Geriatric Dentistry – Being Old is NOT a Disease!

By Dr. Max Zaslavsky

Ft Lauderdale Dentist Elderly

Dentists can be quite discriminating on the patients they are willing to treat.  A growing amount of seniors are in dire need of proper dental care but only few dentists are interested in taking care of this segment of our population.  Some dentists do not discriminate but sadly, lack the proper skills and tools to properly address the dental needs of the elderly.  Finding the right dentist for the care and dental needs of the elderly should not have to be hard to do.  Knowing the dental needs of the elderly and doing a little bit of research in locating the right dentist for seniors, one who has training in geriatric dentistry, is the right step in getting the proper dental care for the elderly.

Hence the first proper step in choosing the right dentist for old people is to judge whether the dentist has the proper and needed skills and tools available to treat old people.  You can also seek recommendations from people you know and see if they know a dentist who may be qualified at treating old people.

When you have found a potentially good dentist, make an appointment and come with questions.  There are dentists who find no problem accommodating visits to assisted living facilities, houses or nursing homes since they know most elderly people live in these types of dwellings and that many old people have difficulty traveling or cannot travel at all.   These dentists know that providing dental service to the elderly may necessitate exactly these kinds of situations.

For the elderly who are able to adequately care for their dental health, there are many ways in maintaining the health and strength of the teeth that can prevent them from needing to go to the dentist.  Good healthy teeth is actually much more valuable for old people since they make eating a much easier activity to do.  If they still have their own natural teeth, updated techniques for flossing and brushing can make their teeth cleaner and healthier.  The elderly also need to be aware of the effects of their medications particularly its effects on their oral health.

A little research can come a long way in the proper dental care of the elderly.  You need to ask the right questions to ascertain a dentist’s ability in giving proper and correct care for the aged.  If they pass the criteria you are looking for and if you feel you can trust the dentist, then go for it.  Also you need to know whether the dentist is fine with your senior’s insurance coverage and whether he/she does entertain house calls.  Finding the right dentist for the elderly may take just a little effort on your part but the outcome will be worth your while.


Cancer Schmancer

By Dr. Max Zaslavsky

Ok I copied that from Fran Drescher’s book. But you know my mom was a big Nanny fan, and I was tortured as a kid to having to watch it with the folks. Even worse to admit; at one time I knew all the lyrics to the theme song. Nightmares of her laugh were recurrent, but the book title is important for the sake of this topic.

In the last 3 weeks I have seen 3 patients who have either had radiation to the face or will be going for treatment in the coming weeks.  The specifics of smoking, lifestyle habits etc. obviously have some impact on why they got cancer. We are all predisposed for something, and if we neglect ourselves, these erratic mutations will become life threatening. The thing that stinks even more is sometimes you don’t even have to neglect yourself, life just happens.  My dad died of cancer. He never smoked a day in his life, but succumbed to cancer of the stomach and esophagus.

My advice as follows is for people who already have cancer and how we can treat them, especially when they will be getting radiation to the head and neck. First and foremost, GET ALL DENTAL TREATMENT DONE BEFORE YOU GET RADIATION. Yes that’s in caps for a reason. Your healing will be slower if you begin to get radiation and then need a tooth to be pulled.  Slower healing = more painful healing.  All necessary extractions, whether it’s wisdom teeth or removal due to infection, should be done prior to any radiation treatment. If a tooth needs to be removed during or after radiation treatment, you run the risk of a condition called osteoradionecrosis. Not to go into too much detail, but the jawbone can actually dissolve, become infectious, or even break if osteradionecrosis incurs. Do you want to be that person who ignored my advice and lands up needing to be admitted into the hospital for a dental infection? Pre-planning is a must in order to prevent such a debilitating disease.

Once you undergo radiation, your salivary glands will become decimated.  Since saliva is a buffer that helps prevent dental decay, you will become more prone to getting cavities. These cavities can grow exponentially in as little as six months in the absence of saliva. Talk with your doctor about your options. In my office I suggest a cocktail of various gels, pastes and rinses that will help prevent decay and tooth loss. We use a combination of a saliva substitute (i.e. Biotene) in conjunction with a prescription fluoride toothpaste (Prevident, Prodentec), and a calcium/phosphorus paste (MI Paste).

