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Dental Town Magazine Article Feature

November 29th, 2016

We are happy to announce that we've had an article featured in Dental Town Magazine! Give it a read and let us know what you think.

Sealing the Gaps: How Prevention Makes Profit by Mary Jane Livingston

Tooth decay is the largest chronic disease in the United States for children ages 6–11, beating out asthma and hay fever, according to the Centers for Disease Control and Prevention. Forty percent of decay occurs in the pit and fissure areas, and dental sealants can play a large role in prevention. This statistic begs the question: Are we doing enough for our pediatric patients?

Why does tooth decay remain the highest chronic disease among children if tooth decay is—as we know—a preventable disease? This is a public health concern. As practitioners, we can help our patients and our community by using dental sealants to increase caries prevention.

Protocols in the office
Establishing protocols and having all team members on the same page is key for the office. It’s essential to have the dental assistants, dental hygienists and front-office staff properly trained in educating patients and parents about the benefits of sealants.

Morning huddles are the best time to review your daily schedule. At this time, the team can discuss who is a good candidate or who has pending treatment for sealants. This works great, both for offices that practice same-day dentistry and for those that have time-constrained patients.

Rather than leave it to the doctor to educate and make treatment recommendations, having the team introduce sealants to patients shows consistency throughout the office. Ultimately, it is the patient’s choice, but this allows patients to be part of the decision-making process.

Most patients agree that they would much rather have a sealant applied than have a cavity fixed, especially since a sealant application is a fraction of the price. While pit-and-fissure sealant is a method of preventive dentistry, it could also become lucrative for the office.

Are we doing enough for our pediatric patients? Why does tooth decay remain the highest chronic disease among children if tooth decay is—as we know— a preventable disease?

We’re not selling snake oil
Advertising and marketing seem to be taboo in the medical and dental world. What office hasn’t run into the skeptical patient who believes that the doctor is trying to make a sell? Presenting treatment is not selling treatment.

We are offering options for how to treat or prevent dental diseases. For whatever reason, we take on the burden for our patients and fail to recognize that it is the patients’ responsibility to take care of their oral health. It is, however, our obligation as health care providers to treat patients and help them achieve a healthier lifestyle.

Education is the magic word that supersedes advertising and marketing. We are educating our patients about preventive care that is beneficial to their oral health. In order to do so, we need to inform patients about the options available to them through the practice.

For example, using the wall space in the waiting room to play educational videos will teach patients and parents about sealants and their benefits.

Social media is a huge marketing and advertising tool. Reaching out to the public is as simple as the touch of a button. The beauty of social media is that a practice has the potential to reach out to thousands of people in the community, or simply to current patients.

As clinicians we forget that sealants aren’t strictly for children and adolescents. Why aren’t sealants recommended or treatment-planned for adults more often? We may have mentally trained ourselves to believe that our adult patients won’t consider sealants because often the treatment is not covered by insurance. This is why education is key.

A hygiene appointment is the perfect time to introduce preventive medicine and allow the patient to make an educated decision. At best, we can try not to let insurance companies dictate our patients’ oral health.

We are educating our patients about preventive care that is beneficial to their oral health. In order to do so, we need to inform patients about the options available to them through the practice.

What works best
You’ve established your protocol and advertised the service, but what products work best? This is a personal preference.

The two common types of sealants are resin-based sealants and glass ionomer cements. As we know, technique is crucial. As with most dental procedures, the patient’s cooperation and keeping the area dry are challenges to placing sealants. A majority of clinicians place sealants independently, while others have assistants helping.

Drs. David Shipper and Howard Vogel of Central Park West Dental in New York City said that it’s easier to set a new appointment for patients rather than run overtime on an existing appointment and sacrifice quality. This is their technique: Vogel cleans the surface area with an air abrasive, isolates the tooth, and then applies etch and bond. Next, he uses composite material rather than traditional sealant material (due to better retention), and cures the surface for 15 seconds.

Hygienist Michele Banks, who works for Arizona’s Dental Sealant Program with the Maricopa County Office of Oral Health, said, “I do not have dental assistants so I use a two-handed technique. I have started to use BeautiSealant by Shofu. I love it. It is easy and fast to place. No etching. The kids seem to like this better.”

