"My child needs to have the muscle attachment under her lip removed, because she is having braces. Do you have any suggestions about how this should be done? I've heard horror stories."
Since
1990, we have been doing this procedure (it’s called a “frenectomy”) with a
laser. Let me emphasize: We do NOT use a scalpel or a pair of
scissors. We use a beam of light – we call it photonic energy. The
proof of the pudding is that we can do it with just an anesthetic jelly (we
call this “topical” anesthetic). No shot. And no discomfort either
during the procedure (which takes about 15 minutes from start to finish) or
afterwards. No post-surgical prescription medication for discomfort is
necessary. No sutures (or stitches) and no follow-up appointment.
We’ve done about a thousand of these procedures with the laser. Our
patients often say afterwards that “lasing is amazing!” We
think so too. That’s one reason why we have 10 different lasers in our office
to meet all the needs of our patients.
"I have heard that you consider yourself a "Private Care Dentist." Just what does that mean?"
The
profession of dentistry seems to be preoccupied with "Managed-Care"
and "Fee-For-Service Dentistry." Perhaps another alternative exists, which has the potential
to provide both patients and practitioners alike with the fulfillment that
seems to be so elusive in our high-tech., production-driven offices in the
Twenty-first Century. This
alternative practice style might be called "Private Care Dentistry." In
Private Care, successful treatment is based on the development of trust as a
foundation for genuine care. A
focus on these qualities move us away from a pre-occupation with production and
procedures to a higher plateau that stresses relationship building, personal
interaction, education, and ultimately, on patient involvement and
responsibility for oral health maintenance.
The
Private Care setting requires a paradigm shift in our view of what the ideal
dental practice should be. Bigger is not necessarily better.
Production is no longer the engine that drives our profit margin. An
increase in patient volume is no longer necessary to maintain income
stream. The time constraints of conventional practice, and
particularly of managed care, do not allow the development of the esoteric
values in the doctor-patient relationship that make dentistry so fulfilling.
Without trust, patients may hesitate to commit to comprehensive care; they may
be more inclined to follow the rigid, insensitive, and unrealistic dictates of
their insurance policy provisions. Without trust, patients are less loyal
to the practice and to the efforts that are made to maintain their oral
health. When patients see value in our office, they make the commitments
that lead to successful comprehensive care. As the well-being of the
dentist, staff, and patients alike becomes the number one priority in a Private
Care setting, the stress associated with both Managed Care and Fee For Service
dentistry become intolerable.
In a
Private Care setting, only those patients who are willing to initiate the
relationship with a complete examination and treatment plan are accepted into
the practice. New Patient
Examination appointments are interactive, and involve the patient in education,
diagnosis, and treatment planning.
This takes time, and so the appointment may typically last for two
hours. Many patients who visit our
office comment that they have never had such attention, that the dental team
has never listened to them so carefully, that they have never before understood
so thoroughly the processes at work in their mouths, and that they have never
had explained to them in such clear terms what could be done to improve the
quality of their oral health. When
the proposed treatment is integral to an office mission statement that values
the relationship, patients tend to support our recommendations with enthusiasm.
The
overall effect of Private Care dentistry is that fewer patients are seen, but
better, more comprehensive dentistry is performed. We are more inclined to treat our patients in a holistic
way. As a result, they are happier
and healthier in part because they enjoy the feeling that comes with
comprehensive care that is provided in an environment that speaks directly to
their needs. In our Managed Care
or Fee For Service world, Private Care is a safe haven for patients who want a
better alternative.
"What can I expect at my first visit to your office that might be different than other offices?"
All of us
at The Center for Advanced Dental Technologies are pleased to welcome new
patients to our office. We
accomplish a lot at the first visit, and allow two full hours to complete all
the initial procedures that will establish a solid foundation on which to build
our professional relationship with our new patients. At the
first visit, we review the medical/dental history, and complete a thorough
evaluation of the teeth, gums, and oral structures. We diagnose oral health care needs and present our findings
in terms of prognosis, recommended treatment, cost, and the time required to
complete the treatment. We answer
any questions regarding treatment at that time. We are
committed to providing our patients with quality care in an atmosphere where
their comfort and well-being are our top priorities. Our goal is to help them to maintain a healthy mouth for
life. If our new patients
have any questions before their first visit, we urge them to give us a call.
"My son just had his braces taken off, and although the orthodontist did a great job straightening his teeth, his smile doesn't look as nice as I'd hoped it would. I can't quite put my finger on it. What do you think might be wrong?"
