Broken Teeth – When Humpty Dumpty Can Be Put Back Together

By Dr. Max Zaslavsky

Extreme Sports1

Wow, talk about a Sunday!!

Here I was in my office catching up on bills and paperwork, when the phone rang. A friend of a friend had been playing flag football and ran face first into another player. His tooth was loose and needed help. His tooth was so loose, I probably could have taken it out with just my fingers. Panic? Not me! I’ve done this before, but my patient had not.

So let’s talk about the weekend warrior. You know who you are. The guy who plays flag football, or the guy who decides to relive his Warped Tour days thinking he’s Tony Hawk and gets on a skateboard; or even the guy who plays a little racquetball at LA Fitness. It’s you who I am talking to.

First of all, don’t stop working out. Be healthy, be happy, and go get some frozen yogurt afterwards.

It’s ok, you deserved the fro-yo……put some Nutella on top of it.

Boxer

But look, you need to wear a mouth guard. I know I know, the other boys don’t wear guards. But you’re special. Yes you! I’m talking to YOU! Wearing that mouth guard can prevent tooth loss and even a concussion. So I need you to wear it. Preferably a dentist will make you a custom one. Yes, it is more money than the one you get at Sports Authority, but it will fit way better therefore protecting your teeth more efficiently. Also, by custom fitting it, we can make it sports specific. This means we can create a guard to the specific thickness depending on the sport. A boxer needs a mouth guard with a certain protection that’s at a way different thickness than a mixed martial artist. Each sport has its own special needs in thickness. If you are playing racquetball on the weekends, you do not need the same kind of guard as someone who plays ice hockey.

What is that? You don’t need a guard because you aren’t a professional athlete? Yes you are right. It doesn’t stop people from getting the best golf clubs even when they aren’t very good at golf; or the best clothes from Under Armour even when you are not looking like Derek Jeter. The biggest difference between those examples and a guard, is that this will actually protect you from that one silly mistake where it may cost you thousands in dental bills.

Ok, 2nd thing– Don’t get drunk and fall (dedicated to my Theta Xi fraternity brothers from Auburn University).

Need more? Don’t drink a lot of vodka and fall. I know it’s funny when Snooki on Jersey Shore (or on Snooki and J-Wow) falls from being drunk, but it’s really not cool. I had 2 severe dental trauma cases in one week from drunken falls (and it wasn’t even St. Patrick’s Day or Cinco de Mayo).  At the end of the day we all become adults. It stinks, but drink responsibly. When you fall, and break your 2 front teeth because you passed out from drinking excessively, you need to take a pause and step back a bit. These repairs from broken teeth will have to be done and redone over your lifetime all because of a split second accident. So please drink responsibly, and be around friends who can help you up when you are down for the count.

The youngest you will ever be is today. Live your life to the fullest. Make the most of it. Just be smart.

Dr. Max Zaslavsky
6451 North Federal Highway #129
Fort Lauderdale, FL 33308
Ph: (954) 491-3544

Photo Credit: Hakonthingstad and Mimoza291 on Flickr

Sugar is Killing U.S.

By Dr. Max Zaslavsky

Where did we as a nation go wrong? I remember growing up and mom doing the cooking. Now I am 36, so growing up wasn’t too long ago. Eating healthy meals wasn’t difficult. You had your vegetable, your protein, and if you were good and ate all of your food, you had your dessert.

Sugar isn’t anything new. In fact my dessert as a kid could have been an apple or a cookie and both of those contain that wonderful sweetness we all desire. Furthermore, who doesn’t like sweets? It’s ok to not like something for being too bitter, or salty, but you can not deny the sugar. So sugar for all of us has been around since the beginning yet we are becoming an unhealthier nation. Notice I did not say fatter. Yes we are fatter, but I have younger and younger people who appear slim but have diabetes at an extremely early age- from mid to late 20’s.

U.S. children for the first time in history have lesser of a chance to outlive their parents. Amazing, right? Look we all know we are becoming an unhealthier nation. Some of y’all reading this applaud Michael Bloomberg for making his strides in trying to limit soda intake, and some of you may abhor him. Regardless, he recognizes type 2 diabetes is on the rise, and so is obesity. Secondly, he sees one big thing a lot of the media hasn’t touched on and that is the effects of sugar in the form of high fructose corn syrup (HFCS).

HFCS is now in the majority of products that we consume. From bread, to salad dressings, it’s there. Don’t believe me? Just run into your local Kroger, Pathmark or Publix and look around. Yes, even cereals have it.

