Secrets Your Dentist Doesn't Want You To Know

[Zeno Swijtink]

Secrets your dentist doesn't want you to know
Daniel Solin
Aug 27th 2009 at 1:00PM


Going to the dentist may seem like a mundane chore, but it can quickly become an expensive one. Here's what you need to know to get the most for your money when shopping for dental care.

Recently, I addressed the annual convention of the International Association of Comprehensive Aesthetics (IACA), an organization of dentists dedicated to continuing education. It was quite an eye-opener.

I realized I knew very little about my dentist. Even worse, I didn't know how to determine if my dentist had the right qualifications and equipment to provide first-class dental care.

There are approximately 165,000 dentists in the U.S., and the U.S. Bureau of Labor Statistics estimates that the yearly earnings of dentists averaged $147,010 in 2007. There is no doubt we are spending a lot of money on dental care and most people do not have dental insurance. But are we spending our money wisely? This is an area of particular interest to retirees and those planning to retire, because dental health issues tend to become more pressing as we age.

Here are the secrets your dentist may not want you to know - but you need to know to get the best care possible:
Secret #1: Your dentist may not be as educated as you think.

Secret #2: Your dentist may not have the latest technology.

Secret #3: Your dentist may be using mercury.

Secret #4: The lab may be more important than your dentist.

Secret #5: There's more to good dentistry than filling cavities.

Secret #6: You are probably using the wrong specialist for dental implants.

Secret #7: Bad dental advice about dentures can be fatal!

Secret #8: Your dentist may not know enough about sleep apnea.

Secret #9: Not all cosmetic dentists have the skills to really improve your smile.

Secret #10: How to avoid the root canal your dentist says you need.

The full entries are below.

Secret #1: Your dentist may not be as educated as you think.

Dentistry has changed a lot since your dentist graduated from dental school. One practitioner told me changes come "almost daily." There have been major advances in most materials used in fillings, bonding and root canals.

The world of neuromuscular dentistry has evolved at a particularly rapid rate. This branch of dentistry treats misalignment of the jaw which can cause headaches, sleep apnea, worn or cracked teeth and severe jaw pain, among many other symptoms.

Dental techniques have also changed. Laser systems can regenerate bone lost to gum disease and improve smiles with gum contouring. Lasers and air abrasion systems can be used to remove some decay without numbing the patient and to achieve superior dental cleaning.

If your dentist is not actively engaged in continuing education, it is unlikely that he or she is keeping up with these developments. Here are some specific questions to ask:

How many hours of continuing dental education a year do you do? The top dentists I interviewed do 100 hours or more.

Where do you go for your dental education? Some of the top places for continuing dental education are LVI Global, the Pankey Institute and the Scottsdale Center for Dentistry.

Secret #2: Your dentist may not have the latest technology.

Technology is an important part of today's dentistry. Is your dentist current? Here are some questions to ask:

Digital x-ray: Dentists who do not have digital x-ray equipment are practicing in the dark ages. Digital x-rays use less radiation than film. They are easier to read and the ability to manipulate contrast makes diagnosis more accurate. This equipment is expensive. It costs $30,000-$50,000. You are worth it.

Ultrasonic Cleaning: Ultrasonic instruments vibrate plaque and calculus off your teeth, even in areas below your gums. It is much more comfortable than old-fashioned hand scraping. They can remove heavy stains (like tobacco and coffee) from the tooth and even treat periodontal disease.

Total cost to your dentist: Around $2000. There is no excuse for not having it.

CEREC: For many dentists, this is the information they don't want you to have. The CEREC system lets your dentist provide a ceramic crown, onlay or veneer in only one visit. Use of CEREC can conserve the tooth structure and permit the dentist to seal the tooth in one appointment. No gagging impressions. CEREC means fewer injections, less drilling and no annoying temporaries.

The big rub is cost. A CEREC system will cost around $120,000. Personally, I don't care. If I have a choice between a dentist who has it and one that doesn't, the availability of CEREC will be the deciding factor.

Diagnodent: This is a laser which the dentist shines on the tooth and it tells whether there is a cavity and how deep it is. What's more, the laser can even tell your dentist that a root canal may be required. With the use of this technology, the dentist can detect cavities, and find them at an earlier stage, than traditional poking around the tooth (and no one likes that!). The initial investment is $4000.

Secret #3: Your dentist may be using mercury.

I know the American Dental Association and the FDA have no problem with mercury fillings. However, none of the top dentists I spoke to would put mercury in the mouths of their families or their patients. They use a composite filling instead.

Mercury is toxic. As one dentist told me, "the only place I can legally put mercury is in your mouth or in a hazardous waste container." Norway and Sweden have banned the use of mercury fillings.

Even without the toxicity controversy, the use of mercury fillings is still questionable. Mercury expands and contracts with temperature changes, just like in an old fashioned thermometer. This can lead to cracked teeth.

