Smiles by Payet Dentistry – Beautiful Smiles. Lifetime Care

Family, Laser, and Cosmetic Dentistry by Charlotte dentist Dr. Payet.

NPR and Dan Ariely on Dentistry

First off, let me say that I have been an NPR supporter (yes, including financial support) for many years, so please do not misunderstand my post and think I am bashing NPR itself.  HOWEVER………I have an axe to grind with Mr. Robert Siegel of All Things Considered, the evening news program that used to be one of my favorite programs for the drive home from work. And it all has to do with the particular intervew with Professor Dan Ariely, of Duke’s Fuqua School of Business in Durham, NC, about dentistry, which was aired on Tuesday, October 5th.  Please take a moment to read the transcript:

Copyright © 2010 National Public Radio®. For personal, noncommercial use only. See Terms of Use. For other uses, prior permission required.

ROBERT SIEGEL, host:

Dan Ariely conducts experiments, too. He’s a professor of psychology and behavioral economics at Duke, where he does research into our predictably irrational behavior. And he comes on the program from time to time to share his research.

Today, Dan Ariely on irrationality at the dentist’s office.

Professor DAN ARIELY (Behavioral Economist, Duke University): So, you know, you go to a dentist and the dentist x-ray your teeth and they try to find cavities. And one of the questions you can ask is, how good are dentists, right?

SIEGEL: Mm-hmm.

Prof. ARIELY: So imagine, you came to a dentist, you got your x-ray and then we took your x-ray and we also gave it to another dentist.

SIEGEL: Right.

Prof. ARIELY: And we asked both dentists to find cavities. And the question is, what would be the match? How many cavities will they find, both people would find in the same teeth?

SIEGEL: And I’d really hope it would be somewhere up around 95-plus percent.

Prof. ARIELY: That’s right. It turns out what Delta Dental tells us is that the probability of this happening is about 50 percent.

SIEGEL: Fifty percent?

Prof. ARIELY: Fifty percent, right. It’s really, really low. It’s amazingly low. Now, these are not cavities that the dentist finds by poking in and kind of actually measuring one. It’s from x-ray. Now, why is it so low? It’s not that one dentist find cavities and one doesn’t, they both find cavities, just find them in different teeth.

(Soundbite of laughter)

Prof. ARIELY: And here is what happens. Imagine you’re a dentist and you see a patient, and you really want to find a cavity because you get paid more if you find cavities and you can fix them. And the patient is already on the chair. He’s already prepped. You might give them the treatment right now, really good marginal income for you. How is this motivation to find cavities will influence your ability?

Now, you look at an x-ray, which is a little fuzzy and unclear and there are shadows and all kinds of things are happening. What happens is this unclarity, thus the x-ray helps in some sense the dentist to interpret noise as signals and find cavities where there aren’t really.

SIEGEL: And fill them?

Prof. ARIELY: And fill them, and drill them, expand them. I don’t think they ever tell their patients, hey, I thought it was a cavity but turns out it was just a mistake.

(Soundbite of laughter)

Prof. ARIELY: But they do fill them.

SIEGEL: You’re describing a very private relationship between patient and dentist.

Prof. ARIELY: Yes.

SIEGEL: You’re telling us we should, on average, expect our dentist to be getting it wrong on the x-rays, but that’s not how people feel about their dentists, right?

Prof. ARIELY: That’s right. And the dentists actually have a tremendous loyalty. People are really loyal to their dentist, much more than other medical profession. And I think one of the reasons we go back to cognitive dissonance. Cognitive dissonance is the idea that when people do something painful, they become more committed to the goal. If we have a fraternity and we haze people in a more difficult way, they become more loyal to the fraternity.

SIEGEL: You have dentistry as a hazing experience right now.

Prof. ARIELY: That’s right. And I think the same thing happen with dentists. Dentistry is basically the unpleasant experience. They poke in your mouth. It’s uncomfortable. It’s painful. It’s unpleasant. You have to keep your mouth open. And I think all of this pain actually causes cognitive dissonance and cause higher loyalty to your dentist. Because who wants to go through this pain and say, I’m not sure if I did it for the right reason. I’m not sure this is the right guy.

(Soundbite of laughter)

Prof. ARIELY: You basically want to convince yourself that you’re doing it for the right reason.