So what does this have to do with teeth? I mean this whole time I have been talking sugar yet not talking about decay. Well before I wander into the teeth thing, remember carbohydrates break down into sugar. Where carbohydrates initially break down is in the mouth. So the primary area for sugar break down is the mouth, and if you are eating a primarily Standard American Diet, you are eating A LOT of sugar. More sugar will equal more dental cavities. Even more extreme, diabetes can lead to gum disease and tooth loss.

Tooth loss is not sexy. I say that a lot, but it’s true. For those of you reading this, consider going back to the basics- protein, fruits and veggies. Get rid of soda- diet and otherwise. Consider spaghetti squash to replace spaghetti. It’s wonderful. Eat a banana instead of eating something banana flavored.

Do one thing, and notice the difference. What’s the worst that could happen???

…Healthier teeth and a healthier you!!

Before After Photo

Are Your Dentures Going Gangnam Style on You?

By Dr. Max Zaslavsky

Loose Dentures

In the past I’ve written on why you may need a denture, and some of the medical reasons why you may lose teeth; yet I have not ever written about your long term relationship with your denture. I have found that is it a love/hate relationship when it comes to patients becoming acclimated to their new denture, with love eventually winning.  I wanted to expand on one issue in this blog post regarding the longer you wear your prosthesis- the loss of retention.

In short, we always want to keep teeth. I have never had a patient who says they love their dentures more than they loved their own teeth. In fact, if any of them would go back and reverse their tooth loss, our patients would not hesitate. I have always used the expression to my patients, “Dentures are not sexy.” And even as I say that, day after day, I tend to do quite a few dentures and partials. So let’s fast forward to the love/hate relationship of a patient’s removable and conventional denture.

In the beginning, your denture takes time to adjust. There may be sore spots that need to be corrected and the simple action of chewing takes time get acclimated to. Over time, all is good, and soon we can have you even eating steak and raw broccoli again. But as the years progress, your mouth (with no teeth) remodels. As we all get older, body parts drift, sag, or even become flaccid… and your mouth is no different.

Give it 5 years and that denture that once fit perfect is now moving and loose. You aren’t eating the same way because the denture is wobbly, and it’s at a point where is it uncomfortable. Your mouth is remodeling and YOU have some options on what you can do with your dentist to take care of your wobbly dentures!

  1. Get a new denture. Sometimes the best route to go is to take new impressions and make dentures that are custom to your new remodeled arch. They should fit and feel like what you had some years before. It’s at times the best decision when you have an older denture where even the teeth are worn down.
  1. Relining your existing denture. A reline is where we take the denture you currently have, add impression material to the underside of it, send it to the lab, and in the same day get it back with a new acrylic base added. The greatest benefit to this procedure is not only a lower cost than getting a new denture, but you will get your denture back within the same day. Generally I tend to do this when the teeth are in great shape, but palate portion, or the lower arch of the denture is no longer fitting in a secure fashion.
  1. Placing Implants. Man do I love implants. It not only saves the bone you have left around your arch with no teeth, but we can use these implants as retention to the denture in the same fashion as a button on a shirt. I know that a lot of patients come in with a fear of these titanium root formed objects, but you shouldn’t! A good implant can last you a lifetime so long as you treat it like you would a natural tooth (floss and brush).

If you already had your teeth extracted, it is generally a far better experience having implants placed into your mouth than having teeth taken out. Furthermore, by placing implants, we can actually eliminate the need for items like Fixodent or Poligrip that may interfere with your ability to properly taste foods.

In general, always know you have some options when it comes to ill fitting, loose or wobbly dentures. You shouldn’t have to suffer when you eat, or fear that when you are at a function that your teeth will fall out. Although they will never be as good as what Mother Nature made for you, Fort Lauderdale dentists have progressed to make dentures work better than what your grandfather had.

Photo Credit: Hippolyte

The Crossfit Dental Patient

By Dr. Max Zaslavsky

I delved into Crossfit about 3 years ago when I had moved to Fort Lauderdale to open up my dental practice. I had always worked out, but I had heard about this “Crossfit thing,” and wanted to give it a try. Instantly, I loved the camaraderie and challenges that were presented to me within each and every workout. To a degree, I felt that the challenges and obstacles of Crossfit helped in building my dental office. Any new business, especially in these hard economic times takes some sort of intestinal fortitude. Crossfit helped me mentally deal with the in’s and out’s of air conditioners breaking, dealing with difficult patients, and yes, even taking a tooth out.

