New Office, New Experience

I wanted to take the time to share with you some of my thoughts on dental x-rays. I will start by saying that dental x-rays are extremely important to what we do everyday. There is no doubt about it. We have the ability to see between teeth and under the gums and deep within the jaw bones! We have found cysts and tumors and even stones in the carotid artery. However, we understand people are hesitant to take dental x-rays, and that is totally normal in today's climate of uncertainty and distrust. I get it. We get it. But now imagine at your work, your profession, the most difficult and stubborn person to work with. They want things on their terms, because they don't understand or have been misinformed. They don't mean to be difficult. They want to be helped, or else why would they see you? If they deny the type of diagnostic tools that help you do your job, and you have to guess on what is going on in their situation, you could end up unintentionally hurting them! This is why it is critical to discuss with your dentist the importance of dental x-rays, and how the amount and frequency of them can be altered based on risk of problems and medical history. It does not have to be all or none. A good dentist and dental hygienist will listen to your concerns and come up with a plan that minimizes x-rays, but still allows us to see what is going on in parts of your mouth we cannot see. We have patients that have not had cavities in years, and come to see us every 6 months. As a result, they have gums that are healthy and free of gum disease. We then reduce the amount of x-rays taken in their cases. It is also important to consider that dental x-rays have come a long way since they were invented. New technology has reduced the amount of radiation considerably. A full set of dental x-rays is only recommended once every 5 years. The amount of radiation for this set of x-rays is about the same as the radiation you receive when flying from Florida to California. A chest x-ray is four times more radiation, and a CT scan of your head is about 200 times more. This doesn't mean that the radiation for dental x-rays is insignificant, we still want to be cautious as possible, we just want to put it in perspective. When someone is new to our office we require a full set of x-rays, as this allows us to come up with a conservative and preventative treatment plan. However, we will gladly honor and utilize dental x-rays taken at another dental office within the last 5 years. This saves both radiation and money. So if you moved or are switching dentists, do not be afraid to reach out to your former dental office and request your x-rays, because after all they are your property.

At our office, we get quite a few "second opinion" type of visits. Usually it is something like "A new dentist came in for my old dentist that retired, and all of a sudden they said I have 15 cavities, when I never had any before". Or we hear "The place my insurance sent me to has a different dentist every time I go in there. "Or the old classic:"The dentist and staff just wouldn't listen to what I was looking for", or some variation of this. You will also see negative comments like this on social media sites like Nextdoor or Facebook. In a world of "you get what you pay for", I would recommend going to a dentist that is consistent and allows you to help direct your own treatment. I can't stress enough the importance of consistency. Cavities start small, and can either grow quickly, or a lot of times stay very small. The problem is that one set of x-rays, taken on a given day, cannot accurately tell a dentist whether cavities or other conditions are advancing rapidly or staying put. The best way to evaluate a person's risk for cavities or acid wear or gum disease, is to get to know them. If I see only minor cavities on an x-ray, I tell the patient that we will see how they look at the next exam and go from there. My hygienist and I will give tips on how to keep the potential cavities from growing and mark them in the chart. If I find out a patient is moving out of town, I will caution them to make sure their new dentist does not try to fill teeth that we have been conservatively monitoring for years. This is how dentistry and medicine are supposed to work. Another major complaint we encounter during second opinion evaluations is that individuals received a plan for over ten thousand dollars worth of work without any clear explanation or visual representation. It's very possible this dentist had the patient's best interest in long-term health when crafting such a plan, but that kind of price tag can be a shock to the system, especially with little to no explaining of why or the potential benefits of such treatment. My recommendation would be to simply stop and ask a few questions, such as: "What would be the risk of not doing or delaying such treatment?" "Is there a less expensive alternative that can prevent future damage until I get the funds together?” And last but probably the most effective: "What would you do if you were in my position and money is tight?" Any defensive or short answer to these questions is an obvious red flag. When in doubt, get a second opinion. Find a place that has online reviews which specifically mention being conservative or honest.

