Andrae Bergeron, Author at Adam Brown Dentistry - Monroe NC Dentist

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So far Andrae Bergeron has created 35 blog entries.

Electric Toothbrushes: Are They Worth the Hype?

Andrae Bergeron2020-06-11T13:22:25+00:00August 8th, 2019|Dentist Office Monroe NC, Teeth Cleaning|

At Carolina’s Dental Choice, we think the most important thing is to brush and floss regularly. Beyond that, we do believe there are some excellent advantages to owning an electric toothbrush.

Before you rush out to buy one, let’s review some of the details.

What the Studies Show

A review of studies done by the Cochrane Library in 2014 showed that “Powered toothbrushes reduce plaque and gingivitis more than manual toothbrushing in the short and long term.” Below you will find key results of the controlled studies where manual and electric toothbrushes were compared.

· At one to three months of use, there was an 11% reduction in plaque when using the electric brush.

· After using an electric toothbrush for over three months, there was a 21% reduction in plaque.

· At one to three months, there was a 6% reduction in gingivitis (with the electric).

· After three months, there was an 11% reduction (also with the electric).

Though the old-fashion toothbrush has done the job of keeping our teeth and gums clean for years, the electric toothbrush is the future of oral care. There is no denying an electric toothbrush is better at removing plaque and gingivitis. And, there are even more benefits to the electric toothbrush than these.

Under Pressure

When we brush, it’s natural to feel the need to apply extra pressure in order to scrub our teeth clean. Unfortunately, we tend to use too much force, which may result in pushing our gums back (in addition to scraping the enamel off our teeth). This little bit of extra pressure exposes the pink membrane that covers the roots of the teeth. Eventually, once the roots of the teeth become exposed due to heavy brushing, they become susceptible to decay and disease. Even worse, once the gums have receded, it is difficult to get them back, often requiring painful surgery with long recovery time. The better solution is to use a brush that knows when you are applying too much pressure so your gums can remain healthy and intact.

Recent studies show that when we use an electric toothbrush, we become more focused on the process of brushing, and therefore apply less pressure.

A side benefit of electric brushing is the unfamiliarity of the appliance requires more attention from our brain; therefore, we pay closer attention to the process of dental care.

Ease of Use May Be Better for Seniors, Impaired and Children

Should children use electric toothbrushes? Another benefit to using an electric toothbrush is that it works much better for those with limited mobility.

With over three million cases cited each year, carpal tunnel—a painful syndrome that restricts mobility in the wrist—can make brushing painful. But with an electric toothbrush, you use your wrists much less. Just turn it on and let the bristles do the work.

Seniors with arthritis in their hands or limited shoulder mobility find electric brushes more comfortable to use.

An electric brush is also beneficial for youngsters. Once they reach the age where they begin to brush themselves, parents often find themselves re-brushing to hit all the missed spots. Children that use electric toothbrushes tend to brush more teeth and do a better job cleaning them, which leaves less work for mom and dad.

It’s a great training tool for kids because most electric toothbrushes have a pressure sensor that lets you know when you are, indeed, pressing too hard. Beginners hear the beep and are better able to find the right level of pressure to apply.

The Cost

One of the biggest (if not the biggest) deterrents people offer for not switching to an electric toothbrush is the perceived high price they often carry. The truth is that issues with gums due to manual brushing and trips to the dentist are way more costly in the end. We definitely believe they are worth investment, but to be thorough, we have broken down the cost factors to that our clients may make an educated choice.

We considered the cost of buying new heads and batteries in our research.

Let’s start by looking at the initial cost according to the level of toothbrush:

· A basic battery-operated, vibrating toothbrush costs between $5-$25. Now, this price might not seem very high, but to be honest, there’s not much of a difference between electric brushes at this base level and a standard toothbrush. These cheap electrics vibrate only, no oscillating. When it comes to electric toothbrushes, there is some truth to the notion, “you get what you pay for.”

· The next level up gets you a much more effective toothbrush, but it will cost you anywhere from $75 to $200. Yep, there’s that high price. But, at this level of brush, you will reap the benefits. Plus, depending on the brand of brush you buy, there are additional benefits, such as a timer included in the handle letting you know when to begin and stop brushing; pressure sensors that indicate when you are pressing too hard; a digital reminder letting you know when to replace the brush head; varying brushing modes, and more. This is the level most of us find ourselves shopping. Anything less seems pointless.

· The third level of brush may cost anywhere from $400-$1,000. These brushes include more capabilities, better construction, and materials used.

Now let’s have a look at the additional costs:

· Typically, an electric brush head needs to be replaced every 2-3 months. These heads can cost anywhere from $5-$25, depending on the brand and style you have. Most heads can be ordered (in bulk for a discount) or may be found at your local grocery store.

· If you have a brush that uses batteries, they will need to be replaced every 4 to 6 weeks. This, of course, adds up—but if you find yourself about to purchase a battery-operated toothbrush, chances are it falls into the first level of brush mentioned above, and therefore not any better than your old standard brush.

· Plug-in brushes don’t require batteries, but they do depend on the power running through your house. The overall cost to charge your toothbrush is small.

When it comes to cost, it’s best to find the brand and style you feel most comfortable with first. Then look into each aspect of the price.

Vibrating or Oscillating? Vibrating or oscillating, which works better?