As time passed, I was not only seeing my new friends in the box, but as patients in my office as well. It was definitely a sense of accomplishment to know that the same people you workout with daily, put enough faith in you to treat them in a 2 inch by 2 inch “box” called the mouth. The more I treated my fellow athletes, the more I saw something very common amongst all of them- rampant dental decay and overall poor teeth.

What Your Mouth Says About You

A bright full smile with healthy pink gums creates that youthful appearance that exemplifies health. None of my baby boomer patients walk in asking for yellow teeth with receding gums….not even for Halloween.  Your smile is the first thing anyone will see…way before your ab definition.

A healthy smile serves not only for a welcoming appearance, but also as the first area for a healthy digestive system. When you begin to chew with less and less teeth; you are relying on more pressure to the adjacent teeth to carry the workload. This can lead to even further breakage of other teeth, even if they have no cavities!

When you have missing teeth or inflamed gums, it gives an overall aged effect no matter how good your body looks. Let’s be real for a second, you have a smoking hot bod from all those WOD’s but a mouth that smells and is filled with plaque from not flossing, It’s not attractive. You have 8 pack abs, but when you smile, you look like a Jack O’ Lantern; you’re not getting lucky tonight. When patients say to me, “Oh just take it out,” rather than “I want to fix it,” it makes me cringe. You wouldn’t cut your pinky off if it had a splinter, so nor should you take your tooth out if it has a cavity. Besides, imagine doing Fran, and your denture popped out? Definitely a “no rep” there.

By coming in for your routine check-ups, your dental office can catch potential diseases before they become greater. Diabetes is something we can see in the mouth and treat before it turns into a greater complication. Certain cancers and cysts that could have become far worse than they actually did become were caught on routine checkups in my office. In my office, we have at least one cancer patient a month. Meaning, we have found that at least 12 of our patients a year have had some sort of oral cancer. It’s not a joke, and it can spread quickly to other parts of your body. Just like you workout daily or 3-4 times per week, so should you create a routine to not only treat your mouth at home, but also by seeing us at least twice per year. Prevention and maintenance will always be determinants of success.

Your Diet:

The majority of Crossfit athletes I have seen in my practice have embarked upon a caveman or Paleo lifestyle. The Paleo Diet in and of itself is extremely healthy. In fact, if you are a person who practices the Paleo lifestyle rather than the Standard America Diet, you are going to be healthier and feel better. Furthermore I have noticed in my office that my true Paleo patients tend to have less plaque buildup and dental decay. This would correlate that since you are eating less added refined sugars and/or high fructose corn syrups you would have less chance of dental cavities and gum disease.

To briefly digress, less added sugar would also mean decreased work on the pancreas to release insulin; thereby decreasing your chances of diseases like diabetes, high triglyceride levels, and various cardiovascular diseases. Aside from smoking, diabetes is one of the primary reasons for tooth loss in the U.S.

So where are my Crossfit Patients going wrong? After all, I did say at the beginning of this article, that I saw severe dental decay throughout my Crossfit patient’s mouths.

1. Fear

Yes even men and women who move large sums of weights from one area to another have fear. I have worked on MMA fighters, professional boxers, and Crossfitters. The adage “the bigger they are…..” holds true even in this day and age when we are making dental treatment less invasive and painless. I had one patient say to me, “I would rather give birth,” and it was a man. I have had people who have sky dived more than 100 times, yet fear me (and for the record, I am only 5’5).

Avoidance due to dental fear pertains to anyone. It can stem from a traumatic childhood experience to the fear of the unknown. But things are better now!! In this day and age, dental practices can offer a variety of methods to alleviate dental anxiety. From playing your favorite music to the “old school” laughing gas or full on sedation, we can make your experience a comfortable one.

2. Not Flossing - Create Your Dental WOD

You know how we all want to WOD every day? You know, we want to conquer that challenge, climb that rope, snatch those 200lbs we had been tinkering with? You need to floss every day. Conquer the floss!

My fellow athletes, WE ARE NOT FLOSSING!! We need to make your dental care as much of a WOD as is Fran!

