Aspen Dental General & Cosmetic Dentistry

“Why do I need fluoride?” you may have asked your dental hygienist or your dentist. Fluoride is an element which occurs naturally in the environment; usually in the water. There are areas where fluoride occurs naturally in a very high concentration. This is how researchers discovered the benefits of fluoride, since the areas where fluoride is high, the incidence of dental decay (cavities) is low or non-existent. The Public Health initiative introducing fluoride to municipal drinking water has been the most successful public measure for reducing the incidence of a disease (cavities).

In understanding how fluoride works, its best effect is during the formation of tooth buds, long before the teeth erupt. However, additional benefits can be found when fluoride is topically applied to erupted teeth. There are several ways of achieving this benefit. The first, and easiest is through drinking water which is fluoridated. This is a low concentration (1ppm, which means 1 part per 1 million parts). This is the lowest level found to produce a positive effect. Before the days of the popular “designer water” bottles, most people in the US enjoyed this benefit. However, with the tremendous increase in bottled, or filtered water, the fluoride is usually filtered out. So, that benefit then is lost.

Back in the 1950′s, the toothpaste manufacturers started to add fluoride to toothpaste. This was a great design, as many people will brush their teeth daily, and this served as a great adjunctive approach to topical fluoride. The concentration is higher than in water, usually 1000ppm. Manufacturers have taken great efforts to ensure the fluoride in their toothpastes is in an “active” form; in other words, the fluoride ion can do its magic for the prevention or control of tooth decay.

With these two easy and readily available applications of fluoride, why do some people still get cavities? The answer is complex. It is a combination of physiology (which we cannot change), eating habits and hygiene habits(which we CAN control). If you continue to experience cavities, or you have a long history of cavities, your hygienist and dentist may recommend giving you a topical application of fluoride when you are in the office for a check-up. The concentration of fluoride is even higher, typically about 10,000 ppm. When this service is recommended to you, it is with a sincere preventive motivation on the part of your dental professional. Everyone will agree that it is a great feeling to go in for a dental check, and get an A++ (no dental work to be done); so a good, thorough preventive approach will help accomplish this result. The minimal cost associated with this procedure far outweighs the cost of cavities.

In general, there are three ways to increase the effectiveness of topical fluoride: they are 1. Increased concentration, 2. Increased frequency, and 3. Increased acidulation. When dental professionals recommend an in-office fluoride, they are using the #1 method of increasing the effectiveness of fluoride to decrease the incidence of cavities.

So, the next time you are in your dental office for a check-up, be active in your conversation regarding your home care, and the many ways to  lower your experience with cavities. Ask the question, “Why do I need fluoride?” Plan for what your dental needs may be in your future.  Remember that you and your dentist are partners in deciding your dental future. After all, what else can impact your life as much regarding your enjoyment of meals, your conversations, your smile and, don’t forget, your kiss!

If you like this suggestion for planning for your dental health , contact us for an appointment: www.cherry-creekdentist.com

Why do I need “take home” fluoride? Have you asked this question when your dental hygienist recommends this to add to your daily regimen?

Let’s get some history of fluoride application in dentistry, and put it in a nutshell.

First of all, fluoride occurs naturally in water; in some places in the US it is very high in content, and in other areas, it is almost non-existent. The benefits of fluoride in dentistry were first noted when questions were asked why some people in areas of Texas never experienced decay (cavities). Once research was done, and the natural occurance of fluoride in the water was noted, and the decreased incidence of decay was linked, a new approach for decay prevention was off and running. An effective amount of fluoride in the water was established, since the concentration can produce some staining of teeth when the level of fluoride is too high, and can have no effect if the level is too low. Then, fluoride was introduced into local drinking water. Its greatest benefit occured when teeth were in formative stages, prior to errupting, and also had a moderate effect upon already errupted teeth. The effort necessary to produce this public health benefit was great, and so was the result of the program. It is one of the most successful public health interventions in history regarding the erradication of a disease (dental decay, or cavities). Following this program was the introduction of fluoride in toothpaste.

OK, that is the Reader’s Digest version of the introduction of fluoride for the prevention of cavities.

