Old Dentists Never Die ....
They Just Make a Bad Impression!
My philosophy is that what God gave us is better than anything we can do! My Motto is "Look For Reasons Not to Drill, Instead of Reasons To Drill!" I do not believe in many of the gnathologists ideology to cut perfectly good teeth down, just to develop a centric relationship with an "ideal bite" Besides .. This is what Orthodontists and TMJ, etc. bite splints are for anyway! Plus ... Our elderly patients with the WORST OCCLUSIONS ARE NEVER THE ONES WITH TMJ PROBLEMS!!! I don't care whether you use a Stewart Articulator and tattoo the hinge axis! I would much rather have the fewest crowns possible done & articulated with a barn door hinge!!
Now, on the other hand, implants, crowns (where bonded in Heliomolar and Cerec porcelain restorations can't be done instead of full coverage) & full mouth reconstruction in mouths that need it anyway is a different story!
Many dentists have the same conservative view point. Bondodontics, Heliomolar, Cerec porcelain bonded in restorations INSTEAD of crowns in most fracture and amalgam failure cases, etc.
BUT! It is the PATIENTS OBLIGATION to spend the time to find the kind of dentist & dentistry they want done! If you are a patient .. ask around a lot! Be sure the dentist is gentle and has hygienists. Stop by a local Periodontist offices and ask them for a few quality dentist's names. Also be sure your new dentist is looking for reasons not to drill instead of reasons to drill ... Not scaring you into removing good functional amalgam (silver) fillings by saying the Mercury is poisoning your system.... Heck ... One fish dinner will usually give you more mercury than your silver fillings will in a year.
Many of us dentists don't think any patient should ever be embarrassed to even HAVE TO ASK for their own old gold crown back after it was removed for a new one or extracted! They paid for it as part of the expensive crown it was when it was placed! It is theirs to do whatever with! Old gold crowns can easily be sterilized. I think many other dentists feel the same as we do on this too.
It is also the dentists right to be able to treat the type of patients that he wants to too. In our office if a patient doesn't care enough to develop good home care, or is belligerent, no show, etc. .. They are sent a proper letter and asked to go elsewhere. Dentistry is a partnership with the patient. I do not care to waste my time & expertise (and the patients money) putting in work that will fail because of poor home care & or the disregard for regular dental maintenance!
Prevention and conservative dentistry is the name of the game. Porcelain Veneers, bondodontics and Cerec type restorations are better than crowns whenever possible. Implants are better than adjusting good teeth down for bridges, if there is enough bone available, etc.
(From our for Dental Students only page) Always remember your regular patients FIRST. The ones that told their friends about you! The ones that made your practice busy! Once you become busy and if you put most of your emphasis only on new patients with the most work to do and the most money to be made, you will need that full page ad in the paper or phone book!
I am against all hard porcelain occlusal restorations, and all thin Porcelain Occlusals (chewing surfaces). The new Vita II Blocks milled from the Cerec machines, replacing old deep fillings or fractured cusps has plenty of room for strength just by removing the old silver amalgam, without removing much if any good tooth structure for more room that would be too close to the nerve of pulp creating sensitivity. It has porcelain the exact hardness and expansion of our own enamel .. . We are doing Cerec restorations on probably 75% of all the teeth we would have crowned with our high noble before Cerec. We still do full coverage with traditional high noble gold in about 25% of the cases were the old amalgams go way below the tissue levels, etc. Where Cerec (in my opinion) would not be the best to use.
I do not believe in the use of Nitrous Oxide in our office since the release of the study showing it alters the DNA in human sperm causing infertility, etc. And that study was just of the staff involved with the secondary inhalation of it! What might it do with concentrated therapeutic doses used every 3, 4, or 6 months on prophys & dental work of the patients too? Valium works better anyway.
Root Canals, Posts & pins implanted or Cerec porcelain bonded inside our own roots are better than foreign posts implanted into bone without any natural shock absorber & as good a way to seal the bacteria out as a natural root does..... But .......Once an entire tooth is gone though, implants are now the treatment of choice in most areas. The age of the implant has arrived .... For a while anyway, but I just read last month in my weekly Science News that with the break through in genetics & stem cell research, etc. ... Within 15 years we will be able to implant laboratory grown tooth buds from our own Stem Cells and grow new teeth during our entire lives!!! This is what the future holds folks!
If you are a patient that has had or will be having RADIATION TREATMENT in the head & neck areas and you are not having all your teeth removed first! YOU MUST USE PRESCRIPTION FLUORIDE - PREVEDENT 1.1% AT LEAST 3x - 5x PER DAY FOR THE REST OF YOUR LIFE - WILL PROBABLY NEED TO BE ON A SALIVA SUBSTITUTE OR ENHANCER TOO! The saliva glands & the blood vessels in the bone are sclerosed, atrophied = if you EVER HAVE A TOOTH REMOVED AFTER RADIATION YOUR LIFE COULD BE IN JEOPARDY, especially in the first 5 years or so following radiation before new blood vessels can rebuild.
EARLY BRACES: Now this is my opinion only! Expensive (usually around $2,200) interceptive (braces) at an early age - 7 or 8 years old. 90% of the time it is (in my opinion) unnecessary! In my experience I see most of them needing it again anyway at age 12 - 13. Get a 2nd opinion ... don't let anyone make you feel guilty if you don't do it or let your kids pressure you into it because Johnny & Sally are wearing them in the 2nd grade for crimany sakes!
We are all human and can only do our best as we see it ... PLEASE REMEMBER! THIS IS MY PHILOSOPHY & OPINION! (Doc Hemp) THERE ARE 2 SIDES TO EACH COIN. PLEASE LOOK AT BOTH SIDES. It doesn't mean that other opinions and strategies are not as good .... Dentistry is an extremely DIFFICULT, INTENSE & high overhead profession! It is costly in education! Costly in equipment .... Especially if kept up to date! The dentist must run the office and business, keep the ladies from pulling each others hair out -hee-hee, & do all the intense work too! A good dentist may charge more for an individual item but will do it well with good materials & will do the least work necessary. Even dentists that have what some might call poor treatment plans, etc. are probably not dishonest ... They are just doing what they think is best ... That is why it is really the patients responsibility to spend some time finding an office they will be happy with.
Thank You,
Doc Hemp
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