3-2-1 Go: Floss everyday at least once a day, at night before brushing. Brushing alone is not enough to maintain a young healthy smile. The majority of dental disease I see is from cavities and gum issues where food had been collected in-between the teeth and left to ferment. An even greater reason to floss is that there are links between lack of flossing and heart disease. Yes, the same plaque that is in between your teeth is the same plaque that can clog an artery and create a cardiac event. On average, people who floss have less chance of heart disease and will live 4 years longer.

The best ways to floss is to a take large enough string, about 18 inches and wrap it around your middle fingers. Create a “C” shape with your dental floss, and slide up against each tooth in a gentle pattern so as to remove any and all plaque. Patients sometimes tell me they don’t like to floss because their gums bleed. That’s the very reason why you need to floss. Bleeding gums tell us that your gums are inflamed and we need to remove the plaque that is acting like a splinter in those areas.

3. Energy Drinks

This was the biggest discovery I found with my Crossfit athlete patients. I never understood how someone who was following a Paleo lifestyle had so many dental issues until I went through their daily diet- meal by meal. The common thread was there, and that was the consumption of a superfluous amount of energy drinks.

Diet Red Bull alone has more acid content than a regular Coke or Pepsi. The other energy or powdered mixes out there, which have “monster” or an exclamation at the end of their name, are no better. I think somewhere there has been a disconnect between the Paleo diet and these energy drinks. They need to be completely avoided.

What I now see amongst energy drink users and Crossfit athletes is dental decay due to acid erosion rather than sugar. Whereas a cavity from sugar was easier to isolate, acid erosion of a tooth is circumferential. Meaning, that it isn’t in only one spot, but rather all around, making it harder isolate. That cherry or fruit flavored energy blast is not dentally sound when consumed on a daily basis. Yes, you can lose your teeth on even a diet red bull.

So where would we go from here if you already have damaged your teeth with energy drinks? What more can be done to help re-mineralize your teeth if there has been some damage. One of the things we recommend here in my office is the use of prescription strength fluoride toothpastes in conjunction with your regular hygiene routine.  Meaning floss, brush with your normal toothpaste for 2 minutes and then use the prescribed paste for another 2 minutes. By using a paste with 1.1% fluoride (such as Colgate’s Prevident), you can help decrease dental sensitivity, keep large cavities at bay for a period of time until treated, or even potentially re-mineralize smaller cavities. Yes, it is possible, with proper treatment and homecare to re-mineralize small cavities and reverse the decay process.

Max Wod

As a dentist and as your fellow Crossfit athlete, I want to see you all be as healthy with your mouths as you are with the rest of your bodies. Small adjustments made incrementally can help change your life. It did for me when I got my first 300lb squat, my first kipping pull-up and my first rope climb (ok, I still can’t do a rope climb). I want it to feel the same sense of accomplishment for you when you leave your dentist’s office cavity and gum-disease free.

You need to keep your teeth not only to look good but to digest properly. The fewer teeth you have, the less you have to chew with, and trust me, dentures are never sexy.

 

Foods For a Better Smile and a Healthier YOU!

By Dr. Max Zaslavsky

“You are what you eat.” Don’t you hear that quite often? But how often do you hear it regarding your teeth, gums and your smile? Your mouth is no different than the rest of your body. After all, your mouth is the initial source of digestion and it is the primary pathway towards nutrition (good or bad). The foods listed pretty much could be made into a pretty great stir-fry; but don’t hesitate to put your own spin on it:

Broccoli is a great source of fiber, can help prevent cataracts, heart disease, and various cancers. Pretty cool, right? But on top of all that, it creates a biofilm over enamel to help prevent acid erosion. Erosion is one of the main villains to teeth these days due to all the juice and soda consumption.

Healthy Smile

Basil can help reduce stress and clear your skin, but did you know it can help reduce bacteria in your mouth?

Carrots and its consumption have been shown to help increase vision (Vitamin A), and help prevent lung cancer. The high levels of beta carotene can even help the aging and damage of cells. This crunchy alternative to chips can help clean your gums making them healthier.

The calcium in cheese can help make your dental enamel strong extending your smile for many years and help prevent osteoporosis. Furthermore, the lactic acid can help prevent dental decay.

Celery equalizes the body’s pH and is incredibly important to peak health. Did you know that it also helps in increasing salivary content which will dilute sugars and acids in the mouth? This crunchy veggie as well will help in cleaning gums.

Green Tea has had a multitude of benefits from reducing blood pressure to preventing cancers. It can regulate spikes in insulin, thereby regulating glucose (Diabetes patients please take note!!). But it also contains an antioxidant called catechin which reduces bacterial growth that causes gingivitis.