Now, if you return to the original question, “why do  I need take home fluoride?”, there are some other details about applying fluoride to your teeth at home on a daily basis. You eat food and drink fluids every day and, depending on the sugars in those intakes, the end result will be an elevvated level of acid in your mouth for about 20 minutes until your body neutralizes these acids naturally. So, during those 20 minutes, the acids attack your tooth enamel, and this process is referred to Demineralization (taking minerals out of your teeth). When fluoride is applied, it aids in the process known as Remineralization (putting minerals back into your teeth). When these two processes are in balance, you stay healthy; however, if there is more Demineralization than Remineralization, tooth surfaces break down, and caviites occur.

Depending on your dental history and your quality of home care, your dental professional may recommend that you use a home applied fluoride to supplement your dental health. There may be several reasons for this. So, ask yourself these questions: Do you use a fluoridated toothpaste? Do you brush a minimum of two minutes at least twice per day? Do you use dental floss at least once per day? What is your family history regarding dental health?  Do you snack during the day? Do you drink soda (even the sugar-free kind)? Do you sip on coffee with sugar at your desk during work? How often are you ingesting sugar during the day? Do you feel as though you are doing everything you can, but you still get cavities? These are only a few of the questions that need to be answered when evaluating your need for a daily application of home fluoride. When you have had conversations with your dental hygienist and dentist, these are some of the areas that have resulted in the recommendation for using home fluoride.

So, the next time you are in your dental office for a check-up, be active in your conversation regarding your home care, and the many ways to improve your performance, and lower your experience with cavities. Plan for what your dental needs may be in your future.  Remember that you and your dentist are partners in deciding your dental future. After all, what else can impact your life as much regarding your enjoyment of meals, your conversations, your smile and, don’t forget, your kiss!

If you like this suggestion for planning for your dental health , contact us for an appointment: www.cherry-creekdentist.com

Do you have an HSA account? Have you considered how to use this account later on after retirement?

Depending on your age, the planning for retirement living can be an interesting topic. One area to consider is your dental health. Many people who have dental insurance consider dental appointments as something that someone else will “pay for”. There is a very real, and abrupt awakening once the insurance is gone. Some people just say they cannot afford dentistry any more, and stop their preventive visits. The big problem is that dental visits are even more important later in life; to eliminate them is to ensure big headaches (or, really, toothaches).

One creative way to plan for your dental health in retirement is with your HSA account. Each year, try to contribute the maximum amount to this account, but DO NOT SPEND IT. Each year, you can fatten up that account and let it earn interest (measley as it is, it still grows). Just pay for any of your medical/dental costs as you pay for anything else. As the years go by, you will accumulate a nice bundle of dollars. Remember, the contributions to this account are Pre-tax, so they help to reduce your tax responsibilities (at least this is still how it works as of the date of this post). Once you get into this habit, it is very easy. You will never miss the dollars put into the HSA account. If you need some reassurance along the way, just view your bank statement occaisionally to monitor its growth.

Again, depending on your age, try to “fast forward” to your retirement date, and try to visualize your first post-retirement visit to your dentist. How comforting it will be to see your dentist and your hygienist; you already know you will be able to afford those appointments. By continuing to make your preventive appointments, you will keep your dental health in great shape. Just imagine how wonderful that will feel.

As you go in for your dental check ups now, listen to your dentist and your hygienist and understand what you need to do to stay healthy. Plan for what your dental needs may be in your future, particularly after retirement.  Remember that you and your dentist are partners in deciding your dental future. After all, what else can impact your life as much regarding your enjoyment of meals, your conversations, your smile and, don’t forget, your kiss!

If you like this suggestion for planning for your dentaln needs , contact us for an appointment: www.cherry-creekdentist.com

Do you have Flex dollars to spend?

Consider spending them at your dental office. Many people forget that dental expenses qualify for Flex spending accounts. Dental expenses are considered medical expenses in your Flex spending account.

Flex dollars are medical spending dollars which are the typical “use it or lose it” dollars. If you reach the end of your flex plan (which can be any month of the year, but typically end in December) and you have not used those dollars, you will lose them completely. So, do not let that happen to you. If you have any dental work that needs to be done, now is a great time to have that work done, and pay out of your Flex dollars.

Many people do plan to use those Flex dollars, but forget, then try frantically to get a dental appointment at the last minute, and get shut out. So, call your dental office today, before it it too late, and make sure you don’t get shut out.

Use your Flex dollars to help you attain the healthy mouth that you and your dentist have been discussing. Your office will help you plan which procedures can be done before you lose your Flex dollars.  Remember that you and your dentist are partners in deciding your dental future. After all, what else can impact your life as much regarding your enjoyment of meals, your conversations, your smile and, don’t forget, your kiss!

