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Are You Afraid of Needles?

Published on October 14, 2014 by

If you go to any medical office for a procedure, it is likely that you will encounter a needle at some point. Whether it is a blood test, the numbing of an area, or a vaccine… we have all experienced it.

I personally have no problem with needles, but after a recent visit to my dermatologist for a routine procedure on my ankle, I came to realize how some people develop “needle phobia”, and just how special Dr. Joy and Dr. Tom are when it comes to making sure our patients are comfortable with any treatment rendered.

When I laid on that table at the dermatologist’s office and the nurse gave me that quick shot without warning, it was just brutal. I understand that her reasoning was probably “let’s get it over with quickly”, but that complete lack of compassion, that “point and shoot” approach was a total wake up call and made me relate to a lot of our patients’ stories.

Needle PhobiaWe hear from patients on a regular basis that the needle is the worst part of their appointment. They tense up in the chair just thinking about having to get a shot.

I work by our doctors’ side every day.  I have first hand experience of how comforting they are to the patients, and how respectful of any apprehensions a patient may have.  They are so gentle that the only time you will know they have a needle in their hand is when your cheek feels like it weights 100 pounds as the anesthetic is working its magic.

They have the most delicate way to perform the injection, and I speak from experience both as an assistant to Dr Joy and Dr Tom, and as their patient. I have had to have a few procedures over the years and it was pain and stress free every time.

With the help of breathing techniques, effective distraction skills, and Lavender Oils (for those who are open to it), the doctor will have the area of concern numbed before you know it.

We care about how you feel while you are under our watch. Make sure you share what you have experienced in the past, we will make sure you are heard and comfortable at all time during your visit.

To Pre-Medicate Or Not To Pre-Medicate… THAT Is The Question!

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PreMedication In DentistryWho needs to pre-medicate prior to dental work or dental cleanings? It is advised for patients that:

1. Have an artificial heart valve
2. Have a history of infection of the lining of the heart
3. Have had a heart transplant
4. Were born with a birth defect in the heart (congenital heart disease)
5. Have had orthopedic implants in the joints (this used to be recommended but, as of 2012, the ADA and American Association of Orthopedic Surgeons updated that recommendation and it is no longer recommended for patients with artificial joints).

The guidelines are re-evaluated every few years to make sure that they are based on the best scientific evidence. Your physician will have to confirm either way based on your history. These are general guidelines and some exceptions still require pre-medication.

Why was it recommended in the first place? Doctors recommend that a patient take antibiotics before certain dental procedures because we have bacteria in our mouth; cleanings as well as dental procedures allow bad bacteria to be released and enter your bloodstream. When in good health, it does not cause any harm – but in patients with compromised immune systems or conditions I listed above, it can lead to concerns and infection in other parts of the body. This is called “antibiotic prophylaxis” when it is recommended and prescribed by your physician. Always talk to your physician, nurse, or people handling and overlooking your health!


What Is The Cause Of Your Dental Anxiety?

Published on October 3, 2014 by

Fear Of The DentistIt happens every day. I hear patients sharing how much they usually fear dental offices and procedures. These fears are usually caused by past experiences, a poor understanding of what work has to be done, or bad memories that soon become a fear. Patients develop anxieties, making their appointments dreadful. Dentistry has come a long way. The technology of today has so much to offer and it has made dental experiences a much more positive experience. In our office, we take these fears into consideration and listen to what caused that feeling at the first place. We strive to make our patients comfortable during any and every appointment; we take the time to educate you and we want to make sure your experience and perceptions are positive. I am not joking when I say patients often leave saying they had a good time. Our team is friendly and dedicated to your wellbeing. The name Dental Wellness says it all!

What is Periodontitis?

Published on September 30, 2014 by

Periodontitis is a low grade infection of the gums. At this stage, even a high quality brushing may not control the disease because of the amount of calculus accumulated around the teeth. If periodontitis is not treated, it will slowly and painlessly destroy the bone which supports the teeth. Untreated, the disease will eventually cause tooth loss – but it doesn’t have to be that way! Early detection of gum disease and good professional care is the key; we cannot stress this enough. Gum disease can affect our overall health. It can lead to serious health problems such as increased risks of cardiovascular diseases, diabetes and even strokes. It is an active infection and, unless removed, it progresses slowly in both your mouth and beyond as any infection is harmful for your general health. Imagine a cut not healing, filled with pus. Would you really leave it and only have it checked every six months? This is what gum pockets are like. It’s recommended that you have them professionally checked and have plaque removed every three months. Think of that cut mentioned earlier.

Comparison of Healthy Tooth to Periodontitis

Comparison of Healthy Tooth to Periodontitis

What Exactly IS Tooth Decay?

