Author Archives: Robert Miller

I should blog more….

Yup, I should blog more.  Google says I should.  Bing says I should. Yelp says I should.  Every social media marketer says I should.

I keep my eyes and ears open for new subjects to blog about.  I don’t want to post for the sake of posting…(like this, maybe?).  We do post to Facebook a couple of times a week with neat little tidbits and snippets that we think some of you will find interesting.

But I don’t want to bore you with yadda-yadda-yadda!

If you have a question that you want answered, and haven’t had the chance to ask us in person, please send it to us at:  info@millercomfortdental.com  or at: drbob@millercomfortdental.com.

You can also go to the Services & Care tab or the Q & A tab on our website, and there will quite possibly be an answer for you already there.

Thanks for reading, Thanks for looking, Thanks for being part of our Dental Family!

Dr. Bob, Beth, Lynda, Stacy, Amy and Anne!

Yay! The newspaper says I don’t have to floss!!!

WRONG!!!  <<<LOUD SOUND LIKE BUZZER>>  WRONG!!!

So the Associated Press (AP) put out an article that says there is no definitive proof that flossing is actually beneficial.  Wow!  And after all these years of dentists and hygienists telling you to floss!

Well, if you read the article and actually evaluate it, what the article says is that there has been no truly definitive scientific study that irrefutably proves that flossing is beneficial.  They simply evaluated 25+ articles that have been published in various journals, and concluded that the studies were not sufficient to prove the hypothesis.  AP decided that.  Not dentists, not scientists, not doctors, not proven researchers.  AP.

Well, there is no definitive study that proves that walking out in front of a semi-trailer truck moving at highway speed will kill you, but I think that the logic there supersedes “scientific method”.

There is not a dentist or periodontist (gum specialist) practicing today that will tell you NOT to floss.  A toothbrush, whether manual or motorized, will only reach what the bristles can touch.  They cannot touch between the teeth, and below the gumline between the teeth. That is where floss comes in.  It WILL reach between the teeth, and below the gumline between the teeth.
Let’s give an example.  I would suspect that you routinely wash off the top of your stove/range in your kitchen.  And I am sure you get that surface clean!  But how often do you pull the range out from the cabinets and clean the sides of the range and the cabinets?  Not often, I bet.  And when you do, it is usually pretty dirty and greasy and yucky, right?
Same thing with a brush and no floss.  Can’t get between without added effort.  That added effort is floss!

People who floss have fewer cavities between the teeth, fewer gum and bone disease problems (periodontal disease), better health, and better breath. I don’t need a study.  I have been doing this for 31+ years.  I know what works, I see it every day!!!

Please floss!  And it is better to floss before you brush than after.  That way the “stuff” you floss out is better cleansed away when you brush.  7 days a week would be phenomenal!  4-5 days a week would be great!

To steal from NIKE, when it comes to flossing:  JUST DO IT !!!!

I wouldn’t be so scared of the dentist’ office if it wasn’t for the Novocaine. Isn’t there another way to get numb without using a needle?

Not really.  At least not any methods that are dependable and repeatable.  There are some advanced technological systems that might work in certain circumstances, but the equipment is insanely expensive, and each appointment ends up being longer, with more appointments needed to complete your treatment plan.

But the good news is that the new widely used systems that we have to administer the local anesthetics are much more advanced, compared to even just a few years ago. Most patients are amazed how easy, and how different, it can be.

There are some offices that will provide care under sedation or general anesthesia, but it is usually very expensive, and comes with minor risks.  It is a great option for someone whose fear and apprehension would otherwise keep them from seeking care.

In most cases, the discomfort of receiving local anesthetic comes not from the needle, but from the speed and pressure with which the anesthetic liquid is injected.  We use a system called the Wand/STA System that allows us to provide anesthetic for an area, or in many cases just a single tooth.  The system has a computer chip mechanism that senses the backflow pressure against the anesthetic, based on where in the mouth the injection is being given.  The machine then regulates the speed of administration of the anesthetic, which greatly reduces the discomfort during and after the anesthetic process.

My dentist says I have a tooth that needs a crown, but does not need a root canal. My last dentist said I needed a crown because I had a root canal. I’m confused!

