encinodentist

Xylitol Reduces Decay

2009-07-14T10:54:00.000-07:00

Saturday, July 11th, there was an article in the Los Angeles Times, entitled "Xylitol Syrup Curbs Decay Of Baby Teeth in Study". This article stated that xylitol was much more effective than fluoride in reducing decay. Fluoride works by making the teeth stronger. Xylitol works by reducing the decay forming bacteria and therefore the lactic acid produced by the decay forming bacteria. Fluoride and xylitol can work together to give a greater reduction than either alone. The most effective form of xylitol is the gel form, applied directly to the teeth.

Cavity Contro.l

2009-06-22T09:17:00.000-07:00

What can you do if you are a high caries risk person?
Brush and floss correctly using a Sonicare toothbrush.
Limit between meal sweet snacks, especially those containing sugar.
Substitute snacks rich in protein, such as cheese
Use xylitol containg gum or suck on xylitol mints 5 times per day.
Brush 2 times daily with Prevident Plus toothpaste ( 5000 parts per million fluoride)
Get a fluoride varnish treatment for all of your teeth every 3 months
Use MI paste several times daily on teeth (this paste contains calcium and phosphate)
Have sealants placed on any molar unfilled teeth.
Use a baking soda rinse (2 teaspoons in 8oz of water) 4 t0 6 times per day
Get BW xrays every 6 months until have no caries

Dealing with Decay

2009-06-11T04:23:00.000-07:00

Everyday I see patients with cavities. Usually, if they have been coming regularly to their check=up appointments, these lesions are small. But sometimes, all of a sudden, they have huge cavities everywhere on the root surfaces. Things change and now they are at extreme risk. They may have started taking medication that dries up the mouth. Maybe they had a change in diet. They may have started drinking a diet drinks or Gatorade.Maybe they stopped using fluoride toothpaste or brushing with the Sonicare. Maybe they never flossed. Anyone of these factors could cause a problem but several at the same time can definately cause cavities to happen. Next blog is what you can do if you are at extreme risk.

CAMBRA

2009-06-09T19:37:00.000-07:00

When I went to dental school, I thought I learned everything I needed to know about cavities. Now we are having to deal with an epidemic of oral disease occuring in all ages, especially the older and younger patients. To treat the problem we need to assess each persons risk factors and then manage those risk factors to correct the problem. Both the risk asasessment and interventions are bases on the concept of altering the caries balance. The caries balance is a model where pathological factors (bacteria, absence of heathly saliva and poor dietary habits) battle the protective factors(saliva, sealants, antibacterials, fluoride, and an effective diet). With the use of CAMBRA there is evidence that early damage to teeth from dental caries may be reversed and the manifestations of the disease perhaps prevented all together.

Office Update

2008-06-30T09:07:00.000-07:00

This past weekend I completed my DOCS (Dental Organization for Conscious Sedation)course in San Francisco. It was a well organized informative session. I am excited to now have my California Permit. I don't know how many dentists have their permits, but I am proud that I have one. Now I will be concentrating on the implant course at Loma Linda. I am planning to be doing more bone grafting as the year proceeds. I was able to join the AAID ( American Academy of Implant Dentists) as a result of being envoled in the course. I thought everything would be slow this week as the 4th of July is on Friday, but we actually seem pretty busy with people wanting to get stuff done before the holiday.

Updating the blog

2008-05-29T14:28:00.000-07:00

Since I last wrote in the blog I have been attending many classes in the dental field. I attended a 4 month mini-residency in Dental Sleep Medicine at UCLA taught by several doctors in the field. The course director was Dr. Dennis Bailey. I really learned alot. Many people dignosed with sleep apnea ( closing of the airway during sleep) are not comfortable with the often prescribed CPAP machine. There are many different type of dental appliances that are designed to hold the airway open while the patient is sleeping. We learned which type of appliance to use in different situations. Most of these rely on moving the jaw forward and opening the bite. We were able to treat patients at UCLA, and it was exciting to see such a good response from the patients. I especially liked the good air appliance that Dr. Bailey has developed. Since the class I have made several of these appliances and they seemed to work really well.
In April I went to Chicago, where I took a class in oral conscious sedation given by DOCS ( Dental Oral Conscious Sedation) In June in San Francisco I will complete the training. In this class you learn about the latest drugs to relax the patient and help every patient to have a comfortable experience in the dental office. There are estimated to be 11 million people in the state of California that never go to the dentist because thet are so afraid . We are already able to use drugs to reduce anxiety that the dental appointment brings about and have found that people do alot better when they are comfortable.
I am attending the 2008, implant maxi course at Loma Linda. This is a 9 month intensive course, that allows you to do implant surgeries on your own patients at Loma Linda. It is fabulous. I have taken it before and feel comfortable placing implants where there is enough bone. Now I am learning more about bone grafting. This will be usefull where there isn't enough bone. We have guest lecturers from around the world. We also get to join the AAID (American Academyof Implant Dentistry)

Newsletter and Website

2007-12-10T14:16:00.000-08:00

We have a new newsletter that was just sent out. It is posted on our web-site www.robertacervenydds.com. It covers our new music, new chairs, dry mouth, and a few other dental subjects.

