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TAKING A GIANT BITE OUT OF DENTAL CONFUSION

TAKING A GIANT BITE OUT OF DENTAL CONFUSION

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TAKING A GIANT BITE OUT OF DENTAL CONFUSION

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372 pages
3 hours
Lansat:
Sep 23, 2014
ISBN:
9781628386400
Format:
Carte

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"Just as you would not build a house on sand, you certainly don't want to have your teeth restored on an unsound foundation." Runkle emphasizes how vital healthy teeth are. He introduces new-age dentistry, through which anything is possible. Runkle recognizes its connection to self-esteem and to success. "We all want to look our best. The way we look causes us to feel good about ourselves, and the way we feel is the way we act. The actions we take determine the results we get or our level of suc

Lansat:
Sep 23, 2014
ISBN:
9781628386400
Format:
Carte

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TAKING A GIANT BITE OUT OF DENTAL CONFUSION - Richard S. Runkle Dds

Acknowledgments

I would like to acknowledge and thank a group of dentists, physicians, and others who have been extremely influential in my own enthusiasm and thinking regarding the practice of dentistry and the writing of this book.

Thank you, Dr. Larry Rosenthal, for your work in practicing and teaching of cosmetic dentistry. The courses taught in New York, both the introduction and advanced courses given over the course of almost a year were extremely valuable in my grasping an understanding and application of the principles outlined in this book. Dr. Ross Nash, a master in the field, was an instructor and lecturer for us in the workshops, seminars, and clinical applications and was always a great help when called upon.

Dr. Bill Dickerson, the founder of the Las Vegas Institute for Advanced Dental Studies, teaches and lectures on like subjects, has been very meaningful, and has had a serious impact on my own philosophies and practice of dentistry.

And Dr. Hal Huggins and Dr. Thomas Levy have affected my belief, practice, and writings in the area of mercury toxicity. I have known Hal for over thirty years, and he has made a great deal of sense over this period. He has legions of followers including dentists, physicians, chiropractors, and other health care professionals. In more recent years, he has connected with Dr. Tom Levy, a cardiologist physician and recently a lawyer too, who also freely expresses support for Dr. Huggins as well as writing and lecturing on the subject.

Also I want to thank New Image dental laboratory from the Atlanta, Georgia, area and its owner and founder Jeff Polland for his help in furnishing slides for the section in the laboratory portion of the chapter on restorative dentistry.

Arid thanks so much to Dr. Albert Konikoff for his slides related to the chapter on periodontics. I also want to thank Bob Riddell for his many hours in helping me to formulate the text and pictures in my new Toshiba lap top and his patience in teaching me how to use it. Also, for all the jokes he told me (all clean ones, I might add, but very funny). And thanks to Maggie Gomez for her aid in helping me get the many miscellaneous slides and for her photographic skills needed to complete this book.

The one person that helped me from the very beginning with computer input, long before I ever had the Toshiba, was Don Henshaw, also known as the office doctor. Don not only did all of my early word processing but also editing, as he added many constructive suggestions. And my gratitude to Herb Zost for his help and advice in the printing and production of the final product and for all of the fantastic baseball stories we shared. And finally, thanks to Dr. Brock Rondeau for his excellent teaching of orthodontics and the pictures he has furnished and to Dr. William Brizzee, Dr. Russel Christensen, and Dr. Blair Isom for their pictures.

Introduction

I decided to write this book about five years ago when I realized that there was nothing out there resembling it. There is a vast need for the dental consumer, you, to know what your options are and to achieve a background so you can make better decisions about your dental care. There are hundreds of pamphlets and booklets that explain the various procedures for you, but I know of no contemporary texts with copious pictures to illustrate for you just what we are talking about. There are whole books for the consumer on just small areas of medicine, such as the heart, blood pressure, or the brain including psychiatry and psychology. Now, finally, you have a reference to aid you in making the dental decisions necessary over your lifetime. And too, I know that if you follow these guidelines, you should save many thousands of dollars on dental bills over the rest of your life. But more importantly, you can look better, feel better, and achieve the confidence from your smile and speaking that we all desire.

