Happy New Year! from Dr. Larry Stone

HappyNewYearAs we begin the New Year I want to take this opportunity to wish everyone a healthy and successful 2016. No doubt it will be an interesting and exciting year, especially with a presidential election looming ahead.

The New Year always brings changes, and dentistry is no different in that regard. The familiar adage: “The only constant is change” applies to all. At the ADA meeting last October in Washington, DC, I attended a program entitled “The Future of Dentistry”. There are changes coming not only in how dentistry is delivered but in new materials and technologies as well.

As always, we will do our best to keep up with new developments and to keep you informed of the advancements in the science and art of dentistry that have been scientifically shown to produce positive results and good outcomes.

I look forward to seeing you in the New Year. If you have any questions in the meantime, you can contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have about any issue in the field of dentistry.

How Long Should Your Teeth Last?

Portrait of family keeping their hands one another at home

Last week our local paper, The Intelligencer (Sunday, October 25,2015), ran a terrific article by Sarah H. Kagan, PhD, RN entitled “Getting Older Doesn’t Mean You Have to Lose Your Teeth”. Dr. Kagan is a professor at the University of Pennsylvania School of Nursing where she specializes in geriatric issues. Being married to a geriatric nursing specialist has also given me the opportunity to learn quite a bit about older folks. God willing, I may someday even become one myself!

Basically, Dr. Kagan espouses what I have been telling my patients for years – which is despite the fact that we humans only get 2 sets of teeth, “baby” or primary teeth and “adult” or permanent teeth, those permanent teeth should be just that…permanent! In other words, with the knowledge and technology available to us today, people should be able to keep their teeth for a lifetime.

Now the interesting question becomes: What constitutes a “lifetime”? The February/March issue of TIME Magazine featured an infant on the cover with the headline: “This Baby Could Live to be 142 Years Old”!

Do I think that even under the best of circumstances we could keep our adult teeth for 142 years, or even 400 years as Aubrey DeGrey has suggested – once we find a cure for cancer? NO, I don’t, even though tooth enamel is the 7th hardest naturally occurring substance known to man!

Given the fact that my father and grandfather both lost all their teeth and wound up wearing dentures, this is a concern to me. In fact, it used to give me nightmares! But no more, now that we have dental implants widely available. If for some reason, despite my meticulous home care, I should lose my teeth, I would get dental implants.

Just as people who need new hips or knees can get hip and knee replacements, most patients who lose teeth can have them comfortably replaced with dental implants.But for now, let’s take care of those pearly whites that God has blessed us with.

For more on how to take care of your teeth, visit my earlier post on four dental lessons you can learn from your car, or If you have any questions in the meantime, you can contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have about this or any other issue in the field of dentistry.

What Exactly is “Occlusal Disease”?

And what does it have to do with tricycles?

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Dentistry has traditionally diagnosed and treated three basic conditions relating to our teeth and their support systems:

  1. Tooth Decay (dental caries),
  2. Periodontal disease (diseases affecting the supporting structures of the teeth – the gums and bone) and
  3. Occlusal disease – those conditions affecting how the teeth meet when biting.

Occlusal disease has been without a doubt, the least understood of the three.

Fundamentally, the human jaw works like a tricycle, with the jaw joints acting like the rear wheels and the front teeth, like the front wheel, serving to guide or steer the lower jaw. A person’s occlusion or “bite”, as it is commonly called, just refers to how the upper and lower teeth meet when you close. Our back teeth have many hills and valleys which we call cusps and fossae. These cusps and fossae are supposed to interdigitate with each other like teeth on gears wheels. When they don’t, bad things happen!

Common symptoms when teeth don’t meet evenly and work together may include: uneven tooth wear, teeth and fillings that chip and break, sore jaw muscles, jaw joint problems, grinding, increased sensitivity to cold, and more. Patients and dentists alike are often puzzled by symptoms they can’t readily connect to a problem with the bite. Even worse, patients are often skeptical of treating these conditions, especially when they don’t understand the benefits.

The most overlooked and underutilized of all dental treatments is the occlusal adjustment or occlusal equilibration. It is simply the mechanical adjustment or smoothing of the biting surfaces of the teeth to allow the teeth to meet harmoniously. It is painless and is often all that is needed to correct a bad bite. For additional information you can search the American Dental Association and Academy of General Dentistry’s websites, or simply ask us the next time we see you.

If you have any questions in the meantime, you can contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have about this or any other issue in the field of dentistry.

Who’s Your Dentist?

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I know I’m probably preaching to the choir here, but over the last few months I’ve had occasion to ask several people I’ve met who their dentist was. What I heard in response was the name of some corporate entity, usually beginning with the letter “A”. When I then said: “No, I don’t think you understand…Who is your dentist?”, I would get this puzzled look. They couldn’t tell me the name of their dentist because they didn’t know it. I guess they were just seen by whatever dentist was working there that day!