I can understand why you are confused.  So let’s break it down.
It is important to know why the tooth is having a crown placed, and the condition of the tooth before the crown is placed.  You can also go to the Services and Care section of our website, and read about crowns and root canal treatments.

We place crowns for multiple reasons.  The major reasons are:
1.  a large previous filling that has broken down or has new decay, and needs to be replaced, but there will not be enough tooth remaining to support the stresses and forces of chewing.
2.  A broken cusp or a vertical fracture in the tooth, when the exam and your symptoms show that a filling just won’t be enough.
3.  A back tooth after having had a root canal treatment, or a front tooth after a  root canal treatment where there is existing damage to the tooth structure, or a large previous filling.

There are some other reasons, but for sake of this discussion, those are the big ones.

We do a root canal treatment when the living part of the inside of a tooth is irreversibly damaged, and your symptoms confirm the need.  Many teeth that need crowns do not have symptoms that indicate or confirm the need for a root canal treatment.  This is not to say it might not in the future, but at the time of treatment the root canal therapy is not indicated.

An adult can put tremendous pressure on their back teeth when chewing, clenching, or grinding.  I have read research articles that say we can put as much as 250-300 pounds per square inch on our back teeth!  And when we are asleep, that amount can increase 6-10 fold!
We have always known that placing a crown on a back tooth with a root canal treatment is indicated to protect the tooth from those big-time forces. But now we have studies that show that the more important reason to place a crown is to provide total coverage and seal over the tooth to prevent what is called micro-leakage.  This is the infiltration of saliva, acids, and bacteria that take place over time around a filling.  If these bacteria get to the root canal seal, then the seal may fail.  This may result in a root canal therapy re-treatment, or possibly (infrequently) loss of the tooth.

So, in answer to your question:  Almost every tooth that has had a root canal treatment will need a crown, but not every tooth that has a crown will need a root canal treatment.  Each tooth will be evaluated individually, and the treatment planned, determined, and discussed with you.

Still confused?  Ask Dr. Bob at your next visit.

Radiation Information (An X-ray Say-Hey!)

It’s always in the news, always on TV.  They tell you to be careful and smart about exposure to radiation, and ask questions.  We agree. Here is some information that will help you be careful, and ask the right questions.

What is radiation, you ask?  Radiation is a form of energy in waves.  It exists on a broad spectrum, from low-frequency waves like radio waves and microwaves, to high-frequency waves like Gamma rays and X-rays. Radiation includes things such as light and radio waves.

In our context, we use “ionoizing radiation”, which means radiation that can pass through matter, and cause the matter to become electrically charged, or “ionized”.  An X-ray is really like a super-charged flashlight that passes through the subject matter, and leaves a shadow image on the film or the sensor.  Does anyone remember putting a flashlight right against your hand, and seeing the shadow of the bones in your hand? Kind of like that.  Only a lot more scientific!

We all encounter radiation each day as a matter of course from a variety of sources.  According to the United States Nuclear Regulatory Commission, the average American is exposed to about 6 milliSieverts (mSv) of radiation annually.  A Sievert is a unit of measurement used to measure radiation energy exposure.  A milliSeivert (mSv) is 1/1000 of a Sievert.  A typical digital dental X-ray provides 0.005 mSv of radiation.  That means you could have 1200 digital dental Xrays before you reach the amount of exposure we get EVERY YEAR just by living on planet Earth!  
A plane flight from NYC to Los Angeles gives you .04 mSv, or 80 times more than a typical digital dental X-ray. Mowing your lawn on a sunny day gives you more radiation than an annual set of 4 digital dental Bitewing X-rays. And we mow our yards how many times in a year?  And did you know that a fraction of potassium (a mineral we need for normal body function) is radioactive.  A banana can contain 0.0001 mSv, or 1/10,000th of a mSv.  There are radioactive compounds in soil, concrete, brick and stone.  There is radiation from outside of our atmosphere that can penetrate high-altitude places. Radon gas in homes and soil is one of the largest contributors known to contribute to background radiation.

