Pi DENTAL CENTER BLOG

Chris Raines

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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.

Ask A Dental Question Or Schedule An Appointment

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!

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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

When Looking For Dental Implants, How Does The Dentist Measure Up?

Posted by Chris Raines on Oct 11, 2016 12:04:50 PM

Drs. Balshi and Wolfinger lecturing to students and dentistsEach morning, the Pi Dental Center mailbox receives a new batch of emails from people looking for the best dental implant specialist. The other day, we received an email asking if our doctors were as good as Doctor So-and-So in Las Vegas.  

Before responding, I did a little research to learn about So-and-So. I learned that Dr. So-and-So had almost nothing to back up his glitzy persona.

I’ve had the pleasure of working at Pi Dental Center for 29 ½ years for Drs. Thomas Balshi and Glenn Wolfinger! One of my tasks is to document every research article on our website. I document every book they write, every course they teach, every lecture they give, every poster-presentation they produce and every award they receive.  Documenting their distinguished careers is almost a full time job.

Drs. Balshi and Wolfinger are both board certified prosthodontists. Prosthodontists are dentists who specialize in diagnosis, planning, rehabilitation, and maintenance of the teeth and mouth with special emphasis on the patient’s oral comfort, facial appearance, and dental health. Prosthodontists treat patients with congenital conditions, missing teeth and complex dental problems. Prosthodontists receive two or three years of additional training following dental school through an accredited American Dental Association program.

To become board certified, prosthodontists must successfully pass a rigorous examination conducted by the American Board of Prosthodontics. These specialists are subjected to recertification every eight years to insure their clear understanding of current practices that affect the specialty.

Teeth In A Day Course presented by Drs. Balshi and Wolfinger in 2016

Drs. Balshi and Wolfinger’s 118 research articles are available online.

A quick way to learn doctor’s accomplishments is to look at their Curriculum Vitaes. Here is the link to Dr. Balshi’s lengthy Curriculum Vitae  and Dr. Wolfinger’s comprehensiveCurriculum Vitae.

Dr. Balshi has been America’s Top Dentist and International Congress of Oral Implantologists Diplomate. He’s been awarded for 40 continuous years of service by the American College of Prosthodontists, received the Temple University Kornberg School of Dentistry Gallery of Success Award and the American College of Prosthodontics Founders Award. He was named Top Prosthodontist by the Consumers’ Research Council of America. Dr. Balshi earned the United States Army Medal of Commendation, a Freedom Foundation George Washington Medal of Honor, and has been recognized in the Congressional Record of the United States of America.

Both Drs. Balshi and Wolfinger have been at the forefront of dental implant research and development since the 1980’s. Their research has helped to take the journey to fixed teeth from a difficult year-long ordeal that involved many steps to a relatively pain-free one-day procedure.

Drs. Balshi and Wolfinger trained graduate and postdoctoral students from Harvard, Tufts, Loma Linda, Nova Southeastern, Temple, University of Connecticut, University of Maryland and other dental schools and lectured worldwide on surgical and restorative aspects of dental implant treatment.

Pi Dental Center’s prosthodontists successfully provided dental implants to patients with countless complicated problems from diabetes, Cleidocranial Dysplasia, Ectodermal Dysplasia, advanced periodontal disease, congenitally missing teeth, and traumatic injury. 

Some of Drs. Balshi and Wolfinger’s Scientific Accomplishments:

Patients have willingly and readily provided positive reviews for Drs. Balshi and Wolfinger.  The whole team has been commended for their professionalism, caring friendly manner and beautiful result.

Drs. Balshi and Wolfinger are the real deal. Dr. So-and-So — not so much.

If you are looking for a dentist or have questions about dental treatment please feel free to contact us.  We look forward to helping you regain your magnificent and healthy smile.

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Chris Raines
Web Site Administrator
Information Systems Manager

 

 

Tags: dental implants, dentist, choosing a dentist

Is NICE a valid criterion for choosing a dentist?

Posted by Chris Raines on Sep 14, 2016 5:34:28 PM

Dr. Balshi, dentist and prosthodontist, shows care and concern, explains thouroughly, and listens to the patient.Would you say that your dentist is nice? And if so, what qualities would contribute to that opinion? And is “nice” valid criterion in choosing a dentist? The answer is, “That depends.”

Reasons “nice” might not be valid criterion:

  1. The dentist says what the patient wants to hear, whether it is the best advice or not.
  2. The dentist says the condition of the patient’s mouth is good, when it’s not.
  3. The dentist offers an easy and mediocre solution that will not stand up to time or the strong biting forces of the mouth.
  4. The dentist does not encourage the patient to follow a strict hygiene regimen.

