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fear
Ice climber
hartford, ct
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Plenty high enough. Problem is not the speed but that having an actual 120v electric motor in your mouth is generally regarded as poor form.
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High Fructose Corn Spirit
Gym climber
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Micro, thanks!!
I intend to follow every bit of your beta. Your expertise is much appreciated.
I'll see how it goes and report back.
...
That you do about 300 implants a year is... simply... AMAZING. I'm sure this translates to MUCH pain and suffering reduction for hundreds of people. Amazing science and art form you do. Kudos.
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ms55401
Trad climber
minneapolis, mn
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thanks for the info
what's your take on the importance (or not) of flossing? have seen at least a couple pieces in reputable newspapers saying it may not be necessary and that its impact has not been rigorously assessed
I floss -- most but not all nights -- but would be just as happy to have 2 minutes returned to me
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micronut
Trad climber
Fresno/Clovis, ca
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Topic Author's Reply - May 9, 2017 - 05:29pm PT
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ms55,
That "Anti-Flossing" ad/rhetoric/article has been making the rounds lately. Its kinda funny. How do you feel about showering in general. Or changing your socks?
Don't shower for a week....smelly. A month, possible skin sores and serious flaky funk. Three months? Rash, inflammation, scabies?
The thing with flossing is this. Yes, its a hassle. But Brushing alone only removes about 70% of the plaque mass. Leave enough plaque in between the teeth for long enough and you'll get inflammation, cavities and eventually gum disease if you are at all susceptible.
Some people use toothpicks or little skinny floss picker thingies. But those are usually a bit too chubby to fit under the contact point. If they happen to fit for you, then that's kosher. Its not that floss is something magical in itself. Its just recommended to get all the plaque off your teeth every 48 hrs or so in some way shape or form.
Mouthwashes won't do it. They can't penetrate under that ticght contact point. Waterpik is a maybe and works in some cases if the teeth and spaces are just the right size (More spaces is better for Water-Piks).
Bottom line, whoever wrote that article got some media time and some click-bait. But overall the point is that in order to avoid gum disease, you need to do something in your daily routine to get between the teeth. Hope that helps!
Here's a quick public service photo for what I fix every day. Come see me if you don't like to floss and end up looking like this guy! As a Periodontist I see about a case like this every three days or so. Love it!!!
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Reilly
Mountain climber
The Other Monrovia- CA
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Aaaargh! Now I'm motivated to go to my hygienist, Madame Torquemada, this Thursday:
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rottingjohnny
Sport climber
Sands Motel , Las Vegas
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Micronut....Wouldn't it be cheaper to have all your teeth pulled and replaced with dentures...all those dental procedures seem too expensive...? rj
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Fossil climber
Trad climber
Atlin, B. C.
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Thanks Micronut --
I was once a medic/dental tech in the Navy (Korean War) and appreciate what you do. Thanks for offering free advise!
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Jaybro
Social climber
Wolf City, Wyoming
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May 10, 2017 - 06:35am PT
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What if you get a phaser, I mean laser, beam to the brain?
Ps I found some implants I can afford....
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micronut
Trad climber
Fresno/Clovis, ca
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Topic Author's Reply - May 10, 2017 - 09:27am PT
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Del Cross,
I was kind of kidding about the shower analogy. I've gone 28 days without it in the backcountry with no scabies! But spend some time in hospitals with indigent folks who don't/cant bathe and you'll see it ain't so fresh and clean.....gnarly skin diseases can come from bacteria left undisturbed on the surface.
The bottom line with the flossing points I made (and this IS steeped in years of clinical trials and induced pathogenesis models ad nauseum) is that if you leave a "periodontopathogenic" plaque mass between the teeth long enough you get breakdown of the periodontal ligament, chronic inflammation, eventually bone loss and gum disease. Let alone decay if you are susceptible. Whatever you chose to use break up that plaque film use is fine. Floss is just one of the most effective in most mouths with normal spacing and contacts.
REMEMBER: You don't have to floss ALL your teeth........JUST THE ONES YOU WANT TO KEEP!