If you would like to use your Flex dollars before the end of the year, contact us for an appointment: www.cherry-creekdentist.com

Do adults need dental sealants? Absolutely YES!

The best way to explain this is to use an analogy: what do sealants do, in general. Sealants are meant to “seal” a surface against the things that destroy a surface.  Beautiful stone surfaces in kitchens and baths are sealed to protect against moisture an  acids; this is to keep them attractive and useful. Hardwood floors are sealed to protect from constant abrasion, and also to protect their beauty. Seams in kitchen counter tops are sealed to prevent materials from seeping underneath and causing damage. Asphalt surfaces are sealed to protect from moisture seepage and keep the surface smooth for a longer period of time. All of these sealants are used to protect. So, why would you NOT want to seal your teeth?

When teeth are being formed in the jaw, a wonderful layer of enamel is formed on the outside of the tooth. This layer has tremendous strength, as these structures will sustain an enormous amount of pressure during normal chewing throughout your life. The amount of pressure can be from 50 to over 200 psi (wow!). And enamel is  very resistant to the acids formed in your mouth every day as you consume food and beverages. However, there are some areas of teeth that can be weaker during acid attack. One of these areas is on the chewing surface of back teeth (all teeth behind the “eye” teeth). If these chewing surfaces have very deep grooves, it may be nearly impossible for your toothbrush bristles to clean these areas completely. With minute amounts of bacteria gathering in these areas, a cavity will eventually form.

As a sealant is placed, it covers over those deep grooves, and makes cleaning much easier, along with protecting the surface from mouth acids. Over time, you may wear off the sealant, and need to have it replaced. But think about it. Would you rather have a quick application of a sealant on your tooth, or do you prefer to wait until you have a cavity formed and need to have a filling placed. The filling is much more expensive; it cuts into the surface enamel; it most often requires some anesthetic (Novocaine) to numb the pain of the procedure. The good news is: it’s your choice!

Most times insurance will not cover such a procedure, but again, you do not want insurance to dictate how you keep your mouth healthy. For this reason, most offices keep the cost of sealants very low.

So, the next time you are in your dental office for your routine check-up, ask your dental hygienist or your dentist about having your teeth sealed. This procedure can save you much time and money over your lifetime. Remember that you and your dentist are partners in deciding your dental future. After all, what else can impact your life as much regarding your enjoyment of meals, your conversations, your smile and, don’t forget, your kiss!

If you would like to have your teeth sealed before the end of the year, contact us for an appointment: www.cherry-creekdentist.com

Did you ever need to ask “what is a dental insurance maximum benefit” when you discovered that your dental insurance did not cover something and you are left with a large dental bill? Or, did you ever find that you needed quite a bit of dental work to get back in shape, but the insurance coverage was way short of what you needed? This is due to your yearly “Maximum Benefit”. There are a few plans existing which do not have annual maximums, but they are few and far between. Most plans will include an annual maximum of anywhere between $200.00 to $4000.00.

Each time your dental office submits to your insurance company for services, the dollar amount paid out will be calculated against your yearly maximum. Once the insurance has paid out that maximum, you will not have any more insurance to use until your plan renews for the following year. In general, this is a reasonable approach to insurance companies paying out on claims. However, it is interesting to note that dental insurance has not made much of an attempt to keep up with inflation.

Dental insurance came about in the 1970′s, and it was readily accepted and used. For some people, it was the first time dentistry seemed affordable. Since the exams and cleanings and xrays were generally covered at 100%, it was foolish not to have these services done every year. When/as/or if restorative work was needed (cavities found, etc.), there would be some cost to the patient, but the insurance company would help with a percentage of the cost. Here is the interesting part: the annual maximums were set around $1500.00 per year. Back in the 1970′s, $1500.00 would cover quite a bit of dentistry; it could easily cover multiple crowns and fillings, with a few root canals thrown in as well. (Keep in mind that the cost of living was quite a bit less in those days. The price of regular gas was .36, a new car was $3853, the average annual income was $11859, and tuition at Harvard was $2800.)

