Blog
Dental Anxiety, Case Discussion 2
Replacing fear with trust in the therapeutic dental relationship.
A patient visit that started with fear and ended with trust. Her narrative:
” I am a person who can not sleep the night before a dental appointment. Hence the problems I have now growing and not paying rent in my mouth! I do not trust dentists or believe most of what they tell me. After my first visit to Dr Korwin’s office and after 30 years of fears, I’m not sure who I am. I am leaving this office laughing and yes, making my next appointment!
To anyone who is even afraid of the novocaine needle, I felt NOTHING!
Every dentist should train with Dr. Korwin and I bet the world would have beautiful smiles.
F.V., Atl. H., N.J.
Dental Anxiety, Case Discussion
Replacing fear with trust in the therapeutic dental relationship.
A patient presented with dental neglect and a history of dental avoidance stemming from negative past dental experience. He declined any treatment without sedation. After consenting to an exam, he was guided toward therapeutic trust in the professional relationship. An exam with permission statements, retaining full personal control was the first step. After the exam, the possibility of a cleaning emerged and the hygiene visit retaining full patient control followed. A consultation emphasizing results and attainable financial goals provided the framework for the next step. After assurance that the visit would be completely painless and under his total control, the patient now had enough trust to allow a brief visit with local anesthetic and a restoration. Following this quick and completely painless procedure, the patient said enthusiastically, I could kiss you, shook my hand instead, and said he was now ready for his root canal without sedation!
Insight into Immune Response from Periodontal Bacteria
The mouth is telling us something!
A very significant finding for diagnosing and improving the immune system response to bacterial attack comes from periodontal research from The University of Louisville School of Dentistry, published in Science Signaling. The study reports that a bacteria responsible for periodontal disease interferes with the communication network of the human immune system, preventing destruction of the bacteria (P. gingivalis) by white blood cells. This immune interference is a highly sophisticated approach to keeping the bacteria viable in the body. Many diseases which trigger immune dysfunctions (such as Lyme for example) interfere with immune response in unknown ways. The hope is that this particular finding may improve treatment of both periodontal disease and other systemic disease in a more effective manner.
http://stke.sciencemag.org/cgi/content/abstract/sigtrans;3/109/ra11
Teeth on Fire
I’ve said it 3,000 times in the last 12 months. When I use a whitening or tartar control toothpaste, my teeth hurt! Don’t use these popular toothpastes. Instead use Arm and Hammer Age Defying and add MI Paste from GC. The combination is very powerful and tooth sensitivity melts away.
The simplified long winded explanation for this has to do with the anatomy, morphology and physiology of a tooth. Hot or cold sensations are transmitted by small tubules which contain long fluid filled processes coming from the inside of the tooth. Exposed tubules are easily influenced by hot and cold. Whitening and tartar control toothpastes strip away the sediment covering the tubules, exposing the conductor within to hot and cold. MI paste and Arm and Hammer fill in the tubules ( as do other desensitizers) and voila, your teeth feel great! Don’t be a sucker for marketing. The folks that put these ads together did not go to dental school, but they did go to marketing school.
Probiotics for Cavity Prevention
New research shows probiotics, (live microorganisms) in a twice daily mint can rebalance mouth bacteria reducing bad bacteria and increasing good bacteria to increase oral health. After brushing and flossing, application of 100,000,000 colony forming units (CFU) of S uberis KJ2, S oralis KJ3 and S rattus JH145 (called ProBiora3) colonize tooth surfaces, use up nutrients and make the mouth undesirable for the bad bugs which cause periodontal disease and cavities. A commercial mint containing ProBiora3 called EvoraPlus and Evorakids was developed by Dr. Jeffery Hillman and teams at Forsyth Institute, the University of Florida in Gainesville and at Oragenics. The peroxide released by the good bacteria inhibits colonization of bad bugs, reduces sulphur causing oral malodor, and even whitens tooth enamel.
Sunstar Butler has an oral probiotic named GUM Periobalance which is taken once a day. The active ingredient is Lactobacillus reuteri Prodentis from BioGaia, a Swedish biotechnology company. Periobalance increases the ratios of helpful Lactobacillus and decreases harmful Streptococcus in the mouth. New oral balance probiotics are now available even for dogs and cats!
Thanks to Trisha E. O’Hehir, RDH, BS, Hygienetown Editorial Director for this great information.
Gum Disease links to carcinoma
Chronic gum disease may raise your odds for head and neck squamous cell carcinoma.( HNSCC) Each millimeter of bone loss was associated with more than 4-fold increased risk of HNSCC.
Chronic Periodontitis and the Incidence of Head and Neck Squamous Cell Carcinoma; Mine Tezal, Maureen A. Sullivan, Andrew Hyland, James R. Marshall, Daniel Stoler, Mary E. Reid,Thom R. Loree, Nestor R. Rigual, Mihai Merzianu, Linda Hauck, Cheryl Lillis, Jean Wactawski-Wende, and Frank A. Scannapieco; Cancer Epidemiol Biomarkers Prev September 2009 18:2406-2412; doi:10.1158/1055-9965.EPI-09-0334
Oral Cancer Update
Oral cancer screening is something we have done every dental exam visit for the past 3 decades.