February is National Children's Dental Health Month, and I wanted to share some tips on how to keep the littlest teeth healthy. My kids are now three and five years old, and struggling firsthand through these early years has given me a new perspective on how difficult it can be to enforce good oral hygiene at home. Bedtime is pure chaos most nights, and making sure the teeth get brushed and flossed is not easy, but it's doable. I find the hardest part with my kids is diet. They would eat nothing but candy if I let them, and their normal sustenance, as with pretty much all kids, is processed carbohydrates (read: Goldfish crackers). My kids will even try stall tactics at bedtime and whine that they need another snack. I say sure, but we must brush again afterward! Another personal example is that my five-year-old son knocked out his front two baby teeth in a balance-bike accident when he was two years old, and now is terrified of the dentist chair! The struggle is real for all parents. As I've detailed in previous articles, the best start is to have a child seen at a dentist's office right around their second birthday. The first visit may only involve a quick exam while the child sits on a parent's lap, and always ends with a positive-reinforcing trip to the treasure box. It's all about introducing the strange sights, sounds and smells, and future visits can slowly be built-upon, to grow confidence slowly and safely. At home, I recommend parents try to use little flossers between baby teeth as many nights as possible. These can be purchased in giant packs on Amazon. This not only introduces the habit of flossing, but most of these little flossers have fluoride on the string and helps to reduce cavities in between teeth. I make it a game, and I let them floss my teeth, and then they try to do their own. They usually focus on the front teeth, which is easier for them, but I take the time to floss between their back teeth, as this is unfortunately where I see the most cavities during exams at the office. Fluoride is always a controversial issue for many reasons. I recommend Fluoride at all ages, but starting toddlers on a training toothpaste with no fluoride is a good idea, until the child can learn to spit and not swallow toothpaste. If a child is drinking plenty of Fluoridated city water, even if it is mixed in with formula or any flavoring methods, this should help overcome the lack of Fluoride with training toothpaste. However, where I see parents run into trouble is when there is filtered water used in the house, and no Fluoride in the toothpaste. Keep in mind, without Fluoride, the diet has to be nearly perfect, and without processed carbs and sugars. If you are fluoride-averse, there are kid's toothpastes and even lollipops that contain Xylitol which can be a natural alternative. So, parents and grandparents of young children, don't wait, start as soon as possible and get your little one into a dentist's chair to begin the lifelong process of making the dental office a pleasant place. Also remember to focus on their teeth each night during the hectic bedtime routine, it is worth it.

If you asked me what business is most like dentistry, the answer is a car repair place. Sure, dentistry is a medical profession, I am a doctor, I have diagnosed cancer, and I prescribe and dispense medicine. But the similarities of a dentist to a mechanic, and a dental office to a tire shop are striking. Most importantly, there must be trust between you and the dentist or mechanic. People have little clue about what is going on under the hood, just like trying to figure out which tooth is hurting. The trust to have someone tell you the pros and cons of repair work, alternatives to treatment, and risks of "leaving it be" are critical. There is extreme value in trusting someone to correctly figure out what a problem is, and doing so without rushing to judgment and recommending overtreatment (a root canal or a whole new engine!). There are a lot of auto shops and a lot of dental offices out there, so second opinions can provide clarity when trust is questionable. You need trust between a service provider and a consumer in almost any field, but where the two professions align the most is the need for routine maintenance. Whether it is getting your teeth cleaned, or changing the oil, both involve having expert eyes on areas that are typically unseen to make sure problems are not brewing. Routine maintenance generally carries a minor cost, both money and time, but forgoing can lead to much costlier repairs down the road. Last, if problems do arise, the question of patching a repair versus doing it properly can be tricky. They are very situational. Patching an engine or a tire, when a car is on its last legs, is far different than a shiny new car. The same consideration should be applied to teeth and patients. Just be sure to ask the provider for risks and benefits of a patch. The most hidden similarity between the two is the amount of money spent on "new ones". When someone has health challenges, and requires the remaining teeth to be removed and replaced, people will sometimes gasp that it can cost upwards of $30,000 for implants. Yet, a new car easily costs this much and no one bats an eye because it's often financed. If you use a car three times a day, that's about average, but that's also how often you have a meal. And don't forget smiling and speaking, which adds up to way more than you would use a new car.

How does AI help your dentist? Dr. Ryan Collins explains how Banana River Dental uses Overjet AI x-rays to catch hidden cavities and bone loss. Read more!