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In this episode Dr. Marvin goes into the recent advances in technology, and how many dentists are failing to adapt and incorporate the advances in medicine into their own treatment planning. At the Center for Natural Dentistry, we are all about embracing technology and using research that is cutting edge to treat people in a way that is not only good for them today but good for them long term. So with that, lets get going on this week’s episode of Let’s Talk Dentistry!


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— Transcript of Today’s Show —

Hello, you’re listening to Let’s Talk Dentistry.  Merry Christmas.  I hope you enjoyed your Christmas this past Wednesday.  Looking forward to the New Year.  It’s a great time to reflect on what the past year had brought you.  All the good things, hopefully, and all the things that you can change into the future and for this coming year, 2014.  Stay tuned, listen to this whole show.  It’s a half hour show; it talks about dentistry.  I am Dr. Marvin, licensed dentist here in California, ready to help you with your holistic dental questions.  If you want to schedule an appointment with me to get down to the nitty gritty and what’s going on inside your mouth and see if there is anything going on that could definitely be harming your health, then give us a call at 760-536-1199.

The last few weeks we’ve been talking about a lot of different subjects.  For instance, dental insurance.  Be sure to go on iTunes and Podcasts and check out our previous shows.  The last few weeks we also talked about dental insurance and x-rays.  Lots of good information.  If you have questions about what makes our x-rays different, you definitely want to check out those.
Today’s show is going to mainly revolve around technology.  Technology has come a long way in dentistry.  Unfortunately a lot of dentists haven’t caught on with new technology and the new advances.  You’ve got to realize that there are a lot of different type of people out there.  There are some people that are very conservative, very traditionalist, and they found a way to do it in the past, and they feel that is the best way to continue doing it.  They don’t want to have new technology, they don’t want to have to invest in the new technology, so they’re going to continue to do things the other way.  Now the old way, such as doing mercury fillings, works.  I will let you know that a lot of this dentistry, because it’s been around for a long time, it still works.  There’s not much wrong with that, however, if you can use technology or use modern techniques that utilizes those technologies, then you have to get trained, and you have to invest in the equipment.
At our office, I’m a big technology buff.  I’m kind of part of the newer generation, the one that has grown up with computers.  I’ve been working with computers pretty much since college in the early 90’s and really adopted it real well.  I was able to use the technologies to their fullest, and I knew for sure that when I became a dentist, I was going to use technologies to their fullest.
Let me give you an example of some of the technologies that I’ve adopted growing up.  Computers:  I’ve been using computers in our office for our charting, for our note taking, and also for our x-rays.  I’ve been using digital x-rays for over 11 years now.  That’s very important for you, because it takes some skill not only to take the x-rays, but also to read the x-rays and to figure out what’s going on in the x-rays.  Like if it’s a cavity or if it’s gum disease, or if it’s bone infections, you have to know how to use the technologies.  Computers, dental x-rays, and also impression taking.  So, if you’ve never heard of digital impressions, this is a great use of technology.
So let’s go back to what is typical, what most dentists do.  In order to make a dental appliance or a prosthesis such as a crown, bridge, partial, retainer, or braces.  All of those need a model of your mouth, and a lot of dentists in the past have used impressions in this impression material.  If you’ve ever been to the dentist and they put some gooey stuff in your mouth, it goes in gooey, it hardens up, then they pull it out.  When it comes out of your mouth, it’s nice and hard.  Then they can pour some special material like concrete that goes into that impression.  Once that hardens up it forms a model, so it’s an accurate representation of what was going on in your mouth.  This is very common.  It’s still used today.  I still use it in my practice.  With impressions, there’s a lot of different types of materials out there.  Some more accurate then others, but for the most part, it’s gooey stuff that’s put in your mouth.
Well, I adopted this digital impression taking about 10 years ago.  It’s what’s called a Cerac technology.  It’s one particular brand.  There are a lot more companies out there that have developed the technologies.  We’re able to take an actual photograph of your tooth or teeth and gums, put it on the computer, and now we have a model on the computer, as opposed to a model in real life.  If we wanted a model that we can touch and feel and look at that’s not on the computer, we can actually order that.  A company can make that for us.  Technology has come a long way, and these impressions or these pictures of your teeth are extremely accurate.  Actually, more accurate and getting more and more accurate as every new technology or every update comes around.  We’ve been using digital impression taking for a while, and it’s really a benefit for our patients.  One of the biggest benefits for our patients is that they don’t have to go through the impression process.  The impression process can, in a lot of people, be very uncomfortable.  It can cause people to gag or to tear up, and it just doesn’t feel very good.  Sometimes these impressions can take five to ten minutes in order for it to set or get hard.