I have decided to break the book down into sections so that we can explain different areas of our oral health and general health, and how they relate to one another. First, is the section entitled Your First Concerns? In it, we consider where we are in the profession of dentistry today. Then we look at the various options of finding a dentist we are comfortable with and who can fulfill our needs. We, then, look at the prevention portion of our dental home care so that we can minimize our dental expenses, discomfort, and time spent in the dental office.

Infectious diseases, especially HIV/AIDS and hepatitis, are always a concern to all of us and we explore all of these in that particular chapter.

And finally in the last chapter of this section, we take a look at how we can make your visit more comfortable and hopefully even pleasant, and a time you will look forward to.

In the second section, Understanding and Selecting Treatment Choices, we outline in easy-to-understand terms the various areas and specialties of dentistry beginning with the exam and treatment-planning-conference process. We then look at our little ones and see how their needs differ from adults. Then the chapter on periodontal dentistry is discussed, followed by oral surgery and its implication. The next chapter explains what root canals are, why they sometimes need to be done, and how we do them. Then, we discuss implants and how they work. This is followed by the rather extensive roll that orthodontics plays in dental treatment, especially in our younger generation.

Various alternatives are outlined for you and hopefully you will be better equipped to make better decisions regarding your children’s and possibly your own occlusion and aesthetic considerations. Then, we get into the heart of it all: restorative and prosthetic dentistry. This is the chapter that deals with the repair of teeth and their replacement, either with bridges, full dentures, or partial dentures.

The next chapter can be, and to me is, the most exciting chapter of all. It is entitled simply Cosmetic Dentistry. But its implications are deep and wide. You will learn what a porcelain laminate veneer is and how it differs from bonded veneer technology. Also, we will discuss porcelain fused to metal crowns, all porcelain crowns, and aesthetic bridges. Anything to make a patient look better (and probably younger) will be discussed.

The following chapter on the mercury amalgam issue is the most controversial of all. In my opinion it does not need to be controversial: it just is. I think it should be banned from use now and forevermore. The fact that it is so controversial, so many people have suffered irreparable damage from it in spills such at the Bay of Mimosa in Japan. Its ugliness is enough for me. Cost should not even be a factor because of cases such as this.

Then we will delve into high-tech dentistry and explain what we have discovered and how we are using this technology in our dental offices.

The next section, The Inner Workings of Dentistry, will explain organized dentistry, The American Dental Association, and other organizations. We will then go through the advantages and disadvantages of HMO’s, PPO’s, and Financing Dental Care. And finally, we will finish this section with Public Health and Charity and their contribution to dentistry in general.

The last section, Dentistry and Its Relationship to Total Health, will consider misconceptions, misinformation and other myths surrounding the practice of dentistry. I will shed light on what the truths and half-truths are and what really is going on here. Following is the chapter on dentistry’s interrelationship with medicine and health and how each affects the other. There will be a chapter about diet, nutrition, vitamins, minerals and other supplements, and how they relate to general health. And finally, we will discuss the total health picture, longevity, one’s quality of life and how long we can and should live.

Have a nice read and I sincerely hope you will try the many things outlined to increase your quality and quantity of life. Happy reading and best wishes.

Part I

YOUR FIRST CONCERNS

CHAPTER ONE

Dentistry Today

Today’s dentistry is a reflection of all of the spectacular events that have dazzled society since the inauguration of the space age. We have witnessed the information explosion, the development of high technology, and now the proliferation of the World Wide Web. Dentistry could not have escaped these developments, even if it had wanted to. Dentists as both scientists and artists are, of course, as open as everyone else to these almost unbelievable phenomena.

It was more than 40 years ago when we first began using high speed handpieces, the instrument commonly known as the drill. Actually, the handpiece is the power mechanism that holds the drill (known to the dentist as the bur).

Our new composite materials are now widely used to restore teeth to their original form, function, and natural color. They are a spin-off from the space age technology and the materials resulting there from. It is only since the 1980s and the emergence of the HIV virus and AIDS that the widespread use and eventual universal use of latex or vinyl gloves, masks, and eye protection have been worn by dental professionals.