Criteria that is both “nice” as well as valid:

  1. The dentist shows care and concern for the patient.
  2. The dentist and staff are polite.
  3. The dentist listens closely and takes time to hear all of the patient’s concerns.
  4. The dentist thoroughly explains treatment options.
  5. The dentist describes treatment procedures clearly and thoroughly.
  6. The dentist offers the best treatment options that are long lasting, attractive, functional and healthy.
  7. The dentist and staff instruct the patient in the most effective home care techniques.
  8. The dentist checks to make sure that the patient is doing well following surgical treatment.
  9. The dentist and staff instill confidence and help the patient to feel safe.
  10. The dentist and the patient are a team working toward a goal of optimal dental health. Collaboration will assure positive results.

Dr. Wolfinger mentioned, “Listening carefully to a patient’s concerns and creating predictable treatment options based on those concerns is important in developing a good doctor patient relationship.

Consumer reports states, “Growing research suggests that people who have a strong relationship with a physician not only report greater satisfaction with their care but also may enjoy better health.” The same can be said for a dentist.

At Pi Dental Center, a good doctor/patient relationship is essential to successful treatment. This rapport is established during the first visit and maintained through each and every appointment.

During the initial visit, the dentist listens closely to the patient’s concerns and asks pertinent questions.  This in depth conversation is an integral part of the comprehensive diagnostic evaluation.

Review:  “Friendly, informative, clinically careful, and most of all, honest about what is involved. They eagerly answered any and every question!”

The relationship contributes to the patient’s successful treatment outcome. The choice of a dentist can be a challenge.  You can trust and rely on the dentists at Pi Dental Center.

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Tags: dental treatment, doctor patient relationship, choosing a dentist, good doctor/patient relationship

Phlebotomy and PRP at Pi Dental Center

Posted by Chris Raines on Aug 26, 2016 3:52:26 PM

Pi Dental Center Staff Hone Phlebotomy Skills for PRP Procedure with Patients

Pi Dental Center clinical team attends phlebotomy training.Pi Dental Center’s clinical staff recently took part in a Phlebotomy training program to perfect their skill in drawing blood, which they do for the Platelet Rich Plasma (PRP) procedure. PRP accelerates healing and enhances bone growth, which in turn stimulates osseointegration of dental implants.

Phlebotomy

Phlebotomists are trained to draw blood from patients for clinical or medical testing, transfusions, donations, or research.  Pi Dental Center’s clinical department participated in a course given by an approved provider of the American Society for Clinical Laboratory Science. This phlebotomy course consisted of an online tutorial followed by small-group training with a certified instructor in our office. The online portion included lessons and quizzes. The hands-on course included placement of the tourniquet, proper techniques for finding a vein and inserting the needle, patient safety and comfort. Participants even practiced drawing blood on one another.

Pi Dental Assistant, Amy Gambone, felt that the course was quite valuable, stating, “Taking the phlebotomy course helped me tremendously. Safety and making the patient feel confident that they’re in good hands are essential. I feel more confident doing a blood-draw.”

Clinical Director, Martha Mendez discussed the phlebotomy course, “I learned the appropriate technique to draw blood, how to prioritize veins and most importantly, safety.  This course will improve our safety protocol for drawing blood and also ensure that our patients’ experience at Pi is as painless as possible.”

PRP

Andrea and Martha discuss the online portion of the phlebotomy training program.During the PRP procedure, a small amount of blood is drawn in preparation for dental implant treatment. 

PRP is a by-product of blood that is rich in platelets. Platelets are irregularly-shaped, colorless bodies that are present in blood. Their sticky surface lets them, along with other substances, form clots to stop bleeding. Platelets contain growth factors (GFs), which serve as effective inducers of normal tissue repair.

PRP allows the body to take advantage of the normal healing pathways at a highly accelerated rate. During the healing process, the body rushes many cells, including platelets, to the wound to initiate the healing process. Platelets perform many functions; one of which is the release of GFs into the wound. These GFs function to aid the body in repairing itself by stimulating mesenchymal stem cells (MSCs) to regenerate new tissue. The more GFs sequestered into the wound, the more MSCs are stimulated to produce new host tissue. Simply, PRP permits the body to heal faster and more efficiently.

Correct use of  the syringe is described during Phlebotomy training program at P Dental Center.An article in The International Journal of Periodontics and Restorative Dentistry detailed a study regarding use of Growth Factors in molar sites with bone defects.  It advocated the use of Growth Factors in immediate placement of implants at the time of tooth removal. This is because of the high degree of predictability for successful treatment, preservation of bone and soft tissue form, the reduced period that a patient must live without teeth and superior esthetic results.

Dr. Glenn Wolfinger states, “PRP is used to stimulate and accelerate the healing process in the Teeth in a Day® protocol.  We strongly believe that PRP is a critical component of the high success of this protocol.”

As stated in the Journal of Oral Implantology, “Integrating this technique into common practice provides important benefits for patients regarding esthetics, without the risk of infection or transmission of diseases.”

To learn more about PRP click here.

More about bone and healing:

To ask us about dental implant treatment, PRP, or to schedule an appointment:

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Terminology:

Phlebotomy:   the practice of drawing blood

Osseointegration: The biological process by which living bone (osseo) fuses with the titanium dental implant to form a man-made tooth root.