Vibrating or Oscillating Toothbrush

In a study done by the US Library of Medicine, where a 12-week comparison was done between the two types of brushes, the oscillating brush came out on top. The study specifically states, “The oscillating-rotating power brush provided statistically significantly superior reductions compared to the sonic brush…” and goes on to show the oscillating brush causes less bleeding and does a better job at reducing gingivitis and plaque.

Best Electric Toothbrushes for the Cost

In June of this year, The Strategist came out with a list of the “Best Electric Toothbrushes, According to Dentists,” and here are a few of the ones we liked the best:

Oral-B White Pro 1000 Power Rechargeable Electric Toothbrush ($50)

One of the biggest benefits to this brush is its ability to oscillate and vibrate. It also comes with a timer and pressure sensor and does not require batteries. This is a great way to break into the world of electric toothbrushes.

Oral-B 7000 SmartSeries Rechargeable Power Electric Toothbrush ($128)

This brush has all the capabilities as the Pro 1000, but it has an additional six cleaning modes—including one for your tongue. There is even Bluetooth connectivity so you can monitor and track your brushing habits with your phone. Another benefit to this brush is it uses smaller heads. This can help those who have smaller mouths and/or a sensitive gag reflex.

Philips Sonicare ProtectiveClean 4100 Plaque Control ($50)

Even though this brush does not have the circular, oscillating components it does still oscillate—it just does so as one solid piece, rather than multiple cylinders. It comes with a timer, pressure sensor, and naturally soft bristles. Users of this brush note how good the vibration feels, and that the toothbrush does an excellent job at breaking up tartar and plaque.

Philips Sonicare Diamond Clean Classic Electric Toothbrush ($178)

Much like the Oral-B 7000 Series, this brush is the higher-end version of the Philips 4100 Plaque Control. This brush comes with everything the 4100 has, with the addition of five different brushing modes such as “sensitive” and “gum care.” Users say this brush lasts longer, as it is made of high-quality materials, and that it provides that just-back-from-the-dentist level of teeth cleaning.

Overall, we find electric toothbrushes worth the switch. The cost is a bit more, but if you shop around you can often find them on sale. And, after trying different brushes, doing some research on the best brand for you, we think you will find that the most significant expense is the initial cost.

If you are considering changing to an electric toothbrush, feel free to come to talk with us at Carolina’s Dental Choice so we can help you get the best product possible.

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Finding an Experienced Dentist in Monroe, North Carolina

Andrae Bergeron2020-07-16T16:55:10+00:00June 17th, 2019|Adam Brown DDS, Dental Crowns, Dental Insurance, Dental Trends, General, Oral Health, Teeth Whitening|

There are fewer things more stressful than finding a new health provider, much less finding an office and staff to trust you and your family’s smile with. Whether you’re searching for the right dentist to advise your oral health regimen, or are simply in the market for a new dentist, Carolina’s Dental Choice wants to equip you with the right knowledge to find an experienced dentist suited for your treatment needs.

Find an Experienced Dentist—Don’t Get Unnecessary Treatments

In need of a second opinion after getting a hefty price estimate for a procedure, you’re not sure you really need? Had a bad experience with a previous dentist and searching for a new practice to rebuild trust with? Waited so long for a dental visit that you’re just ready for a fresh start and motivation? No judgments and no worries! Finding an experienced dentist does not have to be an ordeal.

It is easy to get overwhelmed by your search for the right dentist. From Google searches, Yelp reviews, to scouring websites and seeking out word of mouth recommendations, there are many ways in which we try to find a great dentist. If you’ve moved recently or switched insurance companies, it can also be difficult to move on from a long-time dentist and find another that meets all of your expectations.

Where should you even start? We have laid out the most important considerations in your search for the right experienced dentist.

Question 1: What makes a good dental practice?

You have probably asked yourself this before. What makes a good dentist? Is it a staff of gentle hygienists? A dentist who spends time in the room with the patient? The cheapest treatment options around? Let’s discuss it!

Expectations should be met with every point of contact, including staff

Whether you are making your first call to inquire about services, scheduling an appointment, or entering the practice, the staff should be welcoming to patients. Practices that leave patients in the waiting room without greeting and without respect for patients’ time are red flags that the dental practice does not respect the time of their clients. A friendly, punctual staff ensures that the visit is great from start to finish.

Active listening

Between the hygienists and the dentist, you need a practice that listens to what you say. As the patient, you are the best advocate and knowledge base of your own health, and a good dental practice values that. By listening to your concerns and requests, and acting on what they hear, rather than talking over the patient or not spending and giving the time to the patient to speak their concerns, the patient will collaborate with the dental practice to ensure they are receiving the best treatment options.

Attempts to know the patient

In a larger practice, we do not expect our dentists to know the patient’s entire history, but no patient wants to feel like another file on the shelf. A dentist taking the time to know you can affect the level of care that the patient gets. Whether that’s making friendly conversation or taking a few minutes to read your chart, attempting to know the patient can make all the difference in your dental care.

Question 2: What are the warning signs of a bad dentist?

Fraudulent dentists certainly are not the norm, but more often than you would think, dishonest practices have impacted patients in their long-term trust in dentistry and their own oral health. The wrong dentist is more concerned with his pocketbook rather than the overall health of your mouth, meaning he may recommend and perform unnecessary treatments. Procedures that aren’t necessary can wreak havoc on your mouth and lead to further problems down the road.