As reported in a recent interview with Michael A Kahn DDS of Tufts University School of Dental Medicine, only 15% of patients are aware of being given an oral cancer exam by their dentist. Since more people die yearly from this than from cervical cancer and melanoma, it should be on the top of your to do list. Risk factors include smoking and chewing tobacco, along with alcohol. The aldehyde in alcohol increase the absorption of cancer causing substances. Dr Kahn advises his patients, as I do, to avoid swishing daily with an alcohol based mouthwash. See my prior post: Why use alcohol containing mouthrinses when there are effective non alcohol mouth rinses available OTC? for a rundown on alcohol based mouthwashes. Perform a self exam once a month. Look for raised red or white patches in your mouth with a flashlight and a hand mirror. If present after two weeks, have us look at it, and possibly take a sample (biopsy) for analysis. Survival is high with early diagnosis and treatment.
Kiss the Boo Boo and make it better!
There’s a reason Mom makes it ouch less!
When mommy kisses her little baby’s boo boo, baby feels better for a good reason. The remarkable compound Opiorphin is an chemical which has been isolated from human saliva. Research shows the chemical has a painkilling effect greater than that of morphine! Our self dispensed boo boo and toothache remedy is available 24-7.
Is there really mental floss?
Dentists and psychiatrists in the UK studied almost 7,000 people aged 20 to 59 and found that gum disease was linked to poor cognitive ability for youngsters as well as oldsters. Inflammation due to gum disease causes damage to white matter in the brain, which results in deficient mental function. Another study at Columbia University found gum disease linked to dementia and Alzheimer’s. The upshot is, psychiatrists are now advising you to floss in addition to brushing.
Lowering Blood Pressure with Calmistry
Rapid non pharmaceutical anxiety relief
We were visited by a very nice medical professional today whose blood pressure due to dental anxiety was 167/106. We delayed his procedure, but after 5 minutes of listening to Calmistry and a breathing exercise, his blood pressure became 143/89, and we quickly started and finished his care.
Valentines Day Kisses
Is there anything too sacred to be tied to dentistry? I think not!
Saliva, which becomes more abundant during kissing, has antibacterial properties that limit halitosis, tooth decay and gum disease.
Happy Valentines Day
(From the Ontario Dental Association)
Lose Weight!
Use the floss twice a day exercise.
When researchers in Brazil studied 13,000 people over a three-year period, they found that men with the highest levels of inflammatory agents in their body were also the most likely to gain weight!
Periodontal disease, which is caused by poor oral health care, is one of the most common sources of inflammation.
Brushing twice a day, flossing, and making regular trips to the dentist are the best ways to prevent the disease.
Can you tell your stomach not to growl?
You can’t stop the rain, peristalsis, or tooth grinding.
Everyone grinds their teeth at times but not everyone knows they do it. Even if they do, it can be hard to stop.
To eat a steak, your teeth have to pound away with about 45 pounds of pressure. Studies show that teeth are in contact only 5 minutes per day while eating. On the other hand, while clenching or grinding, a much greater force is used for a much longer time. Your jaw muscles can produce a peak force of 200 to 300 pounds when clenching, enough to break a tooth.
Since teeth crack at 125 pounds of pressure, those 200 pounds repeated for 6 to 8 hours each day produce visible fractures, loss of supporting bone, and abfractions. Usually mistaken for overzealous tooth brushing, abfractions resemble a sharp horizontal notch cut into a tree with an axe. (Heavy tooth brushing produces root wear that is dished out and wide, not sharp).
For the last 30 years, when I find patients with tooth fractures, excessive wear and abfractions, I always mention it. I show live videos of their teeth and explain the evidence. To my surprise, after seeing this, a few people will say they never grind or clench. I can watch people while they tell me they never clench or grind… in the act of clenching and grinding. An observer can watch their jaw muscles flex and pop while I inform them they are doing it. I hand them a mirror, point it out, and then the conversation stops and there’s a pause in the conversation. Never fails.
Those who don’t demonstrate it on cue, will return 4 weeks later and say…’you know doc, I grind my teeth when I’… and a variety of answers emerge. It is during stressful family or workplace conversations, while driving, while arguing, etc. This scenario happens so often, I now tell some patients to tell me in one month whether they clench or grind.
The fact is that we are always engaged in sub conscious homeostatic activities like digestion that are not supposed to be conscious, until dysfunction clues us in. So the moral of the story is… damage is the result of clenching and grinding, but we are sometimes completely unaware that we are doing this.
Fortunately, help is available to prevent the damage. Stay tuned for the next exciting installment.
How can you tell if a Dentist is excellent?
Is there a measure of dental excellence? .
Some people ask: does he hurt?; is he good with kids?; do his fillings fall out? Some people send in the kids and if they like the Dentist he is ok.
I make it mandatory for everyone in my office to be very concerned with being gentle, kids like me, and my fillings don’t fall out.
There’s another way to tell, though. In my office, a root canal after a filling that I do is necessary only 1% of the time, and only 3.8% of the time when a crown is needed*. (Crowns are done when a tooth is more severely damaged in the first place).
But the “1%” number is a rigorous test. This means that almost all decayed or damaged teeth needing fillings and crowns done in my office don’t need root canals. My staff informs me that in some other offices the percentage is as high as 10% to 50% of the time. If you had a choice, I’m sure you’d rather have just a filling or crown, rather than a filling and root canal. The question and measure of dental excellence is to ask: …’do your fillings and crowns turn into root canals?’ If they don’t turn into root canals, you are in the right place.
