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Chris Raines

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Dental Care and Living Life on Purpose

Posted by Chris Raines on Oct 3, 2017 4:08:52 PM

Picture of a clock. How much time do you invest in tasks that do not fit into any of your priorities?

Would you describe yourself as a “fly by the seat of your pants” kind of person, or do you live your life very deliberately? Or are you somewhere in-between? People tend to fall somewhere along a spectrum between unplanned improvisation and a goal driven existence and tend to have strong opinions about these approaches to living.

In today’s busy world, it is easy to lose track of time on diversions. In an effort to keep abreast of current events, we can spend many hours on the Internet.  Diversions can include watching television, playing video games, and shopping just to name a few.

A friend described their life as, “Stuff is just going on. It is not planned. I roll with the punches.” Another friend writes goals and objectives for life, makes plans, and follows a strict schedule. The first extreme can lead to surprises and adventure, but a chaotic existence, and the second can be organized and safe but seem boring and regimented.

Perhaps the best way to determine if your lifestyle matches your unique perspective is to clarify your values.  Clarification of values is a way to learn what is most important to you so that you can determine whether you are living life in a way that is congruent with your beliefs. The first step is to list your top priorities in their order of importance.

Find Balance

Below is a list of several priorities. Write a number next to twelve that are most important to you. If something is missing, add it to the list and assign a number to it.

List Your Top 12 Priorities

____ Adventure

____ Community

____ Faith, Religion, Church

____ Family

____ Friendship

____ Fun

____ Your health

____ Helping Others

____ Home

____ Intellect and Knowledge

____ Job and Income

____ Love

____ Nation

____ Personal care/appearance

____ Popularity

____ Power

____ Relaxation

____ Security

____ Success

____ Wealth

Think about how you spend your day. How much time do you invest in tasks that do not fit into any of your priorities? Do you have control over your time and activities? If not, how can you align your daily activities to include your priorities? If necessities are not fitting into your schedule, how can you add them? Introspection can help you to live "life on purpose."

Did you list your health as one of your top priorities?  If not, look at the priorities that you chose and consider how your health would impact your chosen priorities. For example, it would be very difficult to seek adventure if you were not healthy. Taking care of your family would be quite challenging. For every item on the list, good health is a prerogative.

List Your Personal Health Priorities from One to Four

____ Medical

____ Dental

____ Nutrition

____ Psychological

____ Exercise

Medical and dental health

Did you list one personal health priority as more important than another? Where did “Dental” fall on your list? While some of these priorities are more time consuming, all are equally important.

Take control of dental health

There seems to be a disconnect between the teeth and the rest of a person’s life. Dental health impacts overall health.  Strong healthy teeth help to safeguard overall health. Problems in the mouth can affect the rest of the body.

Mayo Clinic Reports, “Many studies have shown a connection between gum disease (periodontitis) and other serious conditions, including heart disease. Research suggests that periodontitis is associated with an increased risk of developing heart disease and that people with chronic gum disease have increased thickness of their neck blood vessels. There is also a strong correlation between diabetes and cardiovascular disease, and evidence that people with diabetes benefit from professional teeth cleanings.”

Pat Martin, Office Manager at Pi Dental Center suggests, “Establish good dental habits early in life. If not, your teeth will suffer for it. This consists of home care as well as regular dental check-ups.”

What are your dental priorities?

Prioritizing can lead to a more satisfying life and help you to achieve a delicate balance in your life. Contact Pi Dental Center if you would like to discuss your dental care, schedule a diagnostic evaluation or oral hygiene cleaning.

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Chris Raines
Web Site Administrator
Information Systems Manager
Marketing and Information Technologies Departments

Tags: Medical and Dental Health, dental care

Dentists in the Media and Hollywood

Posted by Chris Raines on Jul 27, 2017 12:54:07 PM

Graphic for blog: Dentists in the Media shows Painless Parker ad, The Dentist's Office with Abbott and Costello and the plant from Little Shop of Horrors

The entertainment industry rarely delivers a kindly portrayal of dentists and dentistry. Whether in movies, in TV series or in print, their representations are centered on the assumption that people don't like going to the dentist. 

Dentists in movies are often characterized as evil, vengeful, malicious, naive, morally bankrupt, or just plain boring. Portrayals of dentists in a realistic or a positive light are a much smaller body of work by far. 

Dr. Thomas Giacobbi, editorial director of Dentaltown Magazine, states that dentistry is rarely depicted in a positive light. 

Lisa Newburger, writing in Dental Products Report says, "Dentists and hygienists get a bad rap! It’s just a fact that certain procedures cause pain. While nobody [goes] into this profession to cause pain (although, have you seen The Little Shop of Horrors?), it’s sometimes an inevitable part of dental work. Pain changes people. It makes the sweet, old lady a little nasty. This can get projected onto the dental professional." 

This negative representation of dentistry compromises good dental health by contributing to people's fear of dentists, making the general public less willing to seek much needed dental care. 

SADISTIC DENTISTS

Orin Schrivello is arguably one of the most well-known deranged dentists on screen or on stage. In the 1986 musical, Little Shop of Horrors, Steve Martin plays the sadistic dentist who likes to inflict pain on his patients and his girlfriend. Until he becomes dinner for the man-eating Audrey II plant from outer space. 

In the 1976 suspense-thriller film, Marathon Man, adapted by William Goldman from his 1974 novel, Dustin Hoffman is tortured by Nazi war-criminal dentist, Dr. Christian Szell (Sir Laurence Olivier). Szell is in the United States to sell a large cache of diamonds stolen from Jews killed at Auschwitz. 