If you are going to a dentist that doesn’t have this digital technology, they’re going to go about it the old fashioned way, which is the regular impressions.  I want to let you know that a lot of times these impressions do not work the first time, so these can cause errors.  When they’re sent to the laboratory in order to be fabricated, they will come back with restorations that don’t quite fit well.  There’s a good possibility that you may need to retake an impression in order to get the crown, bridge, or prosthesis to fit in your mouth.
With these digital impressions, things can go a lot faster.  With these dental impressions we take a picture, then we can package it up in the computer and actually email it to the laboratory.  That saves a lot of time.  We don’t have to package it, put it in a container, send it, take two or three days to get to the laboratory, then they have to pour it up at the laboratory, which could take a couple days.  With these new, digital impressions, since it’s on the computer I share the file with the laboratory, which also has a computer with the same program, the same file.  They can design the restoration on their computer and spit it out into a machine that actually makes the prosthesis, so it literally cuts the time in half.
If you’re sick of going to the dentist and getting these crowns where you need to take an impression, you need to have a temporary made, you have to wait two, three, or four weeks and hope that the first time it fits.  You might want to go to a dentist that does more digital impression taking.  This is a key technology that’s up and coming that we’ve used of over 13 years and have really adopted this into our practice and really have a good grasp of how it works.  A great benefit of this technology is that it saves you time, it saves you discomfort from that gooey impression.
With certain technologies it also saves you a second visit.  Usually when you have any dental work done, such as a crown, inlay or bridge done in your mouth, you have to get numb.  They’re going to give you a shot filled with anesthetic.  When you come back in order to fit it and possibly cement the restoration in, you have to be numbed again.  It’s not only a second visit, but it’s a second shot, and you have to deal with temporaries.
What is a temporary?  A lot of you may not remember.  If you have a crown, you may not remember having a temporary done.  If you have a bridge maybe you don’t remember, or maybe you do.  A temporary crown is a plastic restoration that’s put on your tooth in order to keep your tooth cavity free, and also so the prepared tooth that is cut down does not move.  If they took an impression when they prepared your tooth and they took an impression or took a mold, you want that to be exactly the same as what’s in your mouth.  If you have a temporary put in your mouth (hopefully it’s a good-fitting temporary), then your tooth will not move, so that when you do get the permanent crown back, it will fit well.  You want to make sure that you go to a dentist that, if they are sending this to a lab they do a temporary that fits really well, so that it doesn’t come out when you don’t want it to.  If it does come out, then you have another unscheduled trip back to the dentist to put it in.  Or you’re going to have the crown come off, and now the tooth is sensitive.  That’s a big inconvenience, because now it’s causing you cold sensitivity when you eat.  Or it comes out and it’s your front tooth and you can’t put it back in.  There are a lot of reasons why temporaries are done in order to save the teeth, but sometimes, if you can avoid a temporary and get your permanent restoration done in one visit, that would be my preference.
We use this technology, Cera technology.  Again, we’ve been using it for 12 or 13 years.  It’s very good in my hands; I’ve been using it for such a long time, not only for taking the pictures, but also designing it on the computer.  We’ve also invested in a unit to actually fabricate the restoration in our office.  It’s what we call an in office laboratory.  Since we’re able to do this, we can do it all in one visit unlike all the other times you had a crown.  We have the technology, experience and the skill set in order to do that.  It’s a very, very key investment that we’ve made.  Not only the investment in the technology itself, but in learning how to use it the best.  Fortunately at our office we use bio-compatible materials for this technology.  A lot of times we will test the material to make sure you are compatible with it.  If you are compatible with it, we’ll go ahead and fabricate it in the office.
To recap, the benefits of this technology is you don’t have to have a gooey impression, you don’t have to have a second visit, which means you don’t have to get a second shot.  We’re using bio-compatible materials, and you’re going to get it seated that same day, so you don’t have to come back.  You won’t have to take off more time from work, you don’t have to make another trip, and you can rest assured that it’s going to fit well, because if you’re going to get it that day we’re going to make sure that it fits well.  It’s pretty much the ideal restoration.