Published on July 31, 2014 by

Caries - Tooth DecayWe get asked this question every day! Tooth decay is more commonly referred to as a cavity,  or more specifically dental caries.  Tooth decay is a common disorder causing the breakdown of healthy tooth enamel and sometimes dentin. Cavities are little holes in the teeth causing damage to the structure of teeth. It can cause pain at times as it is an infection. It can also lead to tooth abscess if the pulp is reached, and can lead to the loss of the tooth when left untreated.

How does tooth decay occur?
Bacteria in our mouth change food into acids. That acid, along with bacteria, food, and saliva forms what we call plaque. Plaque forms within 20 min after eating, and if that plaque is not removed regularly, it creates tartar that sticks to our teeth.  Certain foods, like sugar, carbohydrates and sugary drinks play a big factor in developing tooth decay.

Accumulation of plaque and tartar can also affect your gums, resulting in the very common infection known as gingivitis. Gingivitis is what we call an active infection which generates pain.

The acid in plaque will slowly eat the healthy tooth structure away, first damaging the enamel, making its way in the dentin, then eventually reaching even deeper into the pulp when not addressed in its early stages.

The good news is, when detected on time, early treatment is easy and painless for both your mouth and your wallet.



How Do We Treat Cavities?

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The first step is to remove the active decay, then the tooth is filled with resin (although a lot of dentists still use silver amalgam, which can cause serious health consequences).  Here at Drs. Rohrer, we do NOT use amalgam fillings because of our focus on Whole Body Dentistry – it is important to note that amalgam often contains mercury which has been linked to an array of negative side effects and diseases.  Today’s technology offers wonderful materials which are an healthier alternative to amalgan, and can match the color of your teeth.

Tooth DecayFor more severe tooth decay, crowns, onlays or inlays can be recommended depending how much of the decay has reached into the dentin. In case you need a crown, an onlay, or an inlay, it will be a two visit process, as a laboratory will need to make the restoration that will be installed during the second visit.

In the case of more advanced decay, if the nerve is reached, a root canal might be recommended (as long as the tooth can be saved). After the root canal is finished we can prepare the tooth and make an impression for a permanent crown/restoration to be made by the dental lab.

In extreme cases, if the decay is too advanced, the tooth will have to be removed.

So! How Exactly Do I PREVENT Tooth Decay?

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Oral hygiene is at the heart of preventing tooth decay. Home care (flossing, brushing, etc), regular check up including x-rays once a year, and a professional cleaning at least twice a year will help you prevent tooth decay. It is important to note that the ADA recommends professional teeth cleaning to be done every three to four months. Following these steps is your best option for early detection and prevention. You should be brushing at least twice a day or after each meal if possible, flossing at least once a day can go a long way to avoiding cavities, as well.brush-floss

If you have a sweet tooth, by all means honor your cravings, but when possible brush or rinse your mouth with water right after eating to minimize acid buildup. If you drink soda or sugary drinks, do not sip them all day, and if you like candies and mints don’t suck them all day either. Enjoy them, and think of your oral care: rinse, brush and floss!!!

All these tips can help avoiding building that plaque that is so damaging to your oral health – and your overall health, as well…


The Difference Between An Onlay And A Crown

Published on April 11, 2014 by

OnlayWe recommend an onlay if we need to restore a tooth that is broken down so much that a filling is not enough to fix it, when too much of the tooth is missing, or the tooth is cracked and could fracture, when we could not use a conventional filling material due to too much tooth structure missing.  Onlays look very natural, very conservative. It is one of our favorite tooth restoration methods. Onlay can be porcelain or gold.

Although most people like to have them made in porcelain for cosmetic reason as we can match the color of you existing teeth, on a health point of view gold is just as appropriate. A porcelain onlay covers at least one cusp of the tooth and most or all of the chewing surface of the tooth. It strengthens it so that it won’t fracture. One advantage of porcelain onlays is that they preserve more of the natural tooth structure. If the tooth’s structure is healthy, it is usually best to leave as much of it in your mouth as possible.

The difference between an onlay and a crown…

A crown covers the entire chewing surface of the tooth and wraps around the entire tooth all the way to the gum line. The porcelain onlay is more conservative as it covers only the weak parts of the tooth, and saves more of your natural tooth. Porcelain onlays require a great deal of expertise to place correctly. They require extensive training in cosmetic dentistry and in occlusion. Very special skills are required to prepare the tooth as well as seating the onlay.

Dr Tom has been making onlays for years, and always favors them as they allow to save more of your tooth. His extensive training and studies under the best Professors combined with years of experience have helped him master the skills required to install onlays, and he has come to love this very conservative and natural approach to tooth restoration.

What To Expect…
During your first visit we will remove tooth decay if any is present. Sometimes what we call a “build up” is necessary if a lot of tooth structure is missing. Dr Tom will prepare your tooth for an impression we take for a laboratory to make your onlay, and finally we will make a temporary. You will be able to function properly with the temporary during the couple weeks the lab usually needs to make your restoration. The second visit will requires less of your time. While this phase is highly technical and requires a lot of skills to prepare both you tooth and the onlay, you will be in and out of the office in a short period of time.

I Am Grinding My Teeth… What Impact Does This Have?

Published on April 10, 2014 by

A lot of people grind and clench their teeth from time to time. When teeth grinding occurs on a regular basis the teeth can become damaged.

Because grinding often occurs during sleep, most people are unaware that they grind their teeth. Every day, we diagnose patients with bruxism. In most cases patients do not know they are grinding, but we can see on their teeth evidence of the wear on their teeth. While we cannot confirm if you are actively grinding, when there is evidence of grinding, something needs to be done to avoid the problem from recurring or continuing.

tmj-painVery often, symptoms like dull, constant headaches in the morning especially, or sore jaw and stiffness in the neck are symptom we can associate with a bruxer. Many times people learn that they grind their teeth by their loved one who hears the grinding at night, but most of the time a patient does not realize they do clench or grind their teeth.
Teeth grinding can be caused by stress and anxiety, it often occurs during the night and is more likely caused by an abnormal bite or missing tooth. In some cases, chronic teeth grinding can result in a fracturing, loosening, or loss of teeth. Chronic grinding may wear the patient’s teeth down, showing some recession.

With time, and if not addressed, teeth can be reduced to almost no more teeth structure and the patient might require a full mouth reconstruction. Not only can severe grinding damage teeth and result in tooth loss, it can also affect your jaws, and create what we call TMJ.

The solution…
We can make a well constructed bite guard, custom made by a laboratory, as it has to be a hard plastic one. Soft guards you can find over-the-counter are soft and not recommended, as they prove to be promoting grinding. If you find yourself grinding, try to train yourself not to clench or grind your teeth and position the tip of your tongue between your teeth. This practice trains your jaw muscles to relax, but we encourage you to talk to us about evaluating the grinding and talk about a bite guard. A bite guard is the best treatment advised to stop the grinding and preserve the health of your teeth.

Do I Really Need A Deep Teeth Cleaning?

Published on April 9, 2014 by

A deep cleaning is recommended when a patient presents with some form of periodontal(gum) disease. Periodontal disease can be described as a silent, persistent bacterial infection that can affect your gums and the bone that supports your teeth as well as your overall body health. Periodontal disease has been associated with increased risks of stroke, heart disease, pregnancy complications and other respiratory infections. Click here (Stages of Periodontal Disease) to learn more about the different forms of periodontal disease.

Deep Cleaning

According to the ADA, more than 70% of US adults suffer from some form of periodontal disease. Many patients are diagnosed with periodontal disease on a daily basis, and usually extensive treatment follows that diagnosis. Problem is that sometimes patients don’t really know what they are getting into. They wonder why they should proceed with the treatment or even if they need the treatment at all.
I hate to break it to you, but chances are that if a dentist recommended a periodontal (deep) cleaning, you will most likely need it. But the most important aspect of this process is not only the diagnosis but also to understand the causes of the disease, and how to prevent it in the future. That is why choosing a holistic dentist, someone who looks at the big picture, looks at the root of the problem and spends the necessary time educating you, could be beneficial not only for your teeth, but for your overall health.

So how do you know if you need a deep cleaning? There are some indicators that can help you determine if your gums are healthy or have active bacterial infection:

  • Red, swollen and tender gums
  • Gums that bleed after brushing or flossing – healthy gums should NEVER bleed
  • Persistent bad breath
  • Pain while chewing
  • Loose teeth

The best way to determine if you have periodontal disease as well as the degree of the infection in your mouth is to measure the size and depth of your gum pockets. A periodontal charting, performed either by the doctor or the hygienist, helps determine the degree of the disease and how much treatment is needed to bring your gums back to health. Your gum pockets are measured in terms of millimeters. 1-3mm pocket depth means normal, healthy gums. Anything above 3mm is considered an indication of inflammation, infection and gingivitis or periodontal disease. On my article “Stages of Periodontal Disease”, I provide a more thorough explanation of the signs and symptoms of Periodontitis and how this disease can affect your overall health. So, how do you keep a deep cleaning within your budget? Many times, when a dentist presents a treatment, it will include many services that can be postponed or maybe avoided. For instance, even though there are many benefits to using an electric toothbrush, if you want to keep your costs down, you can restore your gums back to health using a conventional toothbrush. Another way to save is to do a quadrant at a time or half a mouth. It is not ideal, since you are dealing with active infection, but when finances are a problem, doing some work is better than no work at all. Finally, start brushing and flossing! The simple act of brushing and flossing on a regular basis may significantly decrease (but will not eliminate) the active infection, and may also help decrease the cost of the treatment. You can also use an antiseptic mouthwash, which is used to kill the bacteria causing the infection. In the end, you will need to have your teeth professionally cleaned, especially because most of the infection tends to lay below the gums, where you or your brush have no access. When you do, ask your doctor or hygienist to educate you on how to floss and brush properly. A bad flossing or brushing technique can sometimes do more damage than good.