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As a periodontist, I am asked on a daily basis what toothpaste, floss and mouth rinse I recommend. My patients are typically surprised when I recommend Tom's of Maine organic oral health products.

Tom's of Maine was founded in 1970 by Tom Chappell and his wife, Kate, on their farm near Kennebunk, Maine. Tom, a 1966 graduate of Trinity College in Connecticut, and Kate, an artist and poet, had moved to Maine from Philadelphia in 1968 after Tom quit his job as a benefits counselor at Aetna. Both were intent on living closer to the land and raising their children in a more natural environment. Tom's of Maine was one of the first green companies on the scene to develop commercial organic toothpaste. Today they have a variety of organic mouth care products on the market.

Tom Chappell, whose deep concern for the environment and his employees' well-being have been key factors in determining the company's path. Tom's products contain no artificial ingredients, are not tested on animals, and are packaged in recycled materials. One unusual byproduct of Tom's of Maine was the decision to "tithe" 5 percent of Tom's of Maine's profits and donate the money to environmental, arts, and human needs causes. This figure soon became 7 percent, and then 10. In addition to public giving, the company also looked after the welfare of its employees, offering them retirement savings and profit-sharing programs, childcare benefits, and parental leave, and even free fruit to eat on the job. Factory workers rotated stations every hour to avoid fatigue and boredom, and all were encouraged to perform volunteer work in the Kennebunk community on company time

In 1995, after a seven-year effort, Tom's became the first natural toothpaste to win the approval of the American Dental Association (ADA), allowing it to put that organization's seal on its products. This was a crucial endorsement, as all of the company's major competitors had long sported the ADA seal, which served to assure consumers that their products were effective. The process had taken far longer than usual because the ADA had no standards for natural products, and also because Tom's did not allow testing on animals, which meant new methods of testing had to be devised and certified. The three most popular flavors, spearmint, cinnamon and fennel, were approved first, and the company continued to seek ADA certification for the rest of its fluoride line. Tom's products contain no artificial ingredients, are not tested on animals, and are packaged in recycled materials. Another very important point to mention is that Tom’s of Maine tests their products for safety without the use of animals.

Organic Mouth Care: Tom's of Maine

Tom's of Maine is one of the better known established organic and environmentally friendly companies on the green scene today. The company first began developing organic mouth care in 1975. Tom's of Maine single natural toothpaste was the spark that lead to the organic creation of several types of natural toothpastes, mouth washes and dental flosses. Today they have developed a total of seventeen organic mouth care products, all which now have expanded distribution through a joint venture with Colgate-Palmolive.

Toothpaste

The Tom's of Maine line of organic toothpaste products contains thirteen different types of pastes. While a few of the pastes focus on general mouth health, there are other pastes that have been created for specific mouth related issues . One Tom's of Maine toothpaste is the Anti-plaque Propolis and Myrrh paste created without fluoride to promote healthy teeth and gums while fighting plaque. They also have developed a paste for sensitive teeth and gums called Sensitive CareSLS-free. The Sensitive Care paste uses a purified form of licorice root as an alternative SLS, which is an ingredient in non organic pastes that can sometimes cause more sensitivity when used over an extended period of time. They also have an organic, all natural toothpaste that does contain fluoride.

Mouthwash

The natural mouthwash line from Tom's of Maine only contains two forms of wash for organic mouth care. The first one is the Natural Cleansing mouthwash that uses witch hazel as an astringent and is alcohol and saccharin free. The second one is the Natural Anti-Cavity mouthwash made from Green Tea, Chamomile, Aloe Vera leaf juice and naturally sourced fluoride.

Dental Floss

The organic dental floss that Tom's of Maine offers is made from nylon filaments that are woven together, making a stronger floss. Currently, they have only two products of the same type but where one floss is rounded the other is straight. Both flosses are coated in a combination of natural waxes to help the nylon slid through the teeth easier and be less abrasive to the gums.



I have always believed that it's what's inside that counts. Tom's hopes you'll apply that same rule to their products. They strive to use naturally sourced, wholesome ingredients that just make you feel right when you choose them.