SIEGEL: Every visit to the dentist is an episode in the Stockholm Syndrome here, is what you’re describing. You studied these dental insurance records and you looked at what happens over time as our relationship with the dentist grows over many years, and you find it affects the kinds of decisions the dentist and the patient make, the choices.

Prof. ARIELY: That’s right. So you can imagine that at some point in your dental treatment, you have a choice between things that have the same possible outcome, but one of them is more expensive to you and better financially for the dentist. Which one would you choose and how the duration of relationship be affecting that?

And it turns out that the more time people have seen the same dentist, the more likely the decision is going to go in favor of the dentist. People are going to go for the treatment that is more expensive but has the same outcome. More out of pocket for them, more money for the doctor. So in this case, loyalty actually creates more benefit for the dentists.

SIEGEL: More expensive filling material, for example.

Prof. ARIELY: That’s right. That’s right.

SIEGEL: Well, Dan Ariely, thanks for talking with us again.

Prof. ARIELY: My pleasure.

SIEGEL: Dan Ariely, professor of psychology in behavioral economics at Duke University. His book is “The Upside of Irrationality,” and he talks with us about our rational and irrational decisions from time to time on ALL THINGS CONSIDERED.

Copyright © 2010 National Public Radio®. All rights reserved. No quotes from the materials contained herein may be used in any media without attribution to National Public Radio. This transcript is provided for personal, noncommercial use only, pursuant to our Terms of Use. Any other use requires NPR’s prior permission. Visit our permissions page for further information.
NPR transcripts are created on a rush deadline by a contractor for NPR, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of NPR’s programming is the audio.

Now…….as you can imagine, this has created quite an uproar among dentists, and especially among those of my colleagues and I who have long considered NPR to be a source of (mostly) unbiased and reliable news, as Professor Ariely, whose field in Behavioral Psychology, in 1 fell swoop, condemns all dentists as money-hungry, greedy, unethical, and incompetent!

Of course, there are several problems with this interview that I would like to address:
  • As far as we can tell, Professor Ariely has absolutely NO background in dentistry, nor has anyone been able to learn where he learned to read and evaluate x-rays.
  • No one has yet been able to find any published research by Professor Ariely on this topic, so we really don’t know where he’s pulling this stuff out of, except probably his a**.  😦
  • Please read the quote below, from Delta Dental’s Director of Public Relations (posted on another blog), especially the underlined text (my emphasis).  So……if Delta Dental did not provide the alleged research, where did Professor Ariely get it?
We’re normally fans of Dr. Ariely’s work, but he should not have made reference to Delta Dental when stating that 50 percent of the time dentists will interpret x-rays differently. Delta Dental has no data that could lead to any such conclusion. Delta Dental processes 84 million claims a year for 54 million customers, so obviously we’re interested in making sure those claims are accurate. That’s why we employ dentists throughout the country to review claims for accuracy. Still, we understand that conclusions made in the medical arts, like other arts, are prone to some degree of subjectivity and interpretation. Assuming otherwise would just be irrational.

Thanks,
Chris Pyle
Director of Public Relations
Delta Dental Plans Association

  • No one can seem to find any published research on how dentistry can be related to the Stockholm Syndrome, either.
  • Professor Ariely made no mention of any research that he evaluated as to whether or not the alleged research, allegedly from Delta Dental.  Hmmmmm, kind of one-sided.
  • Professor Ariely has a new book out that he wants to sell lots of copies of……….hmmmmm, no conflict of interest there, right?

So, according to Professor Ariely, all of our Patient Reviews are just because they were somehow pressured into it?  And all of their problems were made up by me so I could make money?  Wow, who knew!  I thought it was because my team and I do our best to make our patients comfortable, take care of their problems at a time and pace that is comfortable for them?  And the lady I referred to another dentist today, because I know he can do better dentures than I can……what in the world was I thinking, doing the right thing for her like that?

Ah well………can you tell I’m fired up?  Let me just say in closing: I love dentistry and I love taking care of people.  That’s why I invest so much time and money in improving myself and my skills every year, as well as in making sure we have leading technologies and techniques to make appointments faster, more comfortable, and just better.  No matter what some Duke Professor says.