Composite fillings look better. They bond to the teeth and make them stronger (mercury fillings weaken the tooth). Teeth with composite fillings are less sensitive to hot and cold. They require less removal of tooth structure.

Mercury fillings are less expensive and easier for the dentist to use. No continuing education is necessary.

To me this is a no-brainer. If your dentist does not use composite fillings, don't use him.

Secret #4: The lab may be more important than your dentist.

If you are like most dental patients, you have no idea which lab your dentist is using. This lack of information could cost you dearly.

Dental labs create dentures, crowns, bridges, orthodontic appliances, and other dental restorations like implant crowns. There is a huge difference in the quality of these labs.

In order to increase profit, some dentists use foreign labs or cut-rate domestic ones. These labs may include tin, aluminum or even lead in their restorations. A reputable, first class lab will certify its restorations contain none of those metals and provide the dentist and patient a warranty on their craftsmanship.

You should be particularly wary if your dentist is using a lab in China or Mexico, where the practice of using those metals is very common. Some of the top labs in the U.S. are Aurum Ceramics, MicroDental Laboratories, da Vinci Dental Studio, and Williams Dental Lab. I am sure there are many others.

If you don't know where or which lab your dentist is using, you need to find out‰¥Ï now!

Secret #5: There's more to good dentistry than filling cavities.

A competent dentist screens for more than tooth decay. He or she should be concerned about sleep apnea, jaw-related pain known as TMJ or temporomandibular joint disorder, periodontal disease, oral cancer, diabetes and hypertension.

Sleep Apnea: Asking simple questions about snoring, weight gain, or medications such as blood pressure or acid reflux drugs can give your dentist clues about sleep apnea. Find a dentist that takes a thorough medical history.

TMJ: Did you know migraines and neck problems can be related to the position of your jaw? Your dentist should feel your joint and ask about any pain or discomfort you may be having.

Periodontal disease: By carefully checking the condition of your gums for periodontal disease, your dentist can detect early indications of heart disease, stroke and diabetes.

Hypertension: Most Novocain used by dentists contains epinephrine, which can increase your blood pressure. If you already have dangerously high blood pressure, the addition of epinephrine could cause a stroke. Your dentist should be aware of your medications and take your blood pressure before giving an injection or doing any dental work.

Advancements in oral cancer screening allow your dentist to find it sooner. A Vizilite exam is a detection tool used by dentists to see tissue changes in their earliest form. The dentist has you rinse with a solution and then shines a specially designed light in your mouth which will indicate the presence of oral cancer. A similar system by Velascope is also very effective at early detection.

If your dentist is not doing these health screenings, find one who does.

Secret #6: You are probably using the wrong specialist for dental implants.

Since dental implants involve the removal of a tooth and replacing it with an artificial tooth, many patients assume that an oral surgeon is best qualified to do it. This can be a flawed assumption.

Periodontists, who specialize in gum disease, may be a better option. Periodontists have special training in gum tissue and underlying bone in the mouth, which are significant issues in dental implants.

Whether you use your general dentist, a periodontist or an oral surgeon, you should ask these questions:

What is your success rate with implants? It should be at least 94 percent.

How long is the procedure? It should be no more than thirty minutes.

Do you use a surgical guide? A surgical guide directs the implant drilling system and provides for accurate placement according to the digital surgical treatment plan. It is important to confirm that the dentist doing your implant uses a surgical guide.

Do you use a CT scan and 3-D imaging software? This technology assesses bone structure and identifies the best sites for dental implant placement while avoiding vital structures like nerves.

Many dentists hold themselves out as implant specialists. You need to screen them very carefully before entrusting them with this surgical procedure.

Secret #7: Bad dental advice about dentures can be fatal!

Dentures are no joke to the millions of senior citizens who use them. While patients often pride themselves on keeping the same dentures for many years, this can be a big mistake. Your dentist should examine your dentures for evidence of wear. Wearing down the teeth on your dentures can result in distorted facial characteristics, collapse of the bite and closure of the airway.

Dentures need to be replaced at least once every seven years. Poor fit or worn dentures can cause sleep apnea, stroke or even death.

Yearly cancer screening exams of denture users are extremely important.

Contrary to common perception, dentures should be worn at night in order to insure that the airway passage is kept open. Your dentist should instruct you on proper denture cleansing and should check you regularly for signs of infection.

Secret #8: Your dentist may not know enough about sleep apnea.

The most common form of sleep apnea is caused by a blockage of the airway during sleep. It is a pretty scary condition. The patient can stop breathing hundreds of times during the night.