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micronut
Trad climber
Fresno/Clovis, ca
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Topic Author's Reply - May 10, 2017 - 09:43am PT
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SomebodyAnybody,
Sounds like you are on the right track in general. Here's a couple thoughts from my own practice and I'm a periodontist.
1. For early gum disease (4-6mm pocketing), Scaling and Root Planing (deep cleanings) is the first line defense. We don't use a laser at this stage but some offices do. It may have some small benefits at that level, but I don't tend to see much improvement in doing it with a laser or just doing it by hand alone. The laser is a bit of an adjunct if anything at that setting. The laser at the low levels allowed for a hygienist, kills some bacteria and stimulates circulation at a micro level. Its not the surgical setting I use that has a cutting/coagulating function. But I can't justify charging patients for it since I have a rock-star hygienist who is amazing and gets great results without the laser. If she does her two visit tango and gets all the tartar off from below the gumline, removes some inflammatory tissue in the process with her tools, and motivates/shows you how to take care of it at home, that early gum disease GOES AWAY. She's a wizard with early periodontitis cases.
2. As the gum disease gets more severe (5-8 mm pocketing, bone loss and mobile teeth) we then bring out the big guns and do LASER Gum Surgery. I use the LANAP protocol and its invasive but conservative and does an amazing job at stopping the disease. Its about 5-6k and is really thorough, but it saves teeth and is really a fantastic option vs. losing your teeth.
3. Lastly. Periodontitis (gum disease) is a disease PROCESS. Think of it like diabetes or high blood pressure. Susceptibility, genetics and your behavior all play major roles. You can be stable and "cured" for a while and the disease can stay away or surprise you and come back. Sometimes its the patient's fault.....no cleanings for a while, they stop flossing, eat like crap and neglect their mouth and the disease returns. Sometimes the patient does everything we ask them. They do the deep cleanings. They improve their homecare and diet. They do the surgery.....and they still decline. Its tough. That's what makes working on the human body so challenging.
My goal is to always do my best to keep them healthy with the most conservative treatment possible and to watch them closely for relapse and stomp on it if it rears its ugly head.
Just know that if you have dealt with some gum disease in the past, you need to keep a close eye on it (3-4 month cleanings is standard for maintenance) and be willing to re-treat if things start to come back a bit.
Hope that helps!
Scott
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Russ Walling
Social climber
from Poofters Froth, Wyoming
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May 10, 2017 - 04:58pm PT
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Micro! You got a bag of falsies for me yet?
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micronut
Trad climber
Fresno/Clovis, ca
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Topic Author's Reply - May 10, 2017 - 05:50pm PT
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They did suggest I either quit coffee or brush right afterwards, saying the staining was harboring the bacteria
Dude thats terrible and totally false!! Seriously!
Do not stop drinking coffee.....I drink three cups a day. It's one of the joys of life. Do not give it up. There is no research to support that nor have I ever seen it and I do this all day long.
Just be a good thorough brush and floss or when you do it. And maybe consider drinking if you sips of water after your last cup of coffee if stain is a real issue for you. It really has nothing to do with gum disease so don't worry about it.
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micronut
Trad climber
Fresno/Clovis, ca
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Topic Author's Reply - May 10, 2017 - 05:52pm PT
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Russ I got nothing man. I just do gum surgery. You need to find a dental lab!
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Jan
Mountain climber
Colorado & Nepal
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May 10, 2017 - 07:33pm PT
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I have questions regarding bone growth in the mouth. I have a cauliflower shaped bony lump on the roof of my mouth which shrinks or grows depending on the amount of supplemental calcium I take. The other is that I have prominent bony phlanges running the sides of my upper jaws. My Japanese dentist in Okinawa when I lived there told me he had never seen those before (the lump in the roof of the mouth he had). He also said in his dental book that they mentioned it was typical of Eskimos. Since I am about 10% Native American and have mildly shovel shaped front teeth, I attributed it to that.
