2. As the body of the mother-to-be changes, and the fibers start to loosen up (to enable the growth of the womb), most other fibers in your body also relax. Including the ones in your gums and around your teeth. As they loosen up, the seal around the teeth is lost and bacteria can grow in to the space under the gum. This is the main cause of the pregnancy gum disease.

Because of this I recommend that my pregnant patients come for re-care visits every 3 months (and sometimes every 2 months) instead of the usual 6. The benefits of these re-care visits are enormous and outweigh the minimal costs by miles.

We do not take any x-rays during the pregnancy (unless it is a matter of life and death), we do preventative care only, prescribe additional home treatment (if needed), improve oral hygiene (where appropriate) and do our best to make your experience as pleasant as possible.

Actually, I often hear the appreciation for providing an environment, where the women can take some time off from their busy schedule and relax.

Also, please remember that it is also of the outmost importance to make sure that the spouse has also healthy teeth, since there is always a chance for the transmittal of dental infection from father to the mother or to the child. This will provide the best requisites for the child to grow up without dental problems.

Here is an article on the web that I came across few days ago:

(I’ll leave my coments at the end of the article)

Secrets your dentist doesn’t want you to know

Daniel Solin, Aug 27th 2009

Going to the dentist may seem like a mundane chore, but it can quickly become an expensive one. Here’s what you need to know to get the most for your money when shopping for dental care.

Here are the secrets your dentist may not want you to know — but you need to know to get the best care possible:
Secret #1: Your dentist may not be as educated as you think.

Secret #2: Your dentist may not have the latest technology.

Secret #3: Your dentist may be using mercury.

Secret #4: The lab may be more important than your dentist.

Secret #5: There’s more to good dentistry than filling cavities.

Secret #6: You are probably using the wrong specialist for dental implants.

Secret #7: Bad dental advice about dentures can be fatal!

Secret #8: Your dentist may not know enough about sleep apnea.

Secret #9: Not all cosmetic dentists have the skills to really improve your smile.

Secret #10: How to avoid the root canal your dentist says you need.

The full entries are below.

Dentistry has changed a lot since your dentist graduated from dental school. One practitioner told me changes come “almost daily.” There have been major advances in most materials used in fillings, bonding and root canals.
The world of neuromuscular dentistry has evolved at a particularly rapid rate. This branch of dentistry treats misalignment of the jaw which can cause headaches, sleep apnea, worn or cracked teeth and severe jaw pain, among many other symptoms.
Dental techniques have also changed. Laser systems can regenerate bone lost to gum disease and improve smiles with gum contouring. Lasers and air abrasion systems can be used to remove some decay without numbing the patient and to achieve superior dental cleaning.
If your dentist is not actively engaged in continuing education, it is unlikely that he or she is keeping up with these developments. Here are some specific questions to ask:
How many hours of continuing dental education a year do you do? The top dentists I interviewed do 100 hours or more.
Where do you go for your dental education? Some of the top places for continuing dental education are LVI Global, the Pankey Institute and the Scottsdale Center for Dentistry.

Technology is an important part of today’s dentistry. Is your dentist current? Here are some questions to ask:
Digital x-ray: Dentists who do not have digital x-ray equipment are practicing in the dark ages. Digital x-rays use less radiation than film. They are easier to read and the ability to manipulate contrast makes diagnosis more accurate. This equipment is expensive. It costs $30,000-$50,000. You are worth it.
Ultrasonic Cleaning: Ultrasonic instruments vibrate plaque and calculus off your teeth, even in areas below your gums. It is much more comfortable than old-fashioned hand scraping. They can remove heavy stains (like tobacco and coffee) from the tooth and even treat periodontal disease.
Total cost to your dentist: Around $2000. There is no excuse for not having it.
CEREC: For many dentists, this is the information they don’t want you to have. The CEREC system lets your dentist provide a ceramic crown, onlay or veneer in only one visit. Use of CEREC can conserve the tooth structure and permit the dentist to seal the tooth in one appointment. No gagging impressions. CEREC means fewer injections, less drilling and no annoying temporaries.
The big rub is cost. A CEREC system will cost around $120,000. Personally, I don’t care. If I have a choice between a dentist who has it and one that doesn’t, the availability of CEREC will be the deciding factor.
Diagnodent: This is a laser which the dentist shines on the tooth and it tells whether there is a cavity and how deep it is. What’s more, the laser can even tell your dentist that a root canal may be required. With the use of this technology, the dentist can detect cavities, and find them at an earlier stage, than traditional poking around the tooth (and no one likes that!). The initial investment is $4000.