According to the World Nuclear Association, annual exposure to 100mSv of radiation or greater caries a small but measurable increase in risk of cancer.  But below that level, the body’s cells can mitigate and heal any damage due to enzyme systems in the human body that repair damage from low-level radiation.

Dental Xray Safety and Considerations: Dental radiation technology is constantly improving, and the newest digital dental Xray systems have reduced the amount of radiation necessary to expose dental Xrays by tremendous amounts over that last 20 years.  A full digital panoramic X-ray is now equivalent to just 3 single shot exposures.  Digital Xrays have reduced the amount of a single exposure to less than 15% of that from 20 years ago, and new digital sensors reduce exposure to 12-18% of that. That means an overall reduction in radiation down to 2-3% of what was used just 20 years ago. That is nearly a 500% reduction! That is amazing!  And the computer software can then enhance and clarify the readings to give us myriad more information than ever before.

Remember, we only take the dental Xray images that we feel are necessary to maintain your oral health.  The benefit of gathering the information from digital Xrays far outweighs the negligible risk

Ask us any questions you have when you are here, and we will do our best to answer them. And for more on this topic, scroll down to our previous entry called “Radiation Conversation”.
_________________________________

Sources:
United States Nuclear Regulatory Commission
Health Physics Society
U.S. Environmental Protection Agency
World Nuclear Association
National Council of Radiation Protection and Measurements

Things happen in threes! (Or “I Have a Cracked Tooth!”)

This week, I was reminded that things happen in threes.  Three different people came in with symptoms in a tooth, and all three were determined to be cracked teeth.  And all three had different manifestations of their symptoms.  And all three are going to have different treatments for those teeth.

One even told me before I checked her tooth that she thought it was cracked.  She felt that way because she had had a cracked tooth previously, years ago, and didn’t want this one to end up like that one.
She was right.  This time, she came in early in the course of her symptoms, and I am confident that placement of a crown will solve her concerns.

But all of this got me thinking about cracked teeth, and the frustration they can cause.  Cracked teeth are a tremendous nemesis to the dental profession.  They can drive patients crazy, and they can drive us to that same crazy place.

So I wrote a Q&A response for our website.  Go to
www.millercomfortdental.com, and check it out!
It is entitled “I have a cracked tooth!”

While you are there, read some other answers.  May learn something new, may not…

Happy Summer! (If it ever gets here…)
Dr. Bob

Radiation Conversation

Another media-induced panic about dental radiation seems to be rearing it’s ugly head thanks to our media system.  The most recent nationally published article linked dental X-radiation to brain cancer.  Scary huh?

Well, what the article didn’t do a very good job explaining (actually did a LOUSY job) was that the study used the arbitrary and subjective recall memories of patients when asked a question about previous dental X-rays.  These adult patients were asked if they remembered having Xrays at the dentist as a child.  No history, no dates, no descriptions of what type of Xrays.  Then if the patient said yes, the researchers ASSUMED which Xrays were taken, and with what type of equipment. Some of these patients were 50, 60, 70 years old.  So they were asked to remember something specific that took place 45-65 years ago.  No other medical histories, family histories, or risk factors for the patients were considered.

Sounds like a well-thought research study to me…

And in the last paragraph of the article, the writer states that the benefits of proper dental xrays outweigh the minimal risk that those Xrays pose, and the writer goes on to say that this should not be considered as a reason not to have dental Xrays.  It should be considered as a reason to limit the Xrays to those needed for proper diagnosis.  Well, any dental office worth their toothpaste doesn’t take Xrays that aren’t necessary for proper diagnosis.  And without those Xrays, a complete and thorough exam cannot be completed, and patients run the risk of simple problems now becoming involved problems later.

Dental Xrays are safe.  The studies lopsidedlly prove that.  Please talk to your dentist if you have concerns.  He or she should be able to clearly and concisely answer your questions.

Brush Your Teeth BEFORE Every Meal?

Chew on This:

There are several new studies that indicate it is better to brush your teeth before you eat than immediately after you eat!  That is completely contrary to what we have all been taught for years.

I am gathering more information, and looking for the definitive article to re-post for you.  But what is now being recommended is that you brush before meals, or wait at least one hour after you eat to brush again.  This has to do with pH levels in your mouth which change after you eat.  By allowing time for the pH levels to neutralize, and return to normal, you are keeping one of the components of the progression of tooth decay in check.

