Do I really need to get my wisdom teeth removed?

            A friend of mine recently sent me an article where the author was warning people against having their wisdom teeth removed. He cited all kinds of risks and the troubles he had during his experience. He even referred to having wisdom teeth being removed as a ‘scam.’ In light of this, I wanted to share some facts and myths about having wisdom teeth removed versus keeping them.

Do all wisdom teeth need to be removed?

            No. There are times when there is adequate room for the wisdom teeth and they can be easily cleaned and maintained. In these situations, extraction is not warranted.

How old should you be when the wisdom teeth are removed?

            The answer varies greatly due to different eruption patterns and when symptoms develop. But typically the younger you are the easier the removal and healing. The more developed the roots, the more challenging the procedure can become. This is why dentists typically recommend extractionb at a younger age.

Will I ever be too old to have wisdom teeth removed?

            If the teeth are symptomatic and/or causing other issues then you are never too old. But if your immune system is compromised or you have been taking bisphosphonates for osteoporosis, removal may not be a good option.

What can happen if I don’t remove my wisdom teeth?

            If the teeth are fully or partially impacted then you could experience tooth decay of the wisdom teeth, decay on the adjacent teeth, cysts, and other serious infections.

Who should remove my wisdom teeth?

            For almost all cases, we recommend an oral surgeon extract your wisdom teeth. They are very experienced, can provide sedation, and can handle any possible complications.

           

The bottom line is each situation is different and each person is different. You should have an open dialogue with you dentist about your concerns and talk through the pros and cons of any treatment option.

I believe in calculated risk and minimizing that risk whenever possible. Most dentists, and the American Dental Association, believe in removing impacted wisdom teeth at a young age to avoid other more serious complications later in life.

For more information, visit www.dentistwestchester.com.

Lee T. Brown, DDS

Brown and Kupper, DDS Inc.

How should I whiten my teeth?

            There are all kinds of products available that can whiten your teeth effectively. There are also a large number of materials that claim to whiten and brighten your teeth. So what is the most effective way and how important is it to whiten? We will try to answer some of those concerns or questions.

Why would it be important to whiten my teeth?

            There is no clinical benefit to whitening your teeth. It will not make your teeth stronger or more resistant to cavities. However, when bleaching is done properly it doesn’t hurt your teeth either. But can whiter teeth boost your confidence and make you more prone to smile? The American Academy of Cosmetic Dentistry found that ninety six percent of Americans believe having whiter teeth makes a person more attractive. The same study found that an unattractive smile can hurt someone’s career prospects. So the hope is a confident and beautiful smile will help to improve your quality of life.

Do it yourself whitening vs. professional whitening:

            There is definitely perception of white teeth being more attractive and a belief that white teeth are healthy teeth. Because of that, do-it-yourself whitening products were 1.5 billion dollars in sales. While I believe there is a time and a place for different over the counter whitening products, I think it is important to weigh the cost/benefit of these against the professional options.

            You could literally spend hundreds of dollars each year on OTC whitening products and still not achieve the desired results. At that point, it would have been beneficial to spend a little more on the professional whitening to get the results you want and spend less in the long term. However, some people (especially younger patients) can reach their goals with OTC whitening strips. The best bet is to consult your dentist to see what could work best for you.

If you have more information about whitening your teeth or other dental related questions, you can learn more at www.dentistwestchester.com.

Lee T. Brown, DDS

Brown and Kupper, DDS Inc. 

Why does my insurance talk about UCR?

             If you have dental insurance, then you have likely seen the phrase ‘Usual and Customary Rate’ (UCR). A dental insurance company will love to use this term, but what does it mean for you? Who determines this number? We want to help you understand where these numbers are derived and how it is applicable to you.

            In reality, there isn’t a ‘usual, customary, or reasonable fee.’ This is a phrase that created by insurance companies to impose their will on dentistry. There isn’t a specific number that insurance has arrived upon, but instead a range of fees based upon percentiles. Even if an insurance carrier was capable of tracking every dental office’s fees, then arrange them into proper zip codes, it is impossible to place a value of the types of materials or the amount of time given to a particular procedure. Assigning a UCR to a dental procedure is like assigning a UCR for a cheeseburger. It doesn’t account for the difference between fast food restaurants versus a high end restaurant. There is no consideration for the ingredients, the service, the quality of preparation, and the execution.

            Another issue frequently encountered involves the percentage of coverage your insurance allows for a given procedure. Again, the insurance companies determine their own definition of which fee percentile a procedure may fall into through their own independent research. After the percentage is determined, an employer is offered different options of which fee percentile to purchase for their benefit package. They may only buy up to the 50^th percentile, and then your out of pocket costs may increase. Even with fees increasing over time with inflation, it is possible that additional expenses may be incurred if your dental insurance has been adjusted to cover a lower percentile.

            Dental insurance is unique from medical insurance and can be very confusing. There are also a lot of differing individual circumstances. Please call us with any questions regarding your current insurance or if you’re ever picking a new policy through your employer. Hopefully we can help you sort through some of the pros and cons of each policy.

For more information, visit www.dentistwestchester.com.

Lee T. Brown, DDS

Brown and Kupper, DDS Inc.

When should the dentist prescribe me antibiotics?

            When you are in pain, you are desperate for a quick fix. You typically are looking for any medication or treatment that will alleviate the problem so you can function normally. With dental pain, it is common to think that an antibiotic will help solve the problem. There are times when it is right thing to do, but there are also circumstances where it could do you more harm than good.

            Physicians and nurses commonly report that many request an antibiotic during cold and flu season. However, most of the problems are due to a virus and not a bacterial infection. Prescribing an antibiotic will not help fight the viral infection. There is a similar situation with dental pain. Many of the reasons that a tooth can be symptomatic are not from a bacterial origin. So taking an antibiotic will not alleviate the pain unless it can be concluded the problem is from a bacterial abscess. But if it is a tooth with this kind of abscess, then antibiotics are the drug of choice. 

            Another major reason dentists have cut back on prescribing antibiotics is from concern over developing a resistance to antibiotics. If you are taking antibiotics, the goal is to kill the undesired bacteria. However, certain bacteria will prove resistant to the drug and survive. The resistant bacteria will proliferate and will become more abundant. If a similar infection returns and antibiotics are needed, there is a concern the antibiotic will not be as affective.

            So what are some other potential options when you are in dental pain? I typically recommend ibuprofen as the first line of defense. But if that isn’t strong enough to take the edge off, we may either prescribe a stronger pain medication or prescribe a type of steroid. The goal of the steroid is to reduce the pain by reducing the immune response to the affected tooth.

            Each individual situation can be different or unique and just because an antibiotic worked previously doesn’t mean it is the ideal choice for your current situation. Have your dentist check the area and work with you to find the best course of action.

For more information visit: www.dentistwestchester.com.

Lee T. Brown, DDS

Brown and Kupper, DDS Inc.

Is your insurance company looking out for you?

            Many people choose to carry dental insurance to offset the costs of semi-annual cleanings and just in case something major goes wrong. So what happens when something bad happens? Will your insurance help cover a procedure that gives the best long term result? Unfortunately, your insurance may have limitations on what procedures they believe they should help.

An example with frequently deal with:

A tooth is missing or must be extracted. You want to replace the missing tooth with a dental implant over a dental bridge. The implants are usually longer lasting, easier to clean, and do not require invasive drilling on your other teeth. Over the long term, they typically result in the least amount financial investment because they will last longer than a dental bridge. Logically speaking, this also means the insurance company will have to contribute less over the long term, which is what they are after.  But for some reason, many insurance carriers will deny you coverage on the dental implant but approve the dental bridge. Both options require a big financial commitment, but the difference in coverage can be a difference maker if you need your tooth replaced. The lapse in dental implant coverage can push someone towards a procedure that doesn’t necessarily have their best interest in mind.