One final, big benefit is that we don’t do crowns unless we really need to.  When a crown is done, for the most part, a dentist removes all the enamel on your teeth.  That’s very destructive to your teeth.  I personally would not want to do that for my own mouth, so why would I recommend it for someone else’s mouth?  What we do in our office is preserve as much tooth as possible.  That’s very important, because once you lose tooth from a drill, after a dentist drills it away, you’re not going to get that tooth back.  Once you’ve drilled so much of that tooth, you can actually damage the tooth further, because of all the drilling.
At the Center for Natural Dentistry, we want to preserve as much tooth as possible.  That’s why we do what’s called inlays and enlays.  Inlays and enlays are up to the dentist to decide if they want to do it.  It depends on what their design is.  This is where dentistry becomes like an art.  A dentist has to make decisions on how much tooth to remove so that they conserve tooth structure, but they also have to have enough strength for the restoration itself.  Let me give you an example.  Porcelain is used a lot in these inlays and enlays because the look of it looks very similar to enamel, and it is the same color as enamel.  You can also bond it.  In other words, you can etch it, then use a special technique in order to chemically adhere or bond to your tooth.  A very, very key component of porcelain that is very, very good.  One of the bad things about porcelain is that it has to be thick.  It has to have a certain thickness, so that it doesn’t break.  Porcelain is made out of crystals, and these crystals can be very brittle.  It can crack.  Once these cracks start to form, they can move and get bigger, just like the enamel in your mouth.  They can form cracks.  It has very similar properties, but one of the negative properties of porcelain is that you have to have certain thickness.  How much thickness do you need?  That’s another dentist dilemma.  How much tooth do I remove to not damage the tooth, but have enough thickness for this subsequent restoration or porcelain that’s going to be on.  These are very key features.
When dentists decide to do an inlay and enlay, if they don’t have the digital technology or the technology to make a restoration and put it in your mouth, then they’re going to have to make a temporary.  I’m going to tell you that temporaries for inlays and enlays are very difficult, because there are more edges and they sometimes come out.  A key to a temporary is that it has to be strong enough to stay in your mouth but not too strong, so you can take it out when you put the permanent one in.  This is the reason why most dentists do inlays and enlays.  Since they don’t do inlays and enlays, they’re not going to recommend an inlay or enlay.
If I were a patient that wanted to conserve as much tooth as possible, I wanted a bio-compatible material, I don’t want any metal, I want it to be strong, I want it to be durable, and I want it to bond to the tooth, so I don’t have any cavities that leak underneath it.  I want to go to a dentist that uses this Cerac technology, or this digital impression taking that’s been around for almost 30 years.  This is a key reason why people come to our office and a key reason why they come from long distances to our office, because they can get more done in less time, conserve tooth structure, use bio-compatible materials, and just get it done in one day.  That alone is a reason for you to call our office.
Today we’re going to have a special.  It’s going to be coming up near the end of the show.  I’m going to give you a special on these type of restorations, on these Cerac restorations.  They are very, very good for people that have mercury fillings, because a lot of these mercury fillings are large.  When you remove the mercury fillings in any decayed or weak part of the tooth, you have a big part of the tooth that’s missing.  For me, there’s still enamel there that we can save or preserve.  These inlays and enlays are great restorations for people that have mercury fillings.
Of course, if you’ve listened to our show before, you know that we remove mercury fillings in the safest way possible.  That’s right, if you have mercury fillings, silver fillings, black fillings (if you don’t know, you’d better go check), if you want to have those taken out or you want us to test to see how you’re reacting to it, then you really need to schedule a visit with us to get a 3D x-ray done, a comprehensive exam.  You’ll get an idea of what restoration we would recommend, what material we would recommend for your particular case, because everyone is different.
Again, you’re listening to Let’s Talk Dentistry.  This is Dr. Marvin.  It’s our in between Christmas and New Year’s Day special.  We’re talking about digital impression taking.  We’re talking about technology.  We’re talking about how you should do what’s best for your teeth, as opposed to just settling into what your dentist uses.  Your dentist has to to be on the cutting edge if you want the best dentistry.  They have to use modern technology and modern techniques to preserve as much tooth as possible.
Let me give you an example.  If your inlay or enlay failed and you still had enough enamel, you could still do a crown later.  It’s very key that you go to a dentist that does inlays and enlays on a regular basis.  You don’t want to just ask your dentist if he does inlays and enlays; they may talk you out of it, because they don’t do them very much.  They would prefer that they do a crown instead.  A lot of these crowns are covered more often by the insurance companies.  If they’re covered more often, they also get paid.  The insurance company is not going to question the crown.