(*Data available on request)
Canker Sores
Canker sores are a nuisance, and can be alleviated with a nightly
1,000 mcg capsule of Vitamin B12.
“A team of physicians at Ben-Gurion University of the Negev has discovered that a nightly dose of vitamin B12 is a simple, effective and low risk therapy to prevent Recurrent Aphthous Stomatitis (RAS), better known as “canker sores.” Canker sores are one of the most common oral lesions. According to lead researcher Dr. Ilia Volkov, “the frequency of RAS is as much as 25 percent in the general population, however, until now, there has been no optimal therapeutic approach.”
The findings were reported in the January/February issue of the Journal of the American Board of Family Medicine 22 (1): 9-16 (2009). Dr.Volkov is a primary care physician in the Clalit Health Services and lecturer in Ben-Gurion University’s Department of Family Medicine in its Faculty of Health Sciences. The researchers tested the effect of vitamin B12 on 58 randomly selected RAS patients who received either a dose of 1,000 mcg of B12 by mouth at bedtime or a placebo, and were tested monthly for six months. Approximately three quarters (74 percent) of the patients of the treated group and only a third (32 percent) of the control group achieved remission at the end of the study.
According to the research, “The average outbreak duration and the average number of ulcers per month decreased in both groups during the first four months of the trial. However, the duration of outbreaks, the number of ulcers, and the level of pain were reduced significantly at five and six months of treatment with vitamin B12, regardless of initial vitamin B12 levels in the blood.
During the last month of treatment a significant number of participants in the intervention group reached ‘no aphthous ulcers status’ (74.1% vs 32.0%; P < .01).” The treated patients expressed greater comfort, reported less pain, fewer ulcers, and shorter outbreaks during the six months while among the control group the average pain level decreased during the first half of the period but increased during the second half.”
Dental Emergency, A Day in the Life.
Play the game fast and painless.
Patient: New
Toothache: Duration 3 weeks
Symptoms: 10 on a scale of 10, sleepless nights.
Diagnosis: Root canal
Treatment: Local anesthetic, root canal, single visit, completed.
Evaluation by patient: Painless, will refer all her friends and family
Length of care: 45 minutes, during a busy day with 25 patients scheduled.
Post Op 24 hours: Comfortable and pain free.
We are very busy, but we always make room for new patients.
Just as you should not give up on your goals and new years resolutions don’t think you can’t find a perfect dentist to solve your dental problems.
I enjoy finding the solutions to complicated dental problems, and solving them quickly and painlessly. If you feel that your dental concerns have not been solved in the past, please give us a call. You will be very pleased.
An Easy New Years Resolution to add Years to your Life
Flossing Adds 1.5 Years to Your Life Expectancy!
Gum disease is kept at bay by removing bacteria around the teeth. Brushing does half the task. Flossing does the rest. Recent research finds that gum inflammation leads to oral bacteria in the bloodstream, explaining gum disease and the higher incidence of heart attack, and stroke. Resolve to floss daily to remove the bacteria that cause decay, bad breath, gum disease and reduce the incidence of stroke and heart disease.
Floss now and live longer!
Air Abrasion
Wow, that was quick.
Air abrasion was invented in the 1950’s, but did not become used in dentistry until the invention of more durable bonding materials which could be easily placed into smaller cavities in the 1990’s. The silver amalgam used in the 1950’s could not be used with air abrasion since it does not stick to the tooth. The techniques of minimally invasive dentistry and air abrasion are used to treat only the cavity and nothing else in the tooth. Once infected tooth decay is removed by the air abrasion stream of aluminum oxide, the tooth opening is then chemically prepared, sealed and then filled with a durable adhesive tooth colored composite. The whole process is painless and is very durable. The tooth is less likely to be sensitive than a silver filling after treatment, and the tooth is stronger since less structure is removed than with traditional drills and silver fillings. This is a fast, painless and lasting method of fixing a problem tooth. I use it for almost every filling since it super cleans the tooth faster and more effectively than any other method.
Progressive Orthodontics
Dr Korwin is one of two Highest Honors Graduates of Progressive Orthodontics since 1984.
Progressive Orthodontic Seminars (POS) was first introduced to general dentists by Dr. Don McGann in 1984. The culmination of years of research and thousands of documented cases, POS has provided over 5,000 worldwide general dentists with a comprehensive straight wire orthodontic education during 2 years and 48 full classroom days of rigorous study matching the standard of care practiced by orthodontists. The program is taught by varying specialists throughout 21 countries and in multiple languages.
The IPSoft program used by Dr. Korwin takes advantage of diagnostic analysis and prediction capabilities offered by computers that were previously unable to dentists, including frontal ceph, model measuring, and visual treatment objectives. In 2003, POS included the Individual Patient Appliance created by Dr. McGann. the first customizable orthodontic appliance on the market. Featuring a wider selection of tools, including rotation brackets, torque brackets, torque/rotation combination brackets, preformed shape arch wires, and custom-welded bands, the appliance worked with IPSoft to design the perfect appliance for each patient, accelerating treatment time and eliminating the need for time consuming wire bending. Hundreds of dentists throughout the world become POS graduates every year.
