Baby teeth (or as we call them “primary teeth”) have a two very important functions. First of all, the kid needs to eat! Just like with adults, children need to be able to chew their food. The other function that is perhaps not so obvious is that the baby tooth is the placeholder for the adult tooth. (We call this the “permanent tooth.”) If a primary tooth is missing, the one behind it often will move forward, and the permanent tooth in the bone below will not have a place to go. Sometimes this permanent tooth will be completely trapped. This can have major ramifications for the overall tooth alignment in the mouth.
Another reason to maintain the health of a primary tooth is because of the risk of infection. Just like permanent teeth, primary teeth can become infected. This can be painful and can affect the entire body. Dental infections can sometimes be serious.
We love to see children at Mint Dental! Children often come for their first visit before the age of 2. We usually start out with a basic cleaning and exam, sometimes on the parent’s lap. We show the child our instruments and how things work. We want them to feel comfortable and never have a fear of a trip to the dentist. Parents can help by always speaking positively in front of their children about dentistry- it makes a big difference!
At Mint Dental, we are honored to be the dental office for your entire family.
So you have dental insurance, but it all seems a bit confusing. There are categories of coverage, there is a deductible, there is a yearly maximum, and there are “downgrades”- what does this all mean?
First of all, let me explain how dental coverage works from a dental office’s perspective. In our office we only have PPO contracts, which is the most common form of dental insurance. This is the main insurance that I’ll be referring to. If we sign a contract with a dental insurance company, then we are “In Network” with that dental insurance company. This means that the company will list us as an “In Network” dentist, and that you, as the patient, will get the most coverage by seeing us (or another “In Network” provider). In exchange, we agree to charge that insurance company’s fee schedule, which is a significant discount from our normal fee schedule.
If a dental practice is not an “In Network” provider, that does not mean you cannot use your insurance benefits at that office. Your insurance will generally still pay a percentage of your treatment at an “Out-of-network” office, but the fees will not be as low and the percentage that the insurance company pays may not be as high.
A deductible is the amount a patient has to pay before the insurance company will contribute to the cost of the treatment. Deductibles for dental insurance are not as high as medical insurance- they are usually anywhere from $25-$150, or sometimes there is no deductible at all. Also, almost always you will NOT have to pay a deductible for a preventive appointment, and usually this is paid for by the insurance company at 90-100%. This means that you should be able to come in for a professional cleanings and examinations twice a year for little to nothing.
Yearly maximums for dental insurance are often very low. The maximum that the insurance company will pay in one year (usually in a calendar year) is anywhere from $500-$2500. Because of that, sometimes it is better to think of insurance money as a gift card that can be applied to your treatment.
An insurance “downgrade” refers to the insurance company only being willing to pay for the cheapest option to restore your tooth. Sometimes the insurance company will only pay for the metal amalgam fillings or will only pay for all metal crowns of the cheapest metal (“base metal”) rather than paying for tooth-colored fillings or tooth-colored crowns. The insurance company will still contribute to paying for your dental treatment, they just will not pay as much. For example, an insurance policy says that the insurance company will pay for 50% of the cost of a crown. However, they will not pay for 50% of the cost of a porcelain (tooth-colored) crown, instead they will pay for 50% of the cost of a base metal crown, contributing that smaller amount to the overall cost of the treatment.
At Mint Dental we work very hard to understand all of these details for each patient’s individual treatment plan. This is a huge part of the management of our practice. We usually have to speak with a representative from the insurance company for each and every patient that we see. We are as thorough as possible, so that our patients will have a close estimate of the cost of their treatment. However, it is impossible to be accurate all the time. Many insurance companies will not fully disclose the details of each plan, and they occasionally give us faulty information. This is why it is important for patients to be empowered to understand their own insurance benefits.
Dental insurance can be wonderful- it offers a lot of help to many of our patients. However, another important aspect of our relationship with dental insurance is that at Mint Dental, we do not allow the insurance company to dictate what is appropriate treatment for the patient. We believe that treatment decisions are best made by the doctor and the patient working together, not by a third party payer.
We would be happy to discuss your particular insurance plan. Please feel free to call our office with any questions at 918-346-6016.
We support the conservative use of fluoride in our office; however we respect your rights as a patient to refuse fluoride treatments and products.
Why do we support fluoride use?
-We believe in Evidence Based Research. This means that all of the decisions about treatments and products that we use in our office are backed by multiple studies that are Peer Reviewed. A Peer Reviewed study is one where the research is subject to the scrutiny of others who are experts in the same field, before a paper describing this work is published in a journal. Peer review requires a community of experts in a given field, who are qualified and able to perform impartial review.
-Fluoride is beneficial to your teeth in two ways: When your teeth are forming, the enamel or outer layer of the tooth is strengthened by low levels of fluoride, and is therefore less susceptible to decay. Secondly, exposure to fluoride in water, toothpastes and in office treatments can actually remineralize enamel- this means it can actually heal enamel that has early decay in it. This can prevent the need for drilling of the tooth and the placement of artificial dental filling materials, which will never be a substitute for natural tooth.
