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Is it gonna hurt?

Dentistry can have the best outcome with comfort in the chair and minimizing stress and anxiety.  Sometimes the dentistry itself causes our problems.   Tooth shape matters,  restoration angle matters, high-shine smooth polish matters, and also strength of design matters with chewing, nutrition, and overall health.  All of these structural issues can contribute to successful outcomes or cause jaw pain, inflammation, further tooth loss, and gum infections.   Patients have a choice in design and materials and usually cost is a factor in the end result chosen — this is an important conversation.  Some patients choose a long-term temporary unwittingly.  Other patients genetically are prone to problems but intentionally choose to have the weaker structure and forget to invest in the long-term guards that protect their teeth even though the damage is apparent.  Still other patients find that dental material options counteract with their biology.

Focusing on the lowest impact to a patient’s overall successful health is my primary focus.  I want this kind of dental care for myself, so this is my focus for you.

I believe in sedation dentistry.  I believe in having the best outcome possible by focusing on what causes the least amount of stress.  Why not forget the whole dental procedure?  It doesn’t have to hurt, it can be forgotten.

Here is something to ponder.  Why is consolidating dental treatment so out of the scope of our “dental insurance focused” minds that we forget how much more gentle this is to our bodies?  Focusing on treating one tooth a year tends to be the most expensive way to treat a mouth both physically doing harm as we match all dentistry to the existing status quo and also doing harm to the pocket book by costing us much more in the long run — this is a constant up-hill dental battle.  Instead, I recommend holding still with bite guards and retainers while the surgeries are addressed one-by-one.  Then, once all foundation work has been completed, it makes more sense to treat all teeth that are clinically fragile in one fell swoop.  When we consolidate treatment the choices of teeth needing treatment can be more conservative.   We touch teeth once, not multiple times through the year.  In this way we don’t keep hurting the nerves of teeth over and over.

My hope is that as I consistently focus on the most conservative treatment for you, in turn, you realize what is going to keep the best balance for your dental and physical health!

 

Why does dentistry COST so much?

Dentistry costs are high because of the high cost of dental equipment, dental materials, and due to the costly training and expertise of your dental team.  Restorative options for repairing or replacing teeth include fillings, veneers, implants, and dentures.  The dental materials used for these restoration repairs and devices also include options of various durability qualities, appearance, cost, and long-term performance.

The materials and lab work for restorations vary greatly in quality and cost, particularly for cases involving expert laboratory clinicians who are highly skilled in working with specialist dentists on complex prosthodontic cases.  Patients’ dental insurance coding and corresponding costs often lags behind the costs of the most durable, cutting-edge materials and fees for outstanding dental clinicians.   Not all dentists are willing to read the fine print or the literature behind older and newly developed materials.  We are lucky to live in times where dentistry can match our function and smile expectations!

 

Why is MINT in so many dental products?

The mint family of plants is a group of very powerful herbs that have oil producing glands. These hair-like oil glands are located on the surfaces of the undersides of the leaves and on the stems — the plant parts used for their powerful effects and for flavorings. 

Spearmint and its offspring peppermint are two forms of mint which have been used since biblical times. The main mint component in these is in the form of the refreshing essential oil mentholMenthol  has become one of the most widely used plant products and is commonly found in mouth wash, cough drops, tooth paste, pain ointments and rubbing creams, cigarettes, candy, and liquors.

Why is menthol so frequently used?   At low concentrations, menthol slows down the response reactions of our body’s cold receptors.  It makes the mouth feel cool and makes a cool drink feel icy cold.  In a larger dose, menthol can work like an anesthetic by making the mouth feel “frozen.” Sometimes menthol can fire things up as an irritant like strong mustard.

There are also other herbs in the mint family notable for this discussion, most of which were in use in Greek and Roman times.  The name of basil, from the Greek word basilikon which translates as “royal” and from the Latin word basiliscus which refers to a dragon, suggests the plant’s use in classical times was linked to a charm against a fire breathing dragon.  Rosemary’s Latin name means “sea dew” and in Roman times it was found by the sea and was considered to be medicinal.  The underside of rosemary needle-like leaves are covered by oil hairs which make them look white.  Marjoram has both sweet and more common forms, and wild marjoram is usually sold as oreganoOregano comes from Europe, and its name from Greek means “mountain joy” or “mountain brightness.”  This should not be confused with the other version of oregano which comes from the Verbena family — a stronger flavored plant native to Mexico.  Thyme and summer and winter savory are also derivatives of the mint family.  All these flavorings were popular with Romans for meat dishes; Romans and Greeks also used it as a fumigant and as an antiseptic. Thyme has been used since the 16th century in mouth washes and cure-all ointments as a disinfectant. Today thyme is considered essential for many current medicinal treatments; for example, it has been shown to be active against salmonella and staphylococcus bacteria.

 

 

How to get rid of WARTS and why this is important?