Signs of Fraudulent Practice

Urgency without explanation:

If your dentist identifies an issue that is not a dental emergency and tells you a procedure needs to be done immediately, you should start by asking why and for full disclosure on the procedure itself. If you are in a new dentist’s chair for a regular cleaning and suddenly you’re bombarded with procedures of a type you’ve never needed before, or that you did not enter the practice asking for help with, then it may be a red flag. When the dentist is vague on the reasoning for procedures, he may be pressuring you into going forward without understanding all of your options.

If it sounds too good to be true, then it probably is:

Some dentists offer very discounted, or even free cleanings as a way to get patients in the door. Once in the chair, they may either hit you with fees that were never mentioned as part of the deal or as mentioned before, pressure you into procedures with intensity.

Lack of Patient Education:

As we mentioned before, the sign of a great dentist is one who educates patients and ensures that decisions are made collectively between the patient and dentist. It is not good practice when dentists and hygienists are not willing to take time and explain the dental issues and recommended procedures to the patient. Even the act of not showing patients their x-rays can be a red flag. Your dentist should take the time to discuss what is shown in your x-rays, point out any lesions or unhealthy teeth, and talk through the treatment plan with the findings.

Question 3: How does dentistry become susceptible to fraud, and how can I determine if I am part of fraudulent dentistry?

We know that for the majority of dentists out there, it took years of hard work and building trust among their patients to make a successful dental practice. But, as in any profession, there are a small number of professionals out there who turn to taking shortcuts for financial gain. For the medical profession in general, medical diagnoses can be subjective. Because of this, we have a number of suggestions to improve patient advocacy.

Understand how your insurance works with the dental practice.

Beyond having a sense of your general dental coverage, you may not know how the dental practices interact before and after your dental visit. After scheduling your appointment, the staff at the dental practice will reach out to your dental insurance company to find out everything that is covered under your provider. So before you even enter the office, the experienced dentist will know everything that can be billed to you during your dental visit. Unfortunately, this can leave the patient vulnerable to receiving treatments that are more likely to be reimbursed by the insurance company, rather than what’s truly right for the teeth.

For example, a dentist may be choosing between a filling and a root canal for a patient. Taking the path with the root canal and crown is more lucrative for the dental practice. This is because it is common knowledge that root canals are easier to pass through an insurance company than a filling, and by receiving a root canal, you’re automatically approved for a crown. Root canals are easier to pass simply because the dentist can justify the root canal by claiming that the patient was in pain. The problem here is that the dentist may have just been able to perform a filling, which is a cheaper procedure and less invasive for the patient.

Now that there are some ways of identifying fraud, let’s talk about active ways to prevent getting in those situations in the first place.

Choose your dentist based on referrals

Your insurance company may be telling you which dentists to see, but take time to do your own research. Seek out others with the same insurance and ask for a recommendation. Or, if you have a current dentist in the same area but you have switched insurance policies, ask your dentist for a recommendation, or ask for a recommendation from a local dentist society or health professional. Just because the insurance company covers a dentist does not make it a suitable referral. Plus, seeking out opinions from family, friends, and co-workers can give recommendations backed by real experiences.

Consider going family-owned rather than corporate

Chain-dentistry practices drive patients through the door with heavy advertising and discounts, quick cleanings, free exams, and of course, hundreds or thousands of dollars in unnecessary dental work. Corporate dental chains can run on a quota-based model that can sometimes lead to practices working on the side of pushing unnecessary treatments.

Ask for the appointment time

Generally, a new patient appointment should take around an hour and a half. If the office tells you that appointment should only last about a half hour, they may be trying to rush you through what should be a thorough cleaning and appointment, rather than give you the time you deserve as a patient. If you’re an established patient, appointment time can vary, but a cleaning should take at least 45 minutes. If it lasts only 15 minutes, it’s time to start asking questions.

Always check your bill

In a true dental scam, a dentist might inflate claims or bill insurers for procedures that the patient didn’t receive. The best way to avoid this from happening is to ensure communication with your dentist, ask for an estimated price upfront (prior to sitting in the dental chair), and always checking your bill at checkout. According to the National Health Care Anti-Fraud Association, it is estimated that Americans lose about $68 billion dollars each year to healthcare fraud. Don’t be a victim of dental fraud; know the signs and do not be afraid to advocate for yourself as a patient.

Check the market rate for common procedures.

There are common procedures you have had before that you know the price for, but when dental pain strikes, sometimes you are willing to pay anything for it to get fixed. It’s at these times when it is most important to ensure that you are being offered a fair, market-rate price, and not just being offered the most expensive procedure that your insurance may or may not cover.

Seek other opinions.

If you have ever had a major dental procedure, it is likely that you might have sought out another opinion. One dentist may recommend that you need it, while another may not. This is totally normal, and encouraged, especially if you feel that any of the signs above are occurring.

Feel out the culture of the office.

While how you feel as a patient is important, seeing how the experienced dentist treats the staff can also impact the care you receive. The best doctors are attentive to patients and staff. If you have a bad feeling with your interaction from the front desk to the dental chair, how can you trust your oral health to the practice? You should feel safe and welcome at the dentist from the moment you walk in the door.

Find a dental provider who’s right for you and your family

Carolina’s Dental Choice is here to make you feel right at home, whether you’re new to the area or a longtime resident. Give us a call today if you’re in need of a welcoming, friendly face in the dental practice world at 704-289-9519.