Corbin Bernsen stars as Dr. Alan Feinstone in the 1996 horror film, The Dentist. When Feinstone discovers his wife's infidelity, his life spirals out of control and he goes on a murderous rampage driven by jealousy and an obsessive-compulsive disorder. One reviewer of this film said, "Fear and pain are the main reasons people don't like going to the dentist, so that's why this is the perfect setting for a horror movie."

In Horrible Bosses, Julia Harris DDS (Jennifer Aniston), is a manipulative, aggressive boss who regularly sexually harasses her subordinate, Dale, whom she blackmails with compromising photos that she took while he was unconscious. 

BUMBLING, INCOMPETENT DENTISTS

The Dentist’s Office aired on the Abbott and Costello Show on December 12, 1952. When Lou Costello's toothache becomes unbearable, Bud Abbott takes him to see a near-sighted dentist. When the dentist, asks Costello, “You don’t mind if there’s a patient before you?” he replies, “I wouldn’t mind if there were 340 patients before me.” 

On the Bob Newhart Show, Dr. Bob Hartley (Bob Newhart), a psychologist, shares his office and his secretary with Dr. Jerry Robinson (Peter Bonerz), a bumbling, eccentric, 70s swinging-single, orthodontist. When Jerry comes into money, he gives up his practice to do nothing but whittle and watch the sun come up. Bonerz appeared as Dr. Robinson on the Bob Newhart Show in 139 episodes from 1972-1978. 

In The Whole Nine Yards, Matthew Perry plays Nicholas "Oz" Oseransky, an incompetent dentist who is on the run from the mob, has a wife and mother-in-law who hate him, is laden with debt after his father-in-law (now deceased) embezzled from the practice, and almost kills a patient with nitrous oxide.

Bob Hope stars in, The Paleface, a 1948 comedy loosely based on real life dentist, "Painless" Edgar Rudolph Randolph Parker, portrayed in the film as a inept, cowardly dentist in the Wild West. 

MORALLY BANKRUPT DENTISTS

Cactus Flower, set in the 1960’s, features Walter Matthau as Julian Winston DDS, a bachelor dentist who deceives his hippy, ditsy girlfriend that he has a wife and three kids to ensure that she will not expect a proposal. 

Novacaine stars Steve Martin, humdrum dentist Dr. Frank Sangster, whose quiet life is derailed when he’s seduced by Susan Ivey (Helena Bonham Carter), and ends up stealing all the narcotics in his office. One small lie and everything unravels into crazy mixed up situations in this 2001 black comedy. 

NAIVE DENTISTS

In Robert Altman's 1970 film, M*A*S*H, the camp dentist, Captain Walter Koskiusko "Painless Pole" Waldowski (John Schuck), begins questioning his sexuality after suffering a "lack of performance" with a visiting nurse. Believing he is impotent due to latent homosexual tendencies, Painless tells Hawkeye he wants to commit suicide rather than disappoint the three girls he is engaged to back home. 

In the 2003 Disney animated film, Finding Nemo, hapless Australian dentist, Dr. Phillip Sherman, captures Nemo and places him into an office aquarium. Clueless as to the needs and value of fish, Sherman allows his rambunctious, destructive niece, Darla, to abuse Nemo and the other fish. 

BORING DENTISTS

Alan Arkin played Shelly Kornpett, in The In-Laws. Arkin portrays a humdrum, mild-mannered New York City dentist preparing for his daughter's wedding. The groom's father, Vince, is a hyper fellow who pulls Sheldon into one misadventure after another. 

DENTISTRY IN A POSITIVE LIGHT

Hermey the Misfit Elf, one of Santa Claus' helpers in the 1964 television special, Rudolph the Red Nosed Reindeer, doesn't enjoy making toys like other elves. Instead, he proclaims, “Someday, I want to be a dentist! It’s fascinating ¾ molars, incisors and bicuspids,” making him a target of elfin ridicule, much like Rudolph with his glowing red nose. He returns in the 2001 computer-animated sequel, Rudolph the Red-Nosed Reindeer and the Island of Misfit Toys, as Hermey the Elf, DDS, with a "Toothmobile" and a crush on the Tooth Fairy. 

Snow Dogs, a 2002 Walt Disney Pictures comedy with lots of corny humor, features a Miami dentist, Dr. Ted Brooks (Cuba Gooding, Jr.), whose life is changed when he inherits a team of sled dogs in Alaska.

Dentists in the Media:
Some other films that feature main characters who are dentists: The Man Who Knew Too Much, Inherent Vice, Charlie And The Chocolate Factory, Ghost Town, Thumbsucker, Eversmile, Secret Lives of Dentists
 

The role of mass media was examined in an article written in 2016 in Odontoestomatología, Patients’ Perceptions About Dentists: A Literature Review. "Nowadays, mass media influences the way people think and behave to a great extent. Mass media have had a key role in the development of dental fear and anxiety, both in children and adults. Dentists have been portrayed in cinema, television and commercial advertising media, sometimes negatively, which has affected people’s fears and has distorted people’s general perception of what dentists are really like. It is well known that dental treatment can be uncomfortable: this image is extensively exploited by the mass media and has resulted in the creation of an imaginary and popular idea of what a dentist is, associated with fear and pain, which in turn has stigmatized dentistry."* 

Mass media help to make the general public fearful of dental treatment and consequently contributes to people's unwillingness to seek needed dental treatment. Therefore it follows that mass media bears some responsibility for the public's poor dental health. 