Drugs and Dentistry

2007-10-11T14:14:00.000-07:00

Most of the medications in the top 50 prescribed drugs are taken long term. The effect, in addition to the intended effect, is to cause a dry mouth. The more drugs you are taking the drier the mouth. Without saliva the patient will get cavities. Even non-prescription medications can cause a dry mouth. To help: keep sipping water, decrease caffiene, build up surface of the teeth with fluoridated toothpaste, rinses, gels, and varnish, chew gum with xylitol, and use sealants.

Drugs-- Most Prescribed in US

2007-10-01T14:28:00.000-07:00

Last weekend I attended the meeting in San Francisco of the ADA ( Amer. Dental Assoc.). There was much to see and do. One of the most attended classes covered the most commonly prescribed drugs in the US. They are according to Dr. Harold Crossley: 1. Hydrocodone with acetaminophen (generic) used to treat acute pain. Can cause dry mouth. 2. Lipitor (atorvastatin) Used to lower cholesterol. 3. Lisinopril (generic): Used to lower blood pressure. 4. Amoxicillin Used to treat broad spectrum of infections. 5. HCTZ (generic) hydrochlorothiazide Diuretic used to lower blood pressure.

MI Paste

2007-07-17T08:23:00.000-07:00

This is a new product to us and we are having patients with sensitive teeth to use it at night to promote re-calcification and reduction in sensitivity. Did you know wine is very acidic and can make your teeth sensitive? Recaldent chewing gum can raise the ph of acidic salia and thereby reduce sensitivity. High fluoride toothpaste and acidulated phosphate fluoride rinses also should be used to combat this problem.

Cerec

2007-06-07T07:50:00.000-07:00

This week we received new software to update our cerec machine. New software always makes a better product, but we need to learn how to use all the new features. This we will be doing this fall in Scottsdale.
Work itself has been busy and good. We seem to be doing our root canal treatments faster with the new process using rotary powered tools and warm gutta percha. This method we learned at the Dental Convention in Anaheim.
Dentistry these days is all about learning and keeping up with all the new developmernts.

Meetings

2007-05-29T12:59:00.000-07:00

Last Wednesday was a meeting of the dental society. There were hardly any attendees It also seemed very disorganized. When we arrived there were no reception people present to hand out meal tickets or name tags. The topic was sleep apnea and snoring. It was fascenating. We learned some new things that we can use. Thank you dental society. Maybe I should try to get involved and improve the management.

Dental Convention

2007-05-14T16:30:00.000-07:00

Last weekend, the Dental Convention was held in Anaheim. There are classes and exhibits. All the dental supply companies are showing their new wares. You see friends from school and from other classes you have taken. It is fun and educational. It can be expensive, as you end up buying lots of new things to use.

Veneers

2007-04-23T14:47:00.000-07:00

Veneers are the answer to many problems. If you want whiter teeth than bleaching can attain or if you want straighter teeth, veneers may be the answer. Pictures to follow in afew days

White Spots

2007-03-16T11:27:00.000-07:00

Little changes can make a big difference to your smile. This patient had white spots after his braces were removed. we bonded over the white spots

Snoring Update

2007-03-07T10:36:00.000-08:00

Our patient with the "Silent Nite" type of snore guard reports he is wearing it nightly. His wife reports that he is so much quieter that she can now sleep in the same room. A success story for the snore guard.

Snore Guard

2007-02-28T19:42:00.000-08:00

I haven't written for a few days because we have been crazy busy. But the latest reported from the wearer of the snore guard is that it is helping alot. It, however, is not perfect. The upper part may need to be remade because it seems loose. And it needs to be modified to open the airway more.

Silent Night Continued

2007-02-20T21:13:00.000-08:00

No news on our patient that has tried everything to keep from snoring. He took his new appliance, called the "silent night", on a trip out of town. But we don't know if it stopped his snoring.

Snore guard

2007-02-15T18:51:00.000-08:00

How does the device work? The snore guard moves the lower jaw into a forward position. This increases the three dimensional space in the airway. This reduces the air velocity and soft tissue vibration. Thus you do not snore. So far our patient reports less snoring with his device in.

Snore Prevention

2007-02-14T13:03:00.000-08:00

We have a patient that has tried alot of things to prevent snoring. Plus he has sleep apnea. he is going to try the silent night snoring prevention device. He said it was fairly comfortable when he was leaving the office, so we will see what he reports. Stay turned.