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Our Commitment to Ethics at Carolina’s Dental Choice

Andrae Bergeron2020-07-16T16:57:05+00:00March 25th, 2019|Dental Insurance, Dental Trends, Dentist Office Monroe NC, testimonial|

At Carolina’s Dental Choice we are strongly committed to the ethical treatment of both our staff and patients. These ethics we work and live by are the cornerstone of our business—and they are much more than a mantra to us. Our commitment to ethics can be seen each day you are in our office, and it is our hope that you are encouraged and comforted by our desire to maintain an honest and professional experience.

The American Dental Association outlines a few desired tenets to ethics for all dental offices in the U.S., and we here at Carolina’s Dental Choice follow five important principles when it comes to caring for our employees and patients:

Patient Autonomy (self-governance)
Nonmaleficence (do no harm)
Beneficence (do good)
Justice (fairness)
Veracity (truthfulness)

Of course these sound wonderful, but exactly how we use them to interact with you on a daily basis is a little more detailed. Let’s take a closer look at each principle to see just how we use it.

Patient Autonomy

According to the ADA’s Principles of Ethics and Code of Professional Conduct document, every dentist has a duty to be truthful with patients. The document states,

“This principle expresses the concept that professionals have a duty to be honest and trustworthy in their dealings with people. Under this principle, the dentist’s primary obligations include respecting the position of trust inherent in the dentist-patient relationship, communicating truthfully and without deception, and maintaining intellectual integrity.”

To us, this doesn’t just mean we are to keep your dental records private. This also means we will keep you in the know when it comes to what is happening with your oral health. It also means you can trust us not to try and manipulate you into having procedures done that are not actually needed. Patient autonomy is the first step in building a trusting relationship.

Nonmaleficence

The ADA’s code of ethics also discusses the importance of nonmaleficence:

“This principle expresses the concept that professionals have a duty to protect the patient from harm. Under this principle, the dentist’s primary obligations include keeping knowledge and skills current, knowing one’s own limitations and when to refer to a specialist or other professional, and knowing when and under what circumstances delegation of patient care to auxiliaries is appropriate.”

You never have to worry about receiving anything but top-of-the-line, professional care at Carolina’s Dental Choice. We continually work according to the notion that if we are not completely sold on an idea, we will discuss with a fellow professional to gain clarity. This means that if we are not 100% confident of a particular procedure with a particular patient, we will not proceed. We want to best for you, and sometimes that means taking the extra time to have a conversation.

Beneficence

The American Dental Association sees benefice as

“…the concept that professionals have a duty to act for the benefit of others. Under this principle, the dentist’s primary obligation is service to the patient and the public-at-large. The most important aspect of this obligation is the competent and timely delivery of dental care within the bounds of clinical circumstances presented by the patient, with due consideration being given to the needs, desires and values of the patient. The same ethical considerations apply whether the dentist engages in fee-for-service, managed care or some other practice arrangement…”

Just ask any of our current patients and they will tell you Carolina’s Dental Choice is always working on behalf of the customer. Since our very first day in office, one of our primary goals has been to always operate for the benefit of others. This is continually our commitment you.

Justice

Though life may not be fair, Carolina’s Dental Choice is determined to treat everyone equally, as stated by the ADA’s fourth principle:

“This principle expresses the concept that professionals have a duty to be fair in their dealings with patients, colleagues and society. Under this principle, the dentist’s primary obligations include dealing with people justly and delivering dental care without prejudice. In its broadest sense, this principle expresses the concept that the dental profession should actively seek allies throughout society on specific activities that will help improve access to care for all.”

We do not discriminate or judge at CDC. We see each patient as unique and deserving of the same professional treatment we give everyone.

Veracity

Lastly, the ADA sees veracity as this:

We will never share your information with others or every give you reason not to trust us. We aim to create relationships with our customers, and a relationship built on honesty is always the best policy.

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Teeth As Tools: How Our Teeth Have Been Used Throughout History

Andrae Bergeron2018-11-05T14:35:48+00:00October 31st, 2018|Dental Trends, Teeth Cleaning|

Our teeth perform so many important functions throughout our life and on a daily basis. On a basic level, we use our teeth to talk, chew, digest food, and properly fill out our cheeks and lips to form our face shape. Without knowing it, you have probably used your teeth as tools in a multitude of ways. Whether you’re opening a bag of snacks by ripping open the seal with your teeth, cutting meat with your teeth, or holding bobby pins as you fix your hair, our teeth are one of the most important tools on our body.

While many of the ways that we use our teeth as tools aren’t particularly healthy for our teeth, and constantly put our teeth at the risk of damage, typically, a healthy tooth will not chip or break during normal function.

Now imagine a time and place where there were no electric toothbrushes, mouthwash, or even dental floss, and suddenly your teeth are one of the most important tools you possess. If teeth have less enamel, decay, or gum disease, they are more likely to chip, shift, or become loose, resulting in eventual tooth loss.

How have humans used their teeth throughout their history when they possibly weren’t as strong and healthy? What did it mean for humans to use their teeth as tools?

Early Ancestors: Teeth as Tools

Eating chocolate

Much of what we know about the life and diet of ancient humans is due to finding their teeth! Archaeologists find dozens to hundreds of teeth for every skeleton or skull. Why do our teeth survive at such high numbers? Our teeth are covered by enamel, which is 97 percent mineral, making our teeth stronger and more easily preserved than the rest of our bones. From the shape of the tooth to the thickness of the enamel, scientists can understand the evolution of humans, how our ancestors lived, what they ate, or even what diseases they had. Variations in teeth are a great way for scientists to classify early human species. As humans migrated across the globe, so did their diets; we know this because human teeth developed thicker enamel to eat other animals, seeds, nuts, and roots.

