Advances In Dentistry…Some Good…Some Not So Good

There have been many advances in dentistry over the last few years. Some are a good value to you, the patient, others, well I would classify them as gimmicks that have not value at all.

A couple of examples of the good ones are implants. In 1968, this office was built by Dr. Nelson. He was one of the implant pioneers in the Portland area. Today the success rate is around 98% and accepted world wide. They have become simplified and their cost, relative to other treatments, have come down. In many cases, a tooth can be extracted and an implant placed the same day! In endodontics (root canals), electronics have taken out much of the guesswork. Nickel-titanium (the same metal that allows the Twistoflex glasses frames to bend so much and bounce back), files, and rotary instruments have made the process much quicker. Most are done in one appointment and in less than one hour!

There have been many other great advances in dentistry. Some technologies, however, in my opinion, aren’t in the best interest of the patients. For example, there is a milling machine that allows the dentist to “make” a crown in a single appointment. What the patient may not know is that the machine is approximately $100,000 and owned by the doctor who now has to make payments. Let me share with you an excerpt from the president of the ODA (Oregon Dental Association) in one of our journals, ” Do not overtreat!! Often that old amalgam restoration will outlast by many times the porcelain crown you just sold the last patient because you need to make a payment on your new Cerac machine. The patient’s pocket is not a bottomless pit. Be reasonable with treatment plans and fees”. (the complete article can be found in the February 2004 Oregon Board of Dentistry News, President’s Message) Need I say more? Besides, I used to be a dental lab technician and I can say, without a doubt, that they are substandard to a quality “hand made” inlay or crown.

Some other examples are “lasers” and those one-hour bleaching systems. Independent (Clinical Research Association) has shown how those bleaching systems don’t work as well as the “home” bleaching systems. An article from the JADA February 2004 issue states, “With respect to esthetics, our literature review showed that power bleaching has questionable whitening efficacy. Jones and colleagues demonstrated that a typical in-office laser bleaching session produced significantly fewer desirable color changes than did two at home bleaching protocols. No perceivable difference between energized versus nonenergized bleaching when performed under standardized conditions.” What happens is that the teeth become dehydrated making them “look” whiter, but it is short lived. There are some other issues, but you might ask yourself, “why are so many dentists pushing these systems?”. Well, mostly it has to do with advertising. Have you seen those “make over” type shows? They are actually paid add spots. These doctors can create a “want” for the dentists campaigns. It has nothing to do with the efficacy of the product!

I have been following these trends and will always do my best to keep my patients well informed of the pros and cons of all treatments. Before using any product in this office, it is thoroughly researched. I love what I do, I love the patients I work with and I will always strive to earn their trust by “watching out for them”.