So here you go people! Mix and match this all up. A healthier you is a better you! A better you makes someone who can be a better mom, dad, girlfriend, boyfriend, or just plain happier :)!

Ok… After this blog post, time for me to grab a donut.

The More Things Change, the More They Don’t Stay the Same.

By Dr. Max Zaslavsky

Patient Chair

Man, I could have done that better! I know, not exactly the words you want to hear coming from your dentist, right? But the reality is, I say that to myself at least once a year. Being a practicing dentist for 10 years now has only made me more frustrated since the technology is ever changing. What I do today will never be as good as what I will be able to accomplish 10 years from now. How do I know? Here’s the easy answer.

When I was in dental school and bleaching was being introduced to us, we were told you make a tray custom fitted to the patient and you give the patient material that they will sleep in over night. The material at the time- 10% bleach by today’s standards is a joke. Being an overnight bleacher myself at the time, that tray would be thrown across the room somewhere around 2am. Ten years later we now have 35% bleach (or greater) where we give our patients instructions to wear for 15 minutes a pop. This doesn’t even take into account 1 hour bleaching- an entirely different conversation in the bleaching world all together.

Another example: My mom had her first implant 12 years ago. At the time it was state of the art, and the latest and greatest in titanium technology. It was made by the #1 implant company in the world. The very same company in present day can make a smaller, stronger implant that can create less tissue recession than the one my mom had 3 presidential terms ago.

So I lose sleep at night. I really do, even with my 200 hours a year of continuing education, trying to figure out how to excel for the benefit of my patients. Furthermore, I think about how I can do and be better daily. Do I have the right office team? Are we where we should be from a technological standpoint? What can I do to simply make my office better than how we did yesterday? The answer as simple as it may sound will always boil down to the relationship and patient care experience.

Everything we do in the office is based on love. Yes, really! The combination of experience, skill, education and especially care equals love. The continuing education, the small advances in technology that you may not always see (but they are there!) are all present based on the genuine concern for thy neighbor, or in this case- patient.

The reality is that the same bonding materials for fillings and even the same filling materials I use today, more than likely will not be used in 2-3 years from now. It’s not because we run a shady practice. Nay nay! Rather, we are constantly striving to do better for our patients. Being better means constantly being on the hub of dental technological advances and changing things to be focused in the right direction

My staff and I do a lot of continuing education. With the different roles we all play in the office, we tend to vary in which classes we all go to, but we do go. As you come into our office, or any dental office for that matter, please keep in mind what you want to see as the end result of your teeth, but also are you sure you are getting the best care with the best materials? Is your office up to date? As a patient, long term or just a one time visit, this is your office also. You are not just going to the dentist, but you are going to someone who is about to drill in your mouth. Ask questions. It’s ok. Be informed, be concerned, be aware. All dentists are NOT created equal, and you as a patient deserves the best.

Photo Credit: Matti Mattila

Jack of All Trades, Master of None.

By Dr. Max Zaslavsky

Barber Dentist

Remember when doctors made housecalls? It wasn’t too long ago where a doctor would know you were too sick to make it into the office, so after work, he would bring his little black bag, with the wooden stick to check your tongue, and that thing that shines light into your eyes, and would diagnose you at the comfort of your own bed. My oh my, how things have changed……

I remember back when I was in college, a physician came to lecture to my undergrad pre-med/pre-dental society and I asked him, “Hey doc, what happened to the housecall?”

He responded, “With the changes in technology, and as we have progressed in the medical field, the black bag is no longer sufficient to properly diagnose an ailment.” The same holds true in what I do in the dental field.

Once upon a time, barbers were the original dentists. It’s true! Google it! You would get a haircut, and if you had a toothache, your barber would lance the tooth out after a few good shots of whiskey, bourbon, or whatever moonshine was there. Now with the ever changing field of medicine and dental that we live in, barbers cut hair….and maybe a shave.

Routinely I refer patients to a specialist for various reasons. The primary reason is because it is out of my field of expertise. Every so often, I get the complaint that a patient is upset because I will not do a certain procedure like a root canal. Even claiming it’s because under their insurance plan, I would not be compensated adequately and I don’t care about them. Realistically, it’s not that I won’t do THAT root canal. It’s more that a specialist in this particular incident, someone called an endodontist, will do it faster, better, and probably under a microscope in order to access and clean every canal of that particular tooth. Remember, in dentistry as in carpentry, the right person will know when to measure twice in order to only drill once. It saves time, and redo’s.