Looking back to Neanderthal teeth, scientists have hypothesized that they use their teeth as a tool, possibly gripping and clamping with their front teeth as they prepped animal hides for clothing and shelter.

What’s clear is that our teeth have evolved to serve us in similar ways as our ancestors. Like our ancestors, we use our teeth to access food or drink. Our teeth can still tell us a lot about our day-to-day life and culture as well!

Early tools to clean teeth

As far as we know, the earliest toothbrush dates back to around 3000BC, where Babylonians and Egyptians configured a toothbrush from frayed twigs. Fast forward a bit to 1600 BC, and we have the Chinese using aromatic twigs from trees as “chew sticks” to freshen their breath.
Some of the earliest tools to clean teeth were made from animal bone. For a stretch of history, and even today in certain parts of the world, coarse animal hair, such as hair from cows, was used to form the bristle on toothbrushes.

Did people in the past constantly have rotted teeth, cavities, and gum disease? Despite a lack of teeth brushing among ancient people, most people did not suffer from dental problems. There are a few explanations:

• The food being eaten was natural, unprocessed, and pure, containing nutrients and vitamins that strengthened teeth against bacteria
• Ancient diets were filled with fibrous foods, where the fiber acted as a brush against the teeth to filter away plaque and food
• Earlier diets lack sugary foods and acidic soda, two of the main detriments of modern diets
• Before cigarettes, humans didn’t smoke, and thus didn’t experience the harmful side effects of smoking on the teeth and human health

About 10,000 years ago at the dawn of the Neolithic period, our ancestors began farming, our teeth began to experience more decay, and dentistry emerged. As recent as the last decade, archaeologists found teeth that had been scraped and even drilled to possibly remove decayed tissue. With the onset of farming came carbohydrate-rich grains and starches. Some oral bacteria actually convert carbohydrates into enamel-destroying acids. There is evidence in numerous cultures across the world at various time periods where people combated decay by hand-drilling small holes into the teeth and scraping with different tools. At this point, you’re probably extremely thankful for the profound progress dentistry has made, even in the last century!

Cosmetic dentistry throughout history

It’s hard to pinpoint when improving the appearance of teeth became more fashionable rather than undergoing treatment to improve teeth function, but we know for sure that it has taken off in the past few years. Patients can now receive whitening treatments, veneers, and dental implants, all of which are cutting-edge procedures for a brighter, whiter smile! But cosmetic dentistry isn’t anything new—it goes back ancient times, where we know people developed tools to clean their teeth as early as 3000BC.
We’ve also been fixing our teeth since prehistoric times. Around 700 BC, there is evidence that Etruscans made dentures with ivory and bone, or constructed dentures from human or animal teeth. This practice lasted all the way up until the 1800s!

In 200 AD, the Etruscans also were using gold to create dental crowns and bridges, although it’s unknown whether this was for a dental treatment or for a fashion statement. The Ancient Egyptians used pumice stone and vinegar to create a toothpaste, and they hammered seashells into their gums as replacements for their teeth.

The 1700’s led to human teeth being used more commonly as dental implants, but our bodies tend to reject other humans’ teeth. In the late 1770’s, the first porcelain dentures were made, and they became extremely popular in the 19th century. By the early 20th century, dentists had switched to plastics and acrylics for dentures.

One of the most famous representations of cosmetic dentistry that comes to mind is that of the United States of America’s first president, George Washington. The legend surrounding Washington’s teeth was that they were made entirely of wood. But, in fact, they were actually made of animal bone!

How do our teeth become damaged from using them as tools in the present day and age?

Well, consider this: when we speak, our teeth are naturally separated during normal speech, and when we eat, food separates our teeth as we chew. When we use our teeth as tools, say to rip open a package or grind into tough foods, our teeth make contact, and suffer damage.

If your tooth has a filling or crown, using your teeth as tools they’re not intended for can pull out the filling or cause the crown to fall off. To those of you constantly holding bobby pins with your teeth to fix hair, bobby pins can actually pop off porcelain veneers on your teeth!

What does this have to do with our ancestors? Well, history repeats itself! We’re prone to using our strong, capable teeth as tools. Although we use our teeth as tools on a daily basis to eat, speak, and chew, improper use can lead to cracking and fracturing your teeth.

However progressive our dental care and habits are, we can truly damage our teeth. In comparison to the pain of damaging your teeth and the price of dental work, recognizing and changing our bad habits is better for our teeth and our wallets.

What if I already damaged my teeth?

You’re not alone if you didn’t know that using your teeth in certain, commonplace ways was damaging. What you should know, is that early treatment is always less extensive and less expensive. If a tooth suffers from minor cracks or chips, your dentist can easily repair them with a filling. If left untreated, these minor chips and cracks make the tooth weaker and more likely to break further, possibly chipping away at enamel and leaving the tooth exposed to bacteria.

Basically, the sooner you act with damaged teeth, the better for your wallet, your comfort, and the overall health of your teeth! Set up an appointment with Carolina Dental Choice to be proactive with your smile.

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Dental Anesthesia Yesterday, Today, and Tomorrow

Andrae Bergeron2020-07-16T16:59:14+00:00September 14th, 2018|Dental Implants, Dental Trends|

If you’ve ever undergone a dental procedure such as a tooth extraction or root canal at Carolinas Dental Choice, you’re most likely familiar with — and have been the grateful recipient of — a dental anesthetic. Numbing agents, like novocaine, work by confusing communication between nerve cells so that the brain doesn’t register pain. However, today’s modern medicine hasn’t always been available, and the path to its discovery and use is a sordid one.

