It’s been reported by the media recently that some dental crowns, made in China, have been found to have excessively high lead content. Generally, these crowns come from very low-priced laboratories, but the full extent of the problem is not yet known.
However, I want ALL of my patients (and potential patients) to know that we do not use any labs in China, and in fact, we rarely use crowns that have metal in them. That’s not to say that we are a “metal-free” dental office; by no means! There are a number of very good reasons to use gold, silver, and mixed metals for different situations, but none of those require that we use cheap crowns from cheap labs that might put you at risk.
In fact, my patients can be reassured that they aren’t getting any metal the huge majority of the time because of our CEREC 3D CAD/CAM system that allows us to make incredibly strong, very natural-looking, beautiful crowns in just 1 appointment. You can literally watch your crown being made!
In those instances that we do have to use a dental laboratory, we can still avoid metal most of the time, but even then……all the labs that we use are proud to say, “Our dental lab work is made in the USA!”
Just so you know it’s perfectly safe to make an appointment for a crown with us, knowing there’s no chance of lead in your crowns or bridges.
Very often we are asked for pain medications after difficult procedures; while they are sometimes necessary, the most effective medications that you can get for dental pain are generally over-the-counter ones. Here’s what we recommend, and it’s what we recommend usually for all but the most difficult surgeries in our office:
- Starting immediately (or even right before the procedure is the best), take UP TO 800mg Ibuprofen (you can take less, but do NOT take more!)
- Three hours later, take UP TO 1000mg acetominophen/Tylenol (again, you can take less, but do NOT take more!)
- Continue alternating these every three hours. Because they work in slightly different ways, by overlapping them you get 2 types of relief at all times. In addition, they do not make most people drowsy compared to narcotic pain medications.
What’s the maximum dosage per day of each? (For Adults)
Ibuprofen/Advil: DO NOT EXCEED 2400mg/day
Acetominophen/Tylenol: Do not exceed 4000mg/day
We could also perhaps name this…..”How do I know if my dentist and I are on the same page?”
While there are an infinite number of variations on this theme, you can break it down into 2 basic groups of dentists. While both can serve you well, given how important the doctor-patient trust relationship is, I recommend you be willing to ask questions of your dentist and his/her team to make sure that you have the same goals for your mouth and dental health. Here are the 2 basic breakdowns:
(1) “If it ain’t broke, don’t fix it.” Dentists who subscribe to this theory generally don’t recommend any treatment until something actually hurts or breaks or is obviously decayed. In other words, let’s say you have a tooth with a crack in it, such as the ones I showed in this post from January ’09: Cracks in Teeth. This group of dentists generally won’t say anything about these teeth unless it actually starts hurting you or the tooth breaks. Given that it is impossible to actually predict when a tooth like that will break or hurt, you may go for many years with teeth in that condition, so the ADVANTAGE of this philosophy is that you don’t spend any money until it actually happens. The DISADVANTAGE is that – when the tooth finally breaks and/or hurts, it is generally in much worse condition than if treated earlier, which means that it will probably be more expensive to fix. Plus, of course, you might have to deal with the pain, and for some reason, these things always happen on nights or weekends when the dentist isn’t available.
(2) “Here’s a potential problem; let’s go ahead and fix it now before it breaks and hurts.”
In this philosphy of care, the dentist will evaluate you for all current and potential problems, inform you, and give you the option of choosing to have the treatment done before the tooth breaks and/or hurts. Of course, the dentist should NEVER try to force you into anything – always remember that you are the ultimate decider of when to have your treatment done. But if you have some trouble brewing in your mouth, wouldn’t you prefer to get it fixed before it gets really bad? Before it gets more expensive? Before you have to suffer?
It’s probably pretty obvious which philosophy we choose at Smiles by Payet Dentistry – #2. We will inform you of any and all problems that we see. We’ll give your our recommendations based on the years of experience and advanced training and available research. We’ll tell you what treatment options you can choose. And then we will sit back and let you decide how much to do, when to do it, and how you want to do it. Please ask us questions until you feel completely comfortable, and don’t worry that you’re hurting our feelings if you decide to wait.
We understand that you will be ready when you’re ready, and we are here to help you when you are. Our goal is simply to make sure that you are fully informed so that you can make the best choice for yourself. Call us for an appointment, or request one through our website by clicking here: Request an Appointment.
Oh, it feels so good to finally be able to announce this, as I’ve been working on it so hard for so many nights after my family has gone to bed, but FINALLY I have begun producing some new Patient Education videos to help explain a number of options that we offer by using pictures of many similar cases.
Over the last 4 years, I have amassed a catalog of about 38,000 digital photographs of the work that we do. You can see my Photography Blog post on the subject of Patient Communication with Digital Photography for more info on how/why we take pictures of our work, but now I’m finally able to turn a lot of those photos into various video formats to highlight problems that many patients have, often without even realizing it, and to let our patients actually see what they can expect once the treatment is completed. It’s really quite exciting! We’re not talking about “stock” photography here, of work that someone else did. EVERY SINGLE ONE of the pictures that you’ll see were taken by Dr. Payet (me), and every completed procedure was performed by Dr. Payet (me) and my Team. (Hope you don’t mind me talking about myself in the 3rd person for a moment there; I was having a Bob Dole flashback after reading some political articles. 🙂
We’ll look forward to showing you these new videos when you come in!
