Metro Dentist

Sara Isenberg has joined metrodentist.net as our technical advisor. Sara will be posting articles about using Social Media -- including Blogging, Twitter, LinkedIn, and Facebook -- to bring more traffic to your website!

Sara is a Web Consultant & Project Manager. She specializes in providing services to web developers, businesses, and individuals who need help with web, social media (blogging, LinkedIn, Facebook, Twitter, and more), email marketing, software application, and other projects.

Sara has extensive experience in the corporate software industry, much of that as a technical account manager where she managed technical relationships between software engineering teams and strategic partners and clients. Sara began working as an independent project manager in 2005. She appreciates both the details and the big picture, and gets satisfaction in bringing organization to any software or business endeavor. Sara particularly enjoys bridging the communication between the technical and non-technical.

Sara was recently listed by We Magazine for Women in 101 Women Bloggers to Watch for 2009 .

For more about Sara, see http://www.saraisenberg.com/

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Invisalign

Invisalign Clear Braces allow a patient to straighten their smile without wearing braces. Using a series of clear plastic aligners, a patient can improve, straighten and reduce crowding without having to resort to traditional braces that involve brackets and wires. Invisalign positioners are virtually invisible! This new technology has revolutionized the straightening of teeth and made the process more acceptable to adults. No longer do most patients need to be self conscious while they undergoing orthodontic treatment. If you are interested in finding out whether Invisalign is right for you why not schedule a consultation with one of our participating Metro Dentists offering Invisalign.
Dental Insurance Basics

Dental Health Maintenance Organization (DHMO) Insurance
This is typically the least expensive way to go for the consumer. Most dental services are provided by dentists who will provide specific treatements and services at no charge (some services may require a co-payment.)

Indemnity Insurance
This plan typically allows the consumer to go to the dentist of their choice. They generally pay a portion of the dentist's fee or a set dollar amount. The Dentist then will submit the invoice for payment. The payment may be made to the insured member or directly to the dentist. You will need to pay the difference between the full charge for the service provided and the amount paid by the insurance.

Preferred provider organization (PPO) Insurance
This is typically less expensive than the Indemnity Insurance. This type of insurance tries to take advantage of the benefits of the HMO by providing a network of dentist to chose from or you can decide to go to a dentist of your choice outside of the network. When you seek treatment from dentists outside of the PPOyou are will pay higher deductibles and/or co-payments.
Cosmetics Problems - Enhancing your smile

C. Cosmetics Problems - I don’t like my smile
People often feel their smiles have room for improvement. Their cosmetic problems often fall into some a small number of categories. See which of the numbers below fits your complaint and then see what can be done about it.
1.My teeth are too dark or yellow
2. My teeth are crowded
3 .my teeth are worn making my smile look tired
4. My teeth have spaces between them
5, I don’t like my silver fillings
6. my teeth look uneven

1.       My teeth are too dark or yellow.

Many smiles can be brightened by whitening procedures. These can be done at home or at the dentist. Using peroxide based formulations smiles can be made many shades brighter and these refreshed smiles can make their owners look both younger and more attractive.

Some patients also can solve this problem with porcelain veneers that can brighten even the most stubbornly discolored smiles. This method is especially good for teeth that have mottled enamel or display a yellow color and excessive incisal wear.

2.       My teeth are crowded .

Problem Smiles with crowded teeth can often be fixed with orthodontic tooth movement. This treatment is not just for kids! Invisalign clear braces are a very popular and relatively affordable way of straightening out smiles! Often crowding or poor tooth alignments can be fixed in less than 6 months of treatment. Since the aligners used are clear, no esthetic hardship will be suffered while undergoing this treatment.

For those who need ‘instant gratification’, porcelain veneer s can also be used to treat poor alignment of teeth and a new smile can often be achieved in a month or less.

3.       My teeth are worn making my smile look tired.
Porcelain Veneers are a great way of restoring the edges of worn anterior teeth. At the same time they can correct minor crowding problems and brighten a smile. Often 6 to 10 veneers need to be done to achieve the best result and their relatively high cost can be an issue for some patients.

