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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I’ve found that many patients don’t really understand what sedation dental care means – what the experience will be like for them. Patients who haven’t explored sedation dental care often assume things that simply aren’t true. Some members of the dental profession even contribute to this confusion by referring to sedation dental care as “sleep dentistry.” That is really a misnomer for the level of sedation dentistry that is normally practiced.

Oral conscious sedation – a level of sedation used to carry out minor to relatively extensive dental procedures – doesn’t put you to sleep (cause you to lose consciousness). When you experience oral conscious sedation, you aren’t subject to the additional risk that comes with increased levels of sedation (such as general anesthesia) that are used for more serious oral surgery purposes. We call those increased levels of sedation deep sedation because they do result in loss of consciousness.

What Does Oral Conscious Sedation Mean?

Oral means that the sedation is provided orally (one or more pills), rather than being given intravenously (with a needle). Secondly, with this form of sedation dental care, you remain conscious, even though you are likely to remember little, if anything, about the treatment experience afterwards. Even those who have experienced it would find it hard to describe the state because of the short-term lack of awareness and time that typically occurs. Many people assume or state that they were asleep because of their lack of recollection. The advantages of remaining conscious are:

• You can still “assist” the dentist – respond to verbal commands (e.g., open your mouth, close your mouth) even though you’re not aware enough to feel like you’re actually participating in the procedure. Your ability to assist can actually shorten the duration of the procedure.
• There is less risk of needing to be resuscitated because of the type of sedation being used.
• This form of sedation is generally less expensive than sedation that renders you unconscious. (The environment, equipment, and staff training requirements all necessarily become more complex to control risk when a patient becomes unconscious. This results in higher costs being passed on to you.)

With oral conscious sedation, you are sedated enough that you will need a caregiver to come to our office and take you home afterward. With many extensive procedures for which we use this method of sedation, patients report that they need less medication to control any post-treatment discomfort compared to when the same treatment is performed without sedation.

Be sure to ask us if you have other questions about sedation dental care and why it might be helpful to you or a family member.

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Dental Health Magazine

If you’re thinking of starting a family, it’s time to be thinking seriously about your dental health. The relationship between your oral health prior to pregnancy and during pregnancy is becoming clearer and clearer with recent research. It’s important that you address dental health issues before pregnancy, because pregnancy may present its own challenges to your oral health.

What does the research show?

First of all, it does not support the old wives’ tale that says you’ll “lose a tooth for every pregnancy,” even though losing teeth can be an outcome of poor dental care during pregnancy due to periodontal disease. (The old wives’ tale was based on the belief that the body would dissolve a tooth to supply additional calcium needed by the developing infant.) Some research findings that support the need for “pre-family dentistry” are as follows:

• More than one study suggests a link between good oral health and fertility. Women seeking fertility treatments were more likely to have bleeding and inflammation of gums than their counterparts who were able to conceive without fertility treatment.
• Somewhere between 60% and 75% of pregnant women will experience gingivitis (often a precursor to more serious periodontal disease).  Hormones associated with pregnancy seem to increase the incidence.
• One study suggests that women with gingivitis or other more serious gum disease are three times as likely to deliver before 37 weeks. Another study suggested that those with severe gum disease were seven times more likely to deliver very early – before 32 weeks.
• Another study suggests that regardless of whether the baby is carried to term or not, it is three times more likely to have a low birth weight (and associated health risks) if the mother has gingivitis during pregnancy.

What are pregnancy tumors?

As many as 10% of pregnant women may develop “pregnancy tumors” – more properly called pyogenic granulomas.  While not cancerous, these growths on the gums can bleed easily and, in some cases, can cause enough discomfort to warrant removal. Even if removed, they may come back. They usually go away on their own after pregnancy.

What can you do before becoming pregnant?

Brush and floss regularly to avoid the plaque build-up that can cause gingivitis. Visit your family dentistry practice for regular dental checkups, and have your teeth cleaned to remove any plaque build-up.  Some information suggests that if plaque does not exist before the pregnancy, the risk of developing pregnancy gingivitis is a fraction of a percent as long as good oral hygiene habits continue during pregnancy.

If you already have inflamed or bleeding gums, see your family dentistry practice to get treatment before you become pregnant if at all possible. If your family dentist isn’t able to provide the needed treatment, he or she will refer you to a periodontist. If you’re having difficulty conceiving, getting your gums in good shape and addressing other health issues may be a less-expensive avenue to try before investing in costly fertility treatments.  Remember, good dental health before and during pregnancy affects not just your own health, but that of your baby.  If you have dental phobia, find a dentist who offers sedation dentistry and get treatment before you become pregnant. Family dentistry practices that offer sedation dentistry may be more “sensitive” and accommodating to your dental anxiety – both before and during your pregnancy.

When are you most susceptible to pregnancy gingivitis?

Risk seems to go up in the second month of pregnancy and peaks around the eighth month. Historically, many women have avoided dental procedures during pregnancy, and that can contribute to risk. This can be a very serious mistake, especially if periodontal disease does develop. One study showed that periodontal therapy reduced the risk of premature birth and low birth weights by 68 percent in women with pregnancy gingivitis. If you’re concerned about risks associated with dental treatment during pregnancy, you may want to make sure to schedule an appointment during your second trimester, or early in your third trimester. No matter what your stage of pregnancy, don’t hesitate to contact your family dentist if you sense that gum disease might be developing.