Implant dentistry has in the last 20 years become an accepted and viable alternative for replacing missing teeth. Forty years ago, implants were still considered experimental and highly unreliable. Now, the technology and materials are being improved every day and it shows. Implants, in fact, permit teeth to be replaced in a way that is healthy and attractive, and much more in keeping with what nature gave us in the first place. Equally appealing is the fact that the replacement teeth are fastened over the gums permanently and securely, without worrying that the new teeth will come loose or need to be removed after meals for cleaning or at night while sleeping. Cleaning implants only requires the same dental care needs as your natural teeth.

Today’s dental office is so electronically sophisticated and high-tech that one could imagine being on a space shuttle or another extremely sophisticated aircraft. Some of the advances include intraoral video cameras that show clearly and vividly, on screen, defects in an individual’s teeth and gums, and the characteristics and condition of old restorations. In fact, video imaging devices can show patients their current face, teeth, and smile, as well as how orthodontics, cosmetic procedures, and other restorative techniques would improve facial features. They can see the results of a particular dental procedure on screen before any intervention is made. Incredibly, the most advanced dental offices even have miniature television sets with goggle-type glasses (and an attached earpiece) that can be worn to see television or a movie while undergoing treatment. Talk about being detached from your dental treatment—this is the ultimate so far.

In addition, among the most important developments is visioradiography, a digitized system of diagnosing dental disease that does not use radiation. There are also other highly advanced radiography systems for diagnosing orthodontic treatment, temporomandibular joint disfunction (TMID), and the older standard systems, all of which, fortunately, use less and less radiation and provide better images.

And now we have tooth cavity preparation systems that use micro-abrasive particles of aluminum oxide through a pressurized handpiece. These systems require no anesthesia (thus no needles) and produce no noise and no pain, and in May 1997, the Food and DrugAdministration (FDA) approved a dental laser for decay removal that exhibits similar features.

The action behind the scene in a modern dental office finds dentists, hygienists, dental assistants, and office managers continually advancing and supplementing their knowledge and technique. And there are numerous lectures, seminars, workshops, boot-camps, and meetings provided at the many dental colleges, dental meetings, conventions, and study clubs throughout the country. Let’s also not forget the videos, satellite-dish courses, closed-circuit TV sessions, and the Internet, along with the usual abundant number of books, magazines, and dental journals. With all of this opportunity to advance the science, dentists are more highly-educated and informed to provide you, the consumer, with the highest quality dentistry ever available.

Dentistry takes up about 5 percent or about $40 billion of the US total annual health care expenditure per year. There are over 140,000 practicing dentists, one dentist for approximately every 1,800 people. The economics of dentistry have changed dramatically in the past 20 years and affect nearly everyone, dentist and patient alike. Dental insurance arrived on the scene in the early 1970s and at that time, while many dentists resisted it, many of us welcomed insurance with open arms, as we thought that dental insurance would increase access to dental care for a large number of groups that had previously received only emergency type care. Most dental plans had annual limits of $750 to $1,500 per family member. They all required a nominal annual deductible payment at the patient’s first visit of the year, and a percentage of co-payment for most procedures ranging from 20 percent to 50 percent. Exclusions existed, as did other rules such as pre-existing conditions and length of time since the same procedure was accomplished on each tooth. Pre-determination was usually required on the more expensive procedures and no more than two cleanings and check-ups were allowed per year. Dental insurance policies such as these are known today as conventional insurance. Well, guess what. Conventional dental insurance today looks much the same way and, in many cases, with the same annual maximum of $1,000. Today, that amounts to $137 compared to $1,000 in the early 1970s—$137 of dentistry! Or to put it another way, the $1,000 worth of dental benefits then per year would pay for $7,299 worth of dentistry today. Why haven’t these benefits kept up with inflation? You be the judge.