4.       My teeth have spaces between them.
Spaces between teeth can be treated a number of different ways depending on a patients budget and the size of the spaces. For small space simple bonding or porcelain veneers can be great ways to eliminate unwanted spaces. Simple bonding involves adding some composite material to the sides of teeth to close diastemas. If it is used properly simple bonding can enhance smiles with minor spaces and looks natural.
For some smiles with multiple spaces between teeth either porcelain veneers or orthodontic tooth movements may be a better treatment modality.   If you like the appearance of your teeth but just want your spaces to disappear orthodontic tooth movement probably is the best alternative since it leaves your teeth in their natural state and if a retainer is used, the results can last a lifetime.
5.       I don’t like my silver fillings.
Lots of patients don’t like their silver fillings. Some do not like the way they look and some have doubts about their safety. Often times silver fillings can be replaced with good looking tooth colored restorative materials. If fillings are small silver restorations can be replaced with bonded composite fillings. If the silver fillings being replaced are large often a tooth colored onlay or crown may be recommended.

6.      My teeth look uneven.
When the edges of the anterior teeth do not line up often patients describe this as uneven. This problem can be addressed in a number of ways including simple bonded additions, porcelain veneers or orthodontic tooth movement. Usually a consultation with an experienced cosmetic dentist is needed to determine which option is best for you.
Dental Tips of the Week

Brushing alone is usually not enough to ensure that a person won’t develop periodontal disease. Since 40% of a tooth’s surface is not reachable by tooth brushing, some sort of interproximal cleaning device should be used on a regular basis. Floss, Stimudents and small interproximal brushe , and all work well. It doesn’t matter as much which method is chosen, but what counts is that one of these is effectively used on a regular basis.Regular and frequent professional cleaning at the dentist also help, since they remove any accumulations of plaque and tarter that have been missed by a patient by their daily homecare regime. Also a patients home care can be checked at frequent cleaning visits and the hygienist will encourage them to do better. Human nature being what it is, patients often perform their best home care immediately before and after their checkups.
Dental headaches

Tension headaches, Migraines and TMJ Face Pain caused by Excessive Teeth Clenching or Grinding

1. I wake up in the night or in the morning with headaches
2. I wake in the morning with a sore jaw
3. I have late afternoon headaches
4. I get migraines
5. I have face pain and was told it is called TMJ.
6. I grind my teeth and:
     a. I broke a tooth
     b. My teeth are wearing down and/or chipping
     c. My partner wakes at night from the sound of my grinding

Excessive and prolonged teeth clenching or grinding is a major factor in causing head pain. Because of this the muscles in the head, neck and shoulders become distorted from excessive clenching pressure, the nerve bundles in the muscles react by causing pain. A wonderful solution to resolving this is with a small, comfortable FDA approved dental device called the NTI that is worn at night. The design of the NTI dramatically decreases clenching and or the damage from grinding. Visit www.headachehelper.com for a fuller explanation.

The NTI is a custom-fitted mouthpiece worn at night to keep people from clenching their teeth in their sleep. The FDA-approved guard prevents tension headaches, TMJ face pain and can reduce migraines for 80% of the people affected by Migraines.
Dental Hygiene