Don’t have any of those videos in Web format quite yet, but keep an eye on our website, Smiles by Payet Dentistry, for them to begin appearing there within the next few weeks. You’ll be able to see and understand so much more easily, I promise!
We’ve actually been a Preferred Provider for Delta Dental Premier for several years now, but we just received confirmation that CIGNA has now processed all the paperwork, and we are officially listed as a Preferred Provider for CIGNA as well. This is great news for the many patients who already receive care with us and who have CIGNA, but for other patients who are seeking a dentist on their list. This will provide some significant savings for anyone whose employer offers them dental insurance through CIGNA.
Of course, I don’t want to miss this opportunity to plug our Smiles by Payet In-House Discount Program, which is a program that we created for our patients with no dental insurance, or who perhaps have dental insurance but it’s a HMO or other plan that won’t allow them to see us, but they value the service and quality we provide and want to keep us as their dentist. Follow the link to our website for more details, or call and talk with Rosie Bonnett, our Front Desk/Patient Care Coordinator, and she can help you get signed up.
As we keep our main practice website current and applicable, we’ve recently added a new page that you will find useful: a Helpful Links page.
This page (along with our Blogroll) will have a variety of links to other websites, to helpful articles, and more.
In the near future, you will find a subset of this page help you find dentists around the USA and even around the world, whom Dr. Payet personally knows and recommends. While we are always sorry to see patients leave, in a town as transient as Charlotte, we know that many of our patients leave town for new relationships, for new jobs, to care for family, for retirement…..but we’ll do our best to ensure that you find an excellent dentist to continue your care or to help you maintain your current dental health. Even if you’re out of town on vacation and something unexpected happens, you may well find yourself as well-cared for as if you were seeing Dr. Payet and his Team right here at home.
There is a rapidly growing area of dentistry concerned with treating sleep apnea and snoring. There’s an important reason for this, too….people who snore and/or experience sleep apnea on a regular basis are at SIGNIFICANTLY higher risk of certain health issues. I am going to relate a very personal story that I hope will help drive the point home, as well as give you a link to a website that will provide you with FAR more detail than I can provide in this blog.
My dad turned 63 in March ’08. Up until that time, he had always been a very healthy individual with no particular health problems. He regularly traveled the world for his job and had been doing so for many years; he and my mom enjoyed an active life, involved with their church and the arts. The only problem that had plagued him for a couple years was a nagging cough that simply would not resolve, no matter what he took. Not just a nagging little cough, but a deep, powerful, and often painful cough that would sap his energy, leaving him drained.
(To interject a bit of dental history: I’d been telling my dad for a number of years that he clearly has a history of grinding his teeth, and coupled with the fact that he had always been an EXTREMELY LOUD SNORER (to the point my mom often kicked him out of bed or slept in another room herself), I’d also recommended he get a sleep study done. With his travel and work schedule, though, it had just never quite worked out.)
Well, in early 2008 he’d finally had enough of the cough and went to see a pulmonologist. During a routine visit to see how well a certain medication was working, they noted that his heart rate was at an alarming 140 beats per minute!! Naturally, they immediately sent him to the hospital! He ended up staying for several days for evaluation.
It ended up taking many months of testing, trying several medications, and undergoing several procedures for his heart and to drain some disgusting and nasty fluid, before they finally got things under control. One of the most crucial tests of all, though, was a sleep study. Remarkably, his sleep apnea was SO BAD that the doctors woke him up halfway through the night to put him on a CPAP machine.
Long story short: the doctors determined that his sleep apnea was one of the largest contributing factors to his heart problems, which had led to the lung problems. Since he started using a CPAP machine to help him breathe at night, he is a different man. Dad says that he now wakes up and feels amazingly well; he actually feels like he slept well! He no longer has the rapid heartbeat; his lungs are no longer filling with awful fluids; he sleeps well; my Mom sleeps well; and he’s healthy again!
If you know that you snore loudly; if you’re a man and your neck size is 16.5 or greater; if you often wake yourself up with “snorts” at night; if you always wake up and feel you’ve slept poorly no matter how many hours you were in bed……..these are some of the risk factors/warning signs that should tell you to see your doctor and your dentist.
I’ll talk more about treatments and how dentists can help in the future, but for now, here’s a link you should follow to learn a lot more — QUITE LITERALLY, THIS COULD SAVE YOUR LIFE, AS IT HAS MY DAD’S. DON’T TAKE A CHANCE:
As I’ve mentioned, there are 2 basic “philosophies” of dental care, although I didn’t really spell them out. They are (approximately, please understand!):
1) Watch and wait until it it actually hurts or breaks,
2) Diagnose and recommend treatment BEFORE it actually hurts or breaks.