October 11, 2010 Posted by | Broken tooth, Bulimia, Cavities, Cracked tooth, News You Can Use, Why Dentistry Fails | , , , , , , , , , | Leave a comment

Dr. Oz talks about Periodontal (Gum) Disease and Total Health

I guess it’s because I don’t watch a lot of TV, but I confess that – until quite recently – I had absolutely no idea who this guy Dr. Oz is.  A friend recently told me that Dr. Oz has some really good material about dental health that can be shared, and since it’s sometimes easier to use someone else’s material instead of having to write it all from scratch myself  🙂 , I figured I’d check it out, and WOW!  I’m impressed!  It’s sad to say, but many physicians really have no idea about how the health of the mouth is connected to the rest of the body, and how valuable their dental colleagues can be in diagnosing a number of medical conditions.  Dr. Oz is definitely not one of them!  I’ll kick things off here with one of his articles.  I have added some bold italics for emphasis (all mine).

The Mouth as a Marker for Disease:

Added to Articles on Tue 09/29/2009
The eye might be a window to your soul, but the mouth is the door to disease. While it might be hard to make the connection between tooth loss and a heart attack, what goes on in your mouth can foreshadow many diseases.

Pocket Watch

One look inside the mouth will reveal that there are bacteria everywhere. For the most, part we cohabitate without a worry – but badly-behaving bacteria can collect in gum pockets to cause swelling, bleeding and bone loss that in turn can cause teeth to loosen and fall out.

People with gum disease (periodontal disease and gingivitis), may harbor up to 500 species of bacteria, and the proximity of that bacteria to the normally sterile bloodstream can be worrisome. Bacteria can enter small blood vessels, travel to other parts of the body and release toxins and trigger inflammatory chemicals that assault arteries and organs. Gum disease and tooth loss is now considered a harbinger for coronary artery disease, infective endocarditis, bacterial pneumonia, diabetes, kidney disease and stroke. Periodontal bacteria have also been detected in the mouths and amniotic fluid of women who have experienced threatening premature labor, miscarriage and may contribute to low-birth weight.

Breath Tests

Breath can be telling too. More than 90% of the time bad breath (halitosis) emanates from bacteria living in gum pockets, under dentures and on the surface of the tongue. It is not only unpleasant to people close to you, but it may also be a clue to other medical conditions.

Oral cancers, lung cancer, certain leukemias and dry mouth syndromes such as Sjogren’s syndrome can cause bacterial overgrowth that contribute to bad breath. And sometimes a systemic disease produces distinct chemical odors:

  • Sweet or fruity odor may indicate uncontrolled diabetes
  • Mousy ammonia odor may indicate liver disease
  • Urine-like fishy odor may indicate chronic kidney failure
  • And fecal odor may indicate intestinal blockage.

To find out if you have foul-smelling breath, ask a truthful friend, or lick your hand and smell the saliva.

Tongue Tip-off

Changes in the tongue can also be a tip-off to disease. A pale, smooth, flattened and sometimes tender tongue can point to iron or vitamin B12 deficiency, a hallmark of the common blood disorder, iron-deficiency anemia. People with Crohn’s disease and ulcerative colitis may notice tiny ulcers. If the tongue looks like a geographic map with areas of dark and light it may indicate an autoimmune disorder such as psoriasis or discoid lupus erythematosus. Recurrent episodes of white patches indicate thrush, an overgrowth of the yeast Candida, which may indicate diabetes. Strawberry red swollen tongue with a white coating and big red bumps is a symptom of Kawasaki disease.

Telling Teeth

Hairline cracks in the teeth can indicate tooth-grinding, the sleep disorder bruxism or mental stress. People with bulimia have enamel loss on their front teeth from the assault of stomach acid from repeated vomiting.

Keep Oral Traditions

Keeping up with a good program of oral hygiene and tending to dental and gum problems before they worsen is key to keeping mouths healthy. People with declining dexterity may need to make modifications that assure that good dental care continues. Electric toothbrushes, vibrating gum massagers and dental water jets can help. Routine dental visits are crucial, especially if you are planning to become pregnant or are facing a course of chemotherapy, which can reduce immunity against oral bacteria and cause mouth sores.

Here’s some help for halitosis, guidance for gums and tips for tooth care.