On the other end of the spectrum, I see patients who regret having a general dentist do a procedure that a specialist SHOULD have done. I saw the ramifications of an implant procedure done so poorly that the general dentist had broken the patient’s jaw. The referred patient came in from another office not knowing why she was in so much pain, and we had to give her the bad news. Of course, this was after she had spent so much time and money in the other office, and now we would have to start from scratch.

So the point to all this- yes a specialist is more money than seeing a general dentist. And yes, a general dentist can SOMETIMES do the same procedure at a reduced cost, and be extremely good at it. Sure you will save money, but what happens when something fails, and now you need the periodontist, oral surgeon, etc. to redo all of it? Short term it’s cheap, but long term it’s more time and money. And just like you the reader, “I ain’t got time for that!”

In the end, just be sure you are in the right hands. As technology, and dental research grows, the days of the “super general dentist” are coming to a close. Sure, you will have general dentists who are more than capable to do more than the usual and customary procedures, but as always, do your research!

 

“It’s Never JUST a Cleaning!”

By Dr. Max Zaslavsky

I was at LA Fitness one Friday night and I happen to run into a patient. “Sam,” as I would call him came up and said hello to me, with a great big smile on his face. He was working out his back, and so was I. In between lat pulldown sets, he said to me, “You know I love all of your staff!” He continued, “That Joanne….man, I have had a lot of cleanings, but never one so thorough as what she does.” Obviously I was proud. It takes a lot of work to assemble the perfect team, and make them a cohesive unit. I definitely took some pride in what he said about my star hygienist. Because of that incident, this blog is dedicated not to what I do, but what should be done in your initial visit to your recalls with your hygienist.

For some of you reading this who are my patients, you know Joanne, and how awesome she is. Joanne, my stellar hygienist, has been a blessing in my life for the past 10 years. She is one of the few people who has always kept in contact with me since I graduated dental school. We had worked together in another office in Deerfield Beach, and I said, “If I ever get my own office, I want her.” Sure enough, almost 5 years ago, she came into my office and began my small startup.

Photo4

Let’s get into the role of what a hygienist should do. Obviously if you know how we do things in our office, this is the criteria you have been accustomed to. If you are in a different office, perhaps you should look to see if these procedures are indeed occurring. Initially, we begin with a full mouth series of x-rays. I know some offices do only 4 bitewings, but not us. It’s not comprehensive, and you are only cheating yourself with only 4. The reason is 4 bitewings (which usually come along with those $39 Groupon offers) can not diagnose infection. Although they can diagnose dental cavities in between the teeth, they will never, ever detect an infection. Different angles of x-ray radiographs detect different facets of a tooth and its surrounding bone structures. We always want to be as complete and comprehensive as possible to see every angle.

Some may argue that we are over exposing a patient to radiation, but with today’s digital x-rays (which is what we have in our office), you are exposing yourself to up to 70% less radiation.

There had been some literature in the news as of late in regards to brain tumors and dental x-rays. The documentation is honestly untrue and the reality is your cell phone usage is probably going to give you cancer before we ever do.

Next up, the hygienist along with your dentist will determine what kind of dental cleaning you will need. If you are a smoker, chances are you will need a more detailed cleaning than the regular prophylaxis. If you do not floss, more than likely you will need more than just a regular 1-hour cleaning. If you have not had a dental cleaning in over 2 years, more than likely you will need more than just a regular cleaning.

How do we determine gum disease?

Periodontal Probe

Bone loss can be determined not only visually, but also via the x-rays we have taken, and periodontal probings. Joanne uses a small measuring stick called a periodontal probe and measures the architecture of the bone structure around each and every tooth you possess. Each tooth has 6 surfaces- 3 in the front and 3 in the back. Normal probing depths are sort of like golf scores- the lower the number the better the prognosis of a tooth. Generally 1-3 millimeters is normal. It means you are flossing and doing what you’re supposed to be doing. It could also mean you aren’t flossing and you just have awesome genetics. Whatever it is, to pseudo quote the Dos Equis man, stay periodontally strong my friends…stay strong.

