People interested in sedation dentistry in Raleigh, NC often ask us that question. Unfortunately, most dental insurance plans do not cover the cost of sedation.

This is somewhat frustrating from my standpoint. There are many people going without needed dental care – from regular exams and cleaning to more serious issues – because of the anxiety they feel about going to a dentist. Those people often wait until the condition becomes serious. At that time, they require much more costly procedures that ARE typically covered by dental insurance.

It’s too bad there’s not an easy way to track what’s happening with these would-be sedation dentistry patients. It’s my guess that accurate comparison data – contrasting costs of early treatment (including sedation costs) versus outlay for treating the more advanced situation – would show that covering sedation dentistry costs could reduce payouts for insurance companies in the long run. Crowns and bridges can be quite expensive in contrast to filling teeth that have small cracks or show small areas of decay.

With time, I hope that dental insurance providers will figure this out. For now, I think patients must do their own financial evaluations. Even without insurance reimbursement for the sedation dentistry costs, it is possible that patients could reduce their out-of-pocket costs in the long run. The later you treat a dental issue, the more expensive it’s likely to be. I don’t advocate using sedation for everyone – only those who need it.

I’m hoping that sedation dentistry will soon be recognized as a (reimbursable) service critical to preventive dentistry for many patients. Until that day comes, our office can work with you to establish a payment plan for sedation dentistry in Raleigh, NC to help you get the treatment you need.

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The Raleigh – Cary metropolitan area has perhaps fared slightly better than other areas of the state in terms of unemployment, but the latest figures show that unemployment in this area are up slightly – from 8.3 to 8.4 percent in June, 2010. In our area, that translates to more than 47,000 people! If you’re one of those, here are a couple of things to keep in mind…

About Regular Checkups

Dental care doesn’t “defer” easily. Try to maintain regular check-ups for all family members if at all possible. A small cavity can be filled relatively inexpensively. Left untreated, it could require a costly root canal and crown. If you’re a new patient, you’ll probably find that I spend a lot more time looking for oral cancer during your checkup than other Raleigh family dentistry practices. It’s more than worth it to me to take the extra time because it’s helped me catch cases early. (Not only is treating advanced oral cancer costly. The Oral Cancer Foundation also says that nearly half of those being diagnosed will not be alive in 5 years. It’s deadly because people don’t normally detect it themselves until it’s in advanced stages.)

About Prevention

As a Raleigh family dentistry practitioner, I can say we’d rather not see any cavities. The cost of preventing most cavities and gum disease is very low. Studies continue to identify ways that poor oral health triggers other general health issues, emphasizing the need to do your part to preserve your oral health. For each family member, annual oral hygiene costs (for twice a day cleaning) are very reasonable. All the items you need for that are:

• Toothbrushes – While sonic toothbrushes are effective, using a manual toothbrush properly at least twice a day is fine. Changing to a new toothbrush every 3 months as we recommend, you’ll need 4 toothbrushes for each family member.
• Toothpaste – Assume one tube of toothpaste per person per month. That’s a generous amount – you don’t need to cover the entire toothbrush!
• Floss – Using 18 inches of floss once a day, one person would use 3 average containers a year, with quite a bit left to spare for extra flossing. We recommend flossing at least once a day.

And regular cleaning can also help you flash a fresher, brighter smile on your next job interview – something that might subconsciously tip the scales in your favor!

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Dental implants have grown more popular because we know so much more about how to ensure success with them. Functionally and cosmetically, they’re as close to the “real thing” that we offer today.

Few of my patients know what it took to get to the current state of the art – or how long it’s been since the earliest attempts. The earliest evidence we have dates back to the Mayan civilization about 600 AD. A young woman exhumed in a 1930s archaeological exploration had three implanted teeth, which everyone assumed were inserted after her death. That practice – replacing teeth after death – dated back to the ancient Egyptians. In 1970, a professor analyzing the Mayan woman’s teeth used x-rays to show that bone had actually grown back around two of the dental implants – evidence that they had been placed while she was still living!

It took a lot of additional trial and error to get where we are today. In the 1700’s, they tried implanting human teeth – those were early lessons in transplant rejection by the human body. In the 1800’s, a lot of experimentation with gold and platinum dental implants occurred – with very limited short-term success.

Like many revolutionary discoveries, the person who is credited with the biggest advance was not someone who set out to develop dental implants. It was a Swedish orthopaedic surgeon (Per-Ingvar Brånemark) who had screwed titanium chambers into bone to observe the bone-healing process as part of his 1950’s research effort. He was surprised to discover that the optical chambers couldn’t be unscrewed when he completed his studies several months later! Bone had fused around the titanium screw inserts.

Fortunately for the world of dentistry, he used his surprise finding (bone fusing with metal) to redirect his focus onto developing titanium dental implants. After all, it was easier to clinically observe implants in the mouth than it was to do so internally (in joint and bone repairs). Decades of additional research by Brånemark and his team proved the viability of titanium screw dental implants and very high success rates. While the idea of using metal screws for dental implants dates back to research at Harvard University in the 1930’s, patients in Raleigh can look outside the U.S. for the earliest successes (the Mayans) and the most revolutionary advances (Sweden).

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Most people looking for orthodontics in Raleigh have one thing in mind – their appearance. We certainly consider that to be important, and we enjoy helping any patient improve his or her smile. What many people don’t realize, though, is that there are other reasons that we might recommend orthodontics services for you or a member of your family. Addressing some of these issues can sometimes be an added benefit of using braces or aligners (such as Invisalign “invisible braces”) to enhance your smile.

Among the other (non-cosmetic) reasons that we might suggest braces for you or a family member are:

• To improve the function of your teeth. We can help you overcome difficulty with biting or chewing.
• To increase your confidence. Childhood peer pressure can be tough. So can adult self-perceptions. Some misalignments may result in minor or significant speech impediments.
• To make daily tooth cleaning easier. This lets you maintain better long-term oral health.
• To improve your tooth and gum health, in general.
• To reduce wear patterns on specific teeth. When enamel wears off, decay is far more likely to occur.
• To reduce possible injury to front teeth that protrude. This is especially important for those who engage in sports activities.
• To help guide your child’s permanent teeth into better positions as they emerge.

One advantage of going to a practice like ours (comprehensive dentistry) is to have us monitor conditions and advise when orthodontics (or some other type of service) are needed to maintain good oral health – to help you avoid costly future tooth loss and replacement. Conditions that aren’t always cosmetically obvious include bite issues (overlap, underlap, cross bite); uneven wear on teeth; jaw shifts when biting that can cause head or neck pain; and spaces between back teeth large enough to cause problems. You may have been born with these conditions, which can become more serious with age, or a new condition can develop over time.

Don’t try to assess your own needs – that’s our job! We’re a leading practice for general dentistry and provider of orthodontics in Raleigh, NC – just one component of our full range of comprehensive dentistry and cosmetic dentistry services. Our goal is to save your teeth, in addition to giving you the smile of your dreams.

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In my last post, I was talking about the practicality of people who live in Cary, NC looking at dentists in Raleigh, NC who might be the best fit for their needs. Someone reminded me that it shouldn’t be a “Cary-only” discussion. I was momentarily focused on Cary because of a recent discussion I had about restaurants in Raleigh and Cary, and how residents of both often limit their choices to one or the other without any real supporting logic.

Those in other neighboring (and in one case even closer) towns should also logically consider dentists in Raleigh, NC when choosing a new dentist.  For example, the heart of Garner, NC is only 7 miles away from our office. Morrisville, Knightdale and Apex are only 12-15 miles away, judging from what Google considers their official central location.

We hope that our comprehensive dentistry and sedation dentistry services are just two of the reasons that will make it more than worth the drive for you – perhaps options not readily available to you in your neighboring town. Make it a point when you visit our practice to check out the continually growing variety of restaurant, cultural and educational options nestled in downtown Raleigh, NC. The “Raleigh” that appears in our practice name (Raleigh Comprehensive and Cosmetic Dentistry) is strictly about our address – not about the addresses of the people we want to serve. We challenge ourselves daily to make it unquestionably worth the trip for every patient, including those who live other states.

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I was recently musing with friends about how we get stuck in ruts – on restaurants and a lot of other things – based on artificial boundaries. Why do we seem to make that leap – that the destination being in a certain town or city determines whether we’ll go there or not? The Triangle area (Raleigh, Cary, Durham, Chapel Hill) may be better integrated into a region than most neighboring cities, but a lot of us still fall into the illogical trap of using the city name.

The Raleigh, NC and Cary, NC divide might be one of the least logical stumbling blocks. It’s less than 10 miles from downtown Cary, NC to our downtown Raleigh, NC office location, depending on the route you pick. (Don’t worry – we have our own parking lot, even though we’re downtown.) From a dentistry point of view, this made me wonder whether Cary, NC residents who are trying to find rarer dental services – like sedation dentistry – are looking online but not finding us. The new regulations by the NC dental board for sedation dentistry might make it even harder for patients who want the service to find certified providers. Maybe I’d not really carefully considered this before because we have a lot of sedation dentistry patients who travel from other states, not to mention those who make the short trip from Cary, NC.

At any rate, the conversation made me think. Maybe I’ll use the maps feature on Google more often to understand my options more logically when I’m looking for services and entertainment venues in the future. And I hope people who need sedation dentistry – especially those who are putting off work they really need – will realize they have more nearby options than they thought. That’s why we pursued the extra training for sedation dentistry years ago and got certified very quickly. We’re trying to remove all the barriers to people getting the treatment they really need or want by providing sedation dentistry, in addition to our other wide range of services.

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In our last blog post, we tried to clear up confusion about cosmetic dentistry for consumers. Similar confusion may exist about Raleigh orthodontics. Many consumers mistakenly believe that they must go to an orthodontist to receive orthodontic treatment.

While an orthodontist does receive specialized training and certification from the NC Dental Board, many consumers don’t realize that some general dentists in Raleigh NC have also taken the time to learn and develop expertise in orthodontics.  These dentists sometimes call their practices comprehensive dentistry practices – because they provide a broader range of services for the convenience of their patients.

Whether you’re an adult who is interested in “invisible braces” (Invisalign), or have a child who may need braces in the future, it’s convenient to use the same dentist who provides your regular dental care to provide your Raleigh orthodontics services. Paperwork and insurance handling are also simplified. For those who experience any type of dental anxiety, getting braces from a familiar professional can help to lessen anxiety. For those patients who need or prefer dental sedation, our practice (Raleigh Comprehensive and Cosmetic Dentistry) is also one of a small number of certified providers of Oral Conscious Sedation in Raleigh NC.

As with any medical or dental service, choose your Raleigh orthodontics provider wisely. Evaluate your provider’s experience and training. For those interested in Invisalign, consider practices (like ours) that have received Preferred Provider status – an indicator of a certain level of clinical training and experience in treating patients using the Invisalign system.

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I’m a strong advocate of consumer awareness. For that reason, I like to be up-front with prospective patients not only about my practice, but about the practice of dentistry in general.  We like patients who make an informed decision in choosing our practice over others.

Many people don’t realize that being a Raleigh NC cosmetic dentist doesn’t require any special certification by the NC Dental Board. And even the American Dental Association (ADA) doesn’t provide a definition for a cosmetic dentist, even though they do provide useful information about the various technologies and dental procedures that are used by cosmetic dentists.

In a nutshell, being a Raleigh NC cosmetic dentist means that you’ve been licensed by the state of North Carolina to practice general dentistry, have a DDS degree, and have a special interest in providing cosmetic dentistry services. This is why it’s especially important for consumers to do their homework when choosing a Raleigh NC cosmetic dentist. Having interest in something is not an indication of skill level. If you’re comparing your options, look closely not only at before/after pictures, but also at the dentist’s specific depth and breadth of experience in performing cosmetic dentistry procedures. Ask about specific experience as it relates to the cosmetic dentistry treatment plan being recommended for you.

Begin your approach to finding a good Raleigh NC cosmetic dentist for your needs much like you would approach buying a car. You may not make the best choice if you are swayed only by looks (before/after photos) and cost. Performance/function must be considered, too. To consistently achieve a great look and function requires experience. The biggest difference between buying a car and buying cosmetic dentistry services is that with smile enhancement every case is different. Cars of a specific model/year can typically be expected to perform the same, and there’s a “standard” way to service them. Some cosmetic dentistry cases are “easy,” some are much more challenging. Before/after photos don’t tell the whole story!

Depth of experience helps to increase the chances that you’ll be satisfied not only with the look of your teeth, but also with the way your teeth function. Beyond assessing experience, you may also want to look for a Raleigh NC cosmetic dentist who will be concerned about your happiness with your smile long after you walk out of the office door. Our practice is in it for the long haul – we want to service your long-range general dentistry needs, too. Our goal is to help you preserve the healthy, beautiful smile we create!

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Not long ago, we posted information about porcelain veneers. Raleigh residents are showing an increased interest in veneers and other forms of cosmetic dentistry. From a consumer standpoint, it’s helpful to know not only what the concepts are, but what questions you should ask if you’re considering getting porcelain veneers in Raleigh. Here are five important questions you might want to ask your prospective Raleigh NC provider. They can help set expectations and potentially help you compare why you’re being told different things by different dentists you discuss your needs with.

1. Do you think that dental veneers are the best approach to getting the smile I’m looking for?  What are my options?
   Be prepared to discuss your goals. Tooth whitening and orthodontic devices may factor into the discussion, either in conjunction with or as alternatives to veneers. Different dentists may have different viewpoints on what is the best plan for you.  Veneers may or may not be a realistic approach to your needs. You tooth color itself can be a factor in determining the best approach for your situation. You may also need to assess the dentist’s experience level with veneers – Raleigh dentists’ experience with cosmetic dentistry procedures can vary widely and factor into their recommendations.
2. What type of veneers do you think are best for my situation and why?
   In the broadest terms, there are composite veneers and porcelain veneers to consider. The location, size, and extent of the “issues” you want to address, as well as your budget, are all factors in answering that question.
3. What type of preparation is required for veneers, and when will the process be complete?
   The type of veneers being used as well as your specific situation will be factors in determining the answer to this. Remember, speed does not always produce superior results.
4. How will I need to take care of my veneers, and how long will they last?
   Porcelain veneers are quite durable, but a reasonable amount of care must be taken with them, as with your natural teeth. Your dentist can discuss this in more detail. If you choose a cosmetic dentist for veneers in Raleigh who will also provide your regular dental checkups, the dentist has a vested interest in your ongoing happiness. He or she can also monitor and counsel you as part of those routine visits and answer any ongoing questions that you might have about your veneers.
5. How much experience do you have with veneers and with situations like mine?
   In some ways, it is helpful to think of your cosmetic dentistry provider as an interior designer for your mouth.  Experience matters, especially since there are no simple “do-overs” for your smile when it comes to porcelain veneers. You’ll need to decide whether you want a beautiful smile that still looks natural, or if you’re looking for something a bit “over the top” in terms of your smile makeover. Not every dentist will agree with the latter approach.

   If you have photos (from magazines or online sources) that help to illustrate what you want, it may useful to bring those with you. They can be a good basis for discussing your wants and how what the dentist recommends will compare to those. Always ask about how much experience the dentist has with using veneers in similar situations to yours.  Dentists with experience are more likely to know what is or is not reasonable to achieve and still provide a highly functional end result. Looks aren’t the only thing that matters!

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Oddly enough, if you’re in the market for Raleigh tooth whitening treatments, you might hope that your teeth are yellow.  That doesn’t mean you should try to stain them. It just means that if your underlying tooth color (underneath the enamel) is in the yellow family, the tooth whitening process is more likely to give you the results you’re wanting, especially if you want bright white teeth.

Many people don’t understand that the results of tooth whitening are influenced by the underlying tooth color, and that tooth whitening (bleaching) only affects the outer (enamel) layer. In fact, a cosmetic dentist can show you the basic system that is used to classify tooth color. We can help you understand, based on that classification system, what type of results you might expect. This is one of the key reasons that the results you get aren’t quite as bright as the results that your best friend received – even if the treatment was identical.  (By the way, tooth whitening treatments should ALWAYS be adapted to the individual patient!)

While there are many types of classification systems for tooth appearance (hue, chroma, value indicators), the “classic” system involves identification of four different hues for the underlying tooth color – A for brown, B for yellow, C for grey, and D for red-grey. These systems are used not only for tooth whitening, but also for making porcelain veneer decisions. It takes a trained eye to determine which color your teeth are – and we use comparative ceramic teeth samples in each color to guide us. It’s not something you’ll determine from just looking in your mirror! Patients often can’t discern the difference between some of the 16 ceramic samples in the classic system, although a well-trained eye can. Tooth whitening for grey (or C) colored teeth can be more challenging than it is for yellow (or B) teeth.

The underlying tooth color is only one of several factors that we take into account in discussing with you what tooth whitening results are reasonable to expect. The “classic” system from Vita is one of the simpler ones, and using even that system goes beyond the four simple (A, B, C, D) categories. We’ll be glad to explain to you our assessment of the tooth whitening effects you’re likely to achieve, along with your aspirations. As with many health-related issues, heredity plays a big role in what we have to work with.  If you’ve been considering tooth whitening and discover that you truly have yellow teeth, heredity may have worked in your favor!

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