Dr. Korwin applies the POS techniques to provide fast effective and comfortable treatment for patients who benefit from traditional braces. Invisalign is an excellent technique, but sometimes cannot achieve the orthodontic goals which traditional braces can. Some patients benefit from a combined technique, short term braces, and finishing with Invisalign.
MICOI
MASTER OF THE INTERNATIONAL COLLEGE OF ORAL IMPLANTOLOGISTS
The International Congress of Oral Implantologists (ICOI) was founded in 1972. With over 12,000 members, the ICOI is the world’s largest dental implant organization for specialists and general dentists. 10% of the membership are awarded Fellows and Masters of the ICOI, and have pursued voluntary programs that evaluate and examine their knowledge of implant dentistry by experts in the field. They have been recognized by their peers and are local leaders as well as global ambassadors. They have accepted a lifelong commitment to learning. ICOI’s Advanced Credentialing Commission recommends members, review their applications and suggests approval for fellowship status. For Mastership status, interviews by ACC is required as well as a review of cases and a written exam administered by ACC members. Documentation requirements include at least 40 implant cases of varying complexity, 100 hours of implant specific education, and letters of recommendation from other implantologists.
MAGD
MASTER OF THE ACADEMY OF GENERAL DENTISTRY
The Fellowship and Mastership designations are two of the most rigorous continuing dental education programs today. A general dentist who is a “Fellow” in the Academy of General Dentistry (FAGD) has been recognized by other general dentists as a leader and example to other dentists of the importance of quality continuing dental education to patient care. A general dentist who has earned the designation “Master” of the Academy of General Dentistry (MAGD) has completed a structured and demanding set of requirements involving all the dental disciplines
To attain Mastership, members must first be Fellows in the AGD. Then dentists must earn an additional 600 approved continuing education credits, meeting minimum requirements in certain dental disciplines, of which 400 hours are hands-on courses. Thus, a Master of the AGD has taken a total of 1,100 hours of continuing education. A Master has studied 16 disciplines in dentistry, such as periodontics, orthodontics and implants.
How FAGD or MAGD Benefits Patients
Fellows and Masters of the AGD follow a lifelong pursuit of continuing education to provide the highest quality of dental care to patients. The award symbolizes the professional responsibility of general dentists to remain current in their profession and reminds each member of the dental profession to continue to learn new techniques for their dental practice. Every dentist who applies for the Fellowship or Mastership Award has their application reviewed by the AGD Council on Dental Education to assure that the high standards of the AGD are met.
How AGD Membership Benefits Patients
When a dentist has achieved the Fellowship or Mastership Award, patients can be assured that their dentist is dedicated to providing the finest care in general dentistry. There are 175,000 dentists in the United States. Of the more than 35,000 members, more than 14,000 members of the AGD have become Fellows and 2,200 have gone on to receive Mastership. The AGD requires all of its members to take at least 75 hours of continuing dental education every three years. Dr Korwin has taken between 150 and 300 hours of continuing education per year.
Invisalign Preferred Provider
CONGRATULATIONS FROM ALIGN TECHNOLOGIES
Invisalign has announced that Dr. Korwin has exceeded Invisalign’s Proficiency Requirements achieving the status of an Invisalign Preferred Provider.
Three Ways Your Dentist Can Save Your Life. (Three)
THE ACID TEST
Excessive acid in the mouth can lead to more cavities. You can do an a home test with a pH strip (ask us for it, or buy one in most drugstores): A reading lower than 6.5 indicates unhealthy levels of mouth acid found in your saliva. Tooth enamel will dissolve at a pH of 5.5. To balance out pH levels, increase your calcium, magnesium, and potassium intake and brush with a pH-neutral toothpaste, which won’t cure the problem but will minimize the damage. We can treat the problem with minimally invasive dentistry including dental sealants.
Three Ways Your Dentist Can Save Your Life. (Two)
DIAGNODENT
Traditionally dentists search for cavities by poking around a patient’s mouth with a pointy metal hook (an explorer). Turns out, prodding teeth with sharp instruments may not be very diagnostic. Instead. we now use Diagnodent, a laser light that can illuminate dead or decaying tissue on teeth. It can also help catch future or present cavities . Now we can detect something developing before we can find it with an explorer or X-rays. When that happens, the tooth can be rebuilt before a deeper cavity can form.
Three Ways Your Dentist Can Save Your Life. (One)
THE VELSCOPE
If you’re old enough to be sexually active, you’re old enough to be screened for oral cancer says Brian Hill, a cancer survivor and founder of the Oral Cancer Foundation. In most cases, that means having your dentist look for any discolored or misshapen lesions in your mouth, But if you use tobacco, drink heavily, or have had persistent human papillomavirus (HPV) infections (a leading cause of oral cancer among men), ask us to search your mouth with a Velscope whose blue light causes possibly cancerous lesions to appear black.
Why Does My Tooth Hurt After a Filling?
Like other parts of the body, if teeth are injured, there are nerves that say ouch.
When you have a cavity that has developed in your tooth, the tooth nerve responds. It can become hyper sensitive and say ouch more quickly, and last longer . A cavity is produced by an infection in the tooth. The acid produced by the germs eat away at the inside until a hole develops.