I also endorse a very simple rinse to endorse a stable oral environment in the mouth. It’s as simple as going to your local dollar store. The rinse can be made simply by combining baking soda and hydrogen peroxide. Yes, it tastes like crap, but the baking soda is neutral and will help create a more neutral environment in your mouth.

So look into these options. If you have cancer, I am sure you have a lot going on right now. But as the saying goes, never give up the ship. Fight the good fight. No success in life was ever accomplished by giving up in life, and I hope you have a good support group around you. I know we were there for my dad when he was ill. And when you need help for your mouth, and living better by just being able to eat and swallow, contact us! We are here for you!

If you have any questions or comments please leave them in the comment section below. I’d love to hear from you.


New Studies Amplify the Health Risks Associated with Periodontal Disease and the Benefits of Treatment.

By Dr. Max Zaslavsky

At the October 2011 American Heart Association scientific sessions in Orlando, two very large studies amplified the increased risk of heart attack and stroke caused by deep periodontal pockets and bleeding – as well as pointing out the benefits of having your teeth professionally cleaned to reduce these risks.

In the first study, 7999 patients with periodontal disease in Sweden were evaluated. Those with a higher number of deep pockets had a 53% increased risk of heart attack. Those with the highest incidence of gum bleeding had more than twice the risk of stroke.

In the second study, 102,620 patients in Taiwan were followed for seven years. Those who had their teeth professionally cleaned at least once per year, had a 24% lower risk of heart attack and a 13% reduced risk of stroke compared to those who had their teeth cleaned once or less in two years.

These huge studies by physicians may be the tipping point that we now have irrefutable evidence of the connection between periodontal disease and systemic health. In addition to these studies, we have scientific evidence for 21 different conditions listed below that are affected by periodontal infection and the resulting inflammation involving virtually every organ system in the body.

1. Heart disease
2. Infectious endocIrdl1is
3. Carotid artery stenosis
4. Stroke
5. Diabetes
6. Rheumatoid arthritis
7. Mouth and throat cancer
8. Pancreatic cancer
9. Colon cancer
10. Kidney infection
11. Lung infection/COPD
12. Low fertility in men
13. Erectile dysfunction
14. Brain abscesses
15. Cognitive dysfunction/Alzheimer’s
16. Infectious Mononucleosis
17. Pre-term babies
18. Yeast infections
19. Multiple sclerosis
20. Osteoporosis
21. Congestive heart failure in dogs

Periodontal Disease

How to Have a Jolly Holiday in Fort Lauderdale without a Dental Emergency.

Geriatric Dentistry – Being Old is NOT a Disease!

By Dr. Max Zaslavsky

In my practice I have had patients in their 90’s with all of their teeth, and I have a 20 year old who currently began his first of 3 root canals. Although these are extremes, we see everything in between- Diabetics, HIV patients, pregnant women.

The in between is by far the most interesting. Recently I had a patient in his 50’s come in with a tooth that needed to come out and needed an implant. He opted for a bridge because he said, “if I was younger, I would get the implant. Who knows how much longer I have to live.” Aside from the tooth, he was a healthy guy. The sad reality- implants are primarily made for an older generation. Young people shouldn’t be losing teeth.  In fact, no one should be losing teeth. We are our own worst enemy. People are getting fatter, portions are getting bigger. We don’t floss. Energy drinks are melting your teeth away… Yes, melting!

Geriatric Dentistry

Everyone tells me they brush. I have never had anyone tell me they don’t brush, but most of my patients wince when I ask them how often they floss. If you are drinking a Monster, Red Bull, etc., you are literally melting your teeth with acid. You know how crazy that is? Your teeth can survive a fire. In fact, a lot of people who were victims to 9-11 were identified by their dental records. We are what we eat; and someone who sips on a big gulp from a 7-11, or even a diet Red Bull throughout the day, will erode their teeth via the acid content.

The fact remains; you will live a healthier life if you floss. Your heart will be stronger. Your gums and surrounding bone will be stronger. There are countless studies to show you will live longer if you floss on a daily basis. As the population ages, I have seen many patients opting for dentures. After all, their parents had them, so why not? This should not be the mindset in this day and age. We as a progressive nation, in times of the internet should be looking into dental implants. If you broke a hip, you would be looking to get a hip replacement wouldn’t you? Or would you want to be on crutches for the rest of your life? Well, we can give you your teeth back. Sort of like the Bionic Man and Terminator rolled into one glorious dental implant.