Dentistry as a profession is changing –no doubt. There are currently about 8,000 dentists in the U.S working in large group practices and many more in smaller multi-office groups. Groups are not necessarily a bad thing, but when corporate entities and franchises like Aspen Dental are dictating (contrary to State laws) how dentists can practice in their offices and forcing dentists to adhere to quotas (as recently happened in New York State), the best interests of patients are not being served.

A friend recently said to me that when a dentist doesn’t feel good enough about what he or she is doing to put his or her own name on the sign in front of the office, you probably don’t want to be going there. By the way, it’s against the law in Pennsylvania NOT to have your name on the sign in front of your office!

Buyer beware! Welcome to the age of consumerism!

Please feel free to discuss this issue with me at your next appointment! If you have any questions in the meantime, you can contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have about this or any other issue in the field of dentistry.

What’s All The Buzz About E-cigarettes?

E-cigaretees_Drl Larry  Stone Blog

E-cigs are electrical devices that vaporize propylene glycol or polyethylene glycol-based liquid solutions into aerosol mists typically  containing various concentrations of nicotine. Having been marketed since 2007 or so, the use of e-cigs (vaping) has now exploded to a multi-billion dollar industry primarily targeted at young people and now heavily controlled by the tobacco industry. The three largest tobacco companies now control over 70% of the e-cig market.

According to the Centers for Disease Control and Prevention the prevalence of use of e-cigs has increased nine-fold among high school students and now exceeds the use of cigarettes in that population. Having prevailed in federal court cases, the industry has succeeded in having e-cigs labeled as “tobacco products” instead of “ drug delivery devices” which makes it much easier to market these products, especially to young people. Because there are currently no product standards for e-cigarettes, they are almost entirely unregulated on the U.S. market!

There have been precious few studies evaluating the health consequences or long term effects of e-cigs, especially in young people. What the scientific community does know is that:

  1. The effects of nicotine on the developing brains of teenagers include altered development of the cerebral cortex and hippocampus.
  2. Smokers who use e-cigs are 59% less likely to quit smoking than those who do not use them.
  3. High levels of nicotine dosing via e-cigs may increase the risk of periodontal disease.
  4. The American Heart Association, The American Association for Cancer Research, the American Society of Clinical Oncology, the Forum of International Respiratory Societies and the American Association for Dental Research have all cautioned against the use of e-cigs.

So there you have it! Just don’t do it!

See you soon for your next appointment! If you have any questions in the meantime, you can contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have regarding the use of e-cigarettes.

Are Dental X-Rays Safe

Dr.LarryStone_Dental Xrays

Most people are familiar with having dentals x-rays taken periodically at dental visits and recognize the benefits of a dental x-ray examination. Occasionally someone still asks me if these X-rays are “safe”. The short answer Is “yes”, but some explanation may be more helpful.

First, dental X-rays involve a fraction of the amount of radiation delivered versus a medical X-ray. Radiation delivered for a treatment purpose, such as targeting cancerous cells in the body (as opposed to X-rays taken for diagnostic purposes), deliver many times more radiation than is required in a dental exam. For example, the amount of radiation one receives for dental purposes is often compared to the amount a person would receive from the environment after spending a sunny day at the beach or after a plane flight at 39,000 feet.

Second, only a small part of the body is typically exposed to a dental X-ray, with the rest often protected by a lead lined shield.

Third, the American Dental Association has instituted a safety protocol referred to as ALARA (As Low As Reasonably Allowable),which offers guidance in minimizing the dosage of radiation needed in specific situations.

Fourth, Pennsylvania requires regular inspection and registration for all X-ray machines (including dental X-rays equipment) to guarantee the public’s safety.

And lastly, many scientific organizations have developed recommendations or regulations on the proper, safe and effective use of X-rays in dentistry, including the Center for Devices and Radiological Health of the U.S. Food and Drug Administration, the American Dental Association as I mentioned, the American Academy of Oral and Maxillofacial Radiology, and the National Council on Radiation Protection and Measurements.

Therefore, as you can see, a lot of people are concerned with your safety with respect to the use of dental X-rays so that you can relax more and enjoy your visit!

See you soon at the office! If you have any questions in the meantime, you can contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have regarding dental x-rays.

Tooth Sensitivity

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Tooth sensitivity is one of the most common complaints we see on a daily basis at the office. There can be many different causes for dental sensitivity including overzealous brushing, using a toothpaste that is too abrasive, unsupervised “whitening”, frequent consumption of acidic beverages (i.e. soda), deficiencies in the structure of the teeth, and so on.

Treatments for sensitive teeth can include using a desensitizing toothpaste, use of prescription strength fluoride toothpastes and rinses and application of any one of a number of desensitizing medicaments in the office.