A filling really is like a biopsy on a tooth. The bad part is completely removed, (we don’t send it in for analysis though), and an artificial replacement is put back. The dentist’s skill combining art and science, makes the tooth look like new right away. Like any body injury, though, the tooth longer to recover, and the nerve, which may be slightly damaged, may be sensitive for a time. As it repairs, the tooth gradually feels better.
Sometimes the nerve doesn’t recover and then the tooth is treated with a root canal or extraction.
Preventive dentistry is the science of repairing problems before you have a toothache or tooth sensitivity. Treat cavities when they are small and the chance of a tooth ache, root canal or extraction drops to near zero.
Why use alcohol containing mouthrinses when there are effective non alcohol mouth rinses available OTC?
Some studies have pointed to increasing evidence that alcohol based mouth rinses may be harmful when used repeatedly.
Ethanol in mouthwash is thought to allow cancer-causing substances to permeate the lining of the mouth more easily and cause harm.
Acetaldehyde, a toxic by-product of alcohol that may accumulate in the oral cavity when swished around the mouth, is also believed to be carcinogenic.
Table 1. Alcohol content of some commercially available mouthwashes (1)
Mouthwash Ethanol concentration (%)
Listerine Antiseptic 26
Listerine Cool Mint 22
Listerine Tartar Control 22
Listerine Citrus Fresh 22
Listerine Smooth Mint 21.6
Cepacol Mint 15
Cepacol 14
Savacol Original 11.5
Savacol Freshmint 9.5
Listerine Whitening 8
Neutrafluor 220 7
Plax 6
Peroxyl 5.5
Neutrafluor 900 5
Natural Dentist 0
Dentyl 0
Biotene 0
Oral B 0
Amosan 0
Neutrafluor 220 Ethanol Free 0
Fluorocare 200 0
(1)The role of alcohol in oral carcinogenesis with particular reference to alcohol-containing mouthwashes
MJ McCullough, CS Farah, Melbourne Dental School, The University of Melbourne, Victoria.
School of Dentistry, The University of Queensland, Queensland, Australian Dental Journal 2008; 53: 302–305
Maintaining Dental Health When Hormones Change during Menopause
Peri-Menopause, Menopause & Post-Menopause
During menopause, you may experience changes in the way things taste, be more sensitive to hot and cold foods, and feel as if your tongue and gums are burning. You may take new medications that cause dry mouth as a side effect. Most importantly, declining levels of estrogen can lead to loss of bone (osteoporosis and osteopenia), which includes the bone surrounding your teeth as well. Also, medications taken to prevent bone loss make more frequent cleanings necessary.
Why not treat these symptoms with oral care products from the store?
Because some over the counter mouth rinses and toothpastes can actually aggravate these problems – and should be avoided.
If you are experiencing any of the conditions mentioned here, at any life stage, I personally invite you to call my office and make an appointment. Together, we’ll work toward customized solutions that will provide you excellent oral health and comfort for your lifetime.
Maintaining Dental Health When Hormones Change During Pregnancy
Pregnancy
A higher level of progesterone can cause exaggerated gingivitis from approximately the second month to the eighth month of pregnancy. Though you take excellent care of your teeth, you may still find that your gums bleed when you brush. For some women, gum tissue becomes so sensitive that an irritant (such as plaque) can make it swell into a large, mostly painless bump (called a pregnancy tumor) that usually goes away within a few months after delivery or can be removed by your dentist if it becomes bothersome.
Whether or not you experience gum sensitivity during your pregnancy, make a dental hygiene visit part of your prenatal care, as periodontal disease has been linked to pre-term birth and low birth weight babies.
Maintaining Dental Health When Hormones Change with Contraception
Taking Oral Contraceptives
Swollen or bleeding gums commonly occur in women taking oral contraceptives. If your symptoms become uncomfortable enough to seek your dentist’s help, be sure to let her or him know specifically what medications you’re taking. Some antibiotics that dentists may prescribe for these symptoms actually decrease the effectiveness of oral contraceptives. So communication with your dentist is key.
Maintaining Dental Health When Hormones Change Monthly
Monthly Cycle
Days before menstruation, you may notice red, swollen or bleeding gums, maybe a sore inside your cheek or a canker sore around your mouth. Thanks to a boost in progesterone, which dilates blood vessels and increases inflammation, some women experience gingivitis symptoms just before their periods or at ovulation. The good news is that these symptoms frequently clear up once the period starts, and there are ways of protecting gum tissue and lessening the irritation if symptoms reoccur every month.
Maintaining Dental Health When Hormones Change in Adolescence
What are the life stage changes in hormone balance that may negatively affect your oral health? And what warning signs can you look for?
Although Women tend to take better care of their teeth than do men, they do not have significantly better oral health than men do. In fact, women account for about 75% of office visits for periodontal care. Part of the unique challenge for women is that hormonal changes cause changes in oral health – directly affecting gum tissue and bone health, and often causing a host of uncomfortable symptoms.
In my practice, I’ve had the privilege of helping many women achieve and maintain not only overall dental health but also relief from the oral symptoms that hormonal fluctuations can bring on.
Puberty
During puberty, an increase in progesterone and estrogen causes more blood circulation to the gums, which may swell and bleed even though you brush and floss regularly at home. Gum tissue becomes far more sensitive at this time, more tender, and easier to irritate. This increased irritation tends to go away as puberty progresses; however, your dentist can certainly help if symptoms become bothersome at this time.