  • Investigate any changes in your oral health
  • Brush in the morning, at night and after meals with a soft toothbrush or African chew stick
  • Use a tongue scraper along the length of the tongue to remove odor-causing bacteria
  • Use an antiseptic mouth rinse
  • Floss between teeth and inside the crease where the gum and tooth meet
  • Keep well hydrated and avoid mouth breathing
  • Don’t smoke or be near someone smoking (that can cause smoker’s breath too!)
  • Try chewing on neem leaves, green cardamom, cloves, parsley, guava peels and gum mastic for breath control
  • Visit the dentist regularly

July 13, 2010 Posted by | Broken tooth, Bruxism & Parafunction, Bulimia, Cavities, Cracked tooth, GERD/Acid Reflux, Migraine headaches, News You Can Use, Periodontal (Gum) Disease, Sleep Apnea, Snoring | , , , , | 10 Comments

Quality Dental Plan: Charlotte’s BEST Dental Discount Plan

Thanks to some connections across the country, I am very pleased to announce another exciting development in our dental practice that we truly believe will benefit patients, and that is the Quality Dental Plan, the first nationwide dental discount plan that is truly designed to be AFFORDABLE to both employers and individuals.  In fact, we plan on going out into the small business community to promote this as an affordable way to offer dental benefits to their employees and for their employees to get better dental coverage than with traditional or even PPO dental insurance.  So just how does the Quality Dental Plan work?

For Employers:

Talk about economical and simple to administrate: all you have to do is pay a 1-time annual fee of $345 per employee……AND THAT’S IT!  You have now provided each employee with dental benefits that far exceed what they can usually get from typical dental insurance.  No monthly deductions, no monthly payments, and I’d bet about anything that you will be paying less than you currently pay for your company’s dental benefits.  It COMPLETELY eliminates your administrative work except that all you have to do is let us know if you add or subtract any employees during the year.  THAT’S IT!  And if you want to add a little more value for your employees, you can sign up their family members for ONLY $195 EXTRA PER PERSON!

Theoretical Employer Scenario:
10 Employees x $345 = $3450 annual enrollment.  You’re done.  🙂
Say each employee has 1 family member, so you decide you want to cover them, too.  So 10 family members x $197 = $1970; so now you’ve paid a TOTAL of $5,420 and ALL of your employees and their 1 family member now are members of the Quality Dental Plan and have benefits in our office.  And you’re done!  🙂

Individuals/Families:

If you read the scenario for employers above…..it’s the same idea.  All you do is pay $345 annually to enroll, and you only add $197 extra per family member per year.  So you can enroll a family of 4 for a TOTAL of $936.  So it’s pretty darn simple.

So what do you GET with the Quality Dental Plan?

This is the best part (what you’ve really been waiting for 🙂 ):

  • Initial Comprehensive Exam, Complete Set of X-rays, and Routine Child or Adult Cleaning
  • At your 6-Month Check-up, you get your Six-Month Exam and Routine Child or Adult Cleaning
  • Free Custom Whitening Trays!
  • And for the entire 12 months following enrollment, you get 20% OFF ALL OF OUR SERVICES WITH NO ANNUAL LIMIT!

Yes, you read that correctly – 20% off all kinds of treatment. Of course, there are some conditions that go along with the deal, but compared to what so-called “dental insurance” companies offer, they’re insignificant.  So let’s compare the Quality Dental Plan with “dental insurance:”

“Dental insurance” – you only get $1,000-1,500 per year, which has to cover your 2 “free” cleanings/exams/x-rays,  and then you get whatever is left.  Maybe a few fillings or 1 crown, and after that it’s all out of your pocket.

OR

Quality Dental Plan: Your 2 routine child/adult cleanings and x-rays and exams are all included in your enrollment fee, and thereafter 20% off everything with NO LIMITS.   Say you need 5 crowns, well, you get 20% off of each crown, which means that by the time you’ve paid for 4, the last one is almost free when looking at our standard fees.  10 veneers?  20% off!  Six-Month Braces?  20% off! Say you need 5 crowns, 10 veneers, AND Six-Month Braces?  20% off EVERYTHING.