What is the most common way to get rid of oral warts?   Eat proteins and take vitamins to boost your immune system so you can heal and get over the virus!  Yes, warts are a virus!  It can take six months to two years to get rid of the bumps.  If you have them longer than six months, you should begin considering a biopsy; if they last longer than two years, they should definitely be under a watchful eye.  Why?  Because some warts become cancerous — it’s a very small number, but they can have very serious consequences.

The common wart is known by several scientific names including Veruca Vulgaris, Focal Epithelial Hyperplasia, and Condoloma Acuminatum.   All these often seem to be benign and non-cancerous.  They may look pedunclated (which means they have a round smaller base and a round wider top layer) or they may appear to be flat.  They are usually white or red.

The virus involved in warts does not always induce the formation of visible warts or lesions.   When it does, the warts can be removed but they may still recur; sometimes, however,  you can get rid of them.  How?  Duct tape is a common home remedy; and, yes, it really can work!  22% of kiddos get tiny little warts on their hands — most commonly on the back of their hands and fingers.  Teenagers between the ages of 12-16 also commonly get them; but warts are seen more and more on adults and are typically the result of trauma.  30% of wart lesions clear in six months; 60% of wart lesions clear in two years; but some may take three years to clear.  So, yes, grey duct-tape or a gentle nail file may effectively remove a wart; also on the remedy list is dry ice and a 17% salicylic acid (not to be used in the mouth as it makes a nasty sore like an aspirin burn).   But the best way to remove warts is always a gentle laser surgery or regular surgery.

What makes warts occur?  They spread through simple touch contact with the wart which enables the wart virus to land on a new host location.  Skin-to-skin contact is a very easy way to transfer the virus, and people who don’t realize they have the virus still can infect someone who doesn’t have it.  The virus is being shed from skin infected with warts all the time, so it’s important to have very good hygiene in keeping one’s body clean.  Infecting a new person or new location on the same person can usually be traced back to skin-to-skin direct contact such as simply touching the infected hand of another person, mother to newborn baby, self-inoculation from a wart on the skin (including in the mouth) of one area of the body to another, picking your nose, or sexual transmission.

So, how do warts really work?  Human Papilloma Virus (HPV) is a small double-stranded DNA helix which can affect humans with more than 120 types of the virus.  For the virus to replicate itself, it needs a host which produces its own environs.  The host is the basal layer of dermis which has a wound or micro-wound for the virus to enter the skin.  The dermis is the base layer of any area of skin which may be on the exterior of the body or in a body cavity such as in the mouth, ear canal, anus, or cervix. Once the virus has entered the skin, it moves up through the various layers of skin tissue producing up to 100 copies before a visible lesion develops.  So . . .  being infected does not mean there will be a visible lesion that you or your dentist can see.  According to 2009 medical research, up to 80% of the population in the US go through a period of being infected with warts; in Sweden, the figure of 90% has  recently been documented.  Wow!  That’s a lot of people infected with some type of warts!

When warts occur in the mouth, they are most often a round, flat lesion.  90% of mouth HPV lesions biopsied are stages 6 – 11 which means they are benign.  Teenagers have a high risk for these.  For a patient with an oral diagnosis of warts, the mouth and the genitals need to be treated as well as the sexual partner.  If you don’t treat an active partner, wart lesions may be re-inoculated within months. “Condaloma Acuminatum” is the name for warts when they present in the genitals.   These are the most common of the sexually transmitted diseases including 30% of all STD’s.  Genital warts are more common in males, and they are more common in people with sexual partners.  The warts can show up in multiples which often look like cauliflower and are pink or a lighter color.  Those that are more pigmented should be removed immediately.

Why does it really matter?  HPV (Human Papilloma Virus) can be the culprit virus in triggering  cancerous growth throughout the body.  Persistent HPV infected areas in the body, particularly in the mouth, are the highest risk for developing pre-cancerous or invasive cancerous lesions which can spread to other organs of the body.  When HPV becomes cancerous, it is called Squamous Cell Carcinoma.  95% of these cancers are diagnosed in people over the age of 50; the median age is 63.  When a diagnosis is localized (has not yet spread to another area of the body), there is an 80% chance for a 5-year survival rate; but it is only 18% chance for a 5-year survival with late stage diagnosis of this cancer.  Early diagnosis is KEY!

What are the actual statistics?  High risk HPV are oncogenic (cancerous) stages 16 – 18.  HPV is the cause of 99.7% cervical cancers, 80% of vaginal cancers, 50% of penile cancers, 90% of anal cancers, 60-90% of oropharyngeal and tonsillar cancers.  Yes, that number of 60-90% for posterior mouth cancers are linked to the HPV family of viruses which metastasize to other parts of the body resulting in the spread of cancer cells.

My opinion about HPV vaccination: It works best when done before the risk of disease transmission; thus, it is usually recommended for ages 11-12 but also for adolescents and adults between 9-26 years of age.  This can help reduce persistent spread of the infection (metastasizing) because the same oncogenic virus types are implicated in several cancers besides those in the mouth.  In other words, early vaccination may help control HPV oral infection as well as the spread of the virus from the mouth to other parts of the body.

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