Now my American dentist (trained in Cleveland) says that he thinks they are the result of me grinding my teeth. Since I have never had any indication of that and I have slept in rooms full of people in Asia who probably would have noticed, I was doubtful, but he was adamant. He also said I could never be fitted with dentures on my upper jaw because of the bony protrusions and would need implants instead.
I know that Eskimos particularly the women, used to soften leather by chewing it so maybe that was equivalent to grinding teeth??
I'm wondering then what you make of all this?
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zBrown
Ice climber
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May 16, 2017 - 02:13pm PT
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Your thoughts on the going rate for sinus lift bone graft plus implant and crown (in Southern Cal) would be appreciated.
I didn't even know such a thing existed and, luckily for me at least, it's not my jaw.
40,000 year old human mandible, believed to be Romanian
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High Fructose Corn Spirit
Gym climber
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May 16, 2017 - 02:40pm PT
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Micronut's advice in my case was right on.
My dentist excavated an old filling, then refilled it with new composite. The investigation showed not only new caries under the old filling but also the depth of the caries approached very near the root; indeed he said he could see through the remaining layer after cleaning out all the decay (a trained eye, I guess) right to it, i.e., the root, and dared not go any deeper. I asked about a future root canal probability. Pressing him, he told me 70-30 odds. I asked 70-30 against or 70-30 for. He said 70-30 for... root canal. So I've started preparing for one, expectations-wise.
All that was many months ago. So far so good. In other words, no pain. At tooth #31. In the meantime I've shifted my chewing (esp hard stuff, like ice cubes, no just kidding), 90 per cent of it, say, from my right side to my left. This was awkward at first but now it feels "second nature". So harray for all that.
Thanks, Scott, for your advice. It helped in the decision-making.
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Spider Savage
Mountain climber
The shaggy fringe of Los Angeles
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May 17, 2017 - 07:53am PT
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I've got a decent dentist. Year after year, never finds anything. Just cleans and sends me on my way.
So this kid I know is diagnosed with six cavities to fill. He doesn't have the money and puts it off for 3 or 4 years. I send him to my dentist and nothing! No cavities. Cleans his teeth and sends him on his way.
So, what is the deal? Are fillings optional?
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micronut
Trad climber
Fresno/Clovis, ca
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Topic Author's Reply - Jun 28, 2017 - 04:34pm PT
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Jan, ZBrown and Spider....gimme a few minutes to come up with some replies....starting a surgery in a few minutes. I'll get back to you asap.
HFCS glad to hear I was some help in your situation!
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micronut
Trad climber
Fresno/Clovis, ca
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Topic Author's Reply - Jun 28, 2017 - 04:43pm PT
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Jan you have what is called a Palatal Tori or Torus Palatini. VERY common. I see two or three a week. I often point them out to the patients who have no idea they have them...even big ones. They can range from fairly small...
to big old honkers....
Here is some cut and paste from the interwebs that seems spot on.
Palatal tori are more common in Asian, Native American and Inuit populations, and twice more common in females. In the United States, the prevalence is 20% - 35% of the population with similar findings between black and white people.
Although some research suggest palatal tori to be an autosomal dominant trait, it is generally believed that palatal tori are caused by several factors.[1] They are more common in early adult life and can increase in size. In some older people, the size of the tori may decrease due to bone resorption. It is believed that tori of the lower jaw are the result of local stresses (like clenching and grinding) and not solely on genetic influences
If they don't bother you, we don't typically remove them. Its a bit of a hassle surgery and can be pretty painful for a few days afterwards. If a person does end up needing a full upper denture then we do remove them so the denture can fit nicely up against the roof of the mouth. Good luck and let me know if you have any more questions!
Scott
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micronut
Trad climber
Fresno/Clovis, ca
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Topic Author's Reply - Jun 28, 2017 - 04:49pm PT
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ZBrown my fees up in Fresno are as follows:
Surgical placement of implant $2700.00
Bone graft or Sinus lift about $1500.00
This does not include the price of the tooth/crown that goes on top of the implant once it heals up and is ready for "restoration."
Hope that helps give you a framework for what you might end up needing. Cheers.
Scott
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