Pre-Cancer Treatment Dental Treatment, a Must

Q: My husband is about to undergo cancer treatment and his doctor says he might have severe dental problems during and after treatment. What can he do to prevent this? Jill in Lake Worth

A: Many physicians, including oncologists, are not aware of an important publication written by the N.I.H (National Institute of Health), entitled “To Fight Cancer Best, your Cancer Team Should Include a Dentist.” I have recently re-written a version of this booklet with easier verbiage for the general public. This publication will be distributed for free at my next seminar, listed below. I will be covering this important topic as well.

Important pre-cancer treatment needs: Digital X-ray examination, minimizing radiation exposure, fabrication of custom fluoride trays to prevent massive root decay from chemo and/or radiation, removal of un-restorable teeth that could abscess during cancer treatment, possibly resulting in the suspension of the treatment, and relining or re-making ill-fitting dentures.

 EDITOR’S NOTE: Dr. Josephs will be giving a FREE LECTURE on Incision-Free Dental Implant Surgery, Digital Crowns & Veneers, Choosing a Dental Office and NEW TOPIC: Oral Care for Cancer Patients, at the Double Tree Hotel, PGA Blvd. in Palm Beach Gardens on Thursday January 19^th at 4:00 pm. Attendees will receive a FREE copy of his book: “Tooth Talk”. There are only 15 seats left. Call today to register at 561-832-2917

Dr. Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts the “Tooth Talk” radio show on Fridays at 11am and Tuesdays at 8:30am on WBZT AM1230. (www.radiotoothtalk.com) On staff at Good Samaritan Medical Center, Dr. Josephs is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry. 

 drjosephs@palmbeachdentist.com                                                    44 Cocoanut Row, Palm Beach, FL 33480                                          888-DRTOOTH (888-378-6684)                                    www.palmbeachdentist.com         

Less Implants Can Achieve Same Result

Q: I am missing three molars. My dentist wants me to have three implants and three crowns. If I did two implants and three crowns, this would save me $2600. Is this safe to do? Melvin in Boynton

A: Let’s compare kiwis and pomegranates here. If your bone is super dense and plentiful as verified by digital imaging, you can get away with two implants to support three crowns, HOWEVER these three crowns will be connected to each other, like a permanent bridge, with a floating tooth in the middle that can trap food and will require the use of a floss threader.  If you are OK with this and have great oral hygiene and see your hygienist regularly (at the dental office, not at Starbucks.) then, you are OK with the two implants. The ideal treatment would be three implants.

EDITOR’S NOTE: Dr. Josephs will be giving a FREE LECTURE on Incision-Free Dental Implant Surgery, Digital Crowns & Veneers, Choosing a Dental Office and NEW TOPIC: Oral Care for Cancer Patients, at the Double Tree Hotel, PGA Blvd. in Palm Beach Gardens on Thursday January 19^th at 4:00 pm. Attendees will receive a FREE copy of his book: “Tooth Talk”. There are only 30 seats left. Call today to register at 561-832-2917

 Dr. Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts the “Tooth Talk” radio show on Fridays at 11am and Tuesdays at 8:30am on WBZT AM1230. (www.radiotoothtalk.com) On staff at Good Samaritan Medical Center, Dr. Josephs is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry. 

 drjosephs@palmbeachdentist.com                                                    44 Cocoanut Row, Palm Beach, FL 33480                                          888-DRTOOTH (888-378-6684)                                    www.palmbeachdentist.com              

Don’t Short Cut the Number of Veneers

Q: I would like to have veneers on my uppers. I just wanted six, but my dentist insists I do eight to ten. What do you think? Lisa in Wellington

A: Lisa, get to the nearest computer or smart phone and email me. I will respond to the email by attaching a photo of what happens when patients try to cut corners and only treat their front four or six teeth. The photo is of a fashion model in a magazine, believe it or not! Ninety percent of patients show 10 teeth in a full smile. If you don’t treat the full smile, you can wind up looking like you are missing back teeth or reveal the unsightly transition of a veneered tooth adjacent to an un-veneered tooth. For free consumer info on veneers, contact us.