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* Patients’ perceptions about dentists A literature review Henríquez-Tejo, Rocío Belén*, Cartes-Velásquez, Ricardo Andrés  Odontoestomatología / Vol. XVIII No 27 / May 2016

Chris Raines
Web Site Administrator
Information Systems Manager
Marketing and Information Technologies Departments

Tags: dentists in the movies, dentistry in film, dentists in movies, dentists in the media

Sports Guards Prevent Dental Injury

Posted by Chris Raines on Jun 22, 2017 4:45:04 PM

"Hey Mom, Do you remember those thirty-two teeth that I used to have?"

“Hey Mom! Do you remember those 32 teeth that I used to have?”, Bobby asked when he called his mother from the basketball court. This is the phone call that no parent wants to receive. While some sports injuries are unavoidable, damage to the teeth can be significantly reduced by wearing a sports guard.

What is a sports guard?

Sports guards protect your teeth from injury and should be worn during all sports and athletic activities. They are made of strong, durable plastic material that absorb shock and are available in a variety of colors and designs.

7% of all sports injuries are in the area of the faceIs sports guard essential sports equipment?

Yes, sports guards should be worn by anyone who plays contact sports like wrestling, squash, racquetball, hockey, boxing, football, soccer, lacrosse and baseball. People who participate in non-contact activities in which a mouth injury could occur should also wear a sports guard.  Dental injuries can occur during gymnastics, skateboarding and even biking. Professional and amateur athletes, adults and children should wear sports guards when practicing or competing.

What is the difference between a mouth guard and a sports guard?

Sports guards and mouth guards each have a different purpose. Mouth guards are usually worn at night to prevent tooth damage from grinding and bruxing or to maintain tooth position following orthodontics.  Mouth guards are usually hard plastic to protect against clenching and grinding. Sports guards are made of a thicker, more durable material to prevent injury and are usually flexible soft rubber or vinyl to protect against impact trauma.

Sports guards are available in many colors and designs are available.What sports guard to choose for safety and performance?

Inexpensive sports guards can be purchased in sporting goods stores but have several drawbacks. These one-size-fits-all devices do not provide the same level of protection as custom-made devices. The safest, highest quality sports guards are custom made by a dentist. These guards are individually designed in the dental office and fabricated in a dental lab. They offer the most protection and comfort.

Antionette Robinson, Certified Laboratory Technician at Pi Dental Center, states, “Whether you’ve had orthodontic treatment, crowns or implants, wearing a sports guard is important because it protects your investment in your teeth. Dental repairs are expensive. Keeping your teeth safe during athletic activities makes sense.”

An ideal sports guard is resilient yet comfortable and stays in place firmly during activities, allowing the wearer to speak clearly and breathe easily. A well-fitting sports guard makes you feel more confident and can actually improve your game.

How do I maintain my sports guard?

When your sports guard is not in use, it should be kept safely in its storage case. Wash the guard with cool water and soap after each use. Soaking your guard in mouthwash will help it to stay fresh. Avoid leaving your sports guard in direct sunlight or in a hot vehicle. High temperatures can damage your sports guard. Your sports guard may need to be adjusted periodically. Bring your sports guard to your dental visits for evaluation.

Before Sports Guards Were Used:

State-of-the-art sports equipment has not always been available. When Ted was playing high school football in 1957, helmets did not have masks. At age 16, Ted was a right defensive end for the Battlin’ Miners at Minersville High School in Schuylkill County, Pennsylvania.  Football was THE sport. There were only 100 kids in his graduating class and 2/3rds of them played football. In one game, all four of his front teeth were damaged when he took a hit to the mouth. They became loose a few days later and were extracted by his dentist. Ted had no front teeth at his high school graduation and for several years after that. Eventually, a removable flipper was made to hide the empty space. Later in life, Dr. Stout in Chestnut Hill delivered a fixed bridge. Ted was satisfied with his new teeth but, over time, the bridge’s supporting teeth required root canal treatment, then post and cores. Ultimately, the bridge needed to be replaced. The most cost effective solution was a dental implant supported prosthesis. Dr. Glenn Wolfinger placed a permanent prosthesis on four dental implants. Today Ted’s teeth look natural and feel better than they have in years.

What advice do we have for athletes and active people of all ages?

Wear a good quality sports guard! If today’s modern sports guards had been available in 1957, Ted might never have lost his teeth. One sports injury really did cause problems for a lifetime.

If a dental injury does occur, a prosthodontist can help.

Contact us if you have any questions, would like to have a sports guard made, or to schedule an appointment at Pi Dental Center.

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Interesting statistics:

Although 62 percent of organized sports-related injuries occur during practice, one-third of parents do not have their children take the same safety precautions at practice that they would during a game.

Safe Kids USA Campaign Web site. 2009.

According to the CDC, more than half of all sports injuries in children are preventable.

https://www.usatoday.com/story/news/nation/2013/08/06/injuries-athletes-kids-sports/2612429/

Chris Raines
Web Site Administrator
Information Systems Manager
Marketing and Information Technologies Departments

Tags: sports guards, mouth guards, dental sports injury

10 REASONS WHY REBUILDING A SMILE IS A BIG JOB

Posted by Chris Raines on Jun 8, 2017 2:57:46 PM

Rebuilding a smile is a big job - photo of prosthodontist working on a giant set of teeth on an articulator

Rebuilding a smile is no small undertaking. Once teeth are lost, replacing them with enduring, attractive, healthy, functional ones takes years of training, advanced technology, manual dexterity, and varied skills. Pi Dental Center’s Dr. Glenn Wolfinger is a Board Certified Prosthodontist who is equipped to take on this task. 