Unhealthy gums may increase cancer risk

2007-02-07T13:56:00.000-08:00

New reserch linked for the first time pancreatic cancer and gum disease. The men with gum disease seemed to have chronic inflammation. They also have elevated levels of oral bacteria which cause higher levels of nitrosamine, a known cancer causer. More studies will help figure out the mechanism, but meanwhile brush, floss and keep your hygiene appointments.

Small Changes -Big Results Part 2

2007-01-11T15:19:00.000-08:00

These photos show what a big change the removal of some gum tissue can make.

Small Change_Big Improvement in Smiles

2007-01-10T19:42:00.000-08:00

A little bonding material on the tooth around the gumline can make a big improvement in the way teeth look.

Cerec Restoration Photos

2007-01-05T18:10:00.000-08:00

I am trying to learn how to post photos we take in the office on this blog. We are going to use a photo of a cerec restoration we did today first.

We did it. It seems to work so I'm going to try for a photo every working day.

Exostosis

2006-12-14T14:03:00.000-08:00

This is a boney growth on the outside of the lower jaw or upper jaw usually in the bicuspid area. It can look like a shelf parallel to the floor or like a bump. These usually get larger with time , but do not need to be removed unless they are physically in the way of a denture or other dental appliance.

Refurbishing

2006-12-06T12:53:00.000-08:00

Being in this line of work puts alot of wear and tear on our equiptment. This year we are upgrading our delivery carts and sterilization area for starters. There are alot of decisions to be made. We need to use everything for along time, so we want to make the best selections. the next phase envolves new counter tops. Then we want to redo the waiting room. It is begining to sound like next year is going to be very busy.

Fangs

2006-11-02T12:16:00.000-08:00

For Halloween, this year we did custom reuseable fangs. For photos see our website at www.robertacervenydds.com They looked really real. To get the fangs made you do need an appointment for an impression and a trip back to the office to pick them up.

Sensitive Teeth

2006-10-09T09:27:00.000-07:00

Drinking sodas makes teeth sensitive. The sensitivity is caused to a large part because these drinks are acidic. Even diet drinks are acidic. Sodas have no nutritional value and many contain caffeine. So why are we drinking more and more sodas?

Plaque

2006-08-24T11:39:00.000-07:00

Another article in the LA times reporting on the link between dental plaque and plaque in blood vessels. If you have gum severe gum problems you may be more likely to have a stroke if you are over 50. Another reason to floss every day.

Root Canal and a Crown

2006-08-15T21:55:00.000-07:00

Today with the newsoft ware installed on our cerec machine, ( A machine that can make a crown by milling it out of a solid piece of porcelain) we were able to complete a molar root canal and a crown on the same tooth on the same day. This procedure used to take at least 4 visits. This is really good for someone that doesn't like to come to the dentist. Plus you only need to get numb once. It takes a couple of hours, but you don't have to come back.

This patient broke the tooth last week , but the tooth started to hurt over the week-end. It looked like all we would need to do would be a crown. But while we were removing the old filling we found an exposure into the pulp. The only thing at that point we could do was extract the tooth or do a root canal. The root canal seemed like the best choice, as there was alot of tooth left and would be strong enough to hold a crown.

It looked so fantastic when she was done. Yea!

Busy

2006-08-09T10:34:00.000-07:00

We have been really busy here, doing lots of cosmetic dentistry. It seems like it doesn't give me time to do some of the extras, like blog, that I would like to do, but I am very happy to to be doing what I love to do. The summer is just zooming by and it is about time for a newsletter. I may be able to give up the newsletter eventually but not yet. If anyone has any questions for me or would like a newsletter let me know.

Evidence based dentistry

2006-08-01T17:07:00.000-07:00

There is a different approach coming in dentistry. The idea is to weigh the scientific evidence before you recommend or do any thing. We aren't going to do things just because that's the way we have always done it. The most recent area this approach has been used on is topical fluoride. A whole new set of recommendation has been made according to caries risk status and age status.There may be more fluoride in your future

Smiling

2006-07-19T20:57:00.000-07:00

It is always nice to have someone leave with a big smile. The patient in question basically had all his front teeth made whiter and straighter with veneers. Beautiful teeth can make you look younger. Beautiful teeth can make you happy. He was happy and that makes the dentist happy.

