September 2009

A Dramatic Change in Dentistry: No Pain

Author: Paul deVere

“Ten, 15 years ago, cosmetic dentistry looked cosmetic, artificial. But our techniques and materials have gotten so much better. We’re basically driving toward a metal-free industry,” said Dr. Kevin Fader of Island Family Dental. “Within a year, I’ll be metal free.”

Fader explained that metal in fillings and crowns is harder on the gums. From an appearance stand point, it is not the ideal. “Even with a porcelain covered metal crown, a black line can become visible,” Fader said. The crowns he now uses are all porcelain. “They’re actually stronger than metal and look like a natural tooth. Dentistry is always evolving.”

It is not just the cosmetic side of dentistry that’s dramatically changed, but the entire field, from the lab to the dentist’s chair. A generation or so ago, a visit to the dentist’s office was not a happy occurrence. The sound of a drill sent shivers down the spine and knuckles turned white as the patient gripped the chair’s arm rests, ready for the pain that was sure to come. All of that is history.

For Fader that scenario has changed 180 degrees. “As long as you keep up with the technology that works and is more efficient, it is an entirely different experience for the patient today. Patient comfort is first and foremost,” Fader explained. He said that his focus is also on less invasive techniques. He gave examples: “The curing light we use for the resin-based cement that we use to put the crowns on. There are different shades of that [cement] even. Now, it takes 5 seconds [to cure]. It used to be 30 seconds.” Drills are quieter. Anesthetics have improved dramatically. “In the past, all we had was Novocain. That lasted, what, five minutes?” Today, an anesthetic will last for an hour or more with no side effects—and no pain.

Making impressions used to involve a mouthful of rubbery material. “Today,” Fader said, “you put dust on the area, take a picture and send it to the lab. There are no retakes. Patients don’t have to sit there for 10 minutes. We just snap a picture.” Fader is also looking into equipment that will allow him to make crowns right in his office. “Crowns while you wait,” he said, smiling.

Fader said that patients are happier. “The results are fantastic. It’s really instant gratification. Even the temporaries we make are beautiful. I’ve had patients say, ‘I just want my temporaries.’”

There is another whole side of dentistry that’s come along with technology: patient communication. “It used to be something like going to a car mechanic. If he said you needed a new radiator, he couldn’t show you. You just had to trust him.” With digital x-rays, the dentist and patient can communicate visually. “I can show you what’s going on. The x-ray goes up on the computer screen. Patients can see it. I can say that this is a normal tooth and this is decay. We’re such visual creatures. What we can see, we can understand,” Fader explained.

Fader strongly believes that dental care should begin with children as early as possible, between the ages of two and three. “As soon as they have teeth and as soon as they can sit up,” Fader advised. He explained that proper care of baby teeth is critically important to the healthy development of the permanent teeth that follow. He wants to make sure that a visit to the dentist is a good, happy experience for children, especially since fewer than 50 percent of the population goes to a dentist, either because of fear of the dentist or fear of the cost—or both.
“People also let their teeth go because they feel like nothing is wrong. But underneath there can be periodontal disease, gum disease, cavities under the teeth which you can only see on x-rays,” Fader said. “Yet it’s all preventable.”

Fader admits that cost may be the most intimidating factor today. Yet a visit to the dentist twice a year will run about $300 annually. “Three hundred dollars a year for patients to get their teeth cleaned, x-rayed and examined. People neglect cleaning because they don’t have insurance. You don’t need insurance. It really is affordable. My air conditioning inspections cost more than that in a year. I gladly pay it. But my teeth are more important than that.”

By scheduling visits every six months, Fader said he can find a little cavity before it becomes a big cavity. He hopes the semi-annual visit will become as habitual as brushing twice a day. “Brush your teeth morning and night. Use the fluoride rinses that are out there. Nighttime is very important. In those eight hours your mouth gets dry and creates an ideal environment for bacteria production. Intervention prevents this. To me, it’s all pretty simple.”

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