Ben and Gary Show Episodes

What Procedures Do Periodontists Do?

I am solo today. Gary is away learning about Airway dentistry.

We were asked what procedures periodontists do. It is probably best to first answer...

What is a periodontist?

In addition to the standard four year dental training program, a periodontist undertakes three additional years of formal training. 

He specializes in the treatment of bone loss around teeth, the most common cause of tooth loss, and gum disease.

What procedures do periodontists perform?

A periodontist is trained in laser and surgical treatments to regenerate bone and restore gum health.

Using these techniques, he repairs loose gum tissue restoring the gum seal around the neck of the tooth. This protects the tooth from inflammation and further bone loss.

Once gums and bones are restored, periodontists also place dental implants to replace lost teeth.

Can general dentists treat bone loss and gum disease?

General dentists can and do treat gum disease and bone loss with non...

Who Needs Antibiotics Before Dental Procedures?

Patients who have heart issues or joint replacements are often advised to take a precautionary antibiotic before undergoing dental procedures. 

Is this a good idea for all patients? There is a presumed risk of infection related to dental procedures for susceptible patients.

There is also the possible risk of antibiotic resistance which might compromise a patient's treatment in the future. 

What is the tradeoff? Our view is that it depends upon the health of an individual patient. 

Patients Who've Had Joint Replacement Surgery

Orthopedic surgeons have varying opinions about precautionary antibiotics:

• some recommend it
• some recommend it for the first year following surgery
• some do not recommend it

Nobody really seems to know for sure what is the best practice. We follow the recommendation of the surgeon. 

Patients With Heart Issues

 The American Heart Association recommended prophylactic antibiotics before...

And You Thought You Knew How to Breathe!

In this episode, Gary goes solo. Ben is away.

He reports on a course he attended on airway patency - how open your airway is when you sleep. This is a complicated subject we will talk about more.

Sleep Apnea

Sleep is how your body repairs itself. When sleep is interrupted due to sleep apnea (when you stop breathing and wake up), your body's ability to repair itself is also interrupted. Sleep apnea is diagnosed and treated based on how many sleep disruption events happen during the night.

Upper Airway Resistance Syndrome

Some people experience sleep disruptions that are not diagnosed as sleep apnea but also result in sleep disruptions (arousals). These are caused by partially closed airways. The condition is called Upper Airway Resistance Syndrome.

Not only does this condition result in poor quality sleep, but it can also cause depression, anxiety, and pain.

How is Upper Airway Resistance Syndrome Diagnosed?

Upper Airway...

Should You Make Your Own Toothpaste?

We got an interesting question from Katharine. She said a top toothpaste irritated her gums.

Her dentist suggested that she try baking soda with peroxide. She wants to know our take on the pros and cons.

First, there are two reasons a toothpaste might be irritating to the gums.

• If it is whitening toothpaste, it may contain silica (sand) which irritates the gums
• If it contains a high concentration of lauryl sulfate (soap), it has a drying effect on the gums

Homemade toothpaste made of baking soda and hydrogen peroxide pros:

• A toothpaste made of baking soda and hydrogen peroxide was recommended back in the day to treat periodontal (gum) disease
• Its foaming action penetrated the gum pockets with oxygen, killing the oxygen phobic bacteria found there
• You can make your own or buy a formulation

Homemade toothpaste made of baking soda and hydrogen peroxide cons:

• This toothpaste is missing fluoride
• Fluoride has a significant value in preventing...

Can My Gums Kill Me?

Ben goes solo in this episode as Gary's off to California for continuing education followed by some family R&R.

We got this interesting question. Can I die from gum disease? The short answer? Yes and no. No, not directly. Probably yes indirectly.

The link between oral health and overall health, the oral systemic link, is one of the hottest topics in medicine. As it turns out, the bacteria found in the mouth that causes gum disease is the same type of bacteria found in the plaques on artery walls. 

This suggests a link between heart disease and gum disease. Heart disease can lead to heart attacks and strokes. Well, we don't want that!

Maybe the link is a good enough reason to pay closer attention to our dental health. Gum disease is progressive. It causes bone loss which ultimately results in tooth loss.

Missing teeth allow remaining teeth to shift, misaligning bite. Remaining teeth carry an extra force load. Remaining teeth are...