Ok, so you may be thinking, “What’s the catch?  Why does Dr. Payet do this?”  Well, it’s for a few simple reasons:

  1. It SERIOUSLY simplifies our administrative work, ’cause we don’t have to deal with insurance companies (that’s reason enough to do it right there, honestly).
  2. When you’re able to afford the treatment you want and need, it keeps me busier (my staff much prefers that to me being bored and stir-crazy).
  3. It does help you afford the treatment you want and need.

August 24, 2009 Posted by | ANNOUNCEMENTS, CEREC CAD/CAM, Cosmetic dentistry, Dental Care Payment Options, Dental implant(s), Dental Insurance, Dental Office Technology, General dentistry, In-House Dental Discount Plan, LANAP - Laser Surgery for Gum Disease, Laser Dentistry, News You Can Use, PerioLase dental laser, PPO vs. HMO, Restorative dentistry, Short-Term Orthodontics, TMJ and Headache Therapy, Why Dentistry Fails | 3 Comments

Making improvements and updates

As much as I’ve been integrating some awesome new technology into our practice, I’ve also been working to add useful material to my other practice websites and wanted to make sure people take the time to browse through them, too.  I have 2 more websites that I have to get up and running in the very near future, so be on the lookout, but for the moment, I hope you’ll find these 2 sites helpful:

  1. Cosmetic Dentistry in Charlotte by Dr. Charles Payet
  2. General/Family Dentistry by Dr. Charles Payet

August 24, 2009 Posted by | ANNOUNCEMENTS, Cosmetic dentistry, General dentistry, Periodontal (Gum) Disease, Restorative dentistry, Short-Term Orthodontics, TMJ and Headache Therapy, Why Dentistry Fails | Leave a comment

Reuters News story: Cavities and Gum Disease increase risk of heart attack, stroke, diabetes

This article was highlighted by the Academy of General Dentistry warning of the increased risk of heart attack, stroke, and diabetes, among other health issues, due to cavities and gum disease.  See……just because you don’t have a toothache does not mean that your gum disease or cavities aren’t hurting you in other ways!

http://www.reuters.com/article/healthNews/idUSTRE56Q4RM20090727

If you’re concerned about your own overall health but have neglected seeing a dentist to keep these problems from getting out-of-hand, call us today:

704-364-7069  or go to SmilesbyPayet.com to request an appointment.

July 29, 2009 Posted by | ANNOUNCEMENTS, Cavities, News You Can Use, Periodontal (Gum) Disease | , , , , , , , , | Leave a comment

Gold Fillings, Crowns, Onlays for Teeth – still the Gold Standard!

When asked what filling or crown material will last the longest, there is a very simple answer that has held true for over a century now, and it is still true today: Gold crowns, onlays, and dental bridges.  Plain and simple, as much as I love doing cosmetic/esthetic dentistry with the ceramic materials available today, I still feel confident that NOTHING will last as long as a gold tooth restoration.

To tell the truth, I haven’t always felt that way, but I’ve come to that conclusion based on 11 years of seeing dental work that works over the long-term.  For many years after graduating dental school, I never did gold restorations except in extreme situations where it was the only realistic material.  But I have seen too many gold crowns, gold onlays, gold inlays, and even gold bridges that are 30-, 40-, or even 50+ years old!  While very few dental materials have been in use longer than 30 years, of those, none have had the longevity of gold.  So what are the advantages of gold?

  • It requires minimal drilling of a tooth to have sufficient thickness to be strong – only 0.5mm (trust me, that’s SMALL!)

  • It has the ability to deform slightly over time to match changes in adjacent teeth

  • It can be burnished, or “massaged” hard to the tooth edge to create an amazing seal against bacteria, sugar, acid, etc.  Only in the last few years have porcelains reached equivalent seals, and even then the porcelains require absolutely exquisite bonding technique or they’re doomed to early failure.

So here is today’s example of a tooth with a failing silver/amalgam filling (decay around the edges and deep cracks that could have led to the tooth breaking at an inconvenient time) replaced with a gold onlay:

Family dentist Dr. Charles Payet used a gold onlay to fix a cracked tooth that had an old silver filling.

Family dentist Dr. Charles Payet used a gold onlay to fix a cracked tooth that had an old silver filling.

The gentleman who chose this is around 40 years old, and with regular dental care and the same excellent home care he has, this tooth and gold onlay will probably last until he is no longer in need of teeth any longer.