They are proud of their ingredients and they feel like you deserve to be informed, so they post every ingredient on their website. Every ingredient in their products is posted along with their reason for using it and where it's sourced. Here is the link to a list of their incredients: Click Here

• “Making a Dental Practice Eco-Friendly“
• “Dentists Going Green: Eco-Friendly Dental Offices“
• “4 Simple Ways Dentistry Can Help The Environment“
• “The Environment Impacts Of Dentistry“
• "4 Ways Green Dentistry Can Save Green For A Dental Practice"

What Are The Advantages Of Using A Mac Over A PC

Operating System:

Operating System Flexiblity:

Design:

Security:

Compatiblility With Other Mac Products:

MacPractice DDS:

Here is a list of the software abilities:

• Electronic Dental Records

• Digital Radiography

• Periodontal Charting

• Restorative Charting

• Attachments: Insurance, patient intake forms, etc..

• Scheduling

• eClaims

• RX

• ePrescrbe

• Notes

• iPhone and iPad interface. Both remotely and in office.

• Patient Web Interface

• Reports

• Reminders

• Managers

• References

• Help. This is a nice touch. You simply touch the question mark on the software, type in a question you may have and you will get a phone call withing an hour to resolve the problem or answer your question. And this service is not an additional cost.

• “3D Digital Scanning Of Teeth May Soon Replace Plaster Models“
• “New Inventions To Take The Pain Out Of Dentistry“
• “Chip Implanted In Tooth Stores Your Medical History“

The average dentist in the United States, over 40 yrs. old, saved about $28,205 per year for retirement in 2010. True or False?  Keep your answer to yourself, no looking at your neighbor’s paper, and keep your eyes up front. We’ll come back to the quiz in a minute.

The retirement planners of the previous generation often used the analogy of the reliable “three legged stool” when speaking about retirement savings.  A couple days ago in the news there was an article about how retirement planning is a whole new world when compared with the reliable three-legged stool that propped up the World War II generation.  The author suggested that many older Americans “relied on Social Security, pension plans, and personal savings – like three legs to a stool. These folks would stop working and have guaranteed income.” I think of my Dad. He had the same job for 35 years with one of those “big, all-American” car companies that was used to taking good care of their own. Pension plans could be counted on then. Times have changed and it’s even tougher for the dentist to build a great retirement in many ways.

The risk to save more has shifted to individuals at a time when we are living longer. Dentists that find they have not saved enough each year must deal with a complicated new strategy that combines catching up on savings and crafting a transition that fits into the financial plan seamlessly. Let’s look at each leg of this fabled stool individually to understand why it can’t support the weight of an America that is bulging at the waist – woefully un-prepared for a healthy dental retirement.

1. Social security will mean less each year. In 2016, the Social Security Administration will begin paying more in benefits than they collect in taxes. Were you aware that without changes, the Social Security Trust Fund will be exhausted by 2037 and there will be enough money to pay only about 76 cents for each dollar of scheduled benefits? Even more shocking recent news reports state that the Social Security Administration has already started the bleeding. They will pay more in benefits than they collected in taxes in 2010 – six years ahead of the government’s 2016 prediction.

2. Pension Plans will be extinct. A hard-scrabble, blue-collar America could always rely on a private or government backed classic Pension Plan to give them ease after decades of hard labor. We all know private plans have failed left and right, and many more companies have just discontinued their plans without much warning – or drastically cut the plans they promised. To add insult to injury, the Pension Benefit Guaranty Corporation – the government backup for failed plans – is massively underfunded by billions and billions of dollars. Now, even state and local government plans are at risk of collapse. In fact, a recent study conducted by Joshua Rauh of Northwestern University basically said 45 out of 50 state pension plans were at risk of failing in the next 10 to 20 years. So much for that safety net.

3. Savings rates are terrible – but improving. My previous blog about the Financial Revolution in Dentistry spoke of how Americans are – and will continue – to save more money each year.  The ADA 2010 Survey on Retirement and Investments in dentistry reveals some interesting data that supports my opinion that savings is weak. Members can judge for themselves at http://www.ada.org/goto/surveyresearch. The survey claims:

• dentists 35-44 save 16.3% of net income (about 9.8% of gross income at a 40% tax rate)

• dentists 45-54 save 20.8% of net income (about 12.5% of gross income at a 40% tax rate)

There are two significant problems with this.  First, the ADA sent the survey to 11,998 dentists in April 2010. By the end of the month 704 responded – a 6.6% response rate. Why didn’t the other 11,294 dentists comment? Because they are too busy trying to figure out how to save more for retirement and don’t have time for surveys or were too embarrassed to respond. It’s my opinion that respondents are likely those that are saving a respectable amount for retirement and are proud to share it. Second, many dentists believe they save more than they actually do. There is a little bit of having one’s “head in the sand” here.