After completing the doctoral degree program in dentistry, a Prosthodontic specialist receives at least three years of additional training in an ADA-accredited graduate prosthodontic program. Prosthodontics blends science, engineering and esthetics to provide a prosthesis with optimum appearance and function. Prosthodontists treat dental and facial problems that restore missing tooth and jaw structures. They are highly trained in cosmetics, dental implants, crowns, bridges, dentures, and temporomandibular disorders. 

A Board Certified Prosthodontist has successfully passed a rigorous four-part examination conducted by the American Board of Prosthodontics. 

Prosthodontists are experts in many areas: 

  1. A Communicator: Learning what the patient wants is essential to excellent patient outcomes. Effective communication skills with patients, other doctors, family members, and laboratory staff are paramount, as is putting the patient at ease.
  2. A Director: Knowing the best options that integrate the patient’s desires with the best clinical, functional and esthetic needs enables them to provide outstanding dental care.
  3. A Coordinator: Coordinating treatment with other specialists allows Prosthodontists to thoroughly address the patients’ dental needs.
  4. A Teacher: Prosthodontists explain complex concepts about the diagnosis and treatment to patients and their families.
  5. Perceptive: These dental specialists are perceptive with an accurate awareness of the patient’s desires. Prosthodontists are innovators who frequently lead the dental world in new technologies and practices that improve the field.
  6. Precise: The field of Prosthodontics requires extreme attention to detail, sharp analytical skills with exceptional problem solving ability.
  7. Dexterous: Great manual dexterity with a gentle touch is a necessity.
  8. A Scientist and Machinist: Prosthodontists have a clear understanding of anatomy and physiology. They must learn about all of the advanced dental and computer equipment used in the dental office. Understanding the science involved in delivering secure dental implants, placing compatible bone grafting, and doing dental extractions is imperative.
  9. A Creator: Artistry and creativity are major aspects in prosthetic design. The doctor must build a prosthesis that is both esthetically attractive, mechanically functional for chewing and speaking, and long lasting.
  10. Medical Knowledge: Treatment must be performed in a way that will not impair the patient’s medical conditions. Prescription medications must be appropriate for the patient’s medical and psychological condition. Prosthodontists must be up on every new discovery, disease, medication and technology to provide the best patient care.

And A Bonus Reason: In It For The Long Haul: After treatment is completed the doctor must help the patient to adequately maintain the prostheses and avoid further dental breakdown in the coming years. 



Every dental patient and case is unique. At Pi Dental Center, our dedicated team strives to provide customized care specific to individual needs.  Call us to discuss any dental treatment you may need including replacing missing teeth or to schedule your comprehensive evaluation.

 

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Tags: dental treatment, board certified prosthodontist, rebuilding a smile, 10 reasons why, replacing missing teeth

Can this tooth be saved?

Posted by Chris Raines on Apr 13, 2017 11:03:39 AM

Illustration presents various choices when considering whether to save a painful tooth

What happens when a tooth becomes painful? Can this tooth be saved?

When a tooth is painful, the decision whether to save or remove a tooth must be determined. If this tooth can be saved, we determine whether the patient wants to save it. Time constraints and financial concerns are just two of the variables that affect this decision.

Is a damaged tooth always painful?

Dr. Glenn Wolfinger, board certified prosthodontist at Pi Dental Center, was asked if a damaged tooth is always painful. He said, “Not always. A damaged tooth is usually initially uncomfortable. Pain will increase with swelling. But sometimes the pain goes away and the patient mistakenly believes the tooth has gotten better. However, this may mean that the nerve has died inside the tooth, which is a source of infection.”

What about an infected tooth?

Dr. Tom Balshi added, “An infected tooth can lead to medical and heart problems and can go into the blood stream and eventually lead to the brain.” Daryl Weiss, dental assistant, mentioned, “Bone loss can occur and the infection can spread to adjoining teeth.”

What if a tooth is mobile?

Wolfinger continues, “Not every mobile tooth needs to be extracted. All teeth have some level of mobility. Periodontally compromised teeth tend to be more mobile. Increased mobility is a sign that a tooth needs to be evaluated.”

How do we decide if a tooth should be saved or extracted?

“Restorability is the most important part of the decision.  We determine if the tooth can be restored with a filling or a crown. Sometimes root canal is needed.”

“There are times when a tooth is not restorable. At that point a root canal would not be indicated. If the tooth cannot be restored properly, an extraction is the only option.”

“If a tooth is restorable, then it is up to the patient to decide if they want to save the tooth.”

How do patients feel about losing a tooth?

Losing a tooth can be very traumatic. The decision to extract a tooth can be very difficult, even when it is necessary. But it is important to understand that treatment options, like dental implants and AvaDent Digital Dentures that effectively provide healthy, esthetic, and functional results.

What are the criteria?

If decay approaches the bone level, then restoration may not be possible. If there is a root fracture, extraction is indicated.

Can this tooth be saved? Illustration of healthy tooth, tooth with some bone loss, tooth with advanced bone loss

What about extracting the tooth and leaving an open space?

Leaving an open space is not always the best solution. While the actual fee for an extraction is inexpensive, the long term cost is not cheap. Adjacent teeth can shift and make restoration more difficult later on. Missing teeth present an esthetic and functional deficit for the patient.

Is there more than one choice treatment?

There are several options for treatment. During the evaluation, the doctor and patient discuss several aspects of treatment to learn the patient’s most important priorities and explore all available options. Comprehensive treatment plans that outline each option in detail are provided.