Look, no one jumps for joy when they have to wear a denture. I will make for you the best looking denture in the world, but dentures are not sexy. The reality is, when I have to make an upper plate/denture for a patient, although they can function with it, I am covering up all those taste buds on the palate.  The more that taste are buds covered, the less a person can taste, and the more prone for someone to add unnecessary salt for flavor to their diet.  The more salt intake, the greater the incidence for high blood pressure and kidney disease. Kidney disease = renal failure and possible dialysis. Am I being extreme? Not really. I see it every day in my office.

So I want you to floss. I want you to keep your teeth. I want you to stop drinking that high in acid energy drink. If you smoke, STOP.  Heck, I would even like you to get on a treadmill for 20 minutes. I want you to be my next 90 year old patient with all his teeth and some fillings here and there.  And most important, look both ways when you cross the street, and you can DEFINITELY live to be 90.


“But I Like My Tongue Piercing!”

By Dr. Max Zaslavsky

Tongue Piercing1

When I was 20 years old, in college at University of South Florida, I decided on my own to go get my tongue pierced. This was back when I had long hair (when I had hair), multiple piercings in my ear, and I would be in a mosh pit on a weekly or monthly basis as I was bitter for no apparent reason other than to be bitter (blame it on El Nino). How those were the days when I was blasting Nirvana, The Crow Soundtrack, Uncle Luke and The Macarena all in the same car ride to wherever I was going.

The one thing consistent with change is well….change. The hair has been cut off, the piercing are gone (but not forgotten), but the music is not forgotten. In fact, the tongue piercing came out right before my dental school interview. How in the world would I even get through a dental school interview when I would have a metal stub sticking out whenever I spoke?

Looking back, knowing what I know now, the tongue piercing was a dumb idea (Sinatra singing in the background now Regrets….I had a few).  In fact tongue piercings can create a lot of problems for the long term. Patients that I see here in the office say, “Well I can use a plastic stub for my tongue.” The reality is that even a plastic post can break teeth from excessive wear. Granted, the trauma will not be as bad as a metal post, but do you really want stick something through your tongue if you knew that it can break the very teeth you need to keep in your mouth? Extreme cracks may cause the need for fillings, crowns or even root canals.

The second thing to look at is the possibility of infection and swelling. A piercing, tongue or otherwise is an invasive procedure. Worst case scenarios can be a portion of your tongue being removed due to infection, to even bacterial endocarditis which is a severe infection of the heart.  So I guess you have to ask yourself, is it worth it?

The last thing I want to cover is difficulty with speech and swallowing. When you pierce your tongue, your tongue will swell. When it swells, your capability of chewing and digesting will change considerable during the healing process. Your tongue is a muscle that is used to shift food around to your teeth. When you swell, the capability to chew your food can be so interfered with, that you will be digesting larger chunks, thus screwing with your digestive track. Between that, and slurring all your “S” words, I say to myself, “What the heck was I thinking?” But hey, I had to be a little bit nutty to walk into that tattoo shop and just say to the piercer, I want to pierce my tongue.

To quote Ozzy,” The youth is wasted on the young.” No regrets in how I have lived my life, and if you want to get that tattoo, and pierce something, who am I to tell you no? In fact, I am sure we all wish we did a little bit more back in our teens and early 20’s. Maybe you should have stopped reading so many comic books and asked that girl out…..or not had spent so much of your allowance on Mortal Kombat.  But I digress….

Photo Credit: 416style

“If this Blog Post Helps at Least One Person Quit Smoking, I’ve Done my Job… Preventing Oral Cancer.”

By Dr. Max Zaslavsky

Dental Oral Cancer Fort Lauderdale

When I first bought my office here in Ft. Lauderdale, I thought I would be doing a lot of veneers, cosmetics, botox, etc. As the office has evolved, and how I am on staff with Imperial Point Medical Center here in Broward County, I have been doing a lot more medical based dentistry in addition to the fun cosmetic work that I am more accustomed to. This is in no way to say I am disappointed in this evolution. I am a healthcare professional, and my role as a dentist is to educate on aid in prevention in various facets.

