Integer ac ipsum at magna vestibulum volutpat in vel est. Vestibulum ac imperdiet ipsum. Fusce non metus nec nisi sodales cursus. Donec eu arcu mi. Morbi laoreet, ipsum posuere tincidunt sollicitudin, ante odio mattis libero, et pellentesque tellus lorem et risus. Vivamus mauris metus, auctor nec porta non, posuere sed turpis. Pellentesque et orci sit amet neque viverra molestie. Donec sed elit mi, sed sodales lectus. Nullam nulla enim, faucibus non dapibus sed, ultricies vitae elit. Nunc quis sem nunc. Curabitur lectus sem, venenatis id pulvinar ac, vulputate in ante. Duis diam sem, pulvinar id tempus vitae, viverra nec leo. Proin mi tellus, auctor vel rutrum quis, laoreet eu libero. Phasellus porta dignissim erat, in ullamcorper neque lobortis non. Aenean commodo egestas nibh, dapibus feugiat tortor bibendum eget. Morbi tortor justo, ornare ac pretium eu, condimentum vitae velit. Sed imperdiet elementum risus in elementum. Ut lectus ante, pulvinar vitae faucibus faucibus, tristique vel sem.

Vestibulum ante ipsum primis in faucibus orci luctus et ultrices posuere cubilia Curae; Maecenas vel commodo arcu. Curabitur aliquet orci ac ipsum auctor pellentesque. Vestibulum eget porta sapien. Nulla consectetur, erat egestas iaculis facilisis, nulla magna dictum enim, id mollis arcu est eu mi. Suspendisse eu eros ac turpis molestie malesuada. Nulla eleifend, lorem non convallis viverra, velit odio sollicitudin metus, nec eleifend metus libero nec eros. Aliquam non purus ut erat vulputate faucibus. Fusce at nunc tortor. Nam erat lorem, faucibus nec eleifend at, vulputate at velit. Etiam vitae nisl nisi, id sollicitudin nisi. Suspendisse leo quam, fringilla et cursus quis, vulputate sed lacus. Proin lobortis, justo non egestas malesuada, mi diam eleifend velit, ac venenatis urna ante eu massa. Nulla pretium elementum felis, in fringilla est suscipit feugiat. In in arcu sit amet elit facilisis rhoncus. Donec volutpat mi sed dui iaculis nec feugiat nunc egestas. Maecenas ultrices velit ut felis pulvinar ultricies. Nullam magna neque, eleifend ac hendrerit sodales, dapibus sed nunc.

Suspendisse leo libero, pharetra eget scelerisque ac, tincidunt eget justo. Fusce in aliquam est. Quisque eu vulputate lorem. Etiam ut lorem id neque commodo ullamcorper. Donec auctor accumsan enim id sollicitudin. Nullam et enim lectus. Ut eget augue nulla. Fusce nec rhoncus lacus. Sed sit amet elit ut sem gravida vulputate. Maecenas auctor lacinia tortor, id posuere justo ornare ut. Nunc erat augue, blandit at laoreet in, interdum ut nunc.

Vivamus at dui metus, aliquet vestibulum est. Vivamus lectus metus, varius in tempus et, consectetur ac est. Phasellus rhoncus, enim at pellentesque imperdiet, dolor mi tempus nisi, vel venenatis ligula arcu eget nisi. Ut egestas nulla eget leo bibendum eu auctor nunc dignissim. Class aptent taciti sociosqu ad litora torquent per conubia nostra, per inceptos himenaeos. Fusce egestas, dui in scelerisque tincidunt, eros nunc elementum felis, id laoreet risus magna sed eros. Fusce non risus orci, et volutpat velit. Etiam scelerisque lacinia libero ac accumsan. Nam porttitor nisl commodo orci bibendum at imperdiet orci adipiscing. Vivamus sed nunc dolor. Ut id sapien vitae nibh accumsan aliquam. Nam sed risus leo, quis sagittis elit. Donec euismod felis tellus. Curabitur ut magna libero, vel aliquet est. Aenean eu enim a dolor ornare tristique. Fusce dapibus, lorem vitae pretium venenatis, sapien tortor ultricies erat, non aliquet nunc neque in augue. Nunc gravida elit nec lectus viverra sagittis. Vestibulum quam nisl, auctor a mollis et, porta et nulla.

Not only do they evaluate dental materials, products and equipment, but they also do procedures and hygiene, ranging from latest cosmetic and pediatric dentistry procedures.

I often reference their study on tooth brushing. They found that there was not difference in efficacy of using a manual or electric toothbrush. They do this in a properly controlled, unbiased scientific method. Everything else dentists and consumers hear is the opposite. I’m really thankful to have these guys to help me make the right choices for my patients.