Ciao Cavities, drink Coffee
Espresso and Americano drinkers delight
Brush, floss and drink coffee! Italian researchers from the University of Pavia credit a compound called trigonelline, (which gives coffee its aroma and bitter taste), for having both antibacterial and anti-adhesive properties. This helps prevent dental cavities from forming by preventing the cavity causing bacteria Streptococcus mutans from adhering to teeth.
See
http://men.webmd.com/features/coffee-new-health-food?page=3
and
http://pubs.acs.org/doi/abs/10.1021/jf010958t
for further information
Invisalign
Dr. Korwin is an Certified Expert Invisalign Dentist Serving Middletown, Red Bank, and surrounding areas.
Invisalign works extremely well with our many satisfied patients. Some treatments are a short as three months, while some complex cases may take as long as two and a half years. The results are phenomenal. Some orthodontic cases may be faster when combined with traditional braces, either before or after Invisalign. Ask us for a free Invisalign evaluation.
Flossing…it’s not just for gums anymore!
Flossing Adds 1.5 Years to Your Life Expectancy!
Inflamed gums result from not flossing. Recent research studies found that chronic inflammation leads to the release of oral bacteria into the bloodstream, a possible explanation for having gum disease and the higher incidence of heart attack, stroke and other age-related diseases. Researchers at Kiel University in Germany found that the bacteria which cause inflamed gums enter the blood stream and collect in the blood vessels known as the coronary arteries that feed the heart. This contributes to blockages, or plaque buildup that occurs there.
Floss daily to remove the bacteria that cause decay, bad breath, gum disease and reduce the incidence of stroke and heart disease.
VELscope Comprehensive Oral Cancer Tissue Exam Screening is Free
As a service to our patients we do not charge the customary $65 fee for the Velscope comprehensive oral cancer tissue exam, plus, we provide it at every 6 month visit.
Oral Cancer is a disease that can be tamed. If the disease is discovered in late stages, the 5-year survival rate is only 20%-to-30%. But when discovered in early stages, the survival rate leaps to 80%-to-90%. By supplementing the white light oral cancer dental exam with the VELscope system, I can see cancerous and precancerous lesions that might not be apparent to the naked eye. The VELscope system we use is the first product cleared by the FDA and Health Canada to see the earliest lesions.
To follow up on a positive finding we use Oral CD-X sampling and submit slides for evaluation and feedback on suspicious sites.
Overcoming Dental Anxiety Organically
When you think of the dentist how does your body react?
Do you feel nauseous and short of breath? Do your palms get sweaty, your heart race, your hands shake. You are reacting the way your ancestors did when they were faced with a lion, tiger or bear, oh my!
Adrenaline is the hormone that saves your life when you are physically in danger by giving you the energy to make a run for it, or to fight.
At the dentist, however, none of these reactions are useful to you, so the energy only makes you more nervous.
Sedation is a wonderful tool to overcome nervousness.
When you can’t have sedation, exercise can burn off this adrenaline boost and help calm you down.
Do a few push ups, take a walk, climb stairs two at a time.
If you can’t get away or must sit or stay in one place, do isometrics in place by first tensing and then relaxing your muscles. Do seated leg raises; clasp your hands in front of your chest and press together; while standing 3 feet from a wall, lower yourself toward the wall and repeat.
When your heart pumps faster during exercise, the adrenaline dissipates along with the anxious feelings. You’ll be able to deal with dental anxiety more adaptively when the nervous energy has burned off.
Calmistry for Sleep
Have you run out of sheep to count?
For those of us with insomnia, the new Calmistry Sleep program was designed to help you reorient your mind and body to be able to fall asleep easily, sleep deeply through the night and awaken in the morning refreshed and ready for your day Just play the Calmistry Sleep tracks and settle in for the best night’s sleep you can imagine!
Available in our office, and online, buy a CD or download tracks from iTunes, digistation.com, etc.
Calmistry for Dental Anxiety
The missing link to anxiety free dental visits. Imagine finally overcoming your dental fear.
Using guided relaxation, visualization, and gentle but powerful positive affirmations, Calmistry helps create a peaceful, resourceful internal state that you can access anytime – even at the dentist’s office! Listen at home or at the office. It’s completely safe, and absolutely drug-free (a great alternative or accompaniment to sedation dentistry).
Calmistry is available in our office, online at www.Calmistry.com, and will be introduced in the 2010 Henry Schein catalog, the largest North. American and European medical and dental supply distributor.
Gentle Care Trumps Sedation
For many patients a calming touch, genuine concern, and skilled, rapid care eliminates the need for sedation.
It is always an choice for the patient, but sometimes, sedation can be sidestepped with a fantastic result:
“Dr. Korwin was great,I can’t believe I had a tooth extracted etc,etc, without being sedated.
Thanks Dr. Korwin.”
N.F. Eatontown, N.J.
Why take Blood Pressure at the Dentist?
Out of sight, out of mind.