To transition, the picture you see is not something I got off the internet. This is an actual patient who came into my office for something COMPLETELY different than what this photo entails. He had actually come in for a toothache, and to discuss the possibility of dentures or implants. Seeing this upon our comprehensive examination was unavoidable.  In my mind I was thinking for the best. “Well maybe if we take out some of the infected teeth, this swelling area will go down.” But it didn’t and I sent him immediately for a referral.

This white blip in the photo is cancer. To be specific, it is squamous cell carcinoma. The extent of which is to be determined. However he will lose a sizeable portion of his palate along with a possible loss of vision if the cancer has gone too far to his eye. If the cancer is more extensive, he can lose his life. So things just got very real for a good person who smoked too much for too long.

Now you’re wondering maybe, “how did it get so bad….. Or maybe, why did this person wait so long? Those answers I can’t give you. Or at least in this article, there’s no need to. When a patient walks into our office at that given moment, I can only treat what is present. Sure I wish I had seen him a year before.  I know I could have prevented what would now be coming. Did you know that 90% of cancers can be prevented at stage 1?

I hope between what you are reading and the prognosis of this person, it will make you think twice the next time you light up a cigarette. Smoking causes cancer. If you think it doesn’t, well, you’re a fool. The facts are there and we as healthcare professionals can help you. Chantix and Welbutrin are viable options, and you should ask your healthcare provider on what would work best for you.  We can help you quit. We can help you have a better life.


The DANGERS of Dental-Tourism: Buyer Beware!

By Dr. Max Zaslavsky

Dentistry in this country is expensive. Medicine in this country is expensive. Trust me I know. I recently went to my local hospital and was billed $1200 for a stress test (and this was after insurance). We do not live in a socialized medicine system. Not yet, perhaps not ever. And if you think that would be a viable solution, well think again. There are pluses and minuses to any system when it comes to individual healthcare. At times, however, I will have a patient tell me they plan on going to a 3rd world country to get their dental concerns and needs cared for.

Medical tourism is becoming a hot ticket these days, especially for dentistry. Why pay so much money here for needed care when you can stay in a nice hotel and get all the work done in a matter of days? Then poof, off you go, back to the good ol’ US of A, and back to reality. Well I’m here to tell you that there are a lot of problems these days with medical tourism.

Inadequate research

First off, what people proclaim as, “I do my research!” are merely them going onto a website that looks good to them; and feeds them what they want to read. People, you cannot believe all the hype that a website gives you! Not all dentists are created equal, not even in this country! There is a good and bad everywhere. At least when you go to a dentist in your local market, a friend or a neighbor may know the practitioner and can give you the real low down. This leads to problem No. 2…

You’re back in the USA and there’s a problem

You just had all this dental work done. You think you are stellar and now you’re back in Fort Lauderdale ready to take on the world. Uh oh, you have a tooth ache. How can this be? You just stayed at the Costa Rican/Brazilian, etc. resort and had all this work done. Dentistry is a practice. Adjustments, corrections, and especially infections happen. Even the best of what I do can succumb to really bad events depending on the patient and their host response. I once had to take over a case from a patient who had gone to Colombia for his dental treatment. He walked into my office with 3 implants in his hand (yes his hand, not in his mouth). The treatment for this patient was far more expensive in the long run than if he had just done the work in this country. No dentist here wants to take over something in the middle rather than the beginning. Reactive dentistry is not fun.

Implants and other medical devices in other countries are not FDA approved.

In my office, we use grade 4 titanium implants. The majority of implants are grade 4. But it’s not just the metal. It’s the engineering of the metal that creates the integrity or success into bone. Implants come with an expiration date. Meaning if my Straumann Implant is not used by a certain time, it is no longer covered under warranty, nor should it be used. If I use it, and it fails, I can be sued. I may lose my license if I tried to pull that off unsuccessfully.

In other countries it’s not like that. There are companies in this country that take expired medical devices and sell them to other countries where there are no rules or regulations. So although I have to follow certain amount of ethics if for no other reason than to be law abiding, it does not work that way in another country. That Straumann or Astra implant I use here in my office is not the same used in another country; especially if you are paying half the price. If it’s too good to be true, it is.