Cracking Up

2006-07-18T20:39:00.000-07:00

Today I saw a tooth that was completely split all the way to the apex. This was the tooth holding one end of a bridge. The patient will have to have the tooth out and an implant placed. We also will need to place a second implant where the tooth was already missing. If a tooth doesn't heal after having a root canal, there is a chance it is cracked. I think that is what happened in this case.
I am still trying to get the paper work in my offices, at home and work,organized in the new manner. It is really difficult when you are busy working the entire day

More Than Teeth

2006-07-14T14:23:00.000-07:00

There is so much more to running an office than actually working on patients. On my way back from vacation I read the book, " Getting Things Done", by David Allen. So right now I am in a frenzy of reorganization of my office so I will be so much more relaxed after this is done

Dental Implants

2006-07-12T22:23:00.000-07:00

It is so exciting to be able to replace someones missing tooth or teeth with a replacement tooth that doesn't affect the teeth next to it in any way. We are able to insert a a root shaped object into the bone . Let that heal . After the bone is strong, we are able to attach a crown tothe implant. it looks very much like a real tooth

Hi ho, hi ho, It's back to work we go

2006-07-10T20:59:00.000-07:00

Last week we were on vacation. My patients don't seem to like to get their teeth worked on right before a holiday, so it seemed like a good time to take off. Today was the first day we saw patients again. If someone had a true emergency, they went to the dentist that was taking my calls. There were a few people that waited or just had a problem develop over the last couple of days. So it turned out to be a pretty crazy day. We finished off our schedule by delivering an immediate denture. This means that the patient had a few very poor teeth left that we needed to extract. Yes sometimes the only thing that is availabe to us is a denture. The patient did well and amazingly enough looks good.

Holistic Dentists and Root Canals

2006-06-22T08:40:00.000-07:00

There was an article in the Sunday Los Angeles Times about some patients who were suing their former dentist for taking out teeth because they had root canals and these root canals were poisoning their systems. A successful root canal will not poison your system and will and will save the tooth in a state of health. I look at the dentists that are doing this type of treatment as quacks. I think the patients tend to look at these holistic dentists as OK because holistic dentists are also against silver fillings. Patients don't like silver fillings and organized dentistry keeps trying to say that we should all be using silver. Why use silver? Because it is cheap and lasts along time. I say lets not use silver lets use something else that looks good and also will last along time. If we have something better why shouldn't we use it? Insurance companies do not see it that way. All they seem to care about is money not the right or best treatment. It can be very frustrating being a dentist.

Root Canals

2006-06-20T15:47:00.000-07:00

When the pulp of the tooth becomes inflammed and infected, it hurts. This is a classic toothache type of pain. The treatment of choice is usually a root canal. This treatment if successful will keep the tooth in the mouth for years. Over the weekend a couple of patients, had tooth aches and on Monday we started treatment to relieve their discomfort.

Before and After Happiness

2006-06-18T17:20:00.000-07:00

The silver filling visible in this picture is broken and needs to be replaced.

Here the broken filling is replaced by a Cerec restoration milled in our office.

Frustration

2006-06-12T22:27:00.000-07:00

I am still trying to figure out how to get photos into this blog.

Plans

2006-06-07T22:45:00.000-07:00

Starting tomarrow we are going to have photos on the blog. Look for the photo of the day. the problem of the day.

Surprise

2006-06-05T22:08:00.000-07:00

Every 3 years, in our office, you need to fill out a new medical history. Today some one filled out a new medical history and it turned out they need to take pre-med before we could work on them. They had the equivalent of a heart murmer. We are not trying to be difficult we are just trying to do the right thing for the patient. In this case, it is possible to get subacute endocarditis,a life threatening disease. We had to send them home with a new prescription and a new appointment

Smiles

2006-06-01T21:26:00.000-07:00

One of the most exciting things I get to do as a dentist is really improve the way someone looks. A veneer is a covering on the front side of a tooth. It adheres by a type of space age technology. Using a veneer you can make a tooth look whiter, straighter, longer. Using a group of veneers you can change someones smile. I got to make someone beautiful today.

Stress Day

2006-05-31T22:00:00.000-07:00

We had a very stressful day because the air conditioning was not working correctly. This after noon it got quite hot inside the building and there are no windows that open. We were also stressing because the camera would not work correctly. All this makes me think about stress and how much pressure most of us are under. Many people find themselves clenching or grinding their teeth as a result. This can affect your tempormandibular joint and your teeth, causing pain and breakdown of the tissues in the joint or around the teeth. Often what is needed is a bite guard. This usually a hard piece of acrylic that is molded over one arch . If this is made correctly and adjusted right it will prevent most damage. So now you can relax.

Cerec Day

2006-05-30T22:02:00.000-07:00

Some days I am really happy and thankful to have a cerec machine. This was one of those days. We set a record, for us, of preparing the tooth, making the crown , cementing and adjusting the crown all in about an hour. This replaces preparing the tooth, making an impression, then making a temporary crown. In the past, this part alone would take about an hour. Then one would need to come back in several weeks to get the crown installed. We have finally got it. Hooray

2006-05-28T21:16:00.000-07:00

I just sent out a newsletter to all my patients. It costs to get it printed and to mail it. It seems like it would be alot easier to have a blog that all my patients and friends can access. This is my first try