-The research in support of the safe and conservative use of fluoride is overwhelming. Because of this, fluoride use is supported by the following large and reputable organizations:
-American Dental Association
-Centers for Disease Control and Prevention
-American Medical Association
-American Academy of Pediatrics
-US Surgeon General
-American Association of Public Health Dentistry
-American Public Health Association
-National Institute of Dental and Craniofacial Research
-World Health Organization
-International Association of Dental Research
-Fluoride in water is natural. Fluoride is found in streams, lakes and the ocean. The benefits for fluoride in teeth were discovered because of the lack of tooth decay in people living in naturally fluoridated areas. However, the natural water that some people drink is over-fluoridated. Therefore the levels need to be regulated to a lower, safer level. We support fluoridation in water at the lowest level that is considered safe, which is 0.7 parts per million. We also support the Environmental Protection Agency’s efforts to review their current limits on unregulated water. The EPA has previously said that 4 parts per million in areas where fluoride is not regulated is safe, but recent research has shown that this level may be too high. The EPA is currently reviewing this standard.
We welcome you to look through the research available in our office about fluoride. Again, we support your right to formulate your own opinion and refuse fluoride exposure in our office. Please just let us know, and we will be happy to accommodate you.
Teeth whitening is everywhere- you can buy kits at the store, online, in salons, and you can have a teeth whitening procedure in a dental office. The questions people ask us are: “What is the best way to whiten my teeth?” And “What is the difference between In Office Whitening and Take Home Whitening?”
“What is the best way to whiten my teeth?”
First of all, the difference between whitening under the supervision of a dentist and whitening in any other way is that dentists have prescription-strength whitening products, and we know how to handle them. We have the strongest whitening products available and will use them in the proper way, providing you the best results in a safe environment.
Before you whiten your teeth, you need to have an exam by a dentist. The dentist can explain to you what results you can expect from whitening. For example, fillings and certain white spots will not change with whitening and may need to be replaced or treated differently. Sometimes, the results you want can be obtained only through filling material or porcelain. It is best to know this before you whiten your teeth. Also, the dentist can make sure that whitening is not going to harm your teeth. You do not want to place whitening gel into deep areas of decay, and often patients do not know that they have these areas of decay without a proper exam and x-rays.
“What is the difference between In Office Whitening and Take Home Whitening?”
With In Office Whitening, we use our strongest whitening product to whiten your teeth while under our supervision. We use a special “block out” material to protect your gums, and we retract your cheeks to protect them as well. The procedure takes about 1 hour.
Some practices add a light or a laser to their In Office Whitening procedure, but we have decided not to. The reason we have made that decision is that the effectiveness of the light and laser have not been proven, and many patients complain of extreme sensitivity after a whitening procedure with a light or laser. We have very few if any complaints in our office after whitening.
At Mint Dental, In Office Whitening includes take home whitening trays. With this combination, you will achieve the whitest results.
Take Home Whitening involves taking impressions of your mouth and the fabrication of custom-made whitening trays (like clear plastic retainers) that you use at home to whiten your teeth with a prescription-strength whitening gel. Although it is stronger than any products that you can buy outside of a dental office, it does not require the gum protection that the in office whitening gel requires.
At Mint Dental, after you have whitened your teeth, you are enrolled in our Whitening for Life Program. If you keep your regular cleaning appointments, we will give you a touch up tube of whitening gel free of charge. That way, you can maintain your teeth at their whitest over the years.
We would be happy to discuss tooth whitening options further with you. Feel free to contact our office with any questions.
The typical training to be a dentist involves 4 years of college followed by 4 years of dental school. We take 2 national written board examinations. The first tests you on basic science and the science of the human body- these are things like biochemistry, anatomy, etc. The second board has more specific questions about dentistry. There is then a clinical board exam- we work on patients and our clinical skills are evaluated. You also have to take a test about the laws and the ethics of being a dentist that is specific for each state that you live in. After surviving the very intense years of school and passing the exams, you can apply for a license to be a General Dentist.
If you would like to be a General Dentist but you would like some additional training in certain areas, there are 2 residency options: a General Practice Residency (GPR) and an Advanced Education in General Dentistry Residency (AEGD). In our practice, Dr. Avery completed a GPR that involved hospital and operating room training as well as working with patients with special needs like severe autism. Both of our dentists chose to be General Dentists because they like the variety of different types of dental procedures, and they like seeing the same patients regularly and getting to know them.
Some dentists choose to go to school beyond dental school in order to become a Dental Specialist. There are 9 specialties of dentistry. Their official definitions of each are listed below and copied from the American Dental Association website.
Basically, a specialist has additional years of training in one area. An orthodontist, for example, has additional training in moving teeth, in the alignment of teeth, in treating patients with braces, etc. And as an orthodontist, he or she focuses on that type of treatment and no longer does fillings or makes dentures. We will refer you to see a specialist if your situation requires the expertise of someone that focuses on and has a deeper understanding of that area of dentistry. If you have a complicated root canal, we might refer you to an Endodontist. If your child has complex treatment needs or needs to be sedated for dental treatment, we will refer him or her to a Pedodontist.