It’s my opinion that the survey doesn’t accurately reflect the realistic dental landscape – income needed at retirement is understated and the large majority of dentists save far less than 17.3% of net income, as the survey suggests is typical.

Average gross income for the general practitioner dentist in 2010 was $258,520 –  $271,730 for those over 40.  The survey data on this demographic suggests we should see savings of 17.3% of net, or $28,205 per year, when you back out 40% for taxes, etc.  If you answered “True” to the pop quiz, you win an endless supply of this blog. Don’t get too excited, you’ll wake the neighbors.

Regardless of whether you are saving a little more or a little less, the ADA data suggests that all dentists are in the same boat. The average income expected by the dentist at retirement is 49% of current income – or $127,000 expected per year – according to those surveyed.  What a shame a dentist has to cut income at retirement in half and think that is normal or it has to be that way.

Why is it that a dentist thinks they have to accept “average”retirement savings when they haven’t been average their entire life: the best grades, the highest achievers, the most education, the higher-than average income and lifestyle . . . then settle for half their current income in retirement. Really?  In order to meet income requirements in retirement that we believe our clients deserve, a dentist should save 30 to 34% of what goes home – 1/3 of net income each year.  If you think that is unrealistic, don’t take my word for it, listen to those dentists in this Video Library saving that much on a regular basis.

Laura Carstensen studies the longevity of people’s lives at Stanford University and says:,

“As humans, we decide how we are supposed to act by watching the crowd. For retirement, many look at what their parents have done and don’t realize that everything has changed. People need a new infrastructure that helps them know what to do and makes it automatic and invisible and a little bit at a time”.

The recession has shaken dentists up and made the reality of retirement planning even more difficult. The “three-legged stool” doesn’t exist any more.  Dentists will flock back into the market in an effort to make up for losses incurred in recent years and will likely  take unnecessary risk – with high expense – as a result. This approach needs to be balanced with a greater emphasis on increasing savings. Like a line of falling dominoes, that savings will result from better business profit, improved cash-flow, and a more cautious approach to managing assets. As Laura Carstensen put it, the savings should be “. . . automatic and invisible” but doesn’t have to be impossible.

If you are a dentist that is ready to get serious about your retirement, put us to the test and take our Three Week Wealth Workup to find your own potential.

Charlie Sheen appears to have had his porcelain crowns replaced with gold crowns.  The Two And Half Men star was recently released from rehab after going on a 36 hour drug binge with porn stars.  But his continued drug use has meant that it appears his porcelain crowns and/or veneers have had to be replaced with gold crowns.

How Drugs Can Cause Dental Problems

• Cracked teeth: One of the signs of drug induced dental decay is cracked teeth. This happens when drug users grind and clench their teeth. This can happen both while under the influence of the drug and in the aftermath while experience withdrawal symptoms.
• Dry mouth: Xerostomia, which is known more commonly as dry mouth, results when there is a reduction in the saliva that is formed. Saliva provides natural protection for teeth and gums. The use of drugs reduces the production of saliva, and that means that there is lower protection. This condition can be exacerbated by the fact that many drug users sometimes sleep for more than 24 hours at time - often with the mouth open.
• Indifference to oral hygiene: One of the hallmarks of an addiction is an increasing indifference to matters of hygiene. This includes oral hygiene. Many drug users do not bother to brush or floss their teeth, or eat foods that can help strengthen and protect them. This leads to a situation in which the mouth is vulnerable to weak teeth, gum disease and other problems.

It is important to note that the problem of drug induced dental decay can be enhanced by tobacco use, consuming sugary drinks, and the fact that drug users rarely eat (many drugs are appetite suppressants), meaning that there is less of a change for saliva to be produced and used in the mouth.

You should also realize that drug induced dental decay can result from the use of many different drugs.  Even though it is called typically know as "meth mouth", those who are addicted to other substances, including cocaine and even alcohol, may experience a similar oral condition. Additionally, those with problems related to saliva production - even if drug abuse is not an issue - can exhibit the signs of drug induced dental decay. Children, teenagers and adults who do not properly care for their teeth can also, over time, develop what appears to be meth mouth, even without going anywhere near drugs. However, in drug abusers, the characteristic signs of drug induced dental decay generally develop much fast.