So, given that perspective, it is easily seen that dental insurance will not really provide much beyond simple cleanings and check-ups, with a couple of simple fillings, and maybe one crown or root canal. If your needs go beyond that, it will be at your expense. With the dental insurance maximum, is it really worth the cost of premiums? This is a question that you must ask yourself. Every person’s dental needs are different. On the plus side, it can be viewed as a small bit of help to keep your mouth healthy. On the negative side, the cost of the premiums may out-weigh the benefits. In either case, dental insurance should not be dictating the type or amount of dental treatment you choose.

When you experience some disappointment regarding your dental insurance maximum benefit it will be important to remember that you and your dentist are partners in deciding your dental future. After all, what else can impact your life as much regarding your enjoyment of meals, your conversations, your smile and, don’t forget, your kiss!

Have you ever just said, “are dental x-rays necessary?” Have you ever wondered why x-rays (also called radiographs) are taken at the dental office? Have you ever had these x-rays shown to you with an explanation?

There are many things that become visible with an x-ray; these things are not visible by looking at a tooth in the mouth.

When x-rays are taken at routine visits they are intended to show the areas of a tooth that can not be seen with plain eyesite. The areas in between the teeth cannot be seen, but they are the areas where the most common cavities start. The purpose of looking at these areas routinely is to detect a cavity when it is small, and reduce the size of the filling necessary for repair (you may refer to an earlier post about the cost of dentistry). Once a cavity starts it will just get bigger. Bigger cavities require bigger fillings to fix or, if they get even bigger, they may cause toothaches, the need for root canal treatment and/or a crown (cap) to fix the tooth. In these cases the cavity will cause pain, discomfort, time away from a job, family, and also get into the wallet (which is a different kind of pain). All of this can be avoided by those routine x-rays. It is possible that some people may not need these x-rays as often as others, but everyone should have them periodically. The question you should ask yourself is how thorough do you want your examination to be? If you want 100%, you need to include the x-rays. If you are satisfied with 50% or 80% thoroughness, that is your decision, and you need to accept the responsibility if a problem has gone undetected.

There are x-rays taken when a problem exists, also. When a you experience some unusual pain in a tooth, the cause may not be readily visible. An x-ray will show the entire tooth, top to bottom to get the whole picture. If a tooth has started an infection, many times this infection will be visible at the tip of the root (buried deep in the jaw); this will help in deciding what needs to be done to solve the problem. There are usually a couple of options, and you and your dentist will decide which option is best for you. But your dentist will not know what options to give you without the information from the x-ray.

It may be difficult for you to see what your dentist sees when looking at an x-ray. Don’t let that bother you. Remember that your dentist went to dental school to learn how to interpret these x-rays. And also remember, it is the interpretation of the x-ray that you are paying for, not just the x-ray itself. That’s why you want a dentist’s opinion of a problem (that’s why you seek care from car mechanics, electricians, plumbers, doctors, accountants, and the list goes on and on). Fortunately you do not need to be an expert in every field, you just need to know someone who is.

So, the next time you are asked about taking x-rays of your teeth, remember that they are intended to help you. It will be important to remember that you and your dentist are partners in deciding your dental future. After all, what else can impact your life as much regarding your enjoyment of meals, your conversations, your smile and, don’t forget, your kiss!

Have you ever wondered about the cost of dentistry? Have you ever asked your friends how much they pay for dental treatment?

There is a very old saying: Dental treatment is not expensive, but dental neglect is very expensive. This is true in most areas of health care.

When a person neglects to have annual or semi-annual dental check-ups, problems can be occurring slowly and progressively. When that person waits until pain is the motivating factor to make an appointment, usually the problem has become significant. The cost of dental treatment then becomes higher. Two slowly progressing, but significant problems are cavities and gum problems.

A cavity starts out very small; when it is found in its initial stages the remedy is simple: a small filling is needed. If the cavity is allowed to progress, it becomes larger, and the solution is a larger filling (more expensive). If the cavity gets even larger, it may be deep enough to penetrate the nerve inside the tooth; when this happens the only way to save the tooth is to remove the damaged nerve by root canal treatment (quite expensive). Depending on the amount of tooth lost, it is probable the tooth will also need a crown to restore chewing and appearance (now we are getting deep into the wallet). The cost of each of these procedures gets higher and higher due to the time, skill, care and judgement of the dentist plus the cost of materials, lab fees and the staff to assist.