We have relationships with Dental Specialists in the community whom we trust to provide you with excellent care. Often, we work closely with them on Interdisciplinary Cases- this is when a patient has treatment that requires the expertise of a number of practitioners. We stay in close communication with the specialists that we work with.
Please let us know if you have any further questions about dental referrals.
Dental Public Health: Dental public health is the science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice which serves the community as a patient rather than the individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis. (Adopted May 1976)
Endodontics: Endodontics is the branch of dentistry which is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. (Adopted December 1983)
Oral and Maxillofacial Pathology: Oral pathology is the specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. (Adopted May 1991)
Oral and Maxillofacial Radiology: Oral and maxillofacial radiology is the specialty of dentistry and discipline of radiology concerned with the production and interpretation of images and data produced by all modalities of radiant energy that are used for the diagnosis and management of diseases, disorders and conditions of the oral and maxillofacial region. (Adopted April 2001)
Oral and Maxillofacial Surgery: Oral and maxillofacial surgery is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. (Adopted October 1990)
Orthodontics and Dentofacial Orthopedics: Orthodontics and dentofacial orthopedics is the dental specialty that includes the diagnosis, prevention, interception, and correction of malocclusion, as well as neuromuscular and skeletal abnormalities of the developing or mature orofacial structures. (Adopted April 2003)
Pediatric Dentistry: Pediatric Dentistry is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. (Adopted 1995)
Periodontics: Periodontics is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. (Adopted December 1992)
Prosthodontics: Prosthodontics is the dental specialty pertaining to the diagnosis, treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance and health of patients with clinical conditions associated with missing or deficient teeth and/or oral and maxillofacial tissues using biocompatible substitutes. (Adopted April 2003)
Many people for various reasons are missing a permanent tooth at some point in their lives. The questions then are: How do I replace my tooth? Do I even have to replace my tooth? What happens if I don’t have a tooth there?
First, there are several reasons why you should replace a missing tooth. Even if a tooth is not visible, not having it present can affect you in a number of ways, besides the obvious cosmetic and potentially psychological issues.
On a basic level, missing a tooth can often affect your ability to eat. Usually, missing one posterior tooth does not affect chewing ability directly, but it can over time. This is because the forces used for chewing or clenching will now be heavier on the teeth that are still present. For example, if you have 8 molar teeth, and now you have 7, we may find that the other 7 begin to wear more than they would have before. If many of your other teeth already have large fillings or cracks, then that makes it more likely that they could be damaged when they are taking more of the force than they were before.
The biggest problem that we see when a tooth is missing is the movement of the other teeth around the space. The teeth behind the space where the tooth was will often tilt forward into that space. Sometimes, a tooth behind a space will tilt so far forward that eventually the patient is biting on the side of that tooth instead of the “occlusal” surface (the top part that you typically bite on). The other tooth that often moves after a tooth is removed is the tooth that opposes the space (this is the tooth that was biting on the now missing tooth). The opposing tooth will seemingly “search” for something to bite on and will erupt further out of the socket in its quest to find a partner. The long term consequences for this can include the loss of that tooth as well.
The third problem with a missing tooth is loss of bone. Bone can be thought of with the adage “if you don’t use it, you lose it.” Without a tooth present, the bone typically resorbs or shrinks back. The common example of this is seen when a person has had all of his or her teeth removed and wears dentures for many years. After many years without teeth, there is very little bone present for the denture to hold on to. In a one tooth space, the bone loss that occurs usually is minimal, but it is often enough to make it impossible to place an implant in the future. With more than one tooth missing, however, the bone loss can be significant enough to make the face appear collapsed and therefore older.
Once you have decided to replace a missing tooth, you have to decide how. There are 3 options for replacing a missing tooth.
The first option is to fabricate a removable appliance, typically called a “partial.” This is the least ideal choice, because it does not preserve the bone (as previously mentioned) and because you will have to take the appliance in and out of your mouth. The appliance will also need to use the teeth around the missing space in order to stay in. This can put unnecessary force on those other teeth.
The second option is a dental bridge. A bridge is cemented in your mouth, so you do not take it out. This makes it a much better option than a removable appliance. The biggest downside to a bridge is that it requires the preparation of the teeth on either side of the missing tooth. This means that about 2mm of tooth structure from the top and the sides of the teeth on either side will be removed in order to create the bridge. This also means that if anything happens to one or both of these adjacent teeth, the whole bridge will need to be remade. The replacement of the missing tooth is therefore dependent on the health of the teeth on either side. The bridge will also not preserve the bone.
The third and usually best option is a dental implant. A dental implant involves a “root replacement” that will go into the bone where the tooth’s roots previously were. This makes it the best option for preserving the bone, because the bone is being used. The implant will then have a crown attached to it to replace the part of the tooth that is above the bone. The primary advantage of a dental implant is that it is independent of the other teeth around it, and it is most similar to having a real tooth.
If you would like to discuss replacement of a missing tooth or missing teeth, please contact us! Not all options are possible in all cases. We would be happy to see you and further explain all of your specific options.
Welcome to our brand new blog! We will be posting info about Mint Dental as well as dental education for patients periodically here.