If drug induced dental decay is not addressed, and the situation is allowed to continue, it can lead to a number of serious problems. It is possible for gum disease to develop, and for teeth to begin falling out. Additionally, oral cancer is a possibility. Another concern is that disease in the mouth can spread to other parts of the body. Also, poor oral hygiene can weaken the immune system, leaving someone with cavities more vulnerable to colds and the flu, and other attacks on the respiratory system.

I truly hope Charlie Sheen gets his life back on track. The point of this blog was not to bash Charlie Sheen, it was to educate the public of what drug use can do to your oral health.

If you enjoyed this post there is a good chance you will like these posts from my blog as well:

• “Whoopi Goldberg's View On Gum Disease“
• “Snap On A Celebrity Smile“
• “Kanye West's Dreadful Diamond Teeth“

Thanks for reading !!

Pictures of grinning kids may reveal more than a happy childhood: a study from DePauw University shows that how intensely people smile in childhood photographs, as indicated by crow’s feet around the eyes, predicts their adult marriage success.

According to the research, people whose smiles were weakest in snapshots from childhood through young adulthood were most likely to report being divorced in middle and old age. Among the weakest smilers in college photographs, one in four ended up divorcing, compared with one in 20 of the widest smilers. The same pattern held among even those pictured at an average age of 10.

The paper builds on a 2001 study by psychologists at the University of California, Berkeley, that tracked the well-being and marital satisfaction of women from college through their early 50s. That work found that coeds whose smiles were brightest in their senior yearbook photographs were most likely to be married by their late 20s, least likely to remain single into middle age, and happiest in their marriage; they also scored highest on measures of overall well-being (including psychological and physical difficulties, relationships with others and general self-satisfaction).

The scientists speculate that one’s tendency to grin—an example of what psychologists call “thin slices” of behavior that can belie personal traits—reflects his or her underlying emotional disposition. Positive emotionality influences how others respond to a person, perhaps making that individual more open and likely to seek out situations conducive to a lasting, happy marriage.

But there could be a more cynical explanation, according to Matthew Hertenstein, a psychologist at DePauw who led the new study. “Maybe people who look happier in photos show a social face to others,” he says. “Those may be the same people who are likely to put up with partners because they don’t want to appear unhappy.”

If you enjoyed this article, there is a good chance you will like these articles from my blog as well:

• Thumb Sucking Prevention In Children
• Five Signs Your Baby Is Teething
• Baby Bottle Tooth Decay

Thanks for Reading !!

• “6 Things Your Teeth Say About Your Health“
• “Tooth Loss Linked To Memory Loss“
• “Healthy Gums Healthy Heart“

Researchers have found that elderly people who lose their teeth may be at increased risk for dementia.

The new study included more than 4,000 Japanese participants, 65 and older, who underwent a dental examination and a psychiatric assessment. Compared with participants who still had many of their natural teeth, those with fewer or no teeth were much more likely to have experienced some memory loss or have early-stage Alzheimer’s disease.

The findings were published online Dec. 31 in Behavioral and Brain Functions.

Participants with symptoms of memory loss tended to report that they had visited the dentist rarely, if at all. Dr. Nozomi Okamoto, the study’s principal investigator, said that this may be one explanation for the study’s findings but suggested that there may be other links between tooth loss and memory problems.

“Infections in the gums that can lead to tooth loss may release inflammatory substances, which in turn will enhance the brain inflammation that cause neuronal death and hasten memory loss,” she said in a news release from the journal’s publisher. “The loss of sensory receptors around the teeth is linked to some of the dying neurons.”

Gum Disease Can Lead To Tooth Loss

This may lead to a vicious cycle, Okamoto explained. The loss of these brain connections can cause more teeth to fall out, further contributing to cognitive decline.

I found this research extremely interesting and it is the first study that I am aware of that has linked periodontal disease to memory loss.

If you enjoyed this post there is a good chance you will like these posts from my blog as well:

• “6 Things Your Teeth Say About Your Health“
• “Healthy Gums Healthy Heart“
• “Diabetes And Oral Health“

Thanks for reading !!

An immediate dental implant requires planning and skill, in fact it requires team work between the patient – restorative dentist, implant surgeon and laboratory technician. 

There is no question that given the current state of the art in dentistry, that dental implants are pretty much the best way to replace teeth; they are stand alone tooth replacement systems that look and function just like regular teeth. They do not attach to adjacent teeth like dental bridges and don’t have to be taken in and out like removable partial dentures.