I know the American Dental Association and the FDA have no problem with mercury fillings. However, none of the top dentists I spoke to would put mercury in the mouths of their families or their patients. They use a composite filling instead.
Mercury is toxic. As one dentist told me, “the only place I can legally put mercury is in your mouth or in a hazardous waste container.” Norway and Sweden have banned the use of mercury fillings.
Even without the toxicity controversy, the use of mercury fillings is still questionable. Mercury expands and contracts with temperature changes, just like in an old fashioned thermometer. This can lead to cracked teeth.
Composite fillings look better. They bond to the teeth and make them stronger (mercury fillings weaken the tooth). Teeth with composite fillings are less sensitive to hot and cold. They require less removal of tooth structure.
Mercury fillings are less expensive and easier for the dentist to use. No continuing education is necessary.
To me this is a no-brainer. If your dentist does not use composite fillings, don’t use him.

If you are like most dental patients, you have no idea which lab your dentist is using. This lack of information could cost you dearly.
Dental labs create dentures, crowns, bridges, orthodontic appliances, and other dental restorations like implant crowns. There is a huge difference in the quality of these labs.
In order to increase profit, some dentists use foreign labs or cut-rate domestic ones. These labs may include tin, aluminum or even lead in their restorations. A reputable, first class lab will certify its restorations contain none of those metals and provide the dentist and patient a warranty on their craftsmanship.
You should be particularly wary if your dentist is using a lab in China or Mexico, where the practice of using those metals is very common. Some of the top labs in the U.S. are Aurum Ceramics, MicroDental Laboratories, da Vinci Dental Studio, and Williams Dental Lab. I am sure there are many others.
If you don’t know where or which lab your dentist is using, you need to find out… now!

A competent dentist screens for more than tooth decay. He or she should be concerned about sleep apnea, jaw-related pain known as TMJ or temporomandibular joint disorder, periodontal disease, oral cancer, diabetes and hypertension.
Sleep Apnea: Asking simple questions about snoring, weight gain, or medications such as blood pressure or acid reflux drugs can give your dentist clues about sleep apnea. Find a dentist that takes a thorough medical history.
TMJ: Did you know migraines and neck problems can be related to the position of your jaw? Your dentist should feel your joint and ask about any pain or discomfort you may be having.
Periodontal disease: By carefully checking the condition of your gums for periodontal disease, your dentist can detect early indications of heart disease, stroke and diabetes.
Hypertension: Most Novocain used by dentists contains epinephrine, which can increase your blood pressure. If you already have dangerously high blood pressure, the addition of epinephrine could cause a stroke. Your dentist should be aware of your medications and take your blood pressure before giving an injection or doing any dental work.
Advancements in oral cancer screening allow your dentist to find it sooner. A Vizilite exam is a detection tool used by dentists to see tissue changes in their earliest form. The dentist has you rinse with a solution and then shines a specially designed light in your mouth which will indicate the presence of oral cancer. A similar system by Velascope is also very effective at early detection.
If your dentist is not doing these health screenings, find one who does.

Since dental implants involve the removal of a tooth and replacing it with an artificial tooth, many patients assume that an oral surgeon is best qualified to do it. This can be a flawed assumption.
Periodontists, who specialize in gum disease, may be a better option. Periodontists have special training in gum tissue and underlying bone in the mouth, which are significant issues in dental implants.
Whether you use your general dentist, a periodontist or an oral surgeon, you should ask these questions:
What is your success rate with implants? It should be at least 94 percent.
How long is the procedure? It should be no more than thirty minutes.
Do you use a surgical guide? A surgical guide directs the implant drilling system and provides for accurate placement according to the digital surgical treatment plan. It is important to confirm that the dentist doing your implant uses a surgical guide.
Do you use a CT scan and 3-D imaging software? This technology assesses bone structure and identifies the best sites for dental implant placement while avoiding vital structures like nerves.
Many dentists hold themselves out as implant specialists. You need to screen them very carefully before entrusting them with this surgical procedure.