Community minded
Many people who are most at risk for tooth decay do not have access to a regular dentist. However, community and public-health services can help bridge the gap for this population. Volunteering can make a difference in your community. Research your state to see if there is an available school-based dental sealant program. If not, Seal America provides resources on how to create one.

The Maricopa County Office of Oral Health has a successful program. Hygienist Vincent Torres, a program supervisor, said that the program follows the protocols of Seal America. Public sector programs are managed differently than private practice.
The two types of sealants that the program places are preventive or therapeutic sealants. In private practice, we generally use preventive sealants.

In the public sector, therapeutic sealants are placed in the pits and fissures with incipient caries. The reason is simple: sealant material may arrest or stop the progression of the carious lesion, and clinicians have no way of knowing if the child will receive dental treatment in the near future. Therefore, placing sealants will be beneficial for the child, regardless of whether or not there is incipient decay.

You can also reach out to your community by creating public service announcements through social media, or writing articles for your local school or community newspaper. Public health organizations can always use a helping hand, so checking out your local chapter is a great place to start. Better yet, offering a “free clinic day” for those in need will boost your office morale and provide services to your community while increasing your practice’s visibility.

More people are seeking preventive and natural-health treatment alternatives. By establishing protocols, preparing patients, finding dental materials that work for your office, and helping out in our communities, we as dental professionals can help make a positive impact. Let’s get back to basics and make dental sealants a priority.

References
Beauchamp, J., Caufield, P. W., Crall, J. J., Donly, K., Feigal, R., Gooch, B., … Simonsen, R. (2008). Evidence-Based Clinical Recommendations for the Use of Pit-and-Fissure Sealants. The Journal of the American Dental Association, 139(3), 257-268. doi:10.14219/jada.archive.2008.0155

(2014, December 16). Retrieved August 04, 2016, from cdc.gov/healthywater/hygiene/disease/dental_caries.html

Seal America The Prevention Invention Second Edition, Revised. (2011). Retrieved August 11, 2016, from mchoralhealth.org/seal/

Torres, V., RDH, MHI. (2016, August 5). Maricopa County Department of Public Health, Office of Oral Health [Telephone interview].

Banks, M., RDH. (2016, August 10). Maricopa County Department of Public Health, Office of Oral Health [E-mail interview].

Shipper, D. M. (2016, August 09). Central Park West Dental: Sealants, [Personal interview].

Vogel, H. J. (2016, August 12). Central Park West Dental: Sealant Technique, [Personal interview].

How long will a root canal last?

November 23rd, 2016

According to the American Association of Endodontists, root canals have a success rate of over 95% and in most cases they last a lifetime.

There are a few factors that ensure the root canal will last and should be followed.

  • You want to make sure you allow Dr. David Shipper and Dr. Howard Vogel to perform a permanent restoration of the tooth. That means getting the filling and the crown immediately after the canals have been cleaned of all bacteria and debris.
  • Practice good oral hygiene; that means brushing and flossing at least three times a day especially after meals and before bed.
  • Just because a tooth has had a root canal that does not mean the tooth is safe for as long as it remains in your mouth. That tooth can still get a cavity. Since the nerves are no longer present in that tooth you will not feel any pain or experience any other signs of a cavity. That’s why it is important to get regular cleanings and checkups.
  • If the tooth becomes fractured or you develop an abscess, you will feel pain and know there is a problem with the tooth.

Why do root canals fail?

As mentioned above, only about five percent of root canals fail, and sometimes it is not actually a “failure.” In cases, of teeth that have more than one root, it is possible that only one root was infected and filled. If the remaining root(s) become infected in the future, they will also need a root canal performed on them.

There are a few other reasons why your root canal may fail:

  • The first reason is you may not have taken good care of your tooth (teeth). This is commonly seen in children and teens who often have inconsistent oral hygiene habits.
  • If the tooth has more than one root, and one of the roots has a minute infection that is undetectable and goes unnoticed it can cause the root canal to fail. While this scenario is very unlikely, it does occasionally happen.
  • Over time, the seal can become weak and bacteria can enter the tooth. This is also very uncommon but it does happen.