A dental implant is a tooth root replacement made of titanium, which has the unique property of being osteophilic (osteo-bone, philic-loving) and actually fuses to bone. A dental crown, the part of the tooth that you see in your mouth, is attached to the implant. And the great thing about implants is they are not susceptible to decay or periodontal (gum) disease in the same way that teeth are.

Now here are a few important pointers, which hold for dental implants generally and are especially important in cases when replacing a front tooth for an imminent event like a wedding in which you need to look your best.

A photograph showing a fractured tooth broken off at the gum line. A photograph showing an immediate implant and the abutment replacing the fractured tooth. A photograph showing the final crown on top of the implant 3 months after the original surgery.

Many times, a periodontist, oral surgeon or specially trained dentist can place an implant directly into the extraction socket immediately following tooth removal. It is imperative that the extraction of the failing tooth be performed very carefully and without damage to the surrounding gum and bone tissue. This is known as an “immediate” replacement implant. Traditionally the socket is allowed to heal and fill in with new bone first before an implant is placed into it.

The benefit to having an implant placed “immediately” is that only a single surgical procedure is necessary as opposed to two separate procedures. Dental implant success is dependent upon initial stabilization and immobilization in the bone, meaning there should be no movement of the implant at all. This is critical to the fusion of the implant with the bone. Initially, the implant is held securely in place by mechanical forces. As the implant heals, it forms a microscopic bond with the surrounding bone which is known as osseointegration (osseo-bone, integration – to become one with).

It is more difficult to place and secure an implant at the time of tooth extraction because there is less bone available, and the security comes from being able to fit the implant as closely as possible into the remaining socket and to the bone beyond it (where the extracted tooth root ended). This is especially important in the front of the mouth where the teeth show more in what we dentists call the “esthetic zone”.  The procedure carries some risk, but is quite predictable in the hands of an experienced surgeon.

A crown, usually “provisional” in nature can also be placed immediately. This makes it all the more critical to have an initially stable, non-movable implant, because a crown placed immediately will tend to destabilize the implant with biting forces. The provisional crown therefore needs to be made so that it really doesn’t contact the teeth in the opposing jaw so you can’t bite or eat on it for a period of time – this means the new tooth is initially there just for social appearances. We call it a “provisional” crown, since we need to wait until we know that the implant has fully osseointegrated, a matter of 2 – 6 months, before making a final permanent crown. That way we can be assured that not only the bone, but also the gum tissue are stable and fully healed; that the gum level and the “papillae”, the little pink triangular gum that adequately fills the space between the implant crown and adjacent teeth. This can indeed result in a very esthetic, functional and long term tooth replacement.

If you enjoyed this article, there is a good chance you will like these articles from my blog as well:

• “What Are Dental Implants“
• “Dental Implant Success Rates”
• “How To Make Dental Implant Crowns Look Natural“
• “Metal Free Ceramic Dental Implants“

Thanks for Reading !!

What if your toothpaste could tell you whether you needed to leave the house carrying an umbrella? Or how hot the day was going to be?  Odd as it may sound, David Carr of MIT's Media Lab is working on just such a prototype product, "Tastes Like Rain."Carr and his colleagues are focused on super-mechanicals, or the idea of taking a basic object and giving it dynamic properties (consider, for example, the Proverbial Wallets, also out of MIT Media Lab, that know your financial state and prevent over spending).

In this case, toothpaste is modified to dispense one of three flavors depending on the weather. If it's mint, you know it's colder out than yesterday. Cinnamon means it's hotter. Blue stripes indicate precipitation.

The prototype is currently hooked up to a small Linux computer that pulls forecasts, using custom software to compare previous and current temperatures and divvy up the flavors.

Then, linear actuators squeeze out the proper variety of toothpaste through a heavily modded Mentadent dispenser.

Eventually, the technology could be pared down so "Tastes Like Rain" shows up on store shelves alongside the Colgate and Crest. Minus the computer, Carr hints it could be powered on a low-cell battery.

The prototype is in the early stages and Carr is still working out technical specifications. Perhaps selling a base unit that plugs into the wall and serves as a both a communications hub and mixing valve would be a viable option with refill tubes available.

Of course, we're not sure how much reach Carr's device would have given today's easy access to weather apps on phones and computers. But the idea itself is remarkably creative and hints that we're likely to see many more super-mechanical innovations in the future. Cloudy with a chance of potentially awesome.