My crown fees are higher than what you would pay for in most other countries. Again, I have to abide by certain rules and regulations. My labs charge me more, because just like what I do, they are based domestically. When, at times, there is a problem, our local lab can make the necessary adjustments within 5 days or less. This is a huge shift than if we sent out to a lab outside of the country. Generally there would be an additional 2 week hold on even the most minuscule of adjustments.

In Summary

Frankly, you as a patient who had something go wrong will not go back to that country to sue. If you were that cheap in the first place to save some cash by going to a third world country, you’re definitely not going for a legal retaliation. It’s time consuming, cost too much, and doesn’t solve anything while you are in pain. Being a smart consumer when participating in medical tourism is to know your legal ramifications when (not if) something goes wrong. You will have to abide by their laws and speak the language of that country. If you are willing to make the travel arrangements, do the true amount of research (which should be a month or so of dedication), and deal with what may occur thereafter, then go for it. If you think going on a site, and believing whatever is told to you will be perfect….well I have a bridge to sell you in Brooklyn.


Why Dental Sealants are Needed and Why They ROCK!

By Dr. Max Zaslavsky

So let’s talk dental sealants- what they are, and why there are important, and what benefits do they create to you the reader?  So often my blogs are about prevention. I tend to not always talk about cosmetics or the fancy stuff (and I should!), but  it’s simply because I feel that an ounce of prevention always takes precedence before we can move forward with some of the more vain things we all want in our lives.

A part of this blog post comes from a patient who recently said to me, “Why is dentistry so expensive?” Granted she wasn’t the first….or last patient who has said that to me; but for some reason it got me thinking. Prevention is cheap, dental work is expensive. Toothpaste and floss, when you break it down on a daily basis is relatively inexpensive (almost pennies a day). Sealants- a procedure done in office is also relatively inexpensive in comparison to a dental filling that would involve a needle, drill and usually are 3-4 times the cost.

A sealant is a protective layer, sort of like a saran wrap per se, that is placed into the grooves and pits of a tooth (usually a molar).  Like I said, no drilling or needle is required. It’s short and easy.  We simply need a semi-dry tooth where we can apply this protective gel in order to prevent cavities. This gel prevents foods, especially ones associated with sugars from getting into the grooves and fissures of the tooth thus creating a cavity. Generally speaking, we begin to do this for children who are growing their adult 6 years molars, but adults would benefit from sealants as well; since ANYONE, and I mean ANYONE can get a cavity.

Dental Sealants

In the beginning, the sealant may be felt by the tongue since it’s new. However over time, it will feel as natural as what Mother Nature gave you. Generally the sealants last 5-10 years, and are almost invisible to the naked eye.  As the sealant wears down from chewing, the gel can be re-applied as easily as it was done the first time! Now these protective saran wrap coatings for the teeth should be used in conjunction with fluoride. In my office, we are big fans of combining fluoride with dental sealants as they create an environment for a healthy, decay free mouth.

Remember, a filling requires a drill, a needle and tends to need to be replaced every 10 years or so (and frankly, who wants to miss work for a dental treatment). Generally when we need to replace that initial filling, it then needs to be replaced with an even bigger filling, or even a crown. By being proactive, and preventing the cavity in the first place with a sealant, we can save that tooth from needing ANY dental treatment. Prevention will ALWAYS be cheaper than dental treatment. Let’s start the ball rolling from day one, and protect those teeth from decay for good!!

If you have any questions, call me at (954) 491-3544.

A Medical Component of Why You May Need a Denture.

By Dr. Max Zaslavsky

One of the dental services we provide here at Dr. Max Zaslavsky, DMD PA is removable dentures and partial dentures. When I moved over from Ft. Myers to Fort Lauderdale, I thought I would be doing tons of dental implants, and dentures would be a thing of the past. I was severely wrong.

The economy has turned (if you haven’t noticed), and people’s lifestyles as well as their priorities have changed. Sometimes a root canal can’t be afforded and we have to take the tooth out. Generally if there is one tooth that needs to be removed, there is always a second one that needs attention as well.

At times, there are years of neglect, poor dietary habits and smoking that lead to a patient needing a full mouth extraction with a denture to follow. Dentures are not limited to the “old.” People who I have done dentures for have been as young as 21 years of age. Yes, he was drinking 12 Mountain Dews a day.