Our goal is to help our patients maintain and stay healthy. With a busy lifestyle, monitoring blood pressure can sometimes take a back seat. Elevated blood pressure causes systemic disease and shortens lifespan. When we take our patients blood pressure we can flag changes, and refer to a medical professional to help control the problem. Taking blood pressure (at no charge) on all our patients has helped us find many, many, cases of previously unknown elevated pressure. Few dentists do this, but we all should. Some patients have “white coat syndrome” or anxiety when they go to any dental or medical office. In most cases elevated pressure of 10 mm or less can be a healthy response to anxiety. When pressure is elevated by 30 to 50 or more in some cases, then a serious underlying condition is present that should be medically treated. In some cases blood pressure can be so high that dental procedures cannot be provided until the pressure is lowered. Screening for blood pressure is a dental provider’s responsibility and a community service we have provided for decades.
Teeth Whitening
Almost all teeth, even the darkest ones, can be whitened.
Whitening occurs when a peroxide (carbamide or other) is applied to stained areas. Just like bleach in the washing machine, stains are cleared. The darker the tooth color, the longer the whitener must be applied. To minimize sensitivity, the percentage of peroxide is variable, as well as the amount of time the whitener is applied to the teeth. We also use a desensitizer before the whitener for maximum comfort during the treatment. Techniques that involve paint on, tray applied, and light or laser boosted, are all effective. The secret is in the amount of peroxide, the length of time it is applied, and how effective the application technique is. Power whitening is a combination of home and in office whitening. The results are dramatic. We usually whiten teeth after Invisalign for beautiful cosmetic results.
If a tooth has pre existing damage, then sensitivity will likely occur, so cavities and cracked teeth should be fixed before whitening.
Invisalign Vs. Lip Fillers
Painless, easy to maintain, Invisalign creates a fuller natural lip.
Facial appearance is changed easily by repositioning the teeth. Teeth support the lips, and when they are moved they can do the same job that injectable lip fillers can do. Lip fillers on the other hand require repeated injections. Invisalign repositions the teeth so they naturally fill out lip contours erasing wrinkles and smokers lip lines.
Once the teeth are in position, they continue to support the lip without fading. Consult your dentist for this wonderful approach.
Tooth Pain
Painful teeth only get worse when left alone.
Although the pain source can be obvious, sometimes, diagnosis can take time. Pain can appear to come from sinuses, cracked teeth, changes in bite, changes in toothpaste and mouth rinses, clenching and stress, store bought appliances like whitening trays and bite guards, and at the end of the list, cavities, gum disease and tooth fractures. Surprisingly enough, a large number dental complaints do not come from teeth! See your dentist to solve the puzzle.
No Drill Dentistry
Air Abrasion is Fast, Effective, and Painless
Quick, pain free, conservative and complication free, I have been using air abrasion technology without the need for numbing the tooth for two decades. Sometimes, the cavity is so deep, I wonder to myself, why doesn’t it feel uncomfortable, but it is really painless. I always ask the patient to tell me if there is the least bit of discomfort. They say to please continue, and amazingly, we finish the procedure and the patient is happy and leaves without the saggy lip appearance typical of local anesthetic. I wish I had this for myself when I was younger. It is the dentist’s and patient’s dream procedure.
Dry Mouth- The Undiscussed Arid Zone
Avoiding New Cavities
Dry mouth will cause cavities even when you are the best brusher ever. Some patients will develop a whole crop of new decay, especially when they are taking new blood pressure or other systemic medications. Let your physician know if you are getting recent new cavities. This problem is very avoidable with proper diagnosis. Don’t be a stranger to your dentist, you are always welcome.
Laser Gum Treatment
New non surgical gum treatment with a laser is fast and painless.
Some gum problems can be treated with an high tech laser. During this radically advanced care, the bacteria causing the gum infection are vaporized, leaving a disinfected space for the body to heal more rapidly and more effectively. The scarred lining of the crevice or pocket is eliminated as well, allowing healing to proceed more rapidly than with any other technique. Although some gum problems are too advanced for this therapy, mild to moderate periodontal problems respond very well. We have witnessed 100% improvement in some treatments with this rapid, comfortable process.
Unnecessary Root Canals or Extractions
A toothache is not always from a tooth.
Of about 50 patients who had appointments for dental pain in the last 4 weeks, half of the patients were convinced they needed a root canal treatment. A complete diagnosis was undertaken. This included a full history, X- ray, review of prior x rays, palpation of the area, occlusion (or biting) slight percussion (tapping), a gentle air stream, vitality testing, photography for fractures, and comparison to 30 years of similar clinical histories.
Dental X- rays usually showed cloudiness or calcification of the maxillary sinus on one or both sides. This together with marked tenderness in the maxillary tuberosity distal to the root of the last molar indicates a history of sinus inflammation. When the lining of the sinus is thickened from chronic allergies or infection, the ostium (or opening) which drains fluid from the sinus becomes clogged like a stopped up sink. The fluid does not drain, it produces pressure in the small sinus, and the pressure produces pain in the nerve endings within the sinus. This fluid can then become secondarily infected. The roots of the upper teeth are commonly in or near the sinus, so pain in the area is referred, or seems to come from these teeth. The pain actually comes from the sinus itself. The thin bony wall of the sinus expands under pressure, the teeth change position slightly, and then the lower teeth start to ache as well. The correct treatment should be directed to the sinus area. Clenching and grinding your teeth when they are aching makes the problem feel worse and harder to diagnose. Pathognomic for sinus infection diagnosis is a history of increased pain when using stairs or when bending the head down and up. Root canal pain usually doesn’t change with head position, whereas sinus pain changes with fluid level changes (like a carpenter’s level).