If you enjoyed this article, there is a good chance you will like these articles from my blog as well:

• “How Sensodyne Toothpaste Decreases Tooth Sensitivity“
• “Why Teeth Whitening Toothpastes Aren't Whitening Your Teeth“
• “Whiten Your Teeth With Strawberries“
• “Chocolate Toothpaste…Cocoa Extract Fights Tooth Decay“

Thanks for Reading !!

An innovative device which cancels out the noise of the dental drill could spell the end of people's anxiety about trips to the dentist, according to experts at King's College London, Brunel University and London South Bank University, who pioneered the invention.

It is widely known that the sound of the dental drill is the prime cause of dental anxiety, and some patients avoid trips to the dentist because of it. This new device could help address people's fears and encourage them to seek the oral healthcare treatment they need.

The prototype device works in a similar way to noise-cancelling headphones but is designed to deal with the very high pitch of the dental drill. Patients would simply unplug their headphones, plug the device into their MP3 player or mobile phone, and then plug the headphones into the device, allowing them to listen to their own music while completely blocking out the unpleasant sound of the drill and dental suction equipment. The patient can still hear the dentist and other members of the dental team speaking to them but other unwanted sounds are filtered out by the device.

Containing a microphone and a chip that analyses the incoming sound wave, the device produces an inverted wave to cancel out unwanted noise. It also uses technology called 'adaptive filtering' where electronic filters lock onto sound waves and removes them, even if the amplitude and frequency change as the drill is being used.

The device was initially the brainchild of Professor Brian Millar at King's College London's Dental Institute who was inspired initially by car maker Lotus' efforts to develop a system that removed unpleasant road noise, while still allowing drivers to hear emergency sirens. Then with over a decade of collaboration with engineering researchers at Brunel University and London South Bank University, a prototype has been designed, built and successfully evaluated.

Although the product is not yet available to dentists, King's is calling for an investor to help bring it to market. Professor Brian Millar said: "Many people put off going to the dentist because of anxiety associated with the noise of the dentist drill. But this device has the potential to make fear of the drill a thing of the past.

"The beauty of this gadget is that it would be fairly cost-effective for dentists to buy, and any patient with an MP3 player would be able to benefit from it, at no extra cost. What we need now is an investor to develop the product further, to enable us to bring this device to as many dental surgeries as possible, and help people whose fear of visiting the dentist stops them from seeking the oral healthcare they need."

If you enjoyed this article, there is a good chance you will like these articles from my blog as well:

• “Acupuncture Helps Ease Dental Anxiety“
• “New Inventions Take The Pain Out of Dentistry“
• “Nasal Spray Could Replace The Dentists Needle“
• "Sound Waves Soothe Away Fear Of The Dentist"

Thanks for Reading !!

I came across a very interesting study the other day which has important implications for the dental profession.  Forteo, a drug marketed to grow bone in osteoporosis patients, also works to heal bone wounds in gum disease patients, a University of Michigan study suggests.  "This new approach for the treatment of periodontal disease could allow us to rebuild some of the bone that is lost due to periodontal disease, which until this point has been very difficult to achieve," said Jill Bashutski, clinical assistant professor at the U-M School of Dentistry and first author on the study. "Current treatments to re-grow bone around teeth affected with gum disease have limited success rates."  The findings are significant because gum disease is the leading cause of tooth loss in adults and is associated with a host of other health problems. Periodontal disease results in loss of teeth and can be devastating because it compromises speaking as well as eating, which can in turn contribute to poor nutrition.

The generic name of the drug is teriparatide and it is marketed by Eli Lilly and Co. under the trade name Forteo. It's a type of parathyroid hormone and the only anabolic (meaning it grows bone) osteoporosis drug approved on the market in the United States. Typically, other types of osteoporosis drugs such as bisphosphonates work by preventing bone loss.  With bisphosphonates, there is a risk that long term use may lead to ONJ, osteonecrosis of the jawbone.

"There was speculation that the bone that forms in a wound like a fracture or inflammatory disease condition might be more responsive to being built back than other bone," said McCauley, who noted that this proved true in the experimental group.McCauley said the next step is for U-M researchers to test whether the treatment could be delivered locally to target site-specific bone healing. Forteo is not FDA approved for uses other than osteoporosis, but another possible application could be to help grow bone around dental implants.

The study appeared online in the New England Journal of Medicine Oct. 16 and in the print edition Oct. 28. The study was presented Oct. 16 in Toronto at the annual meeting of the American Society for Bone and Mineral Research.