Anything above 3mm is when things become a red flag that we need to address with more scrutiny. If a probing depth of 6 millimeters or greater is measured, we would obviously need to treat things more aggressively than if it was a 4 millimeter pocket. Our hygienist may even suggest a medication to be placed in the gum pocket (called Arrestin) in conjunction with the cleaning in order to clean out the bacteria invading the tooth. The key thing in all this is that a deep pocket needs to be cleaned by a hygienist. Floss and a Waterpik can only go so far into a tooth. If we are addressing a pocket that is 6 or greater, there is no way at all that you can do this on your own. Don’t think you as a patient can fix a periodontally diseased pocket. This is when you need a hygienist like Joanne to get in there and “get ‘er done.” Don’t be that guy who thinks you can do it on your own, and it only becomes worse.

See it’s all about bacteria. It’s all about keeping it clean. If we remove the bacteria, we can remove the plaque that acts like a splinter that hurts the bone surrounding the tooth.  Furthermore, removing the bacteria and plaque surrounding the teeth will only help you and your heart. The same bacteria in gums is the bacteria that you swallow that goes through your system and can create heart issues. Gum disease has been linked to pancreatic cancer, esophageal cancer, and a whole bunch of other things. It’s all connected, and when the primary source of nutrition is your mouth, you need to fix the dental problems before they impose upon everything else.

Periodontal Probe Photo Credit: Durham College

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

By Dr. Max Zaslavsky

Emergency Dentist

Tis the Season... For a Toothache!

As I sit down writing this article on Christmas Eve, drinking my Ovaltine with chia seeds, I know I will be getting a phone call from someone needing some sort of emergency dental treatment due to a toothache. Whether it be a root canal or an extraction, I can only advise you on how to handle the situation if and when it may occur, and then finish it all up with what you can do to prevent forest fires! Sorry, wrong article… What you can do to prevent a dental emergency!

‘Twas the Night Before Christmas… and You Have a Toothache.

Ok, the reality is you probably had that toothache for a while and you should have taken care of it earlier. A toothache just doesn’t happen that day. There’s a tingling, a slight pain, and you ignore it until….tada….Christmas day. I know, I know, you were shopping for presents. Little Jimmy needed the new Xbox and Sophie wanted the latest Barbie.  Quite frankly there’s a ton of excuses but the reality is life in general gets in the way. We all have a tendency to procrastinate, and it just sucks because its Christmas. Now you need someone. You don’t care if it is me or some other dentist in Fort Lauderdale, but you want to get out of pain.

First thing you should do is call your dentist. Usually there is an emergency answering service, or as it is in my office, I have my cell phone on the answering machine. I don’t mind you calling me on Christmas day, Hannukah, Yom Kippur, whenever. As long as you call during a reasonable time, and you are an existing patient, I can call in a prescription for you. If it is a dental infection, we can control (not eliminate) the infection so you may enjoy your holiday, and we can treat you after you have enjoyed your family time and your egg nog. Do not call me at midnight (yes that has happened), or else I will turn into Mr. Grinch!

If you are not an existing patient, or you simply do not have an emergency dentist, things can become a bit more complicated. If you need a dental professional on a holiday, and you have never seen him or her before, the law requires you are seen for a prescription, and obviously for any dental treatment. Generally opening up the office on a holiday will have an added fee attached to that emergency dental treatment. Furthermore, for an emergency dental visit on a national holiday, there is almost no way I will be able to verify your dental insurance. Therefore everything from the time you walk in, to the procedure itself is your responsibility to pay. On the same token, however, I know I will be able get you out of pain so you can appreciate that Honey Baked Ham a little more.

Dental Emergency

The last option is to go the emergency room at a hospital. We had someone call up the office this past week, and when we told her how much it would be to take out a tooth, she said, “I’ll just go to the ER.” I didn’t want to argue, but the truth is, if you have a dental emergency in Fort Lauderdale, the LAST place you want to be is at the ER!!! A physician knows as much about treating a toothache as I do about delivering a baby. We all have our sub-specialties, and the truth of the matter is a physician will give you an antibiotic, a pain med, and tell you to see a dentist after Christmas. All this, and you will spend a ton more – not only in time waiting to be treated, but also in expenses. Last time I checked, hospitals cost way more on any day than me on a day when I’m not even supposed to work.

The best thing you can do is see a dentist regularly (meaning at least every 6 months) for a check-up, cleaning, and diagnostic x-rays. Prevention is always key. If we can prevent the problem from happening in the first place, it will save you time, money and most importantly tearing you away from family on this special day.