A common treatment for sleep apnea is Continuous Positive Airway Pressure (CPAP). CPAP involves blowing pressurized room air through the airway at high enough pressure to keep the airway open. Many patients find it difficult to adjust to this device and want to avoid surgery, which is another treatment option. As an alternative, your dentist, working with your physician, can custom make a device that guides the lower jaw forward, called a mandibular advancement device or MAD. MAD devices are more comfortable to wear and the compliance rates are much higher than using CPAP.

If you have (or suspect you have) sleep apnea, here are some questions to ask your dentist:

Are you a member of the American Academy of Dental Sleep Medicine?

Do you regularly attend the annual meeting of the Academy?

Do you work with Ear, Nose and Throat physicians and sleep physicians, where appropriate?

You can also call sleep centers and ask them what dentists they refer to in your area.

Sleep Apnea is potentially a very serious medical condition. It is important to do careful due diligence before you select a dentist to treat it.

Secret #9: Not all cosmetic dentists have the skills to really improve your smile.

A beautiful smile is a big part of our appearance. Cosmetic dentists promise us beautiful smiles (a "smile makeover"). But how do we know if they can deliver?

Any dentist can call herself a "cosmetic dentist." Here are some questions that will help you select one that is qualified:

1. Have you had post-graduate training? If so,where? The cosmetic dentistry field has changed rapidly over the years. A dentist with no post-graduate training is not likely to be current with these advancements. Look for post graduate training in porcelain veneers from well known schools like LVI Global, the Pankey Institute and the Scottsdale Center for Dentistry.

2. What kind of veneers do you use? The best veneers are either felspathic (super thin) veneers, or CAD/CAM veneers, which can be milled and made by a computer. There are pluses and minuses of both. Your dentist should explain the differences to you.

3. Show me the‰¥Ï veneers! Your dentist should be able to show you ten or more before and after photographs or videos. She should be willing to give you the names of patients who have consented to be used as references. Be cautious. Some dentists use before and after pictures of models they did not work on. Verify that what you are seeing is work done on actual patients!

Secret #10: How to avoid the root canal your dentist says you need.

Your dentist has just conveyed the dreaded news: "You need a root canal. Here's the name of the endodontist I recommend."

Now what?

Endodontists receive at least two years of additional training after dental school. They are root canal specialists. Start by checking to be sure the endodontist is licensed in your state. Some endodontists become Diplomats of the American Board of Endodontics and are "board certified." You can check to see if your endodontist is board certified by going to the American Board of Endondontics Web site.

Ask your endodontist if he uses a surgical microscope during treatment. These microscopes magnify the tooth approximately 20 times and greatly increase success rates. If your endodontist does not use a surgical microscope, find one who does.

Once you go an endodontist, it is almost a foregone conclusion that he will perform a root canal. That is his business and it is very lucrative. But is it always necessary?

Ask your endodontist if he has considered the "ferrule effect". Technically, this means that a root canal is unlikely to be successful if there is not enough tooth structure above the gum line to protect the tooth from coming loose or fracturing after it has been prepared for a crown.

If your tooth fails the "ferrule effect" test, you might be better off with an extraction and an implant, which will likely outlive you.

Still not a walk in the park, but far better than enduring an unnecessary root canal.

[hdwest24]

wow! Thanks for the info. I've been shopping for a new dentist since my one for 18 years in Sebastopol got super angry at me for denying xrays for a routine teeth cleaning after i had explained that i had just gone throught extensive radiation treatment for rectal cancer and didn't want to expose my body to needless radiation. What a dick. Thanks again!

[sharingwisdom]

Having been a dental hygienist for 26 years (though I retired from the field 13 years ago and realize things change), much of this article comes from the viewpoint of traditional dental practices in evolution. This is not taking into consideration Holistic Dentistry. I worked with several holistic dentists in the late 70's who really opened my eyes to the toxicity and dangerous practices in dentistry. And I do alot of research even though I'm retired from the field as I feel it's important to understand this information in the field I'm in now.


1. Dental materials are rarely tested for compatibility for the patient now. Just like when people with pieced ears have sensitivity to nickel, tin and other heavy metals, this is true in the mouth. Dental materials can create allergic responses and off set the body's immune responses. Common Dental Allergens
Sealants are toxic and leach.Dental products causing Neuro-Cutanious Finding a Holistic dentist or naturopath who is aware of these issues and knows how to test the body is important.


2. As far as ultra-sonic cleaning, I used this technology years back. What I found and also hear from other hygienists even now, is that hand scaling is still necessary or the calculas and tactile sense is missed. I'm not saying there isn't a place for the ultra-sonic but it's not all the time. My dentist is also a holistic and a hygienist who gives a wonderful, deep gentle cleaning by hand. I don't need an ultra-sonic.