July 14, 2009 Posted by | Broken tooth, Cracked tooth, General dentistry | , , , , , , , , | Leave a comment

Does dentistry last forever?

This is a question I’m frequently asked, especially when a patient is considering a significant investment of time and money into some form of cosmetic dentistry, such as:

  • Porcelain veneers
  • Bonding (tooth-colored fillings)
  • Porcelain crowns and bridges
  • Teeth whitening
  • Even Six-Month Braces

It’s a very understandable question, and the simple answer to the question, “How long will my dental work last, Dr. Payet?” is “It depends.

Just like a car, your teeth and gums require regular care to ensure that they are working properly.  Sure, you can go 10-20,000 miles between oil changes given how improved cars are nowadays, but do you really want to take the risk?  Same thing with teeth……….some people go for 5-10 years with no dental check-ups and are fortunate when they come in to find no problems, such as cavities or gum disease. But it’s not many people that are so lucky!

I always remember a quote from some lecturer at a dental conference years ago telling us his response whenever a patient asks the question, and it’s really the most honest, best answer that can be given, “Clearly the teeth that God gave you haven’t lasted your entire life, and since I can assure you that my work is not nearly as good as God’s, unless you die first, the work I do (no matter how excellent) will not last forever either.

So what can cause your dental work to fail?

  • Grinding your teeth — when the human jaw clenches, it can create an amazing amount of force, and over time, enough clenching will cause teeth to crack and break.
  • Acidity — anything that increases the acidity in your mouth is good for the bacteria that cause cavities in particular, including Acid Reflux, Sodas, Power drinks (Monster, Red Bull, etc), Sports drinks (Gatorade, Powerade, etc).
  • A very sugary diet — the bacteria that cause cavities love sugar.  High sugar content means the bacteria feed like crazy, produce acid, and the acid is what eats away the teeth to cause cavities.
  • A compromised immune system — your saliva contains important antibodies that help keep the cavity-causing bacteria under control.  If your immune system is knocked back due to a disease or some medication, those antibodies will be decreased, allowing the bacteria to grow uncontrolled.
  • Decreased saliva (dry-mouth syndrome) — again, due to medications or illness, the amount of saliva may be decreased.  With less saliva, there is less “washing” action of the teeth.
  • Trauma — obviously.  LOL  One of my patients a few years ago fainted and fell face-first into a brick wall, shattering a front tooth.  Another ran into a pole, shattering another front tooth.  Clearly, if you are injured in such a way that your natural teeth would break, any dental work will break, too.
  • Bad habits like chewing hard candy or ice regularly — hard candy and ice are just that — HARD!  Ice, in particular, is easily as hard as your enamel and as porcelain or bonding.  So if you bite down on ice frequently enough and/or hard enough, you can break your teeth and dental work.

That covers most of the major causes of dental work failing.  With regular care, use of appropriate mouthrinses and toothpastes, proper brushing and flossing, regularly scheduled check-ups and dental x-rays, using a nightguard, and being aware of diet, etc, your dental work can and should last a very long time.

But always remember — my dental work isn’t as good as the natural teeth God gave you, so my work probably won’t last forever either.  😉

June 30, 2009 Posted by | Broken tooth, Bruxism & Parafunction, Bulimia, Cavities, Cosmetic dentistry, Cracked tooth, Cracked tooth root, Dental Philosophy of Care, General dentistry, GERD/Acid Reflux, Restorative dentistry, Why Dentistry Fails | , , , , , , , , , , , , , , , , , | Leave a comment

A Complete Smile Makeover with Porcelain Crowns for Teeth Damaged by Bulimia

There are many reasons patients come to see me for cosmetic dentistry.  One of the most common reasons is because their teeth are badly worn down from grinding, often in combination with acid erosion that has eaten away at the enamel.  Treating these cases can be complex, because if we don’t properly diagnose and solve the problem that caused the worn, eroded teeth in the first place, then any cosmetic dentistry is sure to fail very fast.

When Jenni (not her real name, as she prefers to stay anonymous) first came to see me through a referral back in 2005 for a Smile Makeover consultation, she admitted that she had suffered from bulimia as a teen, about 20 years prior.  She had recovered from this debilitating disease and had been leading a healthy, normal life for many years, but her teeth had been so eroded that she was extremely self-conscious and embarrassed by her smile.