EDITOR’S NOTE: Dr. Josephs will be giving a FREE LECTURE on Incision-Free Dental Implant Surgery, Digital Crowns & Veneers, Choosing a Dental Office and NEW TOPIC: Oral Care for Cancer Patients, at the Double Tree Hotel, PGA Blvd. in Palm Beach Gardens on Thursday January 19^th at 4:00 pm. Attendees will receive a FREE copy of his book: “Tooth Talk”. There are only 33 seats left. Call today to register at 561-832-2917

Dr. Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts the “Tooth Talk” radio show on Fridays at 11am and Tuesdays at 8:30am on WBZT AM1230. (www.radiotoothtalk.com) On staff at Good Samaritan Medical Center, Dr. Josephs is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry.

 drjosephs@palmbeachdentist.com                                                    44 Cocoanut Row, Palm Beach, FL 33480                                          888-DRTOOTH (888-378-6684)                                                  www.palmbeachdentist.com                                                                                                                                 

Dentists can now give Botox and Dermal Fillers

Q: I have seen in my travels that many dentists are doing Botox and Juvederm. Is this safe?

A: I know this concept is a little hard for many patients to swallow. (Look, believe it or not, 50% of the population is afraid to even get their teeth cleaned by us!)

Many health professionals are providing injectable cosmetics: plastic surgeons, gynecologists, internal medicine doctors, dermatologists and allied health care providers such as physician assistants (PA’s) and estheticians. None of these practitioners learned these procedures in school unless they graduated after 2004. Therefore, they (and myself) learned these skills during recent continuing education courses.

Like anything else, the importance is training. The American Academy of Facial Esthetics trains both dentists and medical doctors on how to use these drugs. Each doctor must know his limitations. One of several advantages of having these procedures performed at the dental office is that they can be combined with your four month check-up and cleaning visits, as most of these drugs wear off in four months. I will address this topic further next week.

EDITOR’S NOTE: Dr. Josephs will be giving a FREE LECTURE on Incision-Free Dental Implant Surgery, Digital Crowns & Veneers, Choosing a Dental Office and NEW TOPIC: Oral Care for Cancer Patients, at the Double Tree Hotel, PGA Blvd. in Palm Beach Gardens on Thursday January 19^th at 4:00 pm. Attendees will receive a FREE copy of his book: “Tooth Talk”. There are only 37 seats left. Call today to register at 561-832-2917

Dr. Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts the “Tooth Talk” radio show on Fridays at 11am and Tuesdays at 8:30am on WBZT AM1230. (www.radiotoothtalk.com) On staff at Good Samaritan Medical Center, Dr. Josephs is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry.  Send questions to drjosephs@palmbeachdentist.com or call 888-DRTOOTH (888-378-6684) or visit www.palmbeachdentist.com

Less Injection Pain by Neutralizing the Anesthetic

Q: With today’s technology, can’t you dentists find a way to eliminate the shot? Dan in Wellington

A: Easy Dan-O. “Chill-ax!” (As my teenage son says.)  You are in luck. Seventeen studies have shown that part of the pain from Novocain injections are from the acidity of the solution and that buffering the solution greatly increases injection comfort.

A new technology has come down the dental pike called Onset. This device injects sodium bicarbonate into the anesthetic solution to decrease the acidity.

Other devices, which have been around for several years are the CCS (Computer Controled Syringe), the Vibraject and the Dental Vibe. These devices inject extremely slowly and block pain stimuli by vibrating the tissues and needle respectively.  For free consumer info on these hi-tech beauties, contact us.

EDITOR’S NOTE: Dr. Josephs will be giving a FREE LECTURE on Incision-Free Dental Implant Surgery, Digital Crowns & Veneers, Choosing a Dental Office and NEW TOPIC: Oral Care for Cancer Patients, at the Double Tree Hotel, PGA Blvd. in Palm Beach Gardens on Thursday January 19^th at 4:00 pm. Attendees will receive a FREE copy of his book: “Tooth Talk”. There are only 39 seats left. Call today to register at 561-832-2917

Dr. Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts the “Tooth Talk” radio show on Fridays at 11am and Tuesdays at 8:30am on WBZT AM1230. (www.radiotoothtalk.com) On staff at Good Samaritan Medical Center, Dr. Josephs is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry.  Send questions to drjosephs@palmbeachdentist.com or call 888-DRTOOTH (888-378-6684) or visit www.palmbeachdentist.com

Implant Attachments for Dentures: What’s best?