While sensitivity is not usually a sign of a more serious dental problem, it can be! If you find yourself experiencing this annoying symptom, please bring it to our attention as soon as possible.

Also, we are currently participating in a federally funded National Practitioner Data Bank Research Network Study of sensitivity. If you are having problems with sensitive teeth you may qualify as a compensated subject in this observational study. You will be treated as anyone else with sensitive teeth and will not be subject to any experimental treatments!

You can contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have regarding sensitivity and to schedule an appointment.

Polypharmacy – Are you at risk for prescribing cascade with your medications?

Pills_polypharmacy_DrLarryStone

As the population in the United States ages, so does the population of dental patients that are typically seen each day. One of the most noted characteristics of this group is the sheer number of prescription medications they take. The average 65 year old is taking five or more medications for a variety of reasons. One of the most serious side effects of many medications is drug-induced xerostomia (dry mouth), which can be devastating to one’s oral health!  (See my prior blog on Xerostomia.)

Another aspect of this “polypharmacy” is that patients taking five or more drugs are at risk of experiencing “prescribing cascade”, which occurs when unrecognized side effects of an existing drug prompts physicians to prescribe a new drug to then treat these new symptoms! The elderly and persons with disabilities are especially prone to prescribing cascade. The Beers list, developed by an expert panel to assess inappropriate drug prescribing, consists of a list of medications that are particularly prone to adverse effects in the elderly.

Please consult with your personal physician should you have any questions regarding this issue. And please let us know if you are experiencing “dry mouth”. Be sure to ask us at your next visit how you can best treat dry mouth. You can contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have and to schedule an appointment.

4 Dental Lessons to Learn From Your Car

Car Maintenance Checklist_Dr. Larry Stone

Now that it’s summertime and our thoughts turn to vacations and road trips, a recent post on the American Dental Association’s website for consumers caught my attention. It discussed how Americans tend to take care of their cars pretty faithfully, and yet, we don’t often perform the same routine maintenance on our teeth.

The following lessons from MouthHealthy.org draw from ways we maintain and preserve our cars to make them dependable. Getting oil changes, stopping for gas and going through the car wash are the things we do without a second thought to keep our car in tip-top shape. The same should be true of our teeth. Prevention is certainly the best medicine when it comes to taking care of the things you depend on most. Be sure you are getting the most mileage out of your mouth by using these strategies in your dental care routine.

Watch What Gets In Your Grill
A grill on a car keeps harmful things from getting under the hood. Think of your own grill, your mouth, as a filter system for your entire body. Everybody’s mouth is full of germs—some good, some bad. The bad ones can cause cavities and gum disease, which can lead to tooth loss. Severe gum disease is also associated with other medical problems, like diabetes, heart disease and stroke.

Keep Your Fuel Tank Full
You wouldn’t put just anything in your fuel tank, so be aware of what you’re putting in your mouth. Keep your engine running with a healthy diet full of fruits and vegetables.

Practice Preventative Maintenance
Your car won’t get very far without fresh oil and proper tire pressure. Your teeth also need regular care. Daily brushing and flossing are the best ways to keep your mouth healthy.

Get a Tune Up
Taking your car in for a tune up can extend the life of your vehicle and catch small repairs before they turn into big fixes. Regular visits to your dentist and good dental habits can prevent many dental diseases and will keep you smiling for years to come.

Be sure to ask us at your next visit how you can best keep tune up your mouth. You can contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have and to schedule an appointment. We look forward to serving you.

Bucks County Veteran ID Card Discount Program – Helps Veterans Afford Area Services

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A recent article by a colleague practicing in central Pennsylvania reminded me of my time in the service. I don’t talk about it that much, but for 2 years after completing my dental education I served as a Senior Assistant Dental  Surgeon with The United States Public Health Service. I was assigned to the U.S. Coast Guard for two years and provided dental care to enlisted personnel at small boat stations throughout the Great Lakes. Most of my patients were young, fairly healthy enlisted men and their dependents.

Being in the service doesn’t pay much and I think we all know how much our veterans have suffered following their service to this great country. It’s estimated that 150 million Americans did not see a dentist last year and that in Pennsylvania alone there are dental health professional shortage areas in 64 of our 67 counties.

I’m proud to say that Bucks County has tried to alleviate some of the inequities experienced by our veterans by Instituting the Bucks County Veteran ID Card Discount Program. By presenting the appropriate paperwork to the Bucks County Recorder of Deeds veterans will be issued an ID card entitling them to discounts at local businesses throughout the county- including my office. In addition, I keep a list of resources in the area that may be able to assist all those less fortunate in accessing dental care.

There’s no reason why our veterans, those who have given so much to this country, should have to go without dental care when they need it the most. If you want to help and have a service or product to offer, call the County Recorder of Deeds to volunteer for this worthy program.

If you are a veteran in need of dental services, Be sure to contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have and to schedule an appointment. We look forward to serving you.