For whatever the case, it seems to go hand in hand that a patient with a denture tends to have some component of medical issues. As part of our services, we are here to accommodate and attempt to make something not only that looks like a natural part of your body, but also is capable of chewing. Dentures will never replace your natural teeth (I wrote a blog post on that some time ago about a patient who wanted me to take everything out).

Diabetes and dental problems are big. When a patient with gum disease/inflammation that can’t be controlled is upon our office, we make a concerted effort to send our patient to their physicians to see if they are diabetic. Increased blood sugar content will decrease your chances of healing not only in the mouth but the rest of your body as well. In extreme circumstance, uncontrolled diabetes not only can lead to limb and vision loss, but to tooth loss as well. Dentists more often than not can be the first line of defense in evaluating whether a patient is diabetic or not or has other medical issues.

Window Dentures

I see all these advertisements where you see things like “gentle dentistry” or “no pain dentistry” and I get it… People have a legitimate fear. Furthermore, people have a tendency to postpone even an evaluation due to fear of what they may find out. If you are reading this, you are a step ahead of the person next to you who goes to the dentist because you, as a patient needs to realize a big proponent of what my profession has forgotten- A dentist is also a doctor. Beyond the treasure chests, the gimmicks, and coupons, I am a doctor with a degree and the subsequent malpractice insurance.

When you are searching for a qualified dentist, what you need to look at is a qualified doctor to help you eat, digest and live a better life. Find someone who wants to save your mouth and create a solid long term foundation for you, because he or she cares. I want every one of my patients to have good oral health. I want to educate them on preventing them from ever needing a denture.

Photo Credit: Tuppus

Dry Mouth, Dentures And a Little Potpourri

By Dr. Max Zaslavsky

So let me say I do not make any money, in the fact that I am going to write a blog post on how much I am in love with Biotene products. If Biotene was a woman, I would want to date it and have a baby with it. That’s how great this product is when it comes to helping my patients with dry mouth. Did I get your attention?


Dry mouth happens for a variety of reasons. Medications appear to be the most common. The population as a whole is getting older, living longer, and we are all taking more often than not, more than one medication. Meds for such ailments as diabetes, HIV/AIDS, cholesterol, etc. can all lead to a dryer mouth. Radiation to the face for a variety of cancers will demolish salivary glands that more often than not will never recover. There are others but these are the most common things we see in my office.

A lack of salivary flow creates a loss of a protection to prevent cavities from occurring. Loss of saliva can lead to an increased amount of cavities and a greater potential for tooth loss. In the last 3 years, I can think of more than 5 patients who have gotten radiation to the face and have suffered devastating tooth loss. They have gone from being orally healthy, to needing extensive amount of restorative dentistry.

This is where Biotene comes in. Biotene has many forms: gum, mouth rinse, toothpaste and gel. I am sure I am missing one in there, but the goal is all the same- to recreate your saliva with enzymes that prevent you from losing your teeth. Furthermore, the rinse can also prevent thrush and several infections that are a common side effect with various dry mouth afflictions. In our office, we give it out to at least 2 patients daily.

But here’s the potpourri, and it’s ALL about the gel… Many patients with loose dentures tend to use Fixodent or Poli Grip when they don’t need to. A dry mouth will inhibit a proper suction and a denture will drop. Furthermore, a dry mouth and a denture adhesive can be painful. It’s sort of like you are ripping a band off your body on a daily basis. It can create sores, and make a denture uncomfortable. We have successfully been able to identify those patients who suffer from dry mouth, and have been able to convert them from using an adhesive to simply applying the Biotene Gel to the inside part of the denture. Our patients have LOVED this change. No sores, more comfort and more importantly a great suction with that adhesive taste whenever they eat.

Potpouri Numero Dos- Cpap machines, dry mouth and Biotene Gel (I told you I love the gel):

Patients who use a cpap machine tend to have severe dry mouth. I had one patient who told me his mouth felt like the Sahara Desert and would wake up every few hours from severe dry mouth. This form of dry mouth tends to create cavities on the back of the upper front teeth.  So here’s a hint- put Biotene gel on the back of your palate prior to applying the cpap machine. It will help. It will help prevent decay and you’ll have a better night’s sleep.

Lastly, if you have dry mouth- get your teeth cleaned every 3 months. An ounce of prevention will help you in keeping your teeth long term.