Since it feels like a toothache, the dentist is the first call. Without time spent diagnosing, everyone will agree a root canal should be done. Teeth that are intact, cavity free and not fractured might be root treated or even extracted. Unnecessary root canal treatment can be avoided by thorough diagnosis and if appropriate, referral to an Ear Nose and Throat physician. Clenching pain can be treated with a properly fitted professionally made night guard or bruxing appliance.
With proper management the problem will resolve, and the patient soon feels better. New Jersey is a prime area for sinus involvement, and these changes are clearly visible on a large percentage of patients x-rays.
The Dental Detective: Complex Problems Take Time to Uncover
A dental problem can be misdiagnosed. It occasionally may take time to find the true cause.
Patient C.. was confused and uncomfortable with facial pain that seemed to shift from left to right and come and go. It was so uncomfortable that she consulted 5 dentists and 2 physicians to no effect. She had multiple root canals and even resorted to extracting some teeth without pain relief. C.. was then referred to me by a relative who was a patient in our practice. When C.. arrived, she was pale and sleepless and maximally uncomfortable. After dental examination, records and diagnosis, the proper solution became apparent. Her teeth were slightly misaligned and she was unconsciously clenching her teeth. The excess pressure of clenching together with her misaligned bite was making her jaw muscles spasm, causing the discomfort. After reviewing the source of the problem, she was instructed to reduce daytime clenching, her bite was smoothed in the appropriate locations and within 2 weeks C.. had a 95% reduction of pain. At a reevaluation, her facial color was back to normal and she reported sleeping well again for the first time.
Dental Face Lift
Non surgical face lift.
Did you know that crowded or crooked teeth can eventually cause wrinkles around the mouth? Treatment with Invisalign or braces repositions teeth so the lips have more support. The slight dental stretch evens out the lip so wrinkles disappear, or even better, never even start.
Denture Settling
Dentures can make you look young again.
Over time, bone that supports dentures fades away. As the dentures settle, the mouth contracts and wrinkles appear, producing “smokers mouth”. Relining dentures, or supporting them with implants can reverse the aging effect caused by diminished bone around the jaws.
Sedation Dentistry
I love how everything is explained so well. I’m never scared to come to the dentist when I know I’m coming here. – Miranda F. USCG, Highlands, NJ
“Thanks to Dr. Korwin along with your staff for making my experience as an “apprehensive patient” comfortable and satisfied. You did a super job, and I would strongly recommend you to anyone I’d consider a friend.” Richard.O. Middletown, NJ.
“After my first visit to Dr Korwin’s office and after 30 years of fears, I’m not sure who I am. I am leaving this office laughing and yes, making my next appointment! To anyone who is even afraid of the novocaine needle, I felt NOTHING! Every dentist should train with Dr. Korwin and I bet the world would have beautiful smiles.” F.V., Atl. H., N.J.
Extractions
“(5 stars) WOW - What a great dental office
I was on a mission to find a great dentist in New Jersey. I have been a resident of NJ for the past four years and continued driving back to Queens, NY to my dentist of 24 years. The ride was getting to be too much so I started researching NJ dental offices on the internet. After coming across Dr. Korwin’s website, I was so impressed with him that I just had to give his office a try. My first visit was quite extraordinary. I met Dr. Korwin and found him to be kind, professional and extremely knowledgable. I just knew by speaking to him that he was going to be a great dentist. His hygenist and dental assistants are outstanding. His office is immaculate, hi-tech and comfortable. The ladies in the reception are are so pleasant and accommodating. I had to have oral surgery and was amazed with the level of professionalism this office displayed. I felt so at ease and relaxed. I was treated very well and the Dr. did a wonderful job. The office even called me the next day to see how I was feeling. I never thought I could replace my former dentist of 24 years but now that I have met Dr. Korwin I am pleased to say that I now have a new dentist.” Christine B., Middletown, N.J,
“Took your time and did a good job. Great Job!! Keep up the good work!” – Deja K. USCG, Highlands , NJ
When extractions are performed with patience and skill, they can be painless during and after the procedure. Our patients tell us again and again,”…that was easy Doc.” And “…I feel great, thanks for calling!
Dentist Red Bank NJ
Expert dental care in your neighborhood by a credentialed experienced dentist offering Invisalign, Orthodontics, Sedation and Anxiety Free Dentistry, Implants, Cosmetics, Whitening, Veneers, Sedation, Calmistry, TMD, Invisalign and Braces, Kodak Digital X Rays, Laser Non Surgical Gum Treatment, Air Abrasion, Porcelain Inlays, Onlays, Crowns, Root Canals, Painless Relief from Toothaches and Cavities
Dentist Middletown NJ
Expert dental care in your neighborhood by a credentialed experienced dentist offering Invisalign, Orthodontics, Sedation and Anxiety Free Dentistry, Implants, Cosmetics, Whitening, Veneers, Sedation, Calmistry, TMD, Invisalign and Braces, Kodak Digital X Rays, Laser Non Surgical Gum Treatment, Air Abrasion, Porcelain Inlays, Onlays, Crowns, Root Canals, Painless Relief from Toothaches and Cavities