Dental Hygiene Issues

Early treatment for periodontal disease is primarily ‘non surgical’ and involves a combination of improved oral homecare, more frequent recall and topical applications of arestin in pockets. These measures can be extremely effective at halting the progress of periodontal disease and can ultimately result in healing of the periodontium (supporting structures to teeth). Of course some patients do not respond to these measures alone and require root planning and even more traditional osseous flap surgery to head off periodontal disease. Early detection of periodontal disease can allow more minimal treatments and can reverse potentially destructive consequences such as bone or tooth loss.
Second Opinion - Dentist
      1.   Why would a patient seek a second opinion? What are the main reasons they want your opinion, or the typical questions they ask you? It is not uncommon for patients to visit a dentist for second opinion. Sometimes they need a confirmation about a diagnosis they have received. Other times they have been given a treatment plan by another dentist that will be costly and time consuming.   Patients often show up for a second opinion about particular tooth or bridge that has been bothering them and they would like my thoughts about their particular situation. Usually they have already consulted another dentist about their problem, but are not entirely satisfied with what they have been told. For those patients who have been to a prior dentist and received an extensive and costly treatment plan, usually they would like to know my thoughts about what has been proposed and want to explore other alternative solutions.
2. Do you personally encourage your patients to seek second opinions if you think it’s necessary? Please explain. I encourage a second opinion is if I have presented a treatment plan and a patient seems uncertain about what I am proposing or if they are having trouble committing to my plan. I am always more comfortable moving forward with a procedure if the patient and I are on the same page. If they seem uncertain about what I have proposed, then the best thing is for them to seek a second opinion or even a third opinion. As long no emergency treatment involved then a second opinion can be a good idea if only to reassure the patient. Often I use specialists for my second opinions. I refer patients to specialist If a tooth might have a guarded or questionable prognosis even after If I chose to treat it. In that event, I tend to suggest a visit to an appropriate specialist for a second opinion, prior to commencing my treatment.   Often it is good for me and the patient to hear a second opinion concerning a tooth or teeth that may or may not respond favorable to a given treatment. Dentists have choices to make about treatments.. Often decisions can be best determined after a consult with the appropriate specialist. The adage ‘Two heads are better than one” definitely can apply.  Another reason for a referral is that some treatment plans can involve one or more specialists. In this case a team approach is the best and usually its best to get the specialists involved early in the treatment planning.  3. Do you think some dentists are offended when a patient seeks have a second opinion? Why or why not? I am sure that some dentists are offended when there patient goes for a second opinion, but I do not believe that they are justified. Dentistry is an art and often times if several dentists have examined the same mouths, they can come up with different treatment plans. Why shouldn’t a patient seek a second opinion?

4. Are there some red flags that patients can look out for – that would maybe indicate they should seek a second opinion? (For example, being diagnosed with a large number of cavities, high cost for treatment, etc.) If a patient goes to a new dentist and is suddenly diagnosed with a large number of cavities this might represent a good reason to get a second opinion, especially if the patient was at another dentist within the last year or so and received a clean dental check up. I think getting multiple opinions is never bad when dealing with a costly treatment plan in a non emergency situation. This especially true for dental patients, since there are many different ways to treatment plan a mouth. Clearly dentists can tend to see mouths differently.

5. After a patient has received a second opinion, how should they process the information they gathered and go about making their decision on their dental care? Are there any rules on how the second-opinion dentist is to handle these situations? For instance, is it unethical for the second-opinion dentist to treat the patient? The dentist giving a second opinion is free to treat the patient, but I my opinion if his diagnosis and treatment plan are similar to the first dentist he should not discourage the patient from returning to that dentist. In general dentists are trained not to say disparaging things about a colleague. In some instances, when we disagree with a proposed treatment plan ,we can be forced to walk a fine line. Usually saying “I disagree with the other dentist’s diagnosis and treatment plan” and then explaining why, is the appropriate response.

6. What is the typical charge for a second opinion? Are they usually complimentary? If there is a charge, does the cost vary — depending on the dentist and/or what’s being reviewed? The fees for second opinions vary from dentist to dentist. In our office we do bill for our consultations.

7. What does a patient need to do to be prepared for a second opinion visit? Do they need to bring anything with them? Patients should bring any materials or papers that have been given to him by ther dentist and also ask for a copy of their radiographs. Usually I do not request they bring a copy of their records.

8. Are there times when getting a second opinion isn’t helpful or advised? Please explain. Sometimes in an acute emergency or when an acute infection is present,   getting a second opinion can be a problem. In some cases providing appropriate emergency care is the most important priority. In that case once the immediate emergency is handled, the patient should seek a second opinion if desired.

10. Any words of caution for patients who are actively looking for second opinions, or tips on how to find the best dentist for a second opinion? In my opinion, Sometimes patients seeking multiple opinions seem to be seeking a dentist who will agree with them. They seem to go from dentist to dentist in search of one who will provide them with a particular answer.   Clearly if you seek enough opinions, some dentist will agree with your own ‘pet ‘treatment plan. If you have had two or three opinions and all are in general agreement, then the consensus plan is usually the best one.
Also many consultations are about a particular type of treatment. If for example your consultation is about a possible root canal , an endodontist would be a good dentist to see. If your problem is a gum problem than a periodontist would be a an appropriate choice. If your wisdom teeth are bothering you why not go to an Oral Surgeon?

Metro Dentist

Dentistry Resource & Information

Invisalign

Cosmetics Problems - Enhancing your smile

Dental headaches

Dental Hygiene

Second Opinion - Dentist