Not only are dental insurance benefits low, but the insurance companies often insert themselves into the doctor-patient relationship, going so far as to influence, if not dictate, diagnose, prioritize, and treatment sequence our options. Today, while many of the insurance companies continue their conventional programs, most are offering alternatives, called Preferred Provider Organizations (PPO’s). These networks are much like Health Maintenance Organizations (HMO’s) but unlike PPO’s, they are not located in a single facility. They are made up of a large number of dentists, each having agreed to follow the PPO’s rules and fees, operating out of their own offices, and mixing private and PPO patients. The idea is to keep dental costs down and thus being viewed as managed health care programs. While the concept sounds good, the problem is that there is, as we say, no free lunch. Somebody or some organization must pay for everything; and, in this case, it’s the consumer and the provider. The consumer pays because, by definition, the level of care must be lowered due to the inability of the provider to furnish quality and ample time, materials and lab services, top-of-the-line personal, and, ultimately, the finest service available. With inferior funding, how could any of this be possible? The provider suffers because the profit margin is inadequate, motivation diminished, and frustration rises to the point of questioning why one wanted to practice dentistry in the first place. This is certainly one of the important dynamics dominating the market place today. Chapter 17 will further discuss these issues in detail.

What kind of education and training is necessary to become a dentist today? A prospective dentist must first graduate from an accredited college with a bachelor’s degree, having appropriate courses in biology, chemistry, and math. One also must take and pass a dental aptitude examination which tests intelligence, knowledge of college course materials previously studied, aptitude with one’s hand-eye coordination, and overall abilities necessary to succeed in dental school.

Then, after being accepted to dental school, there are four more years of education. Upon completion and being deemed a safe beginner, the dentist usually starts a career by joining the military, being accepted as an intern or resident at a teaching institution or learning under an experienced colleague or an associate dentist. During this period, depending on which courses the dental student has chosen, he or she must pass Parts I and II of the National Dental Board. Then come the Regional Boards or the specific state board where the dentist wishes to practice. These examinations include a demonstration of a complete and comprehensive knowledge of all the laws that govern dental practice in that specific state.

Now, let me say a few words about just what else is available for you, the dental consumer. Mention has been previously made about materials, labs, and equipment that are out there. But specific benefits to you have not been mentioned. We can and often do change undesirable and average smiles into dynamic, beautiful, and engaging ones. People’s self-confidence, self-esteem, and sense of worth are often raised many times over. Dentists provide these services every day with porcelain and composite crowns, bridges, on lay fillings, composite fillings, and veneers, minimizing the use of metals and maximizing full porcelain and composite restorations. No metal means no dark lines around the necks of the teeth next to the gums, no tattoos (from semi-precious and non-precious metals) next to the gums, and no more mercury amalgam fillings that are black, gray, or silver in color.

The restorative and cosmetic options available today put you in control of your dental treatment and allow you to have a more toxic-free, healthy, and natural-looking smile.

Earlier, I described a high-tech, state-of-the-art dental office; the opposite also still exists today. You could, perhaps, just as easily find a dentist, practicing what looks like 1950s dentistry, but you may not know it. This dentist may still be using older restorative materials and techniques which do not consider your cosmetic concerns. There are many patch-and-fill dentists who treat just the problem at hand, ignoring the larger picture of the mouth and teeth as a whole. Periodontal (gums, underlying bone, and other supportive tissue) disease goes far too often undiagnosed. This is perhaps the most important aspect of all. Just as you would not build a house on sand, you certainly don’t want to have your teeth restored on an unsound foundation. More teeth are lost after the age of 35 from periodontal disease than any other cause. So it behooves one to choose a dentist who pays a great deal of attention to this part of your diagnosis.

Hard as it is to believe, some dental offices are unclean and unsanitary and their sterilizing procedures and practices are questionable. You will usually get a sense of this the first time you go into a dental office, and your own good sense will tell you to go elsewhere for treatment.

Is it necessary for a dentist to have all of the newest, most advanced, high-tech equipment for you to receive quality dental care? No, it is not. It’s nice for you and the dental team alike to have some or all of it, but, by far, the most important qualities a dentist should possess are skill, care, judgment, training and continuing education, integrity and ethics, a genuine caring about

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