Often,
after the braces come off, there are white lines on the teeth from where the
brackets were cemented to the teeth.
These can be hard to remove without professional intervention. We often make lightening trays for
these patients, and after a week or two with the gel, the lines fade (and the
teeth get a LOT whiter). Also, we
do a “Smile Line Analysis” on each of our post-orthodontic treatment patients,
to see if the gum line follows the natural contour of the teeth. Often it doesn’t and there is an excess
of gum tissue overlying the anatomical crown of the tooth (the part of the
tooth that nature intended be visible to the eye). In this case, we use a laser
to release the smile from bondage to the gum tissue. It’s a very easy procedure that takes about half an hour, and
it really opens up the patient’s smile.
We blend in the new contour right back to the bicuspids (premolars) or
the molar teeth – so if the patient has a really wide smile and has a very
active upper lip, when they smile they will show a lot of teeth (and less
gums). There’s nothing that can
compromise a big, beautiful smile faster than overgrown gums. It seems like no-one likes a gummy
smile, and we have the perfect answer for it – laser recontouring, which often
be done with just a topical anesthetic jelly. We’ve done this many times, and virtually 100% of our
patients are enthusiastically pleased with the result. In some instances, it has transformed
their quality of life. Nothing
creates self-confidence like a beautiful smile. You’ve make a significant investment in time and money
having your child’s teeth straightened.
The revision of the smile line that we do is just the icing on the cake
that every patient deserves.
"My employer is offering me the chance to join something called a "Closed Panel" to take care of all my dental needs. It's really inexpensive. Do you think this is too good to be true?"
Insurance
companies are interested in only their own cost-containment. They spend tens of millions of dollars
annually to teach those who purchase their policies how they can have dental
care for a flat rate of just a few dollars per month. Consumers
must understand, however, that in a typical Closed Panel Scenario, care is less
complete, and quality and service may suffer. A reimbursement mechanism that pays a few dollars per month
for all care that the insured may require can create an incentive for the
dentist to avoid treating patients, avoid comprehensive treatment, avoid
expensive treatment, or avoid quality care.
When
patients are confronted with the decision to chose a closed panel dentist or a
fee-for-service dentist, they need to ask themselves, why would my dentist sign
up to participate in a closed panels?
In our practice, we want to help our patients "Settle For
More." We will help them
every way we can to be able to afford quality care. Patients
who only push price may not be right for our office, anyway. When patients purchase dental treatment
from our office, they are not receiving a product, they are receiving quality,
service, and dependability. As a
matter of fact, the lower fees of a closed panel make an equally powerful
negative statement to patients.
Because our patients are oriented toward quality, service, and
dependability, price is less important to them. A
lesson can be learned from government regulated managed care in the United
Kingdom, where practice within the National Health Service represents the
lowest quality of care anywhere available.
When
consumers ask their dentists if they are “Preferred Providers” of a particular insurance company, the
following should be considered: 1) Patients generally are not required to go to
a “Preferred Provider” listed by their insurance carrier. 2) “Preferred Providers” have no
special training, and no continuing dental education requirements. In fact, his/her office is not better
than any other office, in any way.
3) “Preferred Providers” have no requirement to utilize the latest
dental equipment, such as lasers, air-abrasion, laser cavity detection,
periodontal endoscopy, intra-oral cameras, digital x-ray, and so on. 4) “Preferred Providers” have no
special requirement to provide a clean and safe environment in which to provide
dentistry of the highest quality, such as sterile water delivery systems, and
air-filtration devices. 5) “Preferred”
means only that the dentist is preferred by the insurance company over his/her
colleagues, because he/she has agreed to slash his fees in order to have his
name on the list of “Preferred Providers.” The
question a consumer should ask himself is: “When a dentist cuts his fees in a
deal with an insurance company, in order to attract more patients to his slow
practice, how does he cope with a narrower profit margin?” Can the quality of care remain the same
in an environment of discounted dentistry?
"Do I always have to have a shot when I have a filling done? I hate the needle, but I don't like pain either!"
About half
of the fillings we do can be done quite comfortably without anesthetic (a
shot). The key is using either
air-abrasion (kind of like a sandblaster) or a laser. These instruments allow us not only to do fillings without
anesthetic, but to do them in different areas of the mouth at the same
visit. This saves our patients
time because they get their dentistry done more quickly with fewer
appointments. Not all offices have
the technology to do this.
However, we have been doing it for almost 20 years now, and we’ve gotten
pretty good at it.