Dunes Dental Services

    What do you, as a patient, want from dentistry and not what dentistry you want, is one of the concepts I learned while I am attending my continuing education courses at the Kois Center in Seattle. The Kois Center, ”Cream of the Crop”, challenges dentists to think for themselves and solve problems that extend beyond the borders of existing systems or currently accepted truths, expanding our horizons and helping us be our best. Helping patients maneuvering through the maze of treatment planning options is a co-discovery process during which we learn about our patients and our patients learn about themselves so that we can help our patients make informed choices and we can learn how to help them achieve their goals. In order to help people make the best decisions for themselves, we  begin by helping you, the patient, gain clarity about what is important to you and why; what you value for yourself and why; and how your values relate and sometimes conflict with one another. My place as your dentist is not to disapprove or approve; but rather to ensure that you are aware of your clinical conditions and implications and to have full access to information about possible solutions and implications.   “Very special people are doing very special things in a very special way”  

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A new peptide, embedded in a soft gel or a thin, flexible film and placed into a cavity, encourages cells inside teeth to regenerate in about a month, according to a new study in the journal ACS Nano. This technology is the first of its kind. The new gel or thin film could eliminate the need to fill cavities or drill deep into the root canal of an infected tooth. The new research could make a trip to the dentist's office more pleasant. Instead of a drill, a quick dab of gel or a thin film against an infected tooth could heal teeth from within. Cavities are bacteria and pus-filled holes on or in teeth which can lead to discomfort, pain and even tooth loss. When people eat acidic foods, consume sugary snacks or simply don't maintain proper oral hygiene, bacteria begin to eat away at the protective enamel and other minerals inside teeth. The causes of cavities are varied. But for most cavities, the treatment is the same: drilling into a tooth, removing the decay and filling in the hole to prevent further damage. The gel or thin film contains a peptide known as MSH, or melanocyte-stimulating hormone. Previous experiments, reported in the Proceedings of the National Academy of Sciences, showed that MSH encourages bone regeneration. Bone and teeth are fairly similar, so the French scientists reasoned that if the MSH were applied to teeth, it should help healing as well. To test their theory, the French scientists applied either a film or gel, both of which contained MSH, to cavity-filled mice teeth. After about one month, the cavities had disappeared. MSH-containing films or gels treat cavities; they don't prevent them. People will still need to brush, floss and use mouthwash to help prevent cavities from forming in the first place. So, using the Carifree rinses that our office has available, together with the new MSH gel available soon, will give you a more pleasurable visit to the dentist.

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  Yes, we have available now the most effective technique ever developed for whitening, and unlike other bleaching systems available, it's entirely permanent and there is minimal sensitivity. It's totally safe, and you can still drink red wine , coffee, tea etc. The research behind this method found that as the teeth get older, there is some sort of phenomenon inside the tooth structure that prevents the oxygen from getting in or doing its job. So, younger teeth are more permeable to oxygen( they are whiter when you are young) and older teeth are less (they become darker) because the oxygenation is more and more inhibited. This whitening method we have available in our office starts with conditioning the teeth first, so the tooth structure is going to become microscopically more permeable to the oxygen, and this oxidation process will break down the darker long-chain stain molecules into shorter molecules that are white. We'd start with at- home bleaching trays that are fabricated in a very special way, so you will not loose the bleaching material in your mouth and get all the uncomfortable taste .This will condition the teeth MUCH more than typical bleaching, so not only are the teeth much whiter after the at-home portion , but the oxygen from the high concentration IN OFFICE session that comes next, can REALLY dive into the tooth structure and WHITENS like you've never seen before ! So, the question : Why can I just do bleaching in ONE session over at the mall or in any office ? You just have the answer above. The tooth structure is not conditioned to receive the high concentration of oxygen, there is only dehydration during the bleaching, that gives the sensation of whitening for two days and the original darkness is coming back. And the sensitivity can be very disturbing sometimes. The conclusion is : if you decide to do whitening , do some research and became informed for what really works and is worth the money !

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  It is now time to introduce another new method for conservative treatment of one the most infectios and spreadable disease: dental cavities. We can detect them either clinically or radiologically and distinguish caries according to its progression and extension. Icon is the revolutionary treatment for incipient caries and white spots because it requires NO DRILLING. When a dentist discovers incipient caries that are beyond preventive therapies though too early for restorative treatment, Icon offers a simple alternative to the wait-and-see approach. It inhibits lesion progression and increases the life expectancy for the tooth while providing a highly aesthetic alternative to microabrasion and other restorative treatments for cariogenic white spot lesions. In other words, Icon is a highly infiltrative resin that penetrates deeply into the cavitated tooth structure. It homogenizes with the tooth color, and it is highly resistant to abrasion. On smooth surfaces Icon combines early caries arrest with a cosmetic treatment of cariogenic white spots – in only one sitting! Therefore, a caries infiltration on smooth surfaces is especially well-suited for orthodontic patients after the removal of brackets. For proximal caries treatment gentle on the tooth substance DMG developed a special application to treat even caries with a radiographic progression into the first third of the dentin. It allows quick and easy access to the affected area – without drilling! As research in dentistry advances, I promise to provide my patients with the most preventive and conservative methods that exist in dental field, and this is another one of them, and many will follow.  