To make the best decision, we consider:

  • What is the best choice in terms of dental health?
  • Which option will last the longest?
  • Which will feel the most comfortable?
  • Which choice will allow the patient to eat and speak adequately?
  • Which is the most strong and durable?
  • Which is the most attractive?
  • Which can be achieved most quickly?
  • How does the cost of each choice compare?

How can a patient avoid tooth extraction?

“If the patient maintains a regular oral hygiene schedule and allows us to adequately evaluate the health of the mouth, including radiographic examination as needed, tooth extraction can usually be avoided. Small problems become big ones when they are undiagnosed.”

So what should you do if you suspect a problem?

Try not to wait until a problem becomes an emergency. Schedule an oral hygiene visit at least every 6 months. Contact us as soon as you suspect a problem. Provide the scheduling coordinator with as much information as possible when you schedule your appointment.

Visit Pi Dental Center's YouTube Channel to learn more about dental implant treatment options.

If you have questions, feel free to call us at 215-646-6334.

Pi Dental Center’s mission is to go beyond the preservation and maintenance of teeth to provide the best functional and esthetically ideal treatment. Our aim is to make your dental experience painless, convenient, and comfortable. Our supportive team helps to make your decision painless, straightforward and uncomplicated.

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Tags: dental implants, bone loss, dental pain, tooth loss

Service with a smile

Posted by Chris Raines on Mar 14, 2017 2:01:48 PM

Did we serve you with a smile - sign at grocery storeThe sign at the grocery store said, "Did We Serve You With A Smile?" Service with a smile is a core policy of many companies in their goal to provide outstanding customer service.

A smile communicates a frame of mind and enhances an interaction. It validates statements made by the recipient of the smile. It conveys a caring attitude and improves communication.

Tricia, a center-city Philadelphia hairdresser, was asked if she often smiled while cutting customers' hair. She said, "Yes. My smile may be the only smile the clients see all day. They might not have spoken to anyone other than me. It can cheer a person up. A smile can make someone else's day!"
Some studies have shown that a smile must be genuine. Faking a smile can take an emotional and physical toll. Other studies suggest that the simple act of putting on a smile can be a mood booster, theorizing that smiling activates areas of the brain associated with reward and triggers the release of dopamine.

When asked about smiling while talking on the telephone, Maryellen at Pi Dental Center said yes, “They say people can ‘hear’ a smile.” Smiling while on the phone has been shown to be valuable. A University of Portsmouth, England study showed that people can hear a smile and some can even pick up on different kinds of smiles.

Reluctance to smile hinders communication. Some people who feel self-conscious because of their dental condition do not smile. Proven and predictable dental implant technology and digital dentures restore beautiful smiles and repair damaged teeth quickly and competently. Board certified prosthodontists at Pi Dental Center  have been successfully providing advanced dental care for over 30 years. Teeth In A Day and Computer Guided Dental Implant Treatment, and the No Bone Solution have helped patients with very little bone regain healthy mouths with permanent teeth supported by dental implants.

A smile establishes rapport and reflects the positive attitude that is so vital to productive relationships. A smile can do wonders! Call 215-646-6334 or contact us at the link below to learn more or schedule an appointment.

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Tags: dental implants, permanent teeth, healthy mouths, smile establishes rapport, smile improves relationships

The Opiate Crisis and How It Relates To Dentistry

Posted by Chris Raines on Feb 28, 2017 4:46:08 PM

Pennsylvania Guidelines for Dentists Regarding OpioidsDentists are among the leading prescribers of opioid prescriptions. The opiate crisis, which takes lives, destroys families and increases crime, has significantly increased in recent years. New regulations and programs address this issue.

A February 2017 panel discussion that included the Montgomery County Department of Drug and Alcohol, the Sheriff’s office, County Commissioner, Dr. Valerie Arkoosh, a Salvation Army representative, and survivors and advocates, was held to address the 138% increase in Montgomery County drug overdoses in 2016.

Research suggests that abuse of prescribed opioids can open the door to heroin use. Nearly half of young people who inject heroin surveyed in three recent studies reported abusing prescription opioids before they started heroin. Some individuals reported switching to heroin because it is less expensive and easier to obtain than prescription opioids. *

More people are dying from heroin overdose than in the past and authorities say that this is due to Fentanyl, which drug dealers often use to cut heroin. It is 80 to 100 times stronger than morphine.

Chief Deputy Michael Beaty, Montgomery County Sheriff’s Office, reported 237 drug related deaths in 2016 (213 were accidental and 98 involved Fentanyl). He asserted that drug use increases other crimes, such as theft.

Cocaine, methamphetamine, oxycodone and the prescription anti-anxiety medications alprazolam (Xanax) and clonazepam (Klonopin) contribute to overdose deaths.

Drug abuse is not only an urban problem. It occurs all locations, including suburban and, surprisingly, rural areas. A 2015 report from the Center for Rural Pennsylvania showed that overdose deaths from heroin, which sells for as little as $5 per bag on the streets, as well as prescription painkillers and other opioids have increased by 470% compared to the previous 20 years. More Pennsylvanians ages 20 to 44 are dying annually from overdoses than from motor vehicle accidents.

“Because of the uptick in cases, the treatment system is being severely taxed. Treatment centers, like Eagleville Hospital, need more beds.” said Kay McGowan, Montgomery County Deputy Administrator of Drug and Alcohol.

McGowan addressed the issue of relapse by recovering addicts. “So many people relapse when they are prescribed meds by a doctor.” Physicians and dentists must conduct careful screening  to determine if the patient is in recovery. Alternatives, such as Nsaids, should be prescribed.