As a general rule, at Smiles by Payet Dentistry, we follow the second philosophy. The key to remember, though, is that it is ALWAYS up to YOU to decide when to actually proceed with treatment. I’ll show you what I see by digital photography and x-rays, give you my recommendations, and then it’s up to you to decide what to do about them. We understand that the treatment has to fit into your life – your budget, your schedule, your priorities. I give you my word — I will NEVER pressure you into doing any treatment. I MAY make some very strong recommendations and urge you to proceed with treatment so that you avoid pain, loss of teeth, or other complication, but it’s still your decision, and we promise to respect that.
One of the tricky parts of dentistry is this: we can’t see through old fillings and crowns and bridges, not even with digital x-rays, digital photography, not even with the Zeiss PICO dental microscope that I use. We can only see things AROUND them. And quite honestly, as much as I believe silver amalgam fillings are a perfectly acceptable treatment, I also believe that they hide a multitude of evils. I already showed you the cracks that are often associated with big, old silver fillings, especially in patients who grind their teeth. What I didn’t show you, though, is how much decay (cavity) can be hidden from us by old silver fillings. They may not hurt, but it is not uncommon for there to be so much decay under them that a root canal becomes necessary when it’s all removed — and often times it can not be seen on x-rays! This makes it frustrating for patients, can’t understand why we recommend replacing a filling with a new filling or a crown.
So along with examples of the beautiful dentistry that we provide, I’ll also regularly show you the problems we often encounter when treating teeth, which should help you, the patient, better understand the WHYs of our recommendations.
A perfect example: This lady had these fillings for many years, probably over 20. The molar had just recently started bothering her a little with sensitivity to cold and sweets, but nothing serious. The main reason she wanted them replaced was for appearance, though — the greyish color really showed through on the front of the teeth. You’ll see that they don’t actually look all that bad to an untrained eye. After seeing thousands and thousands of them, though, I had some idea of what to expect……..but even I didn’t expect the problem to be so extensive.
Oh YUCK! See all that black crud? That’s decay — mushy, soft, and definitely NOT healthy. And this is fairly normal to find under 20+ year old fillings, to tell the truth.
Just some food for thought: maybe your dentist has recommended some treatment, perhaps to replace those silver fillings that have been there for 20-30 years, and maybe they’re not even bothering you, so you think, “Nah, I’ll just wait, doc. Thanks but no thanks right now.” Consider this: another 6 months, and this lady probably would have needed at least 1 root canal, maybe even 2. Not only would that have required more time, possible a lot of discomfort, but probably would have added another $1500-2000 in treatment costs.
Do you really want to wait?
For the sake of simplicity, I’d like to make a comprehensive list of the treatment options that we offer at Smiles by Payet Dentistry:
- Routine hygiene visits every 6 months, exams, and x-rays when appropriate
- Non-surgical therapy for periodontal (gum) disease
- Gingival grafting to cover root recession
- Silver (amalgam) fillings
- Tooth-colored (composite resin) fillings, also known as bonding
- All-ceramic/all-porcelain crowns, onlays, and bridges
- Porcelain-fused-to-metal crowns and bridges
- Porcelain veneers, including No-Prep or Minimal-Prep Veneers
- Complete Smile Makeovers and Full-Mouth Reconstructions
- Endodontic treatment (root canals)
- Retreatment of failed root canals
- Short-Term Orthodontics/Six-Month Braces
- Treatment of TMJ Disorders, Chronic Tension Headaches, and Chronic Migraine Headaches
This may seem like a lot of services for one doctor and his team to provide, but I am passionate about providing my patients with the best care possible, as well as allowing them to have as much as possible done in one place. However, when necessary, I work with an excellent team of Dental Specialists, so you can rest assured that – if I can’t solve the problem, I will only refer you to the very best available.
Especially in today’s economic client, we understand that the lack of dental insurance keeps many people away from the dentist. In order to help, we have done some research and created our own “Smiles by Payet In-House Dental Insurance Plan.” For more details, see our website www.SmilesbyPayet.com and at the top of the Home Page you’ll see the announcement, as well as a link to a more detailed explanation. It’s pretty simple , and you can even download the form to apply.
The Basics: An affordable Annual Enrollment Fee of only $295, which covers 2 regular cleanings, x-rays, and check-ups per year, and once you’re signed up, you will receive up to 20% (TWENTY PERCENT) off ANY and ALL treatment options offered at Smiles by Payet Dentistry. Even cosmetic procedures not normally covered by dental insurance, such as Veneers, Bleaching Trays, Deep Bleaching ™, and Short-Term Adult Ortho. This can mean a huge savings for you, but what’s most important is simply that you won’t get off-track with maintaining your dental health.
Besides checking it out on our website, please also call Rosie Bonnett, our Patient Care Coordinator, who can fill you in on the details and get you signed up.
The plan is not open to those who already have insurance at this time due to the complications it would create administratively.