Dental Woodstock – April is Oral Cancer Awareness Month

Each year more than 30,000 Americans are diagnosed with oral cancer and approximately 8,000 will die of the disease.  According to the National Cancer Institute (NCI)  oral cancer, which is more common than leukemia, Hodgkin’s disease, and cancers of the brain, liver, bone, thyroid gland, stomach, ovaries, and cervix, is a major cause of death and disfigurement in the United States.                       

According to the Centers for Disease Control and Prevention (CDC) located here in Atlanta, GA., approximately 75% of all oral cavity and pharyngeal cancers—mouth, tongue, lips, throat,  nose, and larynx— can be attributed to the use of  tobacco related products.  Those who choose to use cigarettes, cigars, pipes, chewing tobacco, or snuff, place themselves at a much higher risk of developing oral cancer and other diseases, such as heart disease, emphysema and chronic bronchitis.

With the level of prevalence described above, the oral cancer screening routinely  performed during one’s hygiene and dental examination is one of the most critical preventative  components of  your bi-annual visits to the dentist .                                       

If you find anything out of the ordinary during a self-examination—particularly anything that does not heal or go away in two weeks, or that has recently changed— make sure you discuss it with your dentist or physician.   April is Oral Cancer Awareness Month and we offer free cancer screening, so please feel free to contact us if you have any questions or concerns.

Source: National Institute of Dental and Craniofacial Research’s (NIDCR) National Oral Health Information Clearinghouse in partnership with the National Cancer Institute, the National Institute of Nursing Research, the Centers for Disease Control and Prevention, and the Friends of the NIDCR.

Novy Scheinfeld, DDS, PC

5471 Bells Ferry Road

Suite 200

Acworth, GA 30102

770-928-7281

www.rightsmilewoodstock.com

info@rightsmilecenter.com

 

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Dentist Acworth: The Difference between Dental and Physician Health Care Costs

Why the cost of your dental care really hasn’t increased that much?  In fact it has either tracked or lagged behind the consumer price index and this is despite all the advances in dental technology.  Compare that observation to your medical care costs.  If you go in to see your dentist and ask for an estimated cost of treatment, 9 times out of 10 you will get a quote.  Try doing that in your physician’s office.   Why?  Because your dental care has been a product of the free market system.  The insurance companies have never yet to invade the purview of your oral health the way they have dominated, if not destroyed your overall health care.

You get your teeth examined, cancer screening, teeth cleaning and x-rays twice a year for less than $300.00.  And that’s about two hours of actual treatment from your dentist and his/her team.  At the physician’s office you go in once a year, see your physician or his PA for about 10 to 16[i] minutes on average and it costs $300 to $900.00, depending on possible immunizations and your blood work (which costs more than twice what an independent lab charges if you have it done outside of your physician’s office).   Physicians are paid by insurance and Medicare submittals based on the procedures they perform and not by the amount of time they spend with you.  So the quicker the visit the more procedures they can bill your insurance.  If they take too long it cost them money, not you.  And all their revenues are based on negotiated fees with your insurance company, not the free market system.  Ah, the key phrase – free market system.  Dentistry never bought into insurance coverage for your treatment and care, and as a result of the free market system there has been a reasonable or to put it better, a withstandable increase to the cost of your oral health care based on the supply and demand curves.

So how much does insurance influence the cost of your health care?  Anecdotally, let me tell you about my daughter’s, but really my experience with health care and why we are the losers in this battle to secure adequate health care treatment at an affordable price.  My daughter had a cyst under her eyelid.  It was not visible to you or me, but it irritated the dickens to her cornea.   I found a specialist and accompanied my daughter to the physician.  It was determined that the treatment required general anesthesia to safely perform the surgery.  When I asked ‘how much’, I received no answer.  I was passed on to the patient coordinator for that physician.  So I asked ‘how much’, and again I received no answer.   They didn’t have a clue what this was going to cost me.  So I immediately said ‘sign me up, I’ll take two’.   Seriously though, they needed my insurance carrier and they would let me know, great.

I get a call from the physician’s office.  It’s going to cost you $800 and change.  Ok, great, and is that my drive out price?  ‘Oh no, that’s just the doctor’s fee.’  Ok, so what else?  I have to call the surgical center.  Ok, how much does that cost?  We [the doctor] don’t know, you just have to call and find out.  So I called.  The gentleman quoted me $1540.00 including 2 hours of facility and the anesthesiologist.  ‘Oh, and you won’t be needing a biopsy, since this is cosmetic.’  No wait, this is not cosmetic, it’s required surgery.  So the gentleman backs up and re-quotes the price.  It will be $4 to 7 thousand for the surgical suite, $1800 & change for the anesthesiologist and X amount of dollars for the biopsy.