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  Bisphosphonate- related osteonecrosis of the jaw(deaden up the jaw bone) adversely affects the quality of life, producing significant morbidity in afflicted patients. Experimental and epidemiologic studies have established a firm foundation for a strong association between monthly IV(injectable type) bisphosphonates and jaw necrosis. Medication such as Aredia, Zometa, Boniva, Reclast used for management of cancer related conditions: breast cancer, prostate cancer, lung cancer, management of osteoporosis, can produce osteonecrosis of the jaw. Estimates of the cumulative incidence of jaw necrosis after the IV administration for a period of three years of the above mentioned medication is between 0.8-12%. Prior to treatment with IV bisphosphonates , the patient should have a thorough oral examination, any unsalvageable teeth should be removed, all invasive dental procedures should be completed. Patients under treatment with oral bisphosphonates such as Fosamax, Actonel,are at a considerably lower risk for jaw necrosis than patients treated with IV Bisphosphonates. The incidence here was calculated to be 0.7/100,000 person/years of exposure. I strongly belive that there is not enough available and reported data regarding the relationship between ORAL bisphosphonates and jaw necrosis, since last week I saw another very healthy patient that took Fosamax for 2,5 years  and went for an extraction in May of '09 and now is presenting with jaw necrosis. It is painful and is not pretty. Takes months of antibiotic therapy, sometimes patients loose half of the jaw, and if the healing occur, there should be monitoring of the area for the rest of the patient life because whenever the immune system is down the jaw necrosis can return. Patients, please be aware and inform your dentist before any surgery such as extractions, implants, root tip surgery or gums surgery involving bone, if you are taking any of the bone building drugs.

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Belive it or not, we can now win the battle against cavities. Think of  thousands of dollars you invested over the years into your mouth! And almost each recall appointment there is another cavity! It is not only frustrating for you knowing that you brush every day the way you are supposed to,and you are flossing too, but it is very frustrating for me as a dentist. I know I did the best restoration ever on that tooth and each tooth that I am restoring, and now there is recurrent cavity? How is that possible? Well it is. Because some people have more acid producing bacteria in their mouth than others. Some produce just a drop, some produce  a bucket. What is happening with the bucket ones? The enamel simply disolves at a microscopic level, but enough for the hungry bugs to destroy the rest of the tooth structure. So, what do we do.... I would like to take the opportunity to introduce you, in advance, to a new standard of care we are providing to all of our valued patients. We at Dunes Dental Services, are committed to integrating evolving scientific understandings with the best new available technology and treatment options. We know this is just one of the reasons you entrust your oral health, along with the health of your friends and family, to us. You can anticipate something a little different at your next appointment. We are now using the CariFree System, which allows us to better anticipate your likelihood of getting cavities. We can then make preventive recommendations, with the goal of lowering your risk of decay, and ensuring a longer life for the dental work you have already invested in and may opt for in the future.The CariFree System uses a simple screening device along with a swab sample of your plaque in order to measure the levels of bad bacteria on your teeth. The test is painless, takes less than one minute, and will help us to make a diagnosis as to whether you have the caries infection or not. Cavities are known to be caused by this bacterial caries infection. This screening test is part of an overall Caries Risk Assessment we will perform. This assessment will allow us to provide homecare recommendations, dietary counseling, re-mineralization therapy of cavities just beginning, and treatment of this infection, all with the goal of lowering your incidence of decay and creating more  predictable results for lasting dentistry. This assessment and screening provides us with very valuable information we can now use to practice minimally invasive dentistry and reduce your time and money spent in the dental chair. We all win!Please feel free to visit the patient section at www.carifree.com for more information prior to your dental visit. We look forward to seeing you soon!

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Everybody that has a cough, is concerned this time of the year with the question"Is it Swine Flu?", "Should I go to see the doctor?", "Can I keep my dental appointment?"In an effort to make the things a little bit more clear, for some, perhaps, more confusing ,because the symptoms that I put together are not written in stone, but research about the regular flu shows that in proportion of 80% they match with the Swine flu symptoms.And as Dr. Roosevelt from a New York hospital was relating on the Fox channel : "If you have flu symptoms this time of the year, 95% chance is the Swine flu, because the other flu is not around yet".Cold Symptoms:    Fever is rare . A hacking, productive cough is often  present .Slight aches and pains are mild .Stuffy nose is commonly present . Chills are uncommon . Tiredness is fairly mild .Sneezing is commonly present .Cold symptoms tend to develop over a few days.A headache is fairly uncommon .Sore throat is commonly present .Chest discomfort is mild with a cold. H1N1 Flu Symptoms:A fever of 100F or more for 3 to 4 days is usually present .A non-productve cough is present .Severe aches and pains are often associated with flu .Stuffy nose is not commonly present .60% of the people with the flu have expirienced chills.Tiredness is often severe .Sneezing is uncommon .The flu hits hard and sudden symptoms like high fever, aches and pain apear within 3-6 hours.A headache is very common with the flu.Sore throat is not present .Chest discomfort is often severe .Meds such as Tamiflu are often given in flu but only for patients with Asthma in the health history, children under the age of 2, patients with low immunity. It is not recommended in mild cases of flu or as profilactic. Because is an airborn pathogen(spreads via air), common gathering places should be avoided. And, yes, you should cancel your dental appointment if any of the above symptoms are present.

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