I think the single greatest art form in clinical dentistry is decay removal. I’ve seen cases posted by some dentists where all of the tooth structure is white or slightly yellowish when they are done cleaning out decay.

Other dentists are willing to leave brown and black areas of tooth structure after they are done cleaning out the tooth assuming that they have removed all of they decay.

I always use a stain to help identify decay when cleaning out a cavity. When I was in dental school they taught us ‘extension for prevention’, which basically meant, ‘remove the decay and then arbitrarily remove a little more just to be safe’. That never really sat well with me.

CR Foundation spent 45 minutes talking about decay removal last time I went to their meeting. Nobody else talks about that because no one is going to sponsor them to do it. It really is the most ethical dentistry continued education forum out there.

Having an organization like this keeps me from having to use my own patients as Guinea pigs by trying different materials and tracking how one does compared to another. The work is all done for me.

I come back each time energized not just by the prospect of being able to do faster, better and more conservative treatment, but also a great feeling about doing the right kind of dentistry.

Thanks, Gordon Christensen!

(OK, it was held at Snowbird in Utah, but, my wife and son came with me and skied the two mornings that I was in the meeting. I got lucky this year and it was actually the two worst times to ski in the 4 days we were out there. We had beautiful powder the last 2 days).

This is kind of common. Some people call the problem ‘TMJ’ and it can be terrible. They can have headaches, neck aches, the muscles in their face could hurt, they might not be able to open very wide or can be wearing away their teeth from the trauma.
If the bite is off I’ll believe anything!

Another patient came in as an emergency visit and was having migraines, the patient had been seen by another dentist and a team of physicians. She’d had MRI’s done trying to find the source of the problems she was having.
After seeing her once in the office I figured out that I might be able to help.
The next time she came in I equilibrated her and her condition is so improved that she is not going to have the surgery that the physicians wanted to try.
Cool stuff.

I’ve used magnification and extra strong light sources to allow me to do the most conservative dentistry possible. We call this microdentistry. The company that I get my microscope glasses from is called Orascoptic. I have a great rep, Lynn Pencek if you ever want someone to talk to about it.  Anyway, Lynn came into my office in the end of last year to help me fix some of my glasses and she told me about this new great product her company has. It’s called Orascoptic DK and it is a painless light that allows me to screen for oral cancer very effectively.

The patient rinses with a special rinse, kind of tastes like salad dressing, and then I turn the lights off, shine this special light in the mouth and look for abnormal cells that would shine in the light. These could be precancerous, cancerous or have nothing to do with cancer. See, the problem is that they all look the same.

It’s not uncommon for someone to have white spots of tissue in their mouth. Sometimes if you keep biting your cheek in one area, or if an area repeatedly gets abraded by food as you eat or regular old cold sores can all look suspicious. The light will separate out many of these.

It’s not definitive, but would prompt me to take a biopsy of the area in question. I’ve been using this Oral CDx brush biopsy system for a few years and have had great results. It’s not really invasive and just running a nylon brush across the tissue will gather enough cells to make a very accurate diagnosis of the condition.

I send the cells out to a lab on a glass slide and they get back to me in a couple of days with the results of the biopsy. If they come back positive or with any concern I will either do a regular surgical biopsy, or I will usually send the patient out to an oral surgeon to do so.

I’m really excited at what the two systems can allow me to offer my patients and the security it can give me and my patients, and as I said before it fits in very nicely with the conservative, minimally-invasive dentistry we’ve practiced in our office for 50 years.

You can find out more about these products here:

http://orascoptic.com/index/orascoptic-products-diagnostic-orascopticdk-2

http://www.sopreventable.com/

Good question.

I always tell them to just bring the kids in with them whenever they come in after the kid is about 1 or 2 years old.

The advantage of having the kid see the parents (and older siblings) have their teeth cleaned and having fun in the office is immeasurable.

It gets to be like a privilege or a right of passage.

This is an benefit that I have as a general dentist is that it’s really easy for the parents to introduce the doctor, office and environment to the child in a very non-threatening manner.

I’ll usually let the child sit on the parent’s lap at the end of the parent’s appointment and do as much as the kid lets me.

Typically this might just be to have them open and let me check that their teeth are lining up in a healthy orientation. If I want to check the teeth I can usually get away with having the kid let me ‘count’ their teeth with an explorer and check for cavities at the same time.

Some times this might be just letting the kid ride up and down in the chair if that’s all that they are up to that day.

It’s very rare that I will have a child not be comfortable with actually having their teeth cleaned by the age of 4. This is probably around when they should get some X-Rays and Fluoride any way.

We usually try to make things fun. For the last 10 years we’ve been using a digital X-Ray system which shows the kid a giant picture of their teeth up on a computer monitor. We can colorize the image, blow it up and play with it several ways. Most of my adult patients turn into kids when they see this for the first time. We also have cameras that allow us to look in their mouths and put the images up on the screen.