Teeth have been causing pain through the ages and remedies to fight the pain are recorded as far back as 2250 BC. A Babylonian clay tablet reveals the recipe to repair cavities — mixing henbane seed and gum mastic. In 1000 BC India, oral care relied on wine. It wasn’t until 1540 that ether was introduced. And while there is no evidence, one can imagine early cave people simple using a large stick to pry out any source of pain.

Early dentistry was commonly performed by barbers. Beginning in the Middle Ages, barbers were performing dental work and surgery in addition to cutting hair and shaving. Blood-letting and leeching, extractions and enemas all were services of the local barber-surgeon. Shave and a root canal? Two bits!

Historical documents from the Wood Library Museum of Anesthesiology detail a Dr. Horace Wells bravely volunteering to inhale nitrous oxide for his own dental extraction in December 1844. Despite nitrous oxide’s reputation as laughing gas, Dr. Wells was a “humbug” during the procedure.

The first nurse anesthetist dates to 1877, but it wasn’t until 1889, at the Philadelphia College of Dentistry, Henry I. Dorr, MD, DDS was appointed as the world’s first Professor of the Practice of Dentistry, Anaesthetics and Anaesthesia.

Dental pain relief developed from the humble beginnings of ether (a pleasant-smelling colorless volatile liquid that is highly flammable) to laughing gas (nitrous oxide) and more recently from ethyl chloride (a gas or volatile liquid) to Procaine (commonly known as Novocaine).

Now dental anesthesia makes what was once a truly torturous process into something that may be simply unpleasant.

Your first experience with dental anesthesia may have been during wisdom tooth extraction (the four hindmost molars which come in during young adulthood) which can cause issues including pushing other teeth out of alignment. Wisdom teeth also tend to be impacted meaning they are stuck just below the gum surface. Nearly 85 percent of adults have had wisdom teeth removed. Another common dental procedure is a root canal, which hollows out a tooth and removes infected pulp inert material.

Dental anesthesia falls into three basic categories:

Local Anesthesia — Medication is injected into nerves within the gums to numb the area to be treated. This type of anesthesia is commonly used during fillings, treating gum disease, or preparing teeth for crowns.

Sedation — Administered by inhaling nitrous oxide, also known as laughing gas, or orally in the form of a pill taken prior to the dental procedure, this form of anesthesia is commonly combined with a local anesthetic to help relieve anxieties and reduce pain.

General Anesthesia — The strongest form of anesthesia available for dental procedures involves intravenous medications that produce a temporary loss of consciousness. General anesthesia is usually only used during extensive oral surgery procedures and requires a medical facility more advanced than a typical dentist’s office.

You may have heard of I.V. sedation and wondered if it were for you. Intravenous (I.V.) sedation has become more common and works well for those with fear of the dentist and dental procedures. It is also ideal for patients whose fear of dentistry has led to a large amount of dental work needing to be completed. I.V. Sedation is also used for outpatient procedures, like colonoscopies. Referred to as “twilight sleep,” the sedation allows patients to wake with little or no memory of the procedure.

While in the United States and much of the developed world there are many options available for safe and pain-free dental procedures, much of the world still has limited options when it comes to oral health care.

According to the World Health Organization (WHO), “In developing countries, oral health services are mostly offered from regional or central hospitals of urban centers and little, if any, priority is given to preventive or restorative dental care. Many countries in Africa, Asia and Latin-America have a shortage of oral health personnel and by and large the capacity of the systems is limited to pain relief or emergency care. In Africa, the dentist to population ratio is approximately 1:150,000 against about 1:2,000 in most industrialized countries.”

This continues more than 20 years the primary care initiative “Health for All,” which has yet to be fully implemented. According to WHO, “in many countries, national capacity and resources — human, financial and material — are still insufficient to ensure availability of and access to essential health services of high quality for individuals and populations, especially in deprived communities.”

The Dental Anesthesiology Research (DAR) Group, based in Alexandria, Va. was founded in 2000. They focus their research in: 1) local anesthesia: anatomy, pharmacology, and therapy. 2) sedation: general anesthesia, deep sedation, moderate and minimal sedation, and, 3) pain management: acute and chronic orofacial pain, orofacial cancerous pain and synalgia.

While those are a lot of big words, the point is that dental anesthesia continues to develop and address more complex patient care including: intravenous and inhalational sedation, sedation in hospital and ambulatory environments, sedation for all dental procedures, including oral surgery, pediatric dentistry, and general dentistry, perioperative patient management: intellectual disability, physical disability, comorbid illness/medical complexity, and dental phobia.

Despite continued advances into pain relief in dentistry, a third of Americans have not seen a dentist in the last year, according to a Gallup-Healthways poll. Many do not see a dentist because of the expense and only wealthier individuals seeking regular dental care, but another reason cited for not pursuing dental care is being the lack of realization that good oral health is key to overall good health. Poor oral care has been linked to heart disease, diabetes, rheumatoid arthritis, and stroke; and research has found that those who suffer from gum disease are twice as likely to develop coronary artery disease. The Mayo Clinic suggests brushing your teeth twice a day, flossing, and eating a healthy diet, along with attending regular dental check-ups.*

While dental procedures can seem scary and overwhelming, advances in anesthesia, options for pain relief during and after procedures, and continuing research to develop additional care methods, are making it easier for you to get the dental care you need.