Q: I would like just two implants and two attachments placed in my lower jaw to keep my lower denture from moving. I have seen some of my friend’s dentures and no two look alike. How do I know which type of attachment is best for me? Layla in Boynton Beach

A: I am glad your friends are comfortable enough to “show their stuff”. This reminds me of a scene in the first Jaws movie where the three shark hunters compare their scars one night on the boat. Sheriff Brody, played by Roy Scheider, was only able to show an appendix surgery scar.

With full lower dentures, it is recommended to place at least four implants for greater stability and retention i.e. Grip. This way if one implant should fail, you still have three to hold the denture in place. If only two implants are placed, and one fails, your denture will put excessive forces on the remaining single implant, which could lead to its failure.

As far as attachments are concerned, there are six major types, made by five different companies. Locator, by Zest Anchor, was recently written up in the Clinicians Report Newsletter and was rated “excellent” by the evaluators. The decision on which to use is based on several factors, including how parallel your implants are to each other and how much room you have between the upper and lower arches of teeth. For a free consumer guide on implant supported overdentures, please contact us.

 Dr. Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts the “Tooth Talk” radio show on Fridays at 11am and Tuesdays at 8:30am on WBZT AM1230. (www.radiotoothtalk.com) On staff at Good Samaritan Medical Center, Dr. Josephs is on the Faculty Advisory Board at McGill University’s Faculty of Dentistry.  Send questions to drjosephs@palmbeachdentist.com or call 888-DRTOOTH (888-378-6684) or visit www.palmbeachdentist.com

Is a Prosthodontist Necessary?

Q: I need extensive implant, crown and cosmetic work. Must I go to a prosthodontist? Beverly in West Palm Beach

 A: If you ask ten people in a room: “What does a prosthodontist do for a living?” nine out of ten will say: “Remove hemorrhoids?” Sorry, wrong end of the body.  A prosthodontist does an extra 24 months of training after dental school, in crown and bridgework placed over natural teeth or on top of implants, as well as porcelain veneers. This allows them to classify themselves as “specialists” and limits the scope of their practice. Their fees tend to be higher on average compared to highly qualified general dentists.

It is not mandatory to be treated by a prosthodontist. There are tens of thousand of general dentists in the USA who have done more of the above procedures than many prosthodontists. A general dentist who practices in an affluent area is likely to have performed more veneer and implant cases than a prosthodontics in a rural or lower socioeconomic area. Either type of dentist can do the job.

EDITOR’S NOTE: Dr. Josephs will be giving a FREE LECTURE on Incision-Free Dental Implant Surgery, Digital Crowns & Veneers and How to Choose a Hi Tech Dental Office at the Double Tree Hotel, PGA Blvd. in Palm Beach Gardens on Thursday December 1stat 4:00 pm. Attendees will receive a FREE copy of his book: “Tooth Talk”. There are only 13 seats left. Call today to register at 561-832-2917

 Dr. Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts the “Tooth Talk” radio show on Fridays at 11am and Tuesdays at 8:30am on WBZT AM1230. (www.radiotoothtalk.com) On staff at Good Samaritan Medical Center, Dr. Josephs is on the Faculty Advisory Board at McGill University’s Faculty of Dentistry.  Send questions to drjosephs@palmbeachdentist.com or call 888-DRTOOTH (888-378-6684) or visit www.palmbeachdentist.com

Osteoporosis Meds and Dental Surgery

Q: I need some teeth pulled and some implants, but have heard medication I take for osteoporosis can put me in danger of getting complications in my jawbone. Should I be worried? Doris in Wellington

 A: Sometimes the media gets on a topic like orange on a Home Depot apron. They just love juicy stories that scare the public half to death.

A comprehensive article in the November Journal of the American Dental Association now sets the guideline straight. “The prevalence of patients getting ONJ (osteonecrosis of the jaw: areas of dead bone that protrude through the gum tissue.) Is .10 percent”. (As in one 1/10^th of one percent i.e. small.) And, “no validated diagnostic test including the CTX test, predicts a patient’s risk level of developing ONJ. There is insufficient evidence to recommend a holiday form these drugs (Boniva, Aredia, Actonel,  Fosamex, etc.) or waiting periods before performing dental treatment for prevention of ONJ”.

This will be addressed at next month’s seminar. For free literature on this topic, call or drop us an email.

