentist.)
And then there are the times when a patient leaves because there was something about our service they didn’t like, only to return when they come to realize that we had done nothing wrong. A couple years ago we had one patient leave quite upset because I had recommended one of her teeth needed a root canal. When her tooth started aching recently, she asked to come back.
It seems like more patients than ever are returning to our dental practice. Maybe it’s a sign that our economy is turning around. Or maybe it’s just a variation of chance. Whatever the reason, we like to think that maybe we’re not doing such a bad job of achieving our mission.
What do YOU think?
Dr. Steve
Roseville Family Dentist
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Congratulations again to Karen Y for winning Yamamoto and Lee, Roseville Family Dentist’s latest Patient Appreciation Drawing. She won a $100 credit off dental services and 1 free month at Fitness MD in Rocklin. Thanks to all of you who make your appointments, keep your appointments and pay what you owe. Keep it up and you may win our next drawing! We’ll be drawing December 1 for another $100 credit off of dental services here at Yamamoto and Lee.
Dr. Steve
Roseville Family Dentist
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As a kid, Halloween was one of my favorite holidays- not quite as good as Christmas, but way better than Thanksgiving. I still enjoy Halloween, but as a dentist I realize it can be hazardous to the health of our teeth. Candy sales approach $2 billion every Halloween. And as we’ve mentioned numerous times in this blog, sugar (NOT the lack of brushing and flossing) is the main culprit in causing tooth decay (aka- cavities).
So what can YOU do this year (other than encouraging your kid to dress up as a dentist…lol) to make Halloween a bit safer for teeth?
First, resist the urge to buy your Halloween candy supply early. I firmly believe that any candy bought more than three days before Trick or Treat night often ends up rotting your family’s teeth before the big night. (Do I lie?)
Second, consider handing out non-decay causing goodies instead of candy. About.com and NationalServiceResources.org have lists of some good alternatives. These include:
- Glow-sticks
- Sugar free gum
- Halloween stickers
- Small cans of playdoh
- Pencils with Halloween erasers
- Halloween bouncy balls
- Temporary tattoos
- Small bottles of bubbles
- Temporary tattoos
- Crayons
- Coins (pennies, nickels, dimes)
- Superballs
- “Slime”
- Sugar-free candy
- Origami paper & instructions
- Bubbles
Third, make sure your little ones only dip into their candy booty at meal times (when they’re likely feeding the sugar bugs anyway) and maybe one other time during the day (if they’ve been good, of course). Remember, it’s not necessarily “how much” sugar we get, but rather “how often” that determines how many cavities we get.
So have fun this Halloween! But try not to make your teeth “scream”. Otherwise, you may end up looking like Jack up above.
Dr. Steve
Roseville Family Dentist
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Karen Y!!! Congratulations on winning Roseville Family Dentist’s Patient Appreciation drawing for a $100 credit off dental services and 1 free month at Fitness MD in Rocklin! Thank you for being a star dental patient here at Yamamoto and Lee, Family Dentistry!
Remember, if you show up for your original appointment time, or pay your portion at the end of the appointment, or schedule your next appointment before you leave the office, you could win our next drawing to be held December 1, 2011. We will be giving away another $100 credit towards dental services here at Yamamoto and Lee, Family Dentistry!
Dr. Steve
Roseville Family Dentist
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This is one of the most common questions dentists get, and it’s a good one. Our exposure to x-rays is cumulative over the course of our lives, meaning it constantly adds up and never goes away. Dentists have known this for many decades (long before we entered dental school). So we are very interested in minimizing the amount of radiation we are all exposed to. I have to say dentists have done an excellent job.
I just stumbled across a group called the Health Physics Society. They help provide health physicists with the information they need to do their job, which is ”to manage the beneficial use of ionizing radiation while protecting workers and the public from potential hazards”. (I’d never heaerd of a “health physicist” before.) Their website has a lot of great information on our radiation exposures- everything from airport screenings and cell phones to tanning salons.
Their page about dental patient issues has some great comparison numbers. Normal background radiation dose is about 360 mrem per year. That’s your annual exposure just by living on this planet. The dose for four bitewing (check-up) x-rays is 0.2 – 0.3 mrem, or less than half of what we are normally exposed to in a day. A full mouth set of x-rays is equivalent to a little more than one days normal background radiation.
On another page, they state, “differences in background levels between different parts of the country are larger than the effective dose for a bitewing. For example, moving from a lower-background region such as Minneapolis, Minnesota, to a higher-background region, such as Denver, Colorado, for a year would result in an increase in effective dose for that year that is about the same as 30 bitewing exams”. The US EPA estimates that we are exposed to 2-5 mrem on a cross-country flight, which is more than twice the exposure of a full mouth set of x-rays.
If any of you are concerned about just how much radiation you are receiving when you see your dentist, I encourage you to check out the “dental patient issues” page.
Dr. Steve
Roseville Family Dentist
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Here’s an update. As previously blogged, we were voted by our dental colleagues as one of the Top Dentists in Roseville, according to www.usatopdentists.com. At that time, we did not know how much of an honor that really was. For all we knew, 90% of the dentists were “selected”. Top Dentists had not yet posted their list. Well, the list can now be found by searching their “Find A Dentist”.
As it turns out, 12 dentists in Roseville were selected, and we were two of them! How many dentists are there in Roseville? I’m not really sure. (I’d love to hear a number if anyone can figure out how to find out.) I know there are 85 dentists in Roseville who are ADA/CDA/SDDS members. I would guess that there are another 20-40 non-member dentists in Roseville. That means about 10% of the dentists in Roseville made the list.
I guess being voted Top Dentists really is something to be proud of! If you really want to know what our dental colleagues have to say about us, visit our testimonials page.
Dr. Steve
Roseville Family Dentist
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