*Medical Daily.

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Opioids in Dentistry: What You Should Know

Andrae Bergeron2020-07-16T16:59:31+00:00August 28th, 2018|Dental Insurance, Dental Trends, General|

Have you ever been afraid of going to the dentist? Whether your fear is based on prior bad experiences or the potential for pain, you’re not alone.

However, many dental patients express a different fear regarding dental pain: potential addiction to prescribed pain treatments. Opioids are a type of narcotic pain medication often prescribed after major dental procedures. Opioids work by reducing pain signals to the brain. They are very effective in treating pain; however, they also carry a risk of addiction.

Opioid abuse and overdose has been an increasing epidemic across all ages, genders, and classes in the United States. A stunning national statistic reveals that although the U.S. represents 5 percent of the world’s population, it consumes 80 percent of the global opioid supply. According to the NC Department of Health and Human Services (NCDHHS), from 1999 to 2016, more than 12,000 North Carolinians died from opioid-related overdose.

Fear of opioids or opioid addiction creates a tricky situation for patients who might be wondering, “How is my dentist going to make sure I am not experiencing pain or suffering, while also avoiding addiction to the pain medications prescribed after dental procedures?’ At Carolinas Dental Choice we make sure to work with you to safely manage your pain.

What are opioids?

Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin^®), hydrocodone (Vicodin^®), codeine, morphine, and many others, according to the National Institute on Drug Abuse. At first, opioids produce feelings of pleasure or euphoria. After repeated and prolonged use, the brain develops a tolerance towards its effects and begins to crave the pleasure-inducing effects, despite becoming less susceptible to the actual pain relief of the drugs.

How addiction to opioids starts

Opioids are very effective in treating pain, especially when someone is in high pain and needs immediate relief. Often, and unfortunately, addiction may be an unforeseen result of a legitimate need for pain treatment. Opioids like morphine, codeine, oxycodone, and hydrocodone are highly addictive and lead to physical dependencies.

Opioids are prescribed for short-term pain management and aid in treating severe pain. Opioids used over a longer period become less effective, which may drive the urge to take higher doses in order to achieve the same effect as when the medication was first started.

What does addiction to opiates look like?

• Using drugs past the prescription or initial pain treatment
• Becoming tolerant and needing the drug more often
• Having withdrawals from the drug
• Strong desire or urge to use the drug
• Continuing use despite financial, legal, or social problems

Once the opioid is stopped, withdrawal symptoms can include muscle and bone pain, insomnia, diarrhea, vomiting, cold-flashes, and more. To lessen the chances of withdrawal take any prescription as directed and plan to taper down doses. Your doctor can help you create a plan to safely reduce your medication use while managing your pain.

Opiates at the Dentist: What’s the problem?

Dentists are the second highest prescribers of opioids in the U.S. Over the past few years however, opioid prescriptions from dentists have been in decline. On average, dentists prescribe three days worth of opioids to their patients, aiming to only administer the lowest-potency opioids for short periods of time for conditions associated with severe pain.

Procedures and conditions that call for opioid prescriptions can range depending on the patient’s pain tolerance and preference, but most commonly include:

• Wisdom teeth surgery
• Tooth/Molar extraction
• Dental infections
• Surgical trauma

The American Dental Association announced new policies to combat the opioid epidemic in March 2018, which include continued education in prescribing opioids and other controlled substances, and statutory limitations on opioid dosage and duration of no more than 7 days for acute pain.

Manage pain responsibly

There is a no one-size-fits-all for treatment, so talking to your dentist to determine what course of action is best for you is a great place to start. At Carolinas Dental Choice we encourage you to update your dentist on your health history, share what medications you might be taking, and disclose if you or someone in your close family are in recovery or have struggled with addiction in the past.

We want to have a conversation with you to answer these questions:

• What is the goal of this prescription?
• At what time and when should I take these?
• How long should I take these drugs?
• Are there risks from this medication?
• What do I do with any extra medication?

Dentists and patients alike need to be on the same page about the perception of pain for these dental procedures, as well as what realistic expectations are for their pain treatment. The goal of pain management is exactly that — management not magic. Often patients may expect to feel absolutely no pain after procedure and anxiety about pain can actually contribute to feeling it. Experiencing a little bit of pain is okay. It will help you keep track of whether something actually hurts and needs treatment or you are continuing to take a medication out of habit. Only treat your pain to the point that it is manageable and does not interfere with your quality of life.

How to treat dental pain without opioids

Opioids are not usually dentists’ first choice to send home with patients. The alternatives to opiates include familiar medications. Over-the-counter pills can be just as effective for controlling pain, and safer, as they are nonsteroidal anti-inflammatory drugs (NSAID).

In a recent study by The Journal of the American Dental Association, the most effective pain relief with the fewest side effects is 400 milligrams of ibuprofen with 1,000 milligrams of acetaminophen. They also found that this combination is more effective than any other opioid or opioid-containing drugs. Most patients can find pain relief with a combination of Tylenol and ibuprofen, or even aspirin, which are easily accessible and inexpensive.

Patients should keep in mind that unlike opiates, the over-the-counter drug combinations may not work as instantly to relieve pain—but, when used correctly and consistently, these NSAIDs will relieve pain as effectively. At Carolina’s Dental Choice we recommend other pain relief measures such as hot or cold compresses, topical numbing gel, and comforting things such as taking a shower or bath, meditating, or distracting oneself with a favorite activity.