In our periodontal practice, we have used Forteo, prescribed and supervised by the patient's medical doctor, with great success to aid in bone regeneration in severely osteoporotic patients prior to dental implant surgery. Although anecdotal, the outcomes are quite remarkable.  Has anyone else had similar experiences?  Your comments are appreciated.

Source:  Science Daily

Journal Reference:

Jill D. Bashutski, Robert M. Eber, Janet S. Kinney, Erika Benavides, Samopriyo Maitra, Thomas M. Braun, William V. Giannobile, Laurie K. McCauley. Teriparatide and Osseous Regeneration in the Oral Cavity. New England Journal of Medicine, 2010; 101016083039040 DOI: 10.1056/NEJMoa1005361

We know how and why implants successfully fuse to bone, but making the crowns (the parts of the teeth that attach to them) look real is another matter. That is where art really meets science. What drives the result is how the tooth or crown shape actually emerges through the gums, and the ability to identically match the color to the adjacent teeth. What follows are some of the predictive factors and criteria for success that dentists involved in implant dentistry have learned through evidence based research, clinical practice and experience over the years.

The Bone Sets The Tone

The first factor is that there needs to be an adequate volume of bone and gum, in the right position to anchor or support a tooth implant. This means that when a tooth is lost, the remaining bone of the tooth socket has to be managed delicately so as to retain as much bone as possible, avoiding the natural tendency of the socket to collapse and resorb (melt away). This can be done by:

* Minimizing trauma during tooth removal, especially important if an immediate implant is to be placed the same day with a temporary crown;
* Using “bone grafting” materials and techniques to minimize resorption;
* Rebuilding bone where lost with regenerative surgical techniques.

These techniques allow an implant to be optimally positioned in order to place a crown in perfect position.

Good Neighbors

Believe it or not the second factor is the amount of bone on the adjacent tooth/teeth. Maintaining a normal volume and height of bone attached to the adjacent teeth actually controls the height of the “papillae,” the little pink triangles of tissue that fill the spaces in the areas beneath where the teeth contact each other. If bone is lost on either side of an implant against a natural tooth, there is no guarantee that the papillae (those small, pink triangle of gum tissue between teeth) will regenerate fully, leading to what we dentists refer to as “black hole disease.”

Tissue Is The Issue

The third factor to consider is the genetic tissue type you are born with. It is a lot more difficult to achieve a great result with genetically thin tissue than it is with thicker tissue types. Think of the gingival tissues like a curtain, the thicker the curtain, the more wear and shrink resistant it will be. Thin tissues are more delicate to work with surgically, tending to recede, and are more see-through, making it difficult to hide the metal of an underlying implant or other implant crown materials. Thicker gum tissues are more robust and resilient, easier to work with surgically, and hide more.

“Emergence Profile” — From Bud Into Flower

The seamless transition from implant into exact tooth replica is almost akin to the transformation of a bud into a flower — it involves the way the crown, which attaches to the implant seemingly emerges through the gum tissue, exactly like a natural tooth. This “emergence profile” involves both the implant shape and how far it is placed below the bone and gum tissues relative to the adjacent teeth. This is dependent upon good planning, surgical experience and skill during dental implant placement, allowing space for the “emergence profile” to be developed.

Work Out The Final — In The Temporary

Where aesthetics is of paramount importance as in the front of the mouth, a customized temporary crown acts as a template or blueprint for a final crown. This allows several of the criteria for success to be worked out ahead of time, including: color, shape and regeneration of papillae. This includes compatibility with the gum tissues and smile line, speech, and biting function. Choice of crown materials, color matching, even the dental laboratory technician — are all mechanical and artistic ingredients that go into the mix before baking this particular pie, and lead to good matching of the implant supported crown to adjacent natural teeth. These factors in and of themselves demand their own skill sets, expertise and experience to achieve optimal success.

Implant to Tooth Versus Implant to Implant

The picture changes when it comes to placing implants next to implants, in addition to adjacent teeth. The distance between the implants and the shape and size of the implants then become even more critical, and in fact it may not be possible to completely regenerate natural looking papillae between the implants relative to the natural teeth.

All Things Considered

There are in fact many more factors to consider in this special situation, but this consultation gives you a flavor for the variety. Good surgical manipulation (in the best sense of the word), experience and skill are all pre-requisites for great implant aesthetics in the most critical places, in the smile line or “aesthetic zone.” As with most of the endeavors discussed, pre-surgical assessment, diagnosis, and team planning (surgeon placing the implant, restorative dentist and laboratory technician making the crown), all go into both the planning and realization of success.