EDITOR’S NOTE: Dr. Josephs will be giving a FREE LECTURE on Incision-Free Dental Implant Surgery, Digital Crowns & Veneers and How to Choose a Hi Tech Dental Office at the Double Tree Hotel, PGA Blvd. in Palm Beach Gardens on Thursday December 1stat 4:00 pm. Attendees will receive a FREE copy of his book: “Tooth Talk”. There are only 16 seats left. Call today to register at 561-832-2917

 Dr. Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts the “Tooth Talk” radio show live on Fridays at 11am and Tuesdays at 8:30am on WBZT AM1230. (www.radiotoothtalk.com) On staff at Good Samaritan Medical Center, Dr. Josephs is on the Faculty Advisory Board at McGill University’s Faculty of Dentistry.  Send questions to drjosephs@palmbeachdentist.com or call 888-DRTOOTH (888-378-6684) or visit www.palmbeachdentist.com

Porcelain Veneers’ Completion Time

Q: I have been considering veneers and would like them to be finished in time for X-mas and New Year’s. Is this possible? Mariah in Boynton

A: I get this question in mid November, every year. Basically, it’s the old lyric: “all I want for Christmas is my two front teeth.” I think the request works for Chanukah and Ramadan as well.

For a typical full smile, ten-tooth upper case; allow four weeks. First visit:  preliminary impressions and photos for the lab with all design notes and any photos of yourself from your past or models cut out from magazines. Second visit: the teeth are made numb, shaped with diamond drills, impressed (with a digital impression scanner called iTero, or traditional “goop” impressions, depending on your doctor’s choice), followed by placement of temporary acrylic veneers. Visit Three: temporaries are photographed and impressed to send to the lab with final design notes and shade choice. Three weeks from this point, your veneers should be back from the lab for insertion.
EDITOR’S NOTE: Dr. Josephs will be giving a FREE LECTURE on Incision-Free Dental Implant Surgery, Digital Crowns & Veneers and How to Choose a Hi Tech Dental Office at the Double Tree Hotel on PGA Blvd. in Palm Beach Gardens on Thursday December 1stat 4:00 pm. All attendees will receive a FREE copy of his book: “Tooth Talk”. There are only 22 seats left. Call today to register at 561-832-2917

 Dr. Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts the “Tooth Talk” radio show live on Fridays at 11am and Tuesdays at 8:30am on WBZT AM1230. (www.radiotoothtalk.com) On staff at Good Samaritan Medical Center, Dr. Josephs is on the Faculty Advisory Board at McGill University’s Faculty of Dentistry.  Send questions to drjosephs@palmbeachdentist.com or call 888-DRTOOTH (888-378-6684) or visit www.palmbeachdentist.com

Minimally Invasive Dental Implant Surgery

Q: A friend of mine had dental implants without cutting the gums or needing stitches. How can this be? Sammy in Deerfield

A: Sometimes technology turns a “billion dollar” industry into a “million dollar” industry; or even less! Example: when was the last time you moseyed over to your local travel agency? Thanks to the Internet, your answer might be: “15 years ago.”

With the development in digital radiography, we can now accurately visualize the topography of the underlying bone beneath the gums to place the appropriately sized implant at the correct angle and depth without incising tissue. Much like sonar can map the floor of the ocean to assist in laying cable.

This allows dentists with the proper equipment and experience to place implants without incisions and sutures by penetrating directly through the gingiva, into bone, often eliminating a second surgery three to four months later to uncover the buried implants.  For free info on this, contact us.

EDITOR’S NOTE: Dr. Josephs will be giving a FREE LECTURE on Hi-Tech dentistry: Incision-Free Dental Implant Surgery, Digital Crowns & Veneers and How to Choose a Dental Office at the Double Tree Hotel on PGA Blvd. in Palm Beach Gardens on Thursday December 1st at 4:00 pm. All attendees will receive a FREE copy of his book: “Tooth Talk”. There are only 37 seats left. Call today to register at 561-832-2917

Dr. Mitchell Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts the “Tooth Talk” radio show live on Fridays at 11am and Tuesdays at 8:30am on WBZT AM1230. (www.radiotoothtalk.com) On staff at Good Samaritan Medical Center, Dr. Josephs is on the Faculty Advisory Board at McGill University’s Faculty of Dentistry.  Send questions to drjosephs@palmbeachdentist.com or call 888-DRTOOTH (888-378-6684) or visit www.palmbeachdentist.com