Articles:

Immediate Postextraction Implant Placement Using Plasma Rich in Growth Factors Technology in Maxillary Premolar Region: A New Strategy for Soft Tissue Management. Oral Implantology, Vol. XXXIX, No. One, 2013.

Platelet-Derived Growth Factor – Mediated Guided Bone Regeneration in Immediate Implant Placement in Molar Sites with Buccal Bone Defects, The International Journal of Periodontics and Restorative Dentistry, Vol. 35, No. 6, 2015.

Tags: dental implants, PRP for dental surgery, Teeth In A Day

More Mobile Phones Than Toothbrushes? Fact or Fiction

Posted by Chris Raines on Aug 3, 2016 2:14:28 PM

More Mobile Phones Than Tooth Brushes? Fact or Fiction

Did you ever hear there were more mobile phones than toothbrushes?  We wondered whether this startling statement was actually true. The Mobile Marketing Association of Asia originally reported this data, stating that, ‘out of 6 billion people on the planet, 4.8 billion have a mobile phone while only 4.2 billion own a toothbrush’ Link to article. 

Jamie Turner of 60 2nd Marketer attempted to determine the validity of this statement.  A Google search using the phrase, “number of mobile phones worldwide,” showed that there are 4.6 billion mobile phone subscriptions worldwide. Yet, the true number of phone owners is more complicated than it seems. In some parts of the world, people have more than one subscription. When this variable was considered, the number of mobile phone owners dropped to 4.2 billion. 

Mr. Turner had even more difficulty determining how many people own toothbrushes. Colgate reported having 34 percent of the market share in manual toothbrushes. Oral-B stated the yearly toothbrush market is $5 billion. By calculating the cost of toothbrushes on Amazon, he determined an average cost to be $3.00 in the US, but closer to $1.55 worldwide.

Ultimately, Mr. Turner concluded that approximately 3.22 billion toothbrushes were sold last year. And although it is almost impossible to determine the actual numbers of toothbrushes or mobile phones, the statement that there are more mobile phones than toothbrushes seems to have some validity. 

3.22 BILLION TOOTHBRUSH OWNERS < 4.0 BILLION MOBILE PHONES OWNERS

Regardless of the exact number of toothbrushes or mobile phones, the real issue is the state of people's oral hygiene and dental health. Is oral hygiene protocol satisfactory to maintain good oral health? 

Recently, ABC News broadcasted an Associate Press story claiming that the medical benefits of dental floss are unproven and challenged the dental profession's recommendation to floss daily.

The American Dental Association has affirmed flossing as an essential part of tooth and gum care and has a web page outlining the benefits of flossing along with an instructional video.

Do the doctors and dental hygienists at Pi Dental Center recommend flossing? 

Dr. Glenn Wolfinger, Board Certified Prosthodontist at Pi Dental Center states, "For most dental implant patients, a toothbrush and Waterpik may be the most ideal method for oral hygiene.  For those with natural teeth, brush and flossing is recommended. Flossing not only removes debris between teeth, but if done properly, could provide positive stimulation to the gingival tissues."

Daily oral hygiene home care can include dental floss, oral irrigators, proxabrushesConnie Hartranft, RDH at Pi Dental Center, affirms, “As a Dental Hygienist who has worked in the field for over twenty years, I do find it surprising that there are limited long term studies on the effectiveness of flossing.  It is accepted that brushing reduces the sticky matrix, filled with bacteria known as plaque on teeth and gums when done properly. Brushing, however, cannot reach the areas between the teeth and slightly below the gum line where quite a bit of bacteria accumulates.  After spending countless hours treating patients, I feel that I have the practical knowledge to state there is a definite difference in the health of the gums and teeth when flossing is done properly in conjunction with brushing.” 

Ms. Hartranft continues, “Many dental hygienists and dentists agree that flossing is not the only way to remove plaque. Other aids include interproximal brushes, water flossers, air flossers, interdental sticks and end tufted brushes. I continue to strongly recommend the importance of removing plaque between teeth to our patients, whether through flossing or other interdental aids.”

Registered dental hygienist, Dolly Kituskie, suggests that patients brush at least twice daily, in the morning and evening. She goes on to recommend replacing the toothbrush every 3 to 4 months.  Using a soft toothbrush is advisable.  Things like floss, mouthrinse, interdental cleaners and tongue scrapers help to reduce plaque and control malodor.  The teeth and oral cavity should be checked by your dentist at least twice yearly. People with periodontal disease or those who are prone to cavities, should see their dental hygienist three to four times a year.

An individualized home care regimen should be developed by the oral hygienist and patient.  A dental cleaning should include oral hygiene instruction to ensure that the patient is using the correct technique.  Routine dental checkups help the patient determine that their home care regimen is sufficient to maintain their dental health.

Please feel free to call us at 215-646-6334 or contact us via the web, if you are due for oral hygiene or have a question.

 

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Tags: Dental Hygienist, oral hygiene, teeth, periodontal disease, toothbrushes