Gum problems also start out small. Everyone has bacteria in the mouth. Daily brushing and flossing help to remove it. If that bacteria gets under the gums into places where a brush and floss cannot reach, it grows. With the growth comes the by-products of bacteria which slowly attack the gums. The attacks first cause bleeding (easy to remedy with a dental cleaning); then it progresses to cause loss of gum attachment (more expensive to remedy). Finally, the attacks cause loss of bone holding the tooth, which usually means the tooth is loose and must come out (extraction is not too expensive, but replacing that tooth is very expensive).

Both of these dental problems can be minimized or avoided completely with regular dental check-ups and treating problems when they are small. If a person has waited a bit to make a check-up appointment, and the news is grim, it is important to discuss the problems with the dentist and dental hygienist. A plan can be made to get things back in order one step at a time. The cost may be higher to begin, but will be less once the treatment is done, and the person stays on regular dental check-ups.

If you experience some grim news it will be important to remember that you and your dentist are partners in deciding your dental future. After all, what else can impact your life as much regarding your enjoyment of meals, your conversations, your smile and, don’t forget, your kiss!

Have you ever wished you could be acknowledged for your loyalty to your dentist? After all, there are many dentists in Denver. Would you like to see a rewards program similar to other programs which abound in business?

Your repeat visits to our office are appreciated. To acknowledge these visits, we started a rewards program in 2012. Here is how it works:

Let’s say you visit us for your regular check-up, and the exam reveals a cavity or some other restorative dental procedure that you need. Once you have discussed this need, you may need to come back for another appointment to resolve this issue (assuming you couldn’t stay that day to have the problem resolved). Well, if you can return within 30 days, we will give you a $20.00 credit toward that procedure….how cool is that?

If you cannot come back so soon, but have the dental work done within 6 months, you will still receive a $10.00 credit toward your dental work.

This credit even works for your regular check-ups: come in when you are due for your check-up (6 months, 4 months, 3 months, or whatever you and your hygienist decide), and you will receive that same $10.00 credit.

Why are we doing this? To encourage you to take care of your dental needs when they are small and easily resolved. There is a very old saying about dentistry: “Dentistry is not expensive, but dental neglect can be very expensive”.

This year, many patients have been pleasantly surprised when they receive their Reward Program credit. So, join the elite group, take care of your smile, and accept our Thanks for your loyalty.

PS: Due to the limits that insurance companies place on us, this reward can only be applied to non-insurance related items.

This is the fourth chapter in the series which is intended to provide some clarity regarding dental insurance coverage.

There have been times when a patient has been very excited to use new dental insurance. If it had been a long period of time since that patient received dental care, there may have been some “catching up” to do.

A common occurrence can be that the patient is told that a  more extensive cleaning is required to get back on track. If the situation is not too far advanced, it may be that a second cleaning appointment is necessary. The longer the stain and “tartar” has been present, the longer it takes to get it all removed. (A little bit like the difference between washing your car once per month, or only once per year.)

Again, due to the differences between dental plans, sometimes the second cleaning will be covered, and sometimes it will not be covered. Some plans will cover two cleanings any time over the twelve months of the plan; once two cleanings have been submitted, the policy will not cover any more cleanings until the plan renews. This can be disappointing when, six months later, the patient goes in dutifully for a regular cleaning, and the insurance will not pay for it. Another twist to the rules will arise when a plan will only cover a cleaning when six months have passed since the last cleaning. In that case, the second appointment to get the patient back on track will be denied; however the next six month cleaning will be covered providing six months have passed. In either of these cases, patients have been disappointed because they thought all cleanings were “free” (no out of pocket expense).

If a greater amount of time has elapsed since a patient had regular care, the damage could be greater. There may be the start of some bone loss, and infections present in the gum tissue. This type of condition could require more than one extra visit for a cleaning. The need for a “deep cleaning” (scaling and root planing) would be explained, and the amount of time and the fees involved. It is necessary for the dentist or the hygienist to do a good job in explaining this procedure; it is something beyond a routine cleaning. If a patient decided not to accept the treatment, that patient would start a long, downward spiral which will eventually end in tooth loss. At times, some patients have been tempted to ask if it was possible to forgo the deep cleaning, and do a simple cleaning instead. A well trained hygienist and dentist will know that providing a simple cleaning at that point would be akin to putting a band aid on a broken leg; it just won’t work.

When you experience some disappointment regarding a “denied dental claim” it will be important to remember that you and your dentist are partners in deciding your dental future. After all, what else can impact your life as much regarding your enjoyment of meals, your conversations, your smile and, don’t forget, your kiss!

Stay tuned for more about your insurance.