Since Jenni’s original issue had been addressed medically, we were safe moving forward with a greatly decreased risk of acid erosion causing problems again, although bulimics are at a much higher risk of GERD/acid reflux, so she is monitored regularly by her physician, and she uses a prescription strength fluoride rinse daily to help protect the teeth under the porcelain.

Due to complicating factors, Jenni’s case was just completed this year; however, I think you’ll see why Jenni is now happy with her smile again, although she doesn’t want everyone to know what she had done,  so she has asked me to not use her portrait.

Cosmetic dentist Dr. Charles Payet, of Charlotte NC, performed a Smile Makeover with Porcelain Crowns to Restore these Teeth Damaged by Acid Erosion/Bulimia

Cosmetic dentist Dr. Charles Payet, of Charlotte NC, performed a Smile Makeover with Porcelain Crowns to Restore these Teeth Damaged by Acid Erosion/Bulimia

May 25, 2009 Posted by | Bulimia, Cavities, Cosmetic dentistry, GERD/Acid Reflux, Porcelain Crowns, Porcelain Veneers, Porcelain-and-metal crowns, Smile Makeover | , , , , , , , , , , , , , | 1 Comment

Just how outrageous is dental “insurance?” Check this out!

As a practicing dentist for almost 11 years now, in a practice that does accept assignment of dental insurance benefits, I have seen almost every conceivable attempt by dental insurance companies to hold up payment, deny payment, or anything they can do to keep the money that should rightfully help pay for your dental care.  But this one took the cake for me, and I have to share.  Which insurance company?  Metlife.  Seriously……..they said there was not enough missing tooth structure due to decay or fracture on these teeth, and therefore they don’t need crowns.  Are they CRAZY!!!!!?!?!?!?!?

Amazing - a dental insurance company said these broken and decayed teeth don't need crowns.  Can you believe it?

Amazing - a dental insurance company said these broken and decayed teeth don't need crowns. Can you believe it?

May 18, 2009 Posted by | Amalgam/Silver Fillings, Broken tooth, Bruxism & Parafunction, Cavities, Cracked tooth, Dental Insurance, Dental photography, General dentistry, Restorative dentistry | Leave a comment

Baby Boomers – get your teeth fixed before you retire when you still have dental insurance and flex plans to help pay

With more and more Baby Boomers approaching or entering retirement, an issue often not considered is their dental health.  I think it is actually an important topic to discuss, even more so in today’s economy.
Many Baby Boomers – my parents included – have put retirement on hold, but it’s still not all that far away, and with retirement usually comes the loss of dental insurance and the loss of medical/dental Flex plans that can help a lot with covering the cost of dental care.  After that, it’s all out-of-pocket.  Ouch!  So we always recommend a thorough re-evaluation of existing dental work for things that may be on the verge of going bad.  Such things could be:
  • Old silver fillings with cavities and cracks that could turn into root canals and crowns or extractions

  • The teeth around the old silver fillings may have cracks that could lead to broken teeth

  • Gum (periodontal) disease

  • Ugly old crowns that could be replaced for a nicer smile in the golden years

  • Replacing missing teeth with dental bridges or implants so you can eat the foods you want

  • Etc etc etc……

This gentleman hadn’t been to the dentist in a number of years but knew that he was approaching retirement, so he wanted to come in, get a cleaning, and find out if he needed to take care of anything while he still had dental insurance.  Turns out that many of his 30+ year old silver fillings were in really bad condition, with pieces chipping off, cavities forming around the edges, teeth cracking, and gum disease to boot.

While the total treatment that he needed involved some gum surgery (not needed for everyone, obviously), the primary issue that we addressed was to clean out the old fillings and cavities, then rebuild the teeth with all-porcelain crowns on several teeth, 1 tooth got a tooth-colored filling, and 1 tooth got a gold 3/4 crown (most of the tooth, but not the whole tooth is covered by the crown).

He can now rest assured that all of the problems with these teeth are fixed, and it’s likely he will not need any of them ever worked on again as long as he takes good care of them.

Broken silver fillings with cavities, fixed with porcelain dental crowns, a gold dental crown

Broken silver fillings with cavities, fixed with porcelain dