DIY Dentistry

            There has been some recent coverage of a student from the New Jersey Institute of Technology who used a 3D printer and laser scanner to create plastic aligners to improve his smile. It is the equivalent of do-it-yourself Invisalign. But is this a DIY project that is worth the risk?

            The advantages of at home dentistry are obvious: convenience and cost. However, there are more risks than meet the eye. Moving your teeth to straighten a few areas is more complicated than you might think. A minor change to one or two teeth can have profound affects on the teeth, jaw, and your periodontal (gum) health. An appropriate analogy may be: If you moved a few support beams in your house and didn’t move them to the correct spot, then part of the house may collapse.

            What if you have a crown fall off? Can you scan the tooth and print a new crown with your 3D printer? Once again the advantages seem obvious but there is more than meets the eye to a dental crown. Some issues you may need to address before creating a new crown:

• What kind of material is appropriate for that tooth?
• What shape should it be to fit my bite?
• How do I know how well it fits to the tooth?
• What kind of cement is appropriate?
• Is there anything wrong with the tooth itself?

If you are unable to adequately trouble shoot all of the questions to the level of a dentist, then you are running a big risk you could cause some serious long term damage to your oral health.

            With 3D printers becoming more popular, more and more people may try to fix their dental problems at home. But like any medical issue, it is best to talk with a professional.

For more information, visit www.dentistwestchester.com.

Lee T. Brown, DDS

Brown and Kupper, DDS Inc. 

How important is using mouth wash?

            There was a recent article in TIME magazine discussing how important and safe mouth wash is in your normal oral hygiene routine. Below we will discuss some of the benefits and limitations of different mouth rinse options.

Can I use a mouth rinse instead of brushing and/or flossing?

            While mouth rinses can be an effective adjunct to your normal brushing and flossing routine, they are definitely not a substitute. They are not designed to replace brushing twice each day and they are not designed to lessen the frequency of dental visits. But they can help to improve your breath and are safe when used properly.

             One exception to this is chlorhexidine gluconate rinse. This is a prescription strength rinse that may be given following a surgical procedure. Following gum tissue grafting, the surgeon may want you to avoid brushing that area to allow for proper healing. Chlorhexidine may be used for a short time to help clean the area. But it is important to remember this is not a long term solution.

What kind of mouth wash should I use?

            The three most common recommendations we have are Crest Pro-Health, Listerine, and ACT. We don’t recommend Scope because it does not have any anti-bacterial properties. It only freshens your breath.

• Pro-Health is all alcohol free and contains some fluoride to help fight tooth decay.
• The Listerine has options that are alcohol free and with alcohol. Both can be affective but the alcohol can feel abrasive to some. There are a number of different options with some varying degrees of fluoride. Consult your dentist or dental hygienist on which is best for you.
• ACT contains fluoride and has an offering designed specifically for children.

Are there any side affects to using a mouth rinse?

            The ADA (American Dental Association) believes there are no substantiated risks to using mouth wash once or twice per day. However, some people may have a mild allergy to different rinses. Symptoms may include red and inflamed gums or a ‘stringy’ white residue on their tissue. Both of these side affects are reversible when you discontinue use and do not cause any permanent problems.

            With so many options available, your best bet is to talk with your dentist and hygienist about what mouth rinse could best work for you. This will help narrow down your options simplify your decision.

For more information, visit www.dentistwestchester.com.

Lee T. Brown, DDS

Brown and Kupper, DDS Inc.

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.