So what happens if your insurance carrier denies coverage on a recommended treatment? There are times when no matter what we do, insurance will simply not provide any coverage on a recommended procedure. But in other situations we can submit a new request for coverage along with a narrative explaining our rationale for the treatment needed. There are times when reason wins and coverage is granted, but unfortunately many insurance carriers are very slow to change their policies to the recommended standards of care.

            We recommend that before you sign with an insurance carrier or package that you do some detailed research on what procedures may be covered. If this seems overwhelming or confusing, I encourage you to call us and we can help you sort through what plan may be best according to the needs and dental history of you and your family.

For more information, visit www.dentistwestchester.com.

Lee T. Brown, DDS

Brown and Kupper, DDS Inc.

What happens to your teeth and body when you binge on sugar?

            We all know that sugar is necessarily the healthiest things for us to eat. But like most things, if we use moderation we should be fine. However, we need to be aware that sugar and sweets affects your body in a number of ways. We will discuss how sugar can affect you in the short term and the long term.

            It is no secret that sugar can lead to cavities. Decay causing bacteria on your teeth feed on the sugar to create cavities. So when you are exposing your teeth to sugar throughout the day without the opportunity to fight back with brushing and fluoride, you are more likely to lose that battle. Moderation is essential, but you should also find a way to brush, floss, and rinse to clean your teeth and mouth following a sugary snack. At the very least you should rinse with water to cleanse some of the sugar from your teeth.

            When you eat sugar, other parts of your body also feel the strain. When you eat sugar, your brain responds the same it would to cocaine or other drugs. Both sugar and drugs cause your body to release dopamine and serotonin. As you become accustomed to that feeling your body craves in more and more. It is good to be aware of this so you can help regulate your desire for more sweets.

            If you continue to overdue sugar and sweets overtime, your blood flow can be affected. Having blood saturated with sugar can damage just about every organ, including your arteries. It is like trying to pump sludge through your body, which will eventually lead to decreased blood flow to all parts of your body. It can lead to chronic diseases and an increased chance of having a stroke.

            An easy way to keep tabs on how much sugar you are ingesting is to pay attention to the labels on whatever you eat. It is shocking to find out how many different foods contain sugar (i.e. ketchup). Simply being aware of what you put in your body is a great first step to limiting sugar intake.

For more information, visit www.dentistwestchester.com.

Lee T. Brown, DDS

Brown and Kupper, DDS Inc. 

Antibacterial Teeth

            Even though it is still in its early stages, there are researchers in the Netherlands developing an Antibacterial replacement tooth that can be 3-D printed. It would be made of a plastic infused with ammonium salts to combat unwanted bacteria. And even better, it could be made in the dental office.

            They tested 2 sets of replacement teeth against each other. One was the traditional dental resin, and the other was made with infused ammonium salts. They applied streptococcus mutans (cavity causing bacteria) to both sets of teeth and found 99% was eliminated on the set with ammonium salts while almost all remained on the control set.

            The next question to ask is whether this new type of replacement tooth eliminates both good and bad bacteria? Some bacteria in our mouth are good and help keep our bodies healthy by fighting unwanted organisms, so we obviously don’t want to get rid of all bacteria. While there is still a lot of research to be done, there is no reason to believe that antibacterial teeth would kill off all the bacteria in the mouth.  "Given that the material works on contact, it is likely that teeth or fillings made from the material would only kill bacteria in a limited radius," ADA officials said. "Whether teeth or fillings made from this material could have any effect on other bacterial strains, or even function in a real human mouth, has not yet been determined."

            Much more research is required to find the answer. This material needs to be tested on more conditions and over a longer period of time. How will toothpaste, saliva, and different medications impact its efficacy?

            If we find that it can positively affect the teeth and your oral health, this could be a major breakthrough for dentistry. The goal is to continue to find more ways to preventative and proactive in dental treatment.

For more information, visit www.dentistwestchester.com.

Lee T. Brown, DDS

Brown and Kupper, DDS Inc.