Emergency Dental Clinic

The second best thing you can do is DON’T BE STUPID! Yeah, you heard me. Don’t get drunk the night before Christmas and get into a fight at a bar with your cousins. Don’t get drunk and trip over your dog and break your two front teeth. Don’t relive your glory days, and do double dutch with your daughter, and then the top of her head hits up underbelly of your chin. Those have been my last few Christmas emergencies.

All you should want for Christmas is to keep your two front teeth. Dream of a white Christmas, white teeth, because after all…..this is “The Most Wonderful Time of the Year.” Have a good one my friends.

Broken Teeth – When Humpty Dumpty Can Be Put Back Together

By Dr. Max Zaslavsky

Max Wod

Up until a month ago, I was unbreakable. For those of you who know me, aside from dentistry, I work out a lot. I love my Crossfit, my gym, my hot yoga, and whatever other activity I can do to keep active. Then, I decided to take a kickboxing class when I was visiting my family in the Bronx, and a novice hit me from behind when he wasn’t paying attention. Down I flew, and after 10 days, I realized it wasn’t a sprain. My achilles was torn and before the news even came out of the doctor’s mouth, I was being scheduled for repair.

Things happen. It’s as simple as that. I was taken down by a beginner who was going through a midlife crisis. So things can happen that are out of your control. So often I have patients come in who were “just” eating a bagel, a piece of bread, and BAM….tooth broken. Teeth can break. There are reasons why, but generally that last thing you just ate was not the reason but rather the straw that broke the camel’s back.

Sometimes a tooth will break because of a large filling (silver or white) that is within the tooth and the enamel just can’t hold it anymore. Another reason would be that there is decay that is so extensive, that the tooth is weakened and cracks. We can go on and on and on…and on, but the bottom line is let’s stop asking why, and let’s talk about how we can fix all this! I mean really, who cares why (except dental nerds like me). You as a patient wants to know how we can fix it….and YOU WANT to fix it.

Cosmetic Dentist Fort Lauderdale

One of the easiest options would be to fill the tooth. Realistically, this rarely happens. The tooth breaks to such a point that a cusp is missing, and a filling won’t suffice. But hey miracles happen, and maybe you luck out. Other times a crown is warranted. A crown is where we make a smaller version of your tooth. We take an impression of it, and a lab creates a tooth that looks like what you once had. Generally, this is what happens, and maybe 85% of the time, this is what I can do for you in your office.

Now let’s go with some more severe cases. If the tooth had such severe decay that the tooth broke, you may need a root canal in addition to the crown. People tend to freak out about the term, “root canal,” but it’s not as bad as your friends will tell you. Your friends at times can be your worst enemy, but in the hands of a qualified endodontist (a term for a specialist in root canals), your root canal will be no harder than performing a filling. After the tooth is treated, you will need a crown. The main reason is because there is so much tooth structure lost, you need something to protect that tooth that is now in a weakened state.

The last thing is if the tooth is so broken, it can not be saved. If that’s the case, well…you’re looking at a removal. If you remove the tooth, you can do nothing. I mean, it’s in the back, right? WRONG!!! We always want to replace what mother nature gave you. If teeth are taken out and you have spaces, your teeth can shift creating greater complications. Shifting teeth will put more pressure on those other more innocent teeth that never broke, and  potentially cause them to break. Therefore, we always want to replace missing teeth. Your best option will be dental implants, but other options can be partials or a full denture. (Dentures are never sexy. Remember that.)

So look, we want to replace teeth because you got to eat. The ones in the back help you chew, so if you think, “oh it’s just in the back, no biggie,” you are wrong. Teeth in the front rely on teeth in the back for support and vice versa. Don’t ignore the entire package or else you will find far greater problems in the long run. Don’t ignore the problems either thinking it will all get better, or you are afraid of the costs involved. Trust me, it’s always cheaper to fix a problem with your body sooner than later. Furthermore, you will have a better outcome when its fixed ASAP.

From the moment of injury to the moment of treatment, it took me 10 days to get my achilles repaired. I was told, “don’t worry, it’s just a sprain” by the trainer in the gym. Remember to always listen to a professional opinion by someone in the medical or dental field before you rely on friends or someone who moonlights as a trainer when he is not working as a physical therapist. It delayed me significant healing time, and I don’t want this to happen to you and your broken tooth. Replacing a tooth with an implant, as good as they are will never give you back a natural tooth. And repairing an achilles is never the same as when it’s 100%, but we can get you back to almost as good as new.

Photo Credit: Andy Wetherill