No procedure dental or medical comes with a 100% guarantee to last a lifetime, but if you take care of your treated tooth, the chances of success are great.

If you have any additional questions about root canals and your oral health, be sure to ask a member of our team at our New York, NY office.

What exactly is tinnitus?

November 16th, 2016

It’s estimated that about one in every five people is affected by tinnitus, which is a ringing or noise in the ears. But tinnitus isn’t a condition in itself; it’s actually the symptom of an underlying condition. Some of these underlying conditions could be hearing loss, injury to the ear, or some sort of circulatory disorder.

Another common cause if tinnitus is a dental injury or dental issue, whether it involves the jaw or the temporomandibular joint, better known as the TMJ. “Somatic tinnitus” is the term given to the version that is attributable to injuries to the head or neck area. Symptoms of somatic tinnitus may include noticeable fluctuations in sound volume, intermittency, headaches, memory loss or increased forgetfulness, and an increased likelihood of being depressed or sad.

Dr. David Shipper and Dr. Howard Vogel will tell you tinnitus usually isn’t serious and is more common in older populations. For that reason, many people won’t even seek an answer to what’s causing it. But people can also experience more severe cases of tinnitus that can affect a person’s ability to complete everyday activities, which has a larger impact on their lives. For people facing these more severe cases of tinnitus, treatment may be necessary to increase their quality of life. It’s also worth noting that tinnitus seems to worsen with age, so while symptoms might not be a problem one year, they may be more significant and distracting the next.

If you have tinnitus that is caused by the misalignment of the TMJ or an injury to the mouth, that’s a condition that can be corrected by Dr. David Shipper and Dr. Howard Vogel and our team at Central Park West Dental. We will work to relieve your symptoms by realigning the jaw or adjusting your bite with routine dental care. Sometimes we won’t even have to go this far, because an oral infection or gum infection may be causing your problem. We might also recommend other life changes, such as dietary adjustments and medication.

If you're experiencing tinnitus-like symptoms and have ruled out various other reasons for it, contact our New York, NY office today. Dr. David Shipper and Dr. Howard Vogel and our team will carefully analyze your situation and put you on a treatment course so that you can kick the symptoms for good.

My child has autism. What should we expect at your office?

November 9th, 2016

At Central Park West Dental, we know that as many as one in 88 children today have some form of autism, a complex brain disorder that affects a child's ability to communicate or form relationships, and makes a child appear distant, aloof, or detached from other people or surroundings. Autism varies widely in symptoms and severity, and some people have coexisting conditions such as intellectual disability or even epilepsy.

That is why Dr. David Shipper and Dr. Howard Vogel and our team are specially trained to provide dental care to the entire special needs community, including autistic children. We know that a visit to the dentist with an autistic child can be difficult. In addition to the common fears associated with strangers, there are also unfamiliar sounds, sensations, bright lights, and tastes with which your child may not be comfortable. We work with parents to make sure visiting the dentist is not so traumatic for our autistic patients.

Dr. David Shipper and Dr. Howard Vogel and our team also know that patients with autism may be more interested in equipment and instruments than in us. We show our patients every piece of equipment we are going to use in a way that they can understand. We also allow a patient to sit in a parent's lap in the open bay if he or she is not feeling at ease. We want your child to enjoy getting to know us and to be comfortable while under our care.

A pleasant, comfortable visit at our New York, NY office builds trust and helps put your child at ease for future appointments. Before a visit, we ask parents or guardians to bring their child's favorite toy, comfort item, music, or other coping device their child requires. We have a caring and compassionate team and know how to help autistic children acclimate themselves to a dental environment. We may not get everything done at the first visit, but we are able to schedule several appointments so that your child can get used to our office, the dentist, instruments, and our staff.

Children, especially those afflicted with autism, are not born with a fear of the dentist, but they can fear the unknown. Our team at Central Park West Dental genuinely cares for our patients beyond their teeth, and are more than happy to discuss any concerns you may have, as well as answer questions about your child's ongoing dental treatment. Please give us a call to learn more or schedule an appointment with Dr. David Shipper and Dr. Howard Vogel.

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