Dentures are no joke to the millions of senior citizens who use them. While patients often pride themselves on keeping the same dentures for many years, this can be a big mistake. Your dentist should examine your dentures for evidence of wear. Wearing down the teeth on your dentures can result in distorted facial characteristics, collapse of the bite and closure of the airway.
Dentures need to be replaced at least once every seven years. Poor fit or worn dentures can cause sleep apnea, stroke or even death.
Yearly cancer screening exams of denture users are extremely important.
Contrary to common perception, dentures should be worn at night in order to insure that the airway passage is kept open. Your dentist should instruct you on proper denture cleansing and should check you regularly for signs of infection.

The most common form of sleep apnea is caused by a blockage of the airway during sleep. It is a pretty scary condition. The patient can stop breathing hundreds of times during the night.
A common treatment for sleep apnea is Continuous Positive Airway Pressure (CPAP). CPAP involves blowing pressurized room air through the airway at high enough pressure to keep the airway open. Many patients find it difficult to adjust to this device and want to avoid surgery, which is another treatment option. As an alternative, your dentist, working with your physician, can custom make a device that guides the lower jaw forward, called a mandibular advancement device or MAD. MAD devices are more comfortable to wear and the compliance rates are much higher than using CPAP.
If you have (or suspect you have) sleep apnea, here are some questions to ask your dentist:
Are you a member of the American Academy of Dental Sleep Medicine?
Do you regularly attend the annual meeting of the Academy?
Do you work with Ear, Nose and Throat physicians and sleep physicians, where appropriate?
You can also call sleep centers and ask them what dentists they refer to in your area.
Sleep Apnea is potentially a very serious medical condition. It is important to do careful due diligence before you select a dentist to treat it.

A beautiful smile is a big part of our appearance. Cosmetic dentists promise us beautiful smiles (a “smile makeover”). But how do we know if they can deliver?
Any dentist can call herself a “cosmetic dentist.” Here are some questions that will help you select one that is qualified:
1. Have you had post-graduate training? If so,where? The cosmetic dentistry field has changed rapidly over the years. A dentist with no post-graduate training is not likely to be current with these advancements. Look for post graduate training in porcelain veneers from well known schools like LVI Global, the Pankey Institute and the Scottsdale Center for Dentistry.
2. What kind of veneers do you use? The best veneers are either felspathic (super thin) veneers, or CAD/CAM veneers, which can be milled and made by a computer. There are pluses and minuses of both. Your dentist should explain the differences to you.
3. Show me the… veneers! Your dentist should be able to show you ten or more before and after photographs or videos. She should be willing to give you the names of patients who have consented to be used as references. Be cautious. Some dentists use before and after pictures of models they did not work on. Verify that what you are seeing is work done on actual patients!

Your dentist has just conveyed the dreaded news: “You need a root canal. Here’s the name of the endodontist I recommend.”
Now what?
Endodontists receive at least two years of additional training after dental school. They are root canal specialists. Start by checking to be sure the endodontist is licensed in your state. Some endodontists become Diplomats of the American Board of Endodontics and are “board certified.” You can check to see if your endodontist is board certified by going to the American Board of Endondontics Web site.
Ask your endodontist if he uses a surgical microscope during treatment. These microscopes magnify the tooth approximately 20 times and greatly increase success rates. If your endodontist does not use a surgical microscope, find one who does.
Once you go an endodontist, it is almost a foregone conclusion that he will perform a root canal. That is his business and it is very lucrative. But is it always necessary?
Ask your endodontist if he has considered the “ferrule effect”. Technically, this means that a root canal is unlikely to be successful if there is not enough tooth structure above the gum line to protect the tooth from coming loose or fracturing after it has been prepared for a crown.
If your tooth fails the “ferrule effect” test, you might be better off with an extraction and an implant, which will likely outlive you.
Still not a walk in the park, but far better than enduring an unnecessary root canal.
Here are my comments:

1. I am very proud of the amount of education I am receiving every year. In the 2008/2009 period it has been about 170 hours so far. I’ve spent tenths of thousand of dollars on this education.