Benny Mosakowski lived in a tranquil suburban community where he attended Plymouth Whitemarsh High School and played football in the 1980’s.  Prescription opioid medications had been prescribed for a football injury.  Benny states that he became instantly hooked on the prescribed pills. He found that the pills were readily available to him but eventually switched to heroin. Benny never thought that heroin addiction could happen but his life quickly spiraled out of control.  Mr. Mosakowski related, “I needed heroin as much as I needed air. I never learned to be an adult or developed coping skills. At 35, I’d had two marriages and 2 children and was sticking a needle in my arm every day.” It took Benny 10 years to stay clean. Thanks to Eagleville Hospital, as of 2012, he has not had another drug. “This is a disease and not a deficiency. I have seen more people die in the past 1 ½ years than in the previous 15. When you reach a state of willingness, if the help is there, you can quit. The problem starts in the medicine cabinet, but then heroin costs less than pills.” Today, Mr. Mosakowski is a survivor and advocate helping others.

The Journal of the American Medical Association reveals that dentists routinely prescribe opioid analgesics. The first sign of this unexpected source of opioid prescriptions was discovered in 2011. At that time a survey of members from the American Dental Association Survey Center was taken and the findings were surprising. The data shows the following:

  • 85% of dental surgeons said they almost always prescribed an opioid
  • 64% of surgeons said that their opioid prescription of choice was hydrocodone with acetaminophen
  • The average number of hydrocodone with acetaminophen was 20 tablets
  • In 96% of the cases, the only medical instructions provided for taking the pills was "as needed for pain”**

Gary Tuggle, who oversees the DEA’s Philadelphia Division, states, “It is imperative that law enforcement, healthcare and treatment professionals, elected officials, and community groups work together to address the factors impacting availability, use and abuse of these drugs.”

“There are many alternatives to opiates that are quite effective,” adds Valerie Arkoosh MD, Montgomery County Commissioner. “If a physician will not consider giving a non-narcotic medication, get a second opinion.” She emphasized, “Patients can just say no to opiates. Parents should always consider non-opiates.” Arkoosh also briefly discussed the new database that doctors and dentists must check before writing opioid prescriptions.

Many people believe that if pain relievers are prescribed by a doctor or dentist, then they are safe.  However, if these medications are taken in larger amounts, more often than prescribed, or for unintended reasons, they can cause severe adverse effects including addiction, overdose, and death. Prescribed medications should never be taken by someone other than the one for whom they were prescribed. Opioid medications should never be combined with alcohol or other drugs.

In light of the current opiate epidemic, dentists must ask themselves how they can effectively help to reduce the problem.  They must learn how to identify patients who have an addiction problem.

Pennsylvania Programs at PA.Gov

What should a dentist do if they suspect that one of their patients has an addiction problem?

New Pennsylvania Department of Health Prescription Drug Monitoring Program (PA PDMP) requirements took effect in January 2017.  Dentists must check the PA PDMP database each time they prescribe an opioid medication.

Governor Wolf said, “By reducing the pattern of over-prescribing painkillers that have such a high risk for abuse, we are fighting back against opioid abuse and heroin use before those habits even begin.”

Providers have a responsibility to diagnose and treat pain using informed clinical judgement that minimizes serious adverse effects. Consideration for the patient’s past and current history of opioid use and abuse must be included when determining which pain medications should be prescribed. The patient’s substance use history should be documented.

Ask open-ended questions to learn about the patient’s drug use. It is as difficult as it is essential. Broaching the subject feels awkward and intrusive.

Unless contraindicated, non-steroidal anti-inflammatory medications (NSAIDS) should be considered. In many cases, NSAIDs have proven to be more effective in treating dental pain than opioids. Pain therapy can be initiated immediately prior to the surgical procedure and continued on a scheduled basis following completion of the procedure.

Patients reporting unexpectedly prolonged pain, particularly those who do not show evidence of ongoing pathology, should not be prescribed opioids. They can instead be referred to a chronic pain specialist.

Relevant information should be provided so patients are well informed about the various options available for pain management. Good physician/patient communication is essential.***

Patients whose behavior indicates the presence of a substance use disorder, should be encouraged to seek evaluation for treatment through their primary medical care provider.

Pennsylvania Medication Take-Back Program ContainerPatients should be instructed in safe disposal of unused medications, to ensure that these meds will not be misused. Through the Pennsylvania Prescription Drug Take-Back Program, Med Return Collection Boxes are available for safe disposal of unused medications, including opioids. This program has placed 492 boxes across Pennsylvania. The total amount of drugs taken back and destroyed in 2015 was 56,252 pounds. https://apps.ddap.pa.gov/GetHelpNow/PillDrop.aspx

Prosthodontist, Dr. Glenn Wolfinger states, “The staff of Pi Dental Center and I have been very aware of the issues regarding opioid use and have been very careful throughout the years in how these medications were prescribed. Non-steroidal anti-inflammatory pain medications have worked well for Pi Dental Center patients.”

In light of the severity of the opioid crisis, it is obligatory that dentists and physicians follow the new Pennsylvania guidelines to identify at-risk patients and to ensure patients are prescribed safe medications.

Contact Pi Dental Center for information about dental treatment and surgical procedures and pain medications.

Ask A Dental Question Or Schedule An Appointment

 


Learn More about the opiate crisis and how it relates to dentistry:

Pennsylvania Department Of Health Prescription Drug Monitoring Program
http://www.health.pa.gov/Your-Department-of-Health/Offices%20and%20Bureaus/PaPrescriptionDrugMonitoringProgram/Pages/PDMP-Portal.aspx#.WLCb-m8rKM8

Link to Portal
https://pennsylvania.pmpaware.net/login

Mapping Pennsylvania’s Worsening Heroin Crisis
http://www.pennlive.com/news/2016/03/pennsylvanias_heroin_crisis_is.html

DEA: Drug overdose deaths up sharply in Pennsylvania By Michael Goldberg
http://www.thereporteronline.com/article/RO/20160715/NEWS/160719879

* National Institute on Drug Abuse
https://www.drugabuse.gov/publications/research-reports/heroin/how-heroin-linked-to-prescription-drug-abuse

** http://www.soberrecovery.com/recovery/how-dentists-are-contributing-to-the-opioid-epidemic/

Info about Gary Tuggle
https://www.dea.gov/divisions/phi/phi_sac.shtml

*** Improving the management of post-operative acute pain Meissner et al.
http://www.efic.org/moxiemanager/data/files/Improving%20the%20management%20of%20post-operative%20acute%20pain.pdf

http://sanctuary.net/prescription-drugs-lead-to-illegal-drug-use/

http://www.health.pa.gov/Your-Department-of-Health/Offices%20and%20Bureaus/PaPrescriptionDrugMonitoringProgram/Pages/PDMP-Portal.aspx#.WLCb-m8rKM8

http://www.newbeginningsdrugrehab.org/guide-to-addiction-prevention-for-seniors/

https://addictionresource.com/addiction/substance-abuse-among-seniors/

http://www.health.pa.gov/Your-Department-of-Health/Offices%20and%20Bureaus/PaPrescriptionDrugMonitoringProgram/Pages/GeneralInfo.aspx#.WK84UW8rKM8

http://www.health.pa.gov/My%20Health/Diseases%20and%20Conditions/M-P/opioids/Documents/opioid_dental_prescribing_guidelines3_13_15.pdf

http://www.health.pa.gov/My%20Health/Diseases%20and%20Conditions/M-P/opioids/Pages/Prescribing-Guidelines.aspx#.WK85N28rKM8

https://www.drugabuse.gov/nidamed-medical-health-professionals/about-addiction-performance-project/addiction-performance-project/talking-to-patients-about-their-drug-use

http://ocw.tufts.edu/Content/70/lecturenotes/1260782

http://us14.campaign-archive1.com/?u=daa8d6d8dddc3e7cf2f933b1c&id=f538cf95e1&e=be06d005f4

http://www.medscape.com/viewarticle/867751

http://www.npr.org/sections/health-shots/2017/02/26/513865623/dentists-work-to-ease-patients-pain-with-fewer-opioids?sc=17&f=1001

Tags: dentist, dentistry, opiate crisis and how it relates to dentistry

Healthy teeth like diamonds

Posted by Chris Raines on Feb 3, 2017 6:12:58 PM

Strong healthy teeth are like diamonds“A tooth is much more to be prized than a diamond.” States Miguel de Cervantes Saavedra in Don Quixote

Diamonds are greatly valued and the most cherished of all gemstones. Strong healthy teeth have often been compared to diamonds. The word, diamond, is derived from the ancient Greek term adámas meaning indestructible and unbreakable. Both diamonds and teeth are described as sparkling, shiny, bright and gleaming.

Strong healthy teeth help to ensure good overall health. Problems in the mouth can affect the rest of the body. Studies suggest that oral bacteria and inflammation associated with gum disease play a role in certain diseases. Diseases like diabetes and HIV/AIDS can lower the body's resistance to infection, making oral health problems more severe. Read Mayo Clinic Oral Health Page.

An attractive smile is both socially and professionally significant. Your smile is the first thing people see when they meet you. A sparkling smile can improve self-confidence and help you to radiate charm and assurance.


In her book, Smile Your Heart Out, Joanne Balshi says, “We all tend to live up, or down, to the vision we see in the mirror.” Dental restoration often leads to widespread improvements in life. Many of our patients who’ve had complete dental makeover’s find that they look years younger with their gorgeous new smiles. And, in some cases, this dental rejuvenation has prompted them to make needed life changes or take on challenges that had previously seemed impossible. Some have improved their overall health regimens; others have completed higher level education. Some have simply begun to smile widely when photographed.

Many people wonder if they are candidates for dental implants. Today, anyone who is missing one or more of their teeth due to injury, disease, or decay may be a candidate for dental implants. Drs. Thomas Balshi and Glenn Wolfinger are board certified prosthodontists, experts in the restoration of teeth. They have successfully treated patients for over 30 years at Pi Dental Center in Fort Washington with everything from crowns, fillings, dental extractions, removable dentures, to digital dentistry, advanced dental implant treatment with bone grafting and computer guided surgery.

Like a diamond, a beautiful smile lights up a whole room. Call to learn how to have strong healthy teeth like diamonds!

Ask A Dental Question Or Schedule An Appointment

Tags: dental makeover, dental health, dental health and quality of life, healthy teeth

Can’t Fool Santa or the Dentist

Posted by Chris Raines on Dec 20, 2016 4:18:41 PM

naughty-nice.jpgHe's making a list,
He's checking it twice,
He's gonna find out who's naughty or nice
Santa Claus is coming to town

He sees you when you're sleeping
And he knows when you're awake
He knows if you've been bad or good
So be good for goodness sake


We’ve all heard the Christmas song, “Santa Claus Is Coming to Town,” written by John Frederick Coots and Haven Gillespi.  This Christmas classic, first sung on Eddie Cantor's radio show in November 1934, cautions children to behave because Santa can magically perceive whether they are naughty or nice.

20161220_100703 copy.jpgSome people try to hide their dental habits from the dentist.  They try to hide their irregular and haphazard oral hygiene by brushing their teeth vigorously right before their dental appointment.  Oral hygiene habits cannot be concealed. Built up stain and food impaction are visible tell-tale signs of poor dental hygiene.  Poor dental hygiene will eventually result in tooth decay, cavities, gum disease tooth loss and can even affect overall physical health.

The dentists at Pi Dental Center recommend brushing after every meal, cleaning between the teeth with dental floss, water flosser or Proxabrush and scheduling oral hygiene cleanings and examination at least twice a year.  Oral hygiene instruction can help patients improve their oral hygiene techniques.

Pi Dental Center’s dentists and hygienists are your partners in dental health, helping you to make sure that your teeth are as healthy and attractive as they can be. Call to schedule your dental hygiene visit.

Ask A Dental Question Or Schedule An Appointment

Related Subjects:
Tooth Extraction
Bone Remodeling
Maintaining Dental Investment

Tags: dentist, oral hygiene, dental health, dental hygiene

Dental Implant Treatment with an AvaDent Prosthesis: Part 1

Posted by Chris Raines on Nov 8, 2016 11:04:16 AM


ken-post-treatment-smile.jpgKen was diagnosed with rare disorders called Osteogenesis Imperfecta and Odontogenesis Imperfecta
when he was a child. As a result of these disorders, Ken’s dental condition deteriorated over the years requiring frequent dental treatment. 

Osteogenesis Imperfecta (OI) is a rare disorder affecting the connective tissue and characterized by extremely fragile brittle bones that break or fracture easily, often without apparent cause. The specific symptoms and physical findings associated with OI vary greatly from case to case. The severity of OI also varies greatly, even among individuals in the same family.

Odontogenesis Imperfecta is a developmental disturbance of one or of several adjacent teeth, characterized by deficient formation of enamel and dentin. Such teeth exhibit delayed eruption into the oral cavity.

In an interview, Ken explained how he came to Pi Dental Center and described his viewpoint about the dental treatment he received from Dr. Balshi.

Ken began by describing his early dental treatment, “I went to a cosmetic dentist. We had tried braces when I was very little.  It wound up making most of my teeth very loose.  So we took the braces off and went through the entire process of letting them get reaffirmed.  So that was the last time my mom, my dad, or I tried to fix it, because of the Osteogenesis Imperfecta. At least that is what we were told.”

“I started reading about dental implants. I went to a dentist who said, ‘No, this is not the way to go.’ He suggested crowns, a million dollar smile and said I would be good for the rest of my life.  They were not.”

Indicating Pi Dental Center, Ken said, “That was when I sought you out.  I started doing research, and my sister-in-law, who worked for Dr. Balshi, said that is exactly what he does, he pioneered it. That summed it up for me.”

Ken had six implants placed in the maxillary arch using the guided implant surgical procedure and All-On-Four® treatment in the mandible.  Pi Dental Center provided AvaDent Tissue Integrated Prostheses (TIP) for the upper and lower arches.

Mr. Swinehart talked about the look and comfort of his final teeth in comparison to his temporaries, “Esthetically everything is fantastic.  The most significant thing for me was how the teeth felt. With the temporary prosthesis, I used to be able to feel flex, whether it was eating pizza or steak.  Not movement, just flexing.  I don’t feel any of that now.  Where I thought it couldn’t feel any better than it did, it feels that much better. I don’t feel that flexing anymore.”

“These feel like they have been my teeth since birth.  I’ve had absolutely no issues. I’ve gone through plenty of steak, lots of beef brisket, when I was down in Memphis, corn on the cob, you name it. I don’t feel hampered by anything.  Including some of the frozen stuff that I was known for breaking my temporary appliance for, I’ve been able to get through without any damage. Steve told me, ‘Go do everything.’  Chocolate chip ice cream - I went through the whole gamut.”

“I am happy for myself and I am happy that I found the doctor who could fix my issues.”

Dr. Balshi mentioned, “It’s not just the doctor, it’s the entire team including the staff, the laboratory support, the engineering, the behind the scenes, the stuff that’s going on in Scottsdale with AvaDent, and in the Netherlands with the AvaDent technology. It takes a lot to put this all together including the robots.”

Ken agreed, “But you’re right, it does take a team. I have never ever felt better or in better hands as a patient regardless of who I saw while I was here.  Be it yourself, or Dr. Wolfinger, or Stephen, or whoever has come into the room.” 

“There is one thing that sticks out, that my parents wanted me to tell you that they’ve seen.  I’ve always thought that I’ve been self-confident to the point of cocky, regardless of what my smile looked like.  The one thing that they’ve picked up on, that I wouldn’t see from the inside out, is the self-confidence and the amount of smiling that I do now versus before. Before, I was just very restrained because I was so insecure of my smile. I was looking for ways to cover it up, glass in front of the mouth, napkin in front of the face, or hand over the mouth, whatever had to be done. I don’t do that stuff anymore. I know I’m not doing that stuff anymore.  So, now, there is an outward self-confidence that I don’t think people see as cockiness. Because people can see that I’m smiling. I’m 46 years old, if I don’t do it now, I never will.”

To learn more about AvaDent Dental Implant Supported Prostheses, treatment for people with congenital dental disorders or guided dental implant treatment, contact us.

WATCH VIDEO:


Ask A Dental Question Or Schedule An Appointment

More about Osteogenesis Imperfecta:

http://www.oif.org/site/PageServer?pagename=Dental

Tags: All-On-4 dental implant treatment, osteogenesis imperfecta and dental implants, Odontogenesis Imperfecta and dental implants, AvaDent with dental implants