If you enjoyed this article, there is a good chance you will like these articles from my blog as well:

• “What Are Dental Implants“
• “Dental Implant Success Rates”
• “Metal Free Ceramic Dental Implants“

Thanks for Reading !!

Last year, if you walked into your dentist's office saying, "Hey, Doc, can you make my teeth look like Jessica Alba or Brad Pitt's?" the answer would have been, "Yeah, sure - with a lot of anesthetic, drilling and permanent reconstruction." But things have changed.

Meet the Snap-On Smile - a thin, flexible, resin shell of perfect teeth that snaps over your actual teeth like a retainer. No adhesive, no drilling. Its inventor, Marc Liechtung, is a dentist at Manhattan Dental Arts, where you can walk in on a Monday, make a painless plaster mold of your teeth and then pick up your new smile by Friday. All for $1,200 to $1,600. Patients can work with a "smile guide" to chose one of 17 colors ("yellow-white," "yellow-gray," even "Extreme White Buyer Beware") and 18 shapes ("squared," "square-round," "pointy"). But many patients just hand Liechtung a celebrity photo and say, "Make my teeth look like this." So he does.

But he wants to make one thing clear: "I did not come up with the Snap-On Smile so people could mimic celebrity smiles." His goal was an affordable, minimally invasive dental tool. "I had patients with almost no teeth who didn't have $20,000 for reconstruction," he says. So this year, after months in the lab, he unveiled Snap-On Smiles. People don't ask Liechtung whether the Snap-On causes permanent damage (it doesn't) or whether you can eat with it (you can - even corn on the cob). "No," Liechtung says, "they just want to know: 'Which is the most popular celebrity?' 'What kind of girls get Halle Berry?' 'Who do guys ask for?' "In the beginning, it made me sick. I thought I invented some serious medical device, but all people wanted to do was use it to make themselves look like celebrities!" Eventually he thought, Well, why not? "A person comes in, I say I can give them any teeth they want, who are they going to want to look like? Me? No!" Liechtung wears a Snap-On every day.

But whose smile is it? "I just made an enhanced version of my own," he says. But people rarely believe him. "I hate to admit it," he says, "but when they persist, I tell them my teeth are Brad Pitt's, because really, who wouldn't want his teeth?"

How Does Snap on Smile Work:

No shots. No dental drilling. No adhesives. You can even eat while wearing the Snap-On Smile  appliance. Patients looking for a non-invasive, reversible, affordable approach to restorative and cosmetic dentistry are excellent candidates for Snap-On Smile. It's an easy, quick and affordable solution for patients who want to feel better, look better, and function better. Patients using Snap-On Smile report an immediate boost to confidence and self esteem. Most are impressed with the natural look and feel of Snap-On Smile and are grateful for the brief time investment - about two weeks - to achieve such life changing results. This revolutionary appliance is the ideal solution for solving a wide variety of short- and long-term clinical challenges, as it serves as both a non-invasive restorative option as well as a diagnostic appliance. Applications include using Snap-On Smile as aesthetic provisionals for implant restorations, as a vehicle for increasing facial height (vertical dimension), as cosmetic removable partial dentures, and even as a long-term smile enhancement. Snap-On Smile can last for years and yet is affordable enough to be temporary. It has also proven to be a terrific incentive for patients who are in need of but are hesitant to commit to more involved restorative treatment. In fact, our research has shown that 40 percent of patients who started treatment with the Snap-On Smile transitioned into more extensive restorative dentistry. Think of Snap on Smile as a professionally made (can only be fabricated by a dentist), highly esthetic, cost effective dental grill. I use Snap on Smiles all the time in my practice as temporary replacements of front teeth while my patients dental implants are healing. I love the appliance and highly recommend it for a variety of uses described above. If you enjoyed this article, there is a good chance you will like these articles from my blog as well:

• “Dr. Welch’s Take on Kanye West’s Diamond Teeth“
• “Jessica Alba: Female Celebrity Smile of the Year“
• “Mario Lopez: Male Celebrity Smile of the Year“

Thanks for Reading !!

We are creating radiographic templates and design proposals for guided implant surgeries with Straumann's coDiagnostiX software and gonyX table.  Have any of you used this system with Straumann or other systems.  It is compatible with 30+ implant systems.  We are starting to set implants in the casts and make immediate temporaries as well for our surgical counterparts.