The negative effect of this decision is that you remove all of the enamel.  If you remove all the enamel from your teeth and your dentist does not use safe protocols in order to remove the enamel, you could be damaging your tooth, you could be damaging the nerve.  You may be subject to toothache, pain in the future, infections, and possibly a dentist will recommend a root canal.
That’s right, dentists will recommend root canals because of work that they did years ago when they were drilling on the tooth.  The dentist likes to drill on the tooth quickly, because they have lots of patients to treat.  They don’t want to spend their time drilling down a tooth slowly.  They want to drill it down as fast as they can.  They use these drills that go 200 to 250 thousand times per minute, it can cause a lot of heat to your tooth.  That tooth will eventually die.  If it dies, you’ve got infections and root canals, then your options are very limited.  At our office, if you’ve listened to our show before, you’ll know that we are not a big fan of root canals.  Root canals are not a great option or a healthy option for your teeth.  If you don’t want root canals, then you have to go to a dentist way early, and make sure that they choose the dentistry that is more conservative, and they protect the tooth as much as possible.  It’s very important.
I’m going to talk about today’s special.  For the first five callers only, if you have a tooth that has a mercury filling, and you want to take advantage of this digital technology to get it done in one visit, to preserve as much tooth as possible, so you don’t have to have root canals or crowns, where you preserve as much tooth as possible, we’re going to give you 20% off your mercury fillings and Cerac technology.  It’s incredible.  You’re going to save hundreds of dollars.  20% off, hundreds of dollars, just for being one of the first five callers today.  You want to call 760-536-1199.  Call right now, leave your name and number.  We track all of these messages, so if you’re number six then you’re out of luck.  If you’re one of the first five callers that call right now, you need to schedule an exam and x-ray if you’re a new patient.  We need to know what we’re doing.  We can’t just do it and not know what we’re doing.  If you’re an existing patient and you’ve been waiting for the best time to do this, and it’s around Christmas time, beginning of the New Year, let’s say you have new insurance benefits, they kick in January 1st, now is as good a time as ever to get your mercury fillings taken out, to get your enlays and inlays done, possibly a crown replacement, because this includes for crowns, and you want to get all of this done as soon as possible in the least amount of time (that is crazy important), you really want to take advantage of this special today.  It’s for the first five callers.
I want to spend the last couple of minutes just thanking people, especially our listeners who are repeat listeners.  They call into our show.  Maybe they’re a patient of ours or maybe they’ve listened to us and just waited to figure out when is the best time to come in.  They realize that this dentistry is rare.
It is extremely rare.  The dentistry where we concentrate on health, concentrate on preserving your teeth, concentrating on using materials that are not harmful to you, all stuff that dentists are just completely unaware of.  They’re unaware.  They like to look at your teeth as completely separate from your body.  We all know that teeth are a part of your body, a big part of your body, and we want to preserve as much, because we don’t want to lose any teeth.  We don’t want to have any infections in our mouth, these chronic illnesses that everybody is suffering from.  My best friend just texted me that one of her siblings passed away.  It’s really sad, because one of her parents is just sickened by the fact that he has outlived two of his children.  It’s these chronic illnesses that are a big detriment to our family.  I know that you, our listeners are getting the knowledge necessary to make the right decisions in choosing your providers, not letting your providers choose your dentistry for you, but choose the providers that think the same language as you, that think like minded and have the knowledge and expertise to get the right dentistry done.  Only the dentistry that is necessary.  So important when it comes to your health.  Don’t look at your dentist as a mechanic and just go to them to get something fixed.  Dentists only know what they know, and more importantly they don’t know what they don’t know.  They’re putting in restorations like metal restorations, mercury fillings, or fluoride in your mouth, do they really know what it’s doing to your overall health, or are they just thinking it’s one size fits all?  Every patient is the say.  They’re just going to use whatever they’ve used in the past, they’re going to use the same technique they’ve used in the past, because they don’t think it’s broken.
Each and everyone of us is different and unique, and we need to be treated that way.  That’s what we do at the Center for Natural Dentistry.  Dr. Godes and myself treat you as a person.  We treat you as ourselves, and we’re going to do our best dentistry possible, so that you’re healthy and you can avoid problems in the future.  Call right now.  I want to wish everyone a merry Christmas and a Happy New Year.  I’ll talk to you next time, same time, same place.  Goodbye