As a cosmetic Dentist that treats the whole family I’ve been lucky with this so far. A lot of the time the technology that I have for my restorative and cosmetic stuff is actually beneficial for the youngest of patients.

Toothbrushes.

Electric/Manual. Hard/Soft. Blue/Purple with sarkles

So what’s the right choice when having to decide between so many different types of toothbrushes?

When I graduated Dental school in 1989 I had to pass boards to become a licensed dentist. On the boards there was a question about toothbrushes.

The gist was that the contemporary wisdom was that hard bristled toothbrushes would abrade the teeth and gums causing receding gums and grooves in the teeth.

I knew the response I would get when I would tell this to my father, who was a firm believer in hard bristled toothbrushes. He was pretty sure the soft bristled movement was a conspiracy between the manufactures, periodontists and the ADA to drum up business.

He brushed his teeth and gums like a fiend with the hardest brushes available his whole life without any recession or gum disease.

Things got kinda tricky when I got into the office and I had to decide what to tell my (our) patients.

Mostly, I just prayed they didn’t ask anything about it.

I would just tell the two sides of the story and let them choose for themselves and tell them that I used a soft brush if they pressed me.

What was my conclusion?

Well, we had certain low percentage of our patients that had gum problems, but over 90% that brushed properly with the soft bristled toothbrushes were great. Surprisingly, over 90% of those ’scrubbing the hell out of their gumlines’ with the hard brushes had no tooth wear or gum disease either.

Basically. they were OK as long as they used them at the gum line aggressively.

Huh!

So what about electric toothbrushes vs. manual?

Well, CRA (which is basically like consumer’s reports for dentists) found that there was NO difference in double-blind, properly conducted scientific studies!

Zounds! Shocking!

Let me relate my own personal experience to further emphasize this.

We get rep.s from all of the companies coming in trying to get us to hawk their Next Great Thing.

They give me samples of their brushes that they sell to us for $60. and recommend we sell them for $100. Not a big mark-up and barely worth the effort.

Anyway, I started using one of these because it seemed really easy. Just put the magic thing in my mouth and it would do all of the work.Then, I started noticing that my gums were bleeding a little for the first time.

So, I tried using the brush as if it were a manual toothbrush and scrubbed my gums with it aggressively.

Things got good again very quickly.

Bottom line. I don’t think it really matters what you use as long as you take it to the gum line and drive the bristles between your teeth and between your teeth and the gum line.

Yeah, Oral B and Sonicare hate me. But, I’m pretty and healthy in the meantime.

P.S. I prefer purple with sparkles.

High Touch is still the most important technique in caring for patients.

I do a fair amount of public speaking and it was interesting when I realized that I was a rare breed as being a third generation dentist.

I had the priveldege of working with my Dad, Joseph F. Dillon, DDS, after dental school.

In those years I started understanding what some of the realities were in dentistry.

There was a lot that I had to relearn when I graduated Temple Dental School in 1989. This was partially because of the advent of adhesive dentistry.

The phrase “paradigm shift” kept being used. This basically meant ‘forget all that stuff we just taught you, you need to be doing it this way now!’ Bonding, veneers, whitening, Implants, digital X-Rays and other techniques that made dentistry faster, less invasive, more painless and BETTER were all coming around.

I learned quickly the advantage of taking a lot of continued education classes, because it made dentistry easier, more fun and BETTER!

But the other side of things were the tried and true clinical techniques my father had seen work throughout his 40 year career. There were many things that weren’t really in-vogue to teach.

Before companies were trying to figure out a way to make a profit off dentists by teaching them Soft Tissue Management non-surgical treatment of periodontal disease my father had made a successful practice of doing so with inferior tools and adjuncts. Things like Periostat, Atridox and Arestin were not available, yet when a student from Penn came out and screened his patients for perio he found them in top 10% nationally without routinely subjecting them to gum surgery as much as most other dentists.

More importantly I benefited from the things I learned that my grandfather taught to my father.

When I met the old-timers in dental school they’d see my last name and ask if “Joe” was my father.

After, I’d say ‘yes’ they’d all invariably exclaim, “I knew your grandfather, he was a great guy!”

Not that my Dad wasn’t, but they would all tell me how my Grandfather was credited as being one of the first people in the area to teach dentists practice management. I came across things that my grandfather wrote and it’s funny that they are the same things that I hear practice management gurus all put their name to these days. Verbatim!

Things like imagining your patients have a sign on their chest saying, “Make me feel important!” were basic tenants to the practice of dentistry in our office.

I’d like to like to think that if my Dad and his dad were looking down on me they’d be pretty happy with my privilege of carrying on the tradition of caring for our patients.