3. Air abrasion for decay removal uses aluminum oxide. I argued with my former employer about this when it was allowed on the market. He told me the company said it was safe (of course they would say that or it wouldn’t sell) even though I showed him that it uses aluminum oxide that can swallowed, breathed and absorbed. There a big health issues with this. Aluminum Oxide Danger


4. The FDA, in it's politically-biased ruling, said the Hg isn't an issue as far as materials in the mouth. Pleaase! It may be a no-brainer for the writer of the article presented but there are dentists who are arrested in other states if they don’t use Mercury/amalgam fillings. When I worked in dental offices, the assistant had to put the mercury in a box labeled hazardous waste material for OSHA. So why should it ever be in our mouths?! Well, taking the Hg out the mouth is just as important as not putting it in it in the first place. Most dentists don't have a clue how to drill this substance out the mouth w/o re-contaminating the patient let alone themselves and their assistants. You might check out Dr. Tom McGuire's website and book at
Mercury Free Dentists, Mercury Safe Dentists, Amalgam Fillings, Mercury Detoxification, Oral and Overall Health He actually lives in Sebastopol and does Hg and other heavy metal testing).


5. Any metals in the mouth can cause galvanic currents when two teeth with metal touch which can lead to tooth sensitivity and pain. This needs to be tested.


6. Just going to the dentist and your head being in a position that cause stress on the vertebrae and jaws cause chiropractic necessity. This cause infringement on other body functions. In fact, there is a dentist in the East Bay who works with a chiropractor to immediately take care of this.


7. There are other ways to work with sleep apnea beside their recommended machines or surgery. Explore other options.


8. As far as root canals, there is no way, unless ozone is used, to get to the many microscopic tubules that still can have bacteria after it is plugged up with gutta percha (which has formaldehyde in it). Traditional materials do not work. Having a dead tooth in the mouth as a holder of space for the dental arch to be held stable is very debatable to me as it effect energetic pathways in the body. And my daughter had a root canal years ago and continued to have constant pain. I kept telling her that I felt they capped the tooth with an amalgam filling under the crown. And that was indeed exposed when she finally had the crown removed. So watch for dentists or endodontists who might do this and think it won’t effect you.


9. When teeth are extracted and eventually the area closes up, it is rare that dentists will check for cavitations, infection in the bone, that can persist for years affecting the immune system. Later if it’s identified as part of a weakened immunity, the area needs to be reopened and scraped out.


10. I have written in the past on this forum about Fluoride, it’s history and affects. It does not help to reduce cavities. https://www.fluoridealert.org/ But not only do they attempt to medicate and toxify our public water with a known neurotoxin, but stuff it down children’s mouths in topical applications as well as putting in the prophy paste that shine your teeth. We even breath fluoride in. I really recommend an excellent video by BBC correspondent, Christopher Bryson and author of The Fluoride Deception.
https://video.google.com/videoplay?docid=4336262446047063653&q=The +Fluoride+Deception&total=34&start=0&num=10&so=0 &type=search&plindex=4


11. Being in energy healing, I have personally witnessed severe hip pain clear up when a tooth implant was removed. Why? Because titanium is a metal used in implants and can still be reactive in the body depending on the individual person’s chemical make-up and sensitivities. In the implant area, the energy meridian went right through the hip.


12. The Vizlite Screening is light and tissue-dye system cleared by the FDA in 2005, is now called ViziLite Plus. This already gives me a clue that there is something up with the product that needs further investigation due to the inefficiency and pay-offs that happen w/in the FDA. What kind of dye and light? The light is Fluorescent, and I couldn’t find at what frequency the light is used or what the dye is. Four studies have compared detection rates with ViziLite screening and screening with ordinary incandescent light and found no significant difference and another study found modest benefit in evaluating patients known to have mucosal abnormalities or previously discovered cancer. A Cochrane systematic review, published in 2006, evaluated screening programs for the early detection and prevention of oral cancer and concluded that (a) there is insufficient evidence to support or refute the use of screening in the general population, (b) systematic examination by dentists and physicians should still be routine, with particular attention paid to high-risk individuals, and (c) randomized controlled trials are needed to determine whether screening programs can detect oral cancer earlier and reduce the number of deaths from the disease In 2008, the American Academy of Oral and Maxillofacial Pathology issued a similar but more detailed position statement. A pilot case control study on the efficacy of acet... [Oral Oncol. 2007] - PubMed result

I hope this adds some extra considerations to your dental evaluations and choice of dentists.

Secrets your dentist doesn't want you to know
Daniel Solin
Aug 27th 2009 at 1:00PM

Going to the dentist may seem like a mundane chore, but it can quickly become an expensive one. Here's what you need to know to get the most for your money when shopping for dental care....

The rest of the original post is available online on the waccobb.net website, or by using the link at the beginning of this excerpted quote. "M"M

[david985]

Very useful post. Found it by Google Search. Thanks for sharing. :)

[ See the earlier very informative posts on this thread starting here ~ Barry ]