Wait, hold on, back up a minute, you just quoted me a price that is almost 7 times what the same procedure would cost if it was elective surgery.  Ah, that key phrase creeps back in to the conversation.  Under a free market system, elective surgery only garners what the market will bear.  But under an insurance based system, physicians don’t know what it costs, so they inflate the costs and hope for some remuneration equal to or in excess of what it really costs under a free market system to treat you.  In other words, it’s a crap-shoot your physician is playing with your health insurance company.   And the loser is you.  So the next time you go to the physician or the dentist, remember why you’re paying what to whom, the physician or your insurance company.  And the next time you discuss health care reform; you’re probably talking about insurance reform.  If we can answer your questions or concerns, please do not hesitate to contact us.

Novy Scheinfeld, DDS, PC

5471 Bells Ferry Road

Suite 200

Acworth, GA 30102

770-928-7281

www.rightsmileacworth.com

info@rightsmilecenter.com

 

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[i] About.com, Trisha Torrey, November 14, 2008.

 

 

Dentist Woodstock: Dental X-ray Alert

The FDA safety communication advises dental professionals to avoid using certain hand-held dental x-ray units.  According to the FDA[1], these hand-held devices could expose the patient to unnecessary and potentially harmful X-rays.[2]  The units are sold online by manufacturers outside the U.S. and shipped directly to the dentist and have not been reviewed by the FDA and do not meet FDA radiation safety requirements.

If your dentist is using one of these devises to x-ray your mouth you need make a serious inquiry into whether or not the device has been approved by the FDA and corresponding state regulatory agencies.  You might want to consider a new dentist, asking yourself why your health care professional isn’t using a standard wall mounted unit.  Is your dentist trying to skirt the law and its requirements that attempt to insure your safety?

All of the units that have been cleared by the FDA bear a permanent certification label/tag, a warning label and identification label/tag on the unit.[3]  If not, then run.  You don’t want this dentist treating your oral healthcare needs.  There are too many ‘good’ dentists who truly care about your health.

The Washington State Department of Health alerted the FDA after tests on a device purchased online revealed it did not comply with X-ray performance standards. FDA is investigating and will continue to monitor the problem.[4]

For now questions can be directed to the Division of Small Manufacturers, International and Consumer Assistance at DSMICA@FDA.HHS.GOV, 1-800-638-2041 or 1-301-796-7100.[5]  If we can be of service or answer any of questions feel free to call us or contact us via email.

Novy Scheinfeld, DDS, PC.

5471 Bells Ferry Road, Suite 200

Acworth, GA 30102

770-928-7281

www.rightsmilewoodstock.com

info@rightsmilecenter.com

Dentist Woodstock: How Much do Dental Crowns Cost?

Dental crowns cost anywhere between $900.00 and $1500.00 each depending on the tooth to being restored. In addition, the cost will vary depending on materials, complexity and the dentist’s training and experience and to some degree the location of the practice.  Insurance may pay part of a crown’s cost if it’s obviously needed for medical reasons, but usually crowns are covered only on a limited basis per year.  Depending on the customers’ needs and wishes, partial and full crowns made of various materials may be utilized.  Crowns are made of gold, porcelain, resin or porcelain-fused-to-non-precious-metal.  A tooth-shaped cap (the crown) covers the entire surface of a tooth, adding strength, durability and stability. This usually requires two office visits; first to prepare the tooth, make an impression and install a temporary crown. The impression is sent to a dental laboratory or manufactured in-house with the use of a CAD aided milling machine to create the permanent crown, which is installed during the second appointment.

There’s often an initial office visit ($65-$102) and X-rays ($85-$135).  One must not forget that there are additional costs that contribute to the overall price involved in crowns, aside from the material and type of crown chosen which are beyond the patient’s control.  A large share of undervalued costs goes toward the treatment itself, lab and production costs for the crown, aftercare and the like.

Dental care on a whole is often considered expensive, but with proper care a crown may last 10 or more years.  Depending upon the general wear and tear a crown is exposed to and how well you keep your teeth free of plaque, it could last indefinitely.  With somewhere between 10 and indefinitely, the investment becomes rather modest, if not inexpensive.

If we can be of service or answer any of your questions please do not hesitate to give us a call.

Novy Scheinfeld, DDS, PC

5471 Bells Ferry Road, Suite 200

Acworth, GA 30102

770-928-7281

www.rightsmilewoodstock.com

info@rightsmilecenter.com

Dentist Woodstock: Women and Your Oral Health

As a woman, you know that your health needs are unique and this includes your oral health needs. And because your needs are unique, you need to take extra care of yourself.  While women tend to take better care of their oral health than men do, women’s oral health is not significantly better than men’s.  This is because hormonal fluctuations throughout a woman’s life can affect many tissues, including gum tissue.  These fluctuations occur when you mature and change, as you do during puberty or menopause, or other times when you have special health needs, such as menstruation and particularly during pregnancy.