We have always recommended that you brush before you go to bed.  That still holds.  It is unlikely that you would eat dinner, and then immediately go to bed, so the hour will have elapsed.  And since all of the nutritional experts tell us we shouldn’t eat after 7:00 anyway, then the time-frames should work out.  And of course we ALL listen to the experts, and NEVER snack late at night.  Right?  right?  right….yeah, right.

So for the time being, start brushing when you get up BEFORE you eat breakfast, and make sure you brush before you go to bed.  Rinsing with water after lunch or snacks is good, but if you brush, do so at least an hour after the food intake.

This weeks Ha-Ha, for those interested.  (Posted on the Miller Comfort Dental facebook page weekly):

A man went to his dentist because he had a strange feeling in his mouth. The dentist examines him and says, “That new upper plate I put in for you six months ago is eroding. What have you been eating?”
The man replies, “All I can think of is that about four months ago my wife made some asparagus and put some stuff on it that was delicious…Hollandaise sauce. I loved it so much I now put it on everything – meat, toast, fish, vegtables, everything.”
“Well,” says the dentist, “That’s probably the problem. Hollandaise sauce is made with lots of lemon juice, which is highly corrosive. It has eaten away your upper plate. I’ll make you a new plate, and this time use chrome.”
“Why chrome?” asks the patient.
To which the dentist replied, “It’s simple. Everyone knows that there’s no plate like chrome for the Hollandaise!”

I know, it’s a real groaner, but I bet you laughed a little…

Dr. Bob

Smiles and Laughter

So our office “mantra” is  Smiles should be seen, and Laughter should be heard…

This is because of more than one reason, but the main reason is we believe that going to the dentist office shouldn’t be something you dread.  I know there are very few people that will stand in line to come see us, but that doesn’t mean it should be the worst thing you do, either.

Another big reason for the motto is that we have to work here all week too!  And we want to have fun at work.  We have good people here, and one of the reasons we all get along so well is that we all have unique, if not slightly warped, senses of humor.

And can you believe someone once told me, and one of my co-workers,  that we were hard to work with because we laugh too much?  I just don’t get that one…

That being said, you should expect smiles and laughter when you are here, not condescension and lectures.

In keeping with that attitude, we will be posting a dental-related joke at least once a week on Facebook and Twitter.  Go to Facebook.com/MillerComfortDental, and LIKE us to follow us.  Can’t guarantee you’ll laugh at all of them, or any of them.  But they will at least get some kind of reaction out of you.  That I promise! And I may come across one that isn’t dental related, but too good to pass up…

This week’s entry:
Q: Did you hear about the Buddhist who refused a Novocaine injection during root canal therapy?
A: He wanted to transcend dental medication

Yup!  A personal favorite!

Dr. Bob

Old Dog, New Tricks

So last weekend was the Star of the North Dental Meeting.  This is the annual Minnesota Dental Association state convention.  It is held at the River Centre Convention hall in St. Paul.  There are many, many great continuing education speakers, in a myriad of different fields and topics.

There is a huge vendors display floor where pretty much every dental supply manufacturer and company show their latest wares, and give their best sales pitches, while giving away tons of samples and free snacks…

It’s kinda of funny (not Ha-Ha funny, but cynical funny) that the lesser known companies, or the fringe companies that are somewhat related to the dental field, but not true dental suppliers, go the way of the big Car Shows.  They hire the pretty girls and the GQ guys, dressed to the nines,  to “pull you in” to their booths, where they can sell you on their latest and greatest things.

But then the REAL dental companies have their well-trained and knowledgeable people there in force, wearing nice suits and ties, or classy business suits and dresses, and pull you in with their knowledge and expertise.

That is where I spent my time, and learned a lot about new technology, updates to previous technology, and what is still out there in the “tried and true” areas.  It is very easy to move booth to booth and compare apples to apples, and decide if we are doing what we want, or if we feel we can improve the quality of the care we provide for you here at Miller Comfort Dental of Lakeville.

It was a fun time, and I learned lots of new fun things.

Dr. Bob