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Wednesday, November 18, 2015

I Don't Want X-rays!

If only we had a dime for every time we heard "I don't want x-rays", we'd be able to take a nice staff vacation!  But here is the tooth of the matter (sorry).  We understand a patients aversion to being over radiated, however x-rays help the dentist find problems the patient may not even know exists.  "Nothing is bothering me, so I don't need them".  The trouble with this statement is that most times pain is the last symptom!  It's no different than going to the doctor for a headache only to find out a tumor has been growing in your brain for years without you knowing or having any symptoms.

In the above x-ray you can see a patient who, more than likely, didn't know that the jaw bone was deteriorating (circled in red).  That space may be a benign cyst (not cancerous) or it may be malignant (cancerous).  It may be where the jaw bone is simply gone, eaten away by infection over the years.  We've had patients with similar issues, who had no idea!!  A biopsy must be taken of the area and tested.  This x-ray could have been a life saver.

That was a severe case, but what about a simple cavity.  You can see in the picture below that the teeth appear to be fine, but you can see the decay between the teeth in the x-ray.  Again, the patient may be completely unaware the decay exists.

Just the other day, I told Dr. Gilmore that I had a bicuspid that, overnight, seemed to determine it was going to be unhappy.  It was very sensitive to air and cold.  He took an x-ray and though he didn't see much in it, my symptoms alerted him to something being wrong.  When he opened the tooth, he found a deep cavity!    Sometimes symptoms are the only clue things are suspicious.

Bottom line: dental x-ray exams require very low levels of radiation.  The levels are similar to the amount of radiation we all get from space and the earth in a day or two.  It could save you pain, money and possibly your life!

It will never cost less or hurt less than it does today.

Wednesday, November 4, 2015

Five Promises

The ADA makes 5 promises to patients regarding their dentists.  In reading through these promises it’s interesting how these are the same rules we’ve adopted in our office as our mission for our patients. 
1. Respect for a patients wants and needs:  I’ve had patients transfer to my practice because they went to another dentist who gave them a $15-20K treatment plan for a full mouth restoration.  The patient felt they were being sold something they weren’t asking for.  When a patient comes into my practice I simply ask them what they want.  Function, aesthetics, etc.  I’m not going to sell a full mouth restoration to a patient who is perfectly happy with the looks of their teeth.  My relationship with my patients is to help them achieve their oral health goals.
2. Do no harm:  This is two part.  The first, I commit to my patients to get the necessary continuing education to stay abreast of the latest techniques, technology and materials that will give them the longest life for their restorations.  The second is that I’m honest about my limitations and will refer to a specialist if necessary. 
3. Do good: This really defines my practice.  From the moment a patient steps foot in my practice I am 100% committed to providing the best treatment available as quickly as a patient can complete it.  It doesn't matter who they are, where they’ve been or where they’re going.  I treat each patient equally and spend time getting to know them, their concerns and having a frank conversation about how we can form a partnership to get it done.  I’ve invested a great deal of money into the best materials and technology to provide my patients with an end product that will be superior.  For example, my Cerec same day crown and bridge machine.  Patients no longer need multiple appointments for crowns and no more wearing annoying temporaries.  I can prep the tooth and deliver the crown within 90 minutes with better margins (where the crown and tooth meet) than I’ve been able to get from the lab.
4. Fairness:   This is my commitment to treat everyone who walks through my door, regardless of race, religion, socioeconomic background, etc. exactly the same.  I will give them the same respect, honesty and quality of work that I give anyone else.
5. Truthfulness:  I will admit this one can get tricky.  I will always give the patient the truth of their current situation, that is non-negotiable for me.  However, patients rarely like it.  It’s very difficult to have a patient come into my office as a new transfer, talk about how long they had their previous dentist and how much they loved him or her and me having to explain to them that they need extensive treatment.  Providers do not do patients any favors by not being completely honest with their patients about their treatment needs.  This is especially true in regards to Periodontal Disease.   “But I’ve been getting ‘regular cleanings’ for years.”  When my highly skilled hygienists take probings (measures the pocket depths between the gums and the teeth),  and determine that there are multiple pockets that measure 5 or greater (1-3 is normal) and that there is bone loss etc., this is an indication that patients have undiagnosed and untreated periodontal disease.  These patients will never be a  ‘regular cleaning’ again.  It’s like diabetes, you can manage it, but it never goes away.  Periodontal Disease requires treatment and regular maintenance that typically goes beyond the two times a year cleanings.  Ultimately, I am sworn to
diagnose what I see and at times that makes me very unpopular, but I owe it to every patient.  It’s the patients responsibility to receive the necessary treatment.

It will never cost less or hurt less than it does today!