According to the Journal of Periodontology[1] at least 23 percent of women between the ages 30 to 54 have periodontitis.[2]  And, 44 percent of women ages 55 to 90 who still have their teeth have periodontitis.  Yet many women do not realize they have it until it reaches an advanced state, which is why regular hygiene check-ups are so important.

Stages of your life – steps to protect your oral health.

Puberty – an increased level of sex hormones, such as progesterone and possibly estrogen, causes increased blood circulation to the gums. This may cause an increase in the gum’s sensitivity and lead to a greater reaction to any irritation, including food particles and plaque. Signs to look for in your teenage daughter are swollen, red and/or tender gums.[3]

It is particularly important during this time in your daughter’s life to make sure she follows a good at-home oral hygiene regimen, including regular brushing and flossing, and regular dental care. In some cases, a dental professional may recommend periodontal therapy to help prevent damage to the tissues and bone surrounding the teeth.[4]

Menstruation – can result in menstruation gingivitis.  Women with this condition may experience bleeding gums, bright red and swollen gums and sores on the inside of the cheek. Menstruation gingivitis typically occurs right before a woman’s period and clears up once her period has started.  Sometimes it occurs concurrent with stressful situations and menstruation.

Pregnancy – increase gingivitis or pregnancy gingivitis beginning in the second or third month of pregnancy that increases in severity throughout the eighth month. During this time, some women may notice swelling, bleeding, redness or tenderness in the gum tissue.[5] As a result of varying hormone levels, between 50%-70% of women will develop gingivitis sometime during their pregnancy – a condition called pregnancy gingivitis.[6] In some cases, gums swollen by pregnancy gingivitis can react strongly to irritants and form large lumps. These growths, called pregnancy tumors, are not cancerous and generally painless.

Studies have shown a possible relationship between periodontal disease and pre-term, low-birth-weight babies. Any infection, including periodontal infection, is cause for concern during pregnancy. In fact, pregnant women who have periodontal disease may be more likely to have a baby that is born too early and too small!

To prevent pregnancy gingivitis it’s especially important to practice good oral hygiene habits, which include brushing at least twice a day, flossing once a day, and using an antimicrobial mouth rinse. If you are due for a professional cleaning, don’t skip it simply because you are pregnant.  Now more than ever, professional dental cleanings are particularly important.

Oral contraceptives – while women are taking drugs to help treat periodontal disease, such as antibiotics, may lessen the effect of an oral contraceptive.  So be sure and consult your dentist about all the medications you are taking.

Menopause and Post-Menopause – not surprising given all the changes happening within your body, but you may experience changes in your mouth as well.  You may notice discomfort such as dry mouth, pain and burning sensations in the gum tissue and altered taste, particularly to salt and pepper.

In addition, menopausal gingivostomatitis affects a small percentage of women. Gums that look dry or shiny or bleed easily and range from abnormally pale to deep red may indicate this condition. Most women find that estrogen supplements help to relieve these symptoms.[7]

Bone loss is potentially associated with both periodontal disease and osteoporosis. Women considering Hormone Replacement Therapy (HRT) to help fight osteoporosis should note that this may help protect their teeth and your jawbone as well as other parts of the body.

What Should You Do?

See a dental professional for cleaning at least twice a year – you need to monitor your oral health.

If referred, see a periodontist in your area. Problems may include: Bleeding gums during brushing, red, swollen or tender gums.   Other issues such as persistent bad breath or pus between the teeth and gums.  If you’re a denture wearer a change in the fit of your dentures may occur.

Keep your dentist informed about any medications you are taking and any changes in your health history.

Brush and floss properly every day.  Review your techniques with a dental professional.

If there any questions that you might have, please contact or call us at our Sandy Springs office to discuss them.

Novy Scheinfeld, DDS, PC

5471 Bells Ferry Road, Suite 200

Acworth, Georgia 30102

770-928-7281

www.rightsmileacworth.com

info@rightsmilecenter.com

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[1] January 1999 issue of the Journal of Periodontology

[2] Periodontitis is an advanced state of periodontal disease in which there is active destruction of the periodontal supporting tissues.

[4] Ibid.

[5] Ibid.

[6] WebMd. Pregnancy Gingivitis and Pregnancy Tumors.

[7] Women and Gums: American Academy of Periodontology Journal. http://www.perio.org/consumer/women.htm.