How Long Do Implants Take?

Don't Start With Implants, Start With A Plan

We got this question from a man in his late sixties with good dental hygiene habits but infrequent dental visits due to living in a remote location. He thinks he needs four implants.

He also has some crowding. He wants to know how long it will take to restore his teeth.

Dr. Dan Pinto, our new restorative specialist joins us to answer this question. Without having seen him as a patient, we are going to address the probable steps and considerations in building this man's restoration.

Diagnosis and treatment plan

We always want to start with a complete picture of where a patient is right now. We take x-rays and for bigger cases build a study model to compare with x-rays. We consider medical history.

From there, we work out a restorative treatment plan. The plan may include addressing any gum health issues. We don't dive in and do implants or any other procedure blind. 

Patient goals

We...

Do We Need To Floss?

Just The Teeth We Want To Keep!

Dr. Dan Pinto is back to help us answer today's question. Do I have to floss?

A while back the NY Times was the first to report that the benefits of flossing are overrated. Are they?

What does flossing do?

Consider what flossing does for us. Flossing helps remove plaque from between teeth, a common area of decay in adults. Flossing improves oral health. We now know that an unhealthy mouth is the source of problems elsewhere in the body.

Do electric toothbrushes and water picks replace flossing?

Makers of electric toothbrushes and water picks want us to believe their products eliminate the need for flossing. Plaque is sticky. A forced stream of water does not remove it.

Think of a dish with stuck on food. It takes more than a stream of water to clean it. It takes some mechanical scrubbing. Plaques removal needs the mechanical action of flossing too.

There are many benefits to electric toothbrushes and water...

 There's A New Man In Town

Meet Dr. Dan Pinto, Smiles International's new associate. Dan is finishing up his training in Prosthodontics at the University of Buffalo and will begin practicing with us in August.

Raised in the Fingerlakes region of upper New York state, Dan is looking forward to some warmer winters with less snow. He vacationed here as a child, enjoying especially the Air and Space Museum.

Dan's hobbies

Dan has a passion for soccer. His Dad is from Bolivia. He believes his love for soccer is in his DNA. He looks forward to watching DC United.

He is a fan of Luis Lionel Andres (“Leo”) Messi who plays for FC Barcelona club and one of the best players in the world.

Dan has also earned a second degree black belt in Tae Kwon Do. The five rules of Tae Kwon Do are courtesy, integrity, perseverance, self control, and indomitable spirit. We definitely see that in Dan.

Dan recognizes that fitness is an important requirement of the practicing...

Mouth Guards

Why do you need them? 

Due to sports injuries and accidents, we see patients with fractured, dislodged, and knocked out teeth. Most of these could have been prevented with mouth guards.

Most of us know boxers, hockey and football players use them. But anytime you are moving fast, there is the possibility of falls that result in damage to your teeth. Unfortunately, protective mouth guards are underutilized.

Soccer, softball, lacrosse, and soccer players should use them. But skateboarding, ice skating, even bike, and scooter riding can result in falls that damage teeth.

 What options do you have?

OK. So you need a mouth guard. What are your choices? The boil and bite mouth guards sold over the counter are one choice.

To use one, you heat it and create a custom fit by biting into the softened guard. These can be bulky and uncomfortable. They can also make it more difficult to breathe. However, they are easily available and less expensive...

Dental Sports Injuries And Accidents

What To Do To Save The Tooth

Whether a parent, coach, teacher, or friend, you may be faced with a dental emergency. Here is what to do to save the tooth.

Broken tooth, nerve not exposed

A broken tooth with no nerve exposed may be saved. Head for your dentist with the injured person and, if possible, the broken piece.

The dentist may be able to bond the broken piece with the tooth or replace the missing part with a bonding material.

This is a good temporary solution for a child or young adult. Later, a more permanent restoration such as a veneer or a crown may be advised.

Broken tooth, nerve exposed.

A broken tooth with the nerve exposed is restored in the same way as a broken tooth without nerve damage. However, depending on how the tooth responds over time, a root canal may be advised.

Dislodged tooth

If a tooth is knocked loose from its socket, it still may be saved. If you are brave, move the tooth back into place immediately. See...