Most people associate major dental procedures with some lingering pain, sensitivity, and discomfort. But if you’re experiencing excessive pain post-dental procedure, don’t hesitate to contact us. Your dentist may recommend an additional evaluation, or develop an alternative pain management plan suited for you.

Struggling with an addiction? Get help.

Various treatment options and resources are available to help people with addiction. Your primary care doctor, dentist, or any other health professional can help assess the situation and recommend treatment options.

Other useful resources centralized in NC include:

The Alcohol/Drug Council of North Carolina

Carolina Healthcare System #ThisisSober Campaign

North Carolina Council of Community Programs – Treatment Services Guide

Recovery Communities of North Carolina

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The History Of Dental Crowns: From Gold To Porcelain

Andrae Bergeron2021-02-05T18:06:15+00:00April 30th, 2018|Dental Crowns|

At Carolina’s Dental Choice, our goal is to make sure that you have a happy, healthy, and beautiful smile. To do that, many patients need a crown to cover one of their teeth but they aren’t exactly sure what the purpose of the crown is or what the procedure entails. Don’t worry; we can answer any questions you have about dental crowns and provide you with a little more information on the history of crowns.

First things first: What is a crown? A crown is essentially a cap that covers a tooth. Crowns are placed over a tooth to improve its shape, size, strength, and even help its appearance. A dental crown can be needed for many reasons, such as:

Protecting a Tooth – If a tooth is cracked or even decaying, a crown can protect a weak tooth from further damage.
Restoring a Tooth – A broken tooth needs a crown to restore the functionality of the tooth.
Covering a Filling – Sometimes, if a tooth has a large filling and there is not a lot of tooth left, a crown will be used to cover and support the tooth and filling.
Holding a Dental Bridge in Place – A dental bridge is something that dentists use to bridge a gap between teeth when a tooth is missing. A crown may be used to cover this gap.

Dental crowns actually have a very interesting history that dates back thousands of years. Four thousand years ago, Luzon, an island in the Philippines, gold was used to modify teeth. Skeletons have been found with gold caps and gold tooth replacements. Evidence suggests that this practice was popular with the chiefs of the time and was a symbol of wealth and power in society. An ancient Italian civilization, the Etruscans, have also been discovered as using gold for dental crowns as far back as 700 B.C. It is thought that wealth and luxury were important to these people and they put gold dental crowns to cover their teeth. Some skeletons were also found with what are essentially the first dental bridges: artificial teeth were held in place with a gold wire which then banded the fake teeth to real teeth. Pretty cool!

Europeans didn’t start utilizing modern dental practices until around the 1400s. They started by carving dentures from bone or ivory and around the 1700s, human teeth were actually the most popular tooth replacement. But this practice did not work well so it quickly fell out of practice. Porcelain dentures became the most successful way to replace teeth and by the 1800’s, porcelain was the standard material for crowns. The first modern dental crown was created by Dr. Charles Land in 1903. He created an all-porcelain jacket by taking a broken tooth and reconstructing it with a porcelain cover. This essentially made the tooth look brand new. This dental crown practice was used until the 1950s, which is when dental technologies started developing into what we now use as dental crowns.

Today, dental crowns can be made with four different types of materials:

Ceramics – These crowns are made with materials that are porcelain based. The benefit to these fillings are the natural look they give teeth, as the color blends well with natural teeth. Porcelain crowns are best for restoring the front teeth because of this. These crown resist wear-and-tear but can become brittle in cases with heavy biting.
Porcelain Fused to Metal – These crowns are attached to the tooth with a metal base and porcelain is then fused to the metal. These crowns make the restoration stronger than if a crown is made of only porcelain. These crowns also better prevent dental decay from recurring. Porcelain fused metal crowns are very durable.
Gold Alloys – While there are commonly called gold crowns, these crowns are made up of gold, copper, and other metals. This creates a strong material that supports the tooth. This is a strong material that doesn’t wear or fracture easily. This material also works well with natural gum tissue.
Base Metal Alloys – These crowns are made with metals that are strong and resist corrosion. When preparing for crowns made with this material, the dentist is able to remove the least amount of healthy tooth. Additionally, this material is gentle on other teeth that touch the crown.

A question that comes up a lot when discussing crowns is “How long will my crown last?” Depending on the material used to make the crown and the dental care of a person, a crown can have a varying lifespan. On average, dental crowns can last from ten to thirty years. However, there are factors such as dental hygiene practices that affect how long a crown can last. Some crowns may crack after some time due to trauma and sometimes the problem is with the tooth itself. Also, some crowns are simply not fitted properly.

Some tips to prolonging the life of a crown:

Brush Your Teeth – It’s always the first thing on the list but brushing your teeth is the most important way to take care of your teeth and your crowns.
Avoid Hard Foods – If you regularly bite into hard foods or ice, your crown is at risk of cracking.
Wear a Mouth Guard – If you are prone to grinding your teeth in your sleep or participate in sports, wearing a mouth guard protects your teeth and your crowns.
Pick the Best Material for You – There are many choices for which material to use for a dental crown, make sure you talk with your dentist and pick the best material for your teeth.

Carolina’s Dental Choice wants to help you understand how dental crowns work. There are a lot of questions to ask if you need a crown: What is it? How long will it take? How much will it cost? We at Carolina’s Dental Choice are happy to answer any questions you may have. If you have questions about replacing current dental crowns or are just ready for a dental checkup, give us a call at 704-289-9519.

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