2. As I have posted before and on my website, I love the technology, where it either improves my treatment options or make life easier on my patients: (Laser, ultrasonic, magnifying glasses, Diagnodent…) are all part of our armentarium. I have used Cerec bfore and I understand it advantages, but at this time there are too many drawbacks yet to this technology.

3. MERCURY! I have not used any amalgam since 2005, once I have opened this location. I have undergone a therapy myself in order to flush out the mercury out of my sysytem. I do not think this requires any more mentioning.

4. In my previous post about the implants, I have named 2 of my favorite labs. You are welcome to check them out.

5. We check everybody for cancer and TMJ disorder. I also work with sleep specialists for the Sleep Apnea and if it is a mild form, we can create an appliance for snorring in our office, otherwise a CPAP will be prescribed by the sleep doctor. We have a very detailed health questionaire and even though it is cumbersome to fill it out, the reason is simple: it is for our patients safety! (Hypertension, Cancer, Thyroid are just a few reasons coming to my mind)

6. I place some implants myself, or depending on the situation, I referr to specialist (oral surgeon oor periodontist) In any case, whenever I place implants, I insist on 3D imaging (CT scan) and all available help we can use (CAD/CAM surgical stents, etc.)

7. Really good point and I try to insist on our patients yearly check - ups. I hope more patients will hear and follow this advice.

8. Please see my remarks to #5

9. LVI is the place where I have done most of my latest education. Every patient is different and needs individual treatment option. I do not believe that NO PREP veneeres (like Lumineers or similar) are a perfect option for everybody, nor do we have to cut away most of the tooth in all cases in order to create perfect esthetic. Common sense and the middle gound often present the better solution.

10. If your tooth nerve is damaged beyound repair, RCT is the only way to save the tooth. The other option is extraction. This is what the author meant. If this would be mine tooth and it is worthy to be saved, than I would always choose a RCT. If the tooth is so bad damaged that it can not be restored, than it is a total different ball game.

^{1st it stimulates your saliva production and this way helps to remove acidity from the mouth and helps remineralize the teeth.}

^{2nd by using a chewing gum with Xylitol there is an additional benefit: bugs think it is sugar, so they eat it.  However, the bugs can not digest it, and they get “plugged-up” and die. To get this effect, you have to use 5 sticks (at a time) of the Rx gum twice a day.}

^{Now, not everybody’s mouth is big enough to accomplish this task. And also chewing gum is non functional use of your muscles and especially for people with TMJ disorder it is not advisable.}

^{So, as usual you have to weight the benefits and decide what is important and more beneficial for you.}

We have acquired a new “toy” for our office - a soft tissue laser. It can do some things that I have done before, just easier and more painless for my patients. But it can do MORE! I can use it to disinfect your gums before the gum treatment (”deep cleaning”) and promote faster and better healing of the gums. I can use it to speed up the healing of canker sore or lip herpes. Everybody, who has experienced this pain and discomfort for 10 days (or “only” 7 days with the prescription), will be amazed to find out how fast and easy the treatment is: usually 3 minutes of application. Absolutely no anesthesia is needed. In most cases all the symptoms are gone within 24-48 hours! It also helps me with the treatment of implants, cosmetic gum re-contouring, denture sores, disinfection of the root canals and so much more. And all of this with virtually no postoperative wound pain. Can you tell that I am excited? You are right! Dentistry has come a long way since I started my dental school in 1982 and I am glad that I have the opportunity to experinece it!

Dear Patients,

 If you have dental insurance and don’t take advantage of it before the end of the year, you will permanently lose those benefits. When the ball drops on TV, and another year has ended, part of the cheering is from your dental insurance company because the benefits you didn’t take advantage of this year are gone forever, and they get to keep your money! If you or a family member have not been in for a check-up or you have dental work to be done, call to schedule an appointment now. Extensive treatment can even be planned to do some of it at the end of this year and the rest at the beginning of next year to double your insurance benefits. Please don’t wait until the year end approaches, appointments are harder to get!

USE YOUR BENEFITS BY THE END OF THE YEAR OR THEY’RE GONE FOREVER! CALL FOR YOUR APPOINTMENT TODAY