Dentist serving Woodstock: Mouthwash and Oral Cancer

There appears to be controversy with respect to whether or not mouthwash containing alcohol may be related to oral cancer.  This controversy arises out the studies that show a link between oral cancer and those that drink alcohol.  Michael Douglas is the most recent case in point.  He has been reported to be a heavy smoker and imbibe alcohol on what is rumored to be on frequent occasions.  The obvious link in theory is that most mouthwash formulas contain alcohol, so the conclusion is that a link to mouthwash must exist here also.  The problem is there are no conclusive studies and at this time there appears to be insufficient evidence to alter the ADA’s approval of mouthwash containing alcohol as an effective method for the prevention and reduction of gingivitis and plaque above the gumline when used as directed.  The ADA Council on Scientific Affairs awarded the ADA Seal of Acceptance to these products after a thorough review of data on their safety and effectiveness.

Of all the studies published on this topic, beginning in 1979, four studies reported some positive results while five found no association. (citations omitted)  What we know is that none of the criteria for causality have been fulfilled by the studies that have been published so far.  The International Agency for Research on Cancer, an extension of the World Health Organization, now identifies the consumption of ethanol in alcoholic beverages as a carcinogenic risk.[1] Alcohol abuse is associated with cancers of the mouth, pharynx, larynx and esophagus. Ibid.  However, the reason for this association is not fully understood – it may be due to a direct effect of alcohol on these tissue.[2]  Because of the conflicting studies and endorsements I could advise you to keep using alcohol formulated mouth rinses.  But if you are concerned and wish to stay on the safe side of the debate, there are non-alcohol based mouth rinses available that appear to be effective in the prevention of gingivitis and plaque.

Our job is to try and educate you on the contemporary issues we face in addressing your oral health and if there are any questions you would like to pose, please feel free to contact us for a free consultation.

Novy Scheinfeld, DDS, PC

5471 Bells Ferry Road, Suite 200

Acworth, GA 30102

770-928-7281

www.rightsmilewoodstock.com

info@rightsmilecenter.com

 

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[1] International Agency for Research on Cancer. IARC monographs on the evaluation of carcinogenic risks to humans. Volume 96. Alcoholic beverage consumption and ethyl carbamate (urethane). Lyon, France: 6-13 February 2007.

[2] Lachenmeier DW. Safety evaluation of topical applications of ethanol on the skin and inside the oral cavity. J Occup Med Toxicol 2008;3:26.

Dentist Woodstock: The Mercury Filling Controversy

 

Deutsch: Amalgamfüllung Español: Ejemplo de Am...
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Whenever I hear a patient ask about amalgam restorations (usually referred to as mercury fillings), I wonder why this question refuses to go away.  For decades, amalgams have been considered the primary restorative material for posterior teeth (the ones in the back) because of their long time success.  After enormous amounts of study the World Health Organization, the FDI World Dental Federation, and the American Dental Association continue to endorse the use of amalgam to restore teeth.   Yet it continues to be demonized by the public, in particular in urban legends over the internet.

As a result the trend is towards the less and less use of amalgams and the greater use of composite resins to restore posterior teeth.  One of our consultants, Tom Limoli of Limoli and Associates notes that US third-party payment data reflects that 65% of direct posterior restorations last year were resin-based composite, while 35% were amalgam.  So regardless of the empirical evidence to the contrary, the patient pool is demanding composite restorations.

Every dentist will need an alternative material to use in the restoration of posterior teeth as this trend continues.  The challenge for the dentist is that composite resins only have a life expectancy of 5 to 8 years.  Given the patient’s desire to be rid of the potential or theoretical health hazards that have been formulated in recent years, amalgam restorations will ultimately be eliminated by the slow and natural death of attrition.  While amalgam has been the material of choice for decades and still remains the primary source of teaching in dental schools today, it may not be in the future.  Given the patient demand for composite restorations and what appears to be the dentist’s propensity to capitulate, we are going to need a better solution to posterior restorations if we want to achieve the same longevity that is achieved through amalgam restorations.

The internet has continued to create an uncertainty on the part of the lay public about amalgams similar to the controversy that surrounds cell phones and brain tumors.  It is interesting to note the dilemma faced by dentists today, when we know that amalgam is the better choice for the restoration, but the popular demand or path of least resistance is a composite restoration.  This disconnect creates some interesting food for thought.[1]

Novy Scheinfeld, DDS, PC

5471 Bells Ferry Road, Suite 200 

Acworth, GA 30102

770-928-7281

www.rightsmilewoodstock.com

info@rightsmilecenter.com

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[1]Additional sources of information came from Gordon J. Christensen, DDS, James F. Simon, DDS, and Howard E. Strassler, DMD. Compendium of Continuing Education in Dentistry, July/August, 2011.