What is the relationship between gingivitis and premature delivery?

Studies continue to be conducted on this. Pregnancy results in changes to levels of estrogen and progesterone, which may affect the immune system and decrease the woman’s ability to fight off inflammation of the gums. Some studies show that pregnant women with severe periodontitis have elevated levels of prostaglandins. Prostaglandins are substances that have an effect on many different bodily functions, and are believed to have an influence on the opening of the cervix and the onset of labor contractions.

Pre-family dentistry planning is important. Getting needed dental treatment before you become pregnant is one of the best gifts you can offer your soon-to-be-conceived child.

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Before you explore your options for porcelain veneers in Raleigh, you should try to understand the real value of porcelain veneers, in general.

The human body – and the composition of every part of it – is absolutely amazing when you study it. Your tooth enamel – which porcelain veneers essentially replicate but don’t completely replace – are no exception. Many people know that tooth enamel is the outer covering of the tooth, but few have really thought enough about it long enough to understand how amazing tooth enamel truly is. At best, most people know that it is hard and has protective properties for the rest of the tooth.

One of the most interesting and amazing things about tooth enamel is its light refraction properties. If you recall from your science classes, materials fall into three basic categories – transparent (see-through), opaque (can’t see through), and the perhaps more sophisticated and complex category – translucent.

Your tooth enamel is a translucent material – meaning that light passes through it, but it also bounces off it in some rather unusual ways. To some extent it has its own color; to some extent it takes on the color of what is behind it; to some extent it takes on the color of the light hitting it. The best material currently available for “mimicking” your tooth enamel is porcelain.  It is a hard material with translucent properties – meaning that porcelain veneers refract light much the same way that your tooth enamel does. Composite resins, sometimes used for veneers, are semi-transparent, but do not have that translucent property that makes healthy tooth enamel sparkle in a very unique and eye-catching way. There may, in fact, be some real scientific grounding before the idiom “flash a smile.”

One advantage to porcelain veneers is that they are generally stain resistant. Think of fine porcelain china dinnerware – it is very hard and has a shimmering glow. It generally does not stain, but will pick up stains if it is cracked or abraded. But it takes relatively serious abuse to abrade it (and have resultant staining!)  There are some precautions you’ll need to follow if you’re getting porcelain veneers – in Raleigh or anywhere else!  Using your teeth as bottle openers is certainly not advised – nor is it advised for your regular teeth/enamel. Biting down on anything hard is never a good idea because it can cause a fracture in your tooth or its enamel, as well as in a porcelain veneer.  Certain teeth cleaning materials used in some dental offices can also abrade the surface of porcelain veneers and destroy some of their luster.

Similar to fine porcelain china, porcelain veneers are both lovely and durable. With reasonable care and avoidance of strong abrasives, they both can provide a lifetime of enjoyment. (Although you probably won’t be passing your porcelain veneers on to the next generation.) If you’re considering porcelain veneers in Raleigh, let us explain your options and why porcelain veneers may be the best choice in creating the smile you want to achieve!

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For centuries, those about to purchase a horse have taken a look in the horse’s mouth as a means of assessing the wisdom of their investment – outward appearances can be misleading. Primarily, horse buyers have been looking for distinct and quite reliable indicators of the horse’s actual age. In recent decades, there’s growing evidence of the importance of looking in humans’ mouths – not so much to determine age, but to potentially predict problems with not only their oral health, but also their general health.

The connections between oral health and general health are truly amazing. If anxiety about dental treatment is causing you to avoid needed treatment – especially for periodontal disease – then you need to start looking for a Raleigh sedation dentist.

Periodontal disease has been shown to have a strong relationship (causative in many cases) to the following medical situations:

· Cardiovascular issues (heart attacks and strokes) – Studies are ongoing to establish periodontal disease as having a causative effect.

· Premature delivery/low birth weight – Observations and studies show a strong tie to the mother’s gum disease, if it exists.

· Diabetes control – That people with diabetes are prone to gum disease has been known for many, many decades, but newer studies suggest that untreated gum disease can make it hard to control blood sugar levels.

· Respiratory health – In hospitals and nursing homes, evidence suggests that severe gum disease can result in inhalation of bacteria and the development of bacterial pneumonia. Studies are also being used to determine whether gum disease causes flares of respiratory disease in people with COPD.

See a Raleigh Sedation Dentist – For Your Health

A sedation dentist can work with you to overcome your dental anxiety and get the treatment you need. This is particularly important if you are suffering from or beginning to develop gum disease. If you have considered looking for a Raleigh sedation dentist but have been concerned about the safety of using sedation, you can feel more assured than ever. In 2009, the NC Dental board enacted formal guidelines for the administration of sedation by dentists. The dental board now certifies that dentists who have permits to practice sedation dentistry have the necessary training and experience to do it safely. The number of Raleigh sedation dentists is limited, but you owe it to yourself and to your family to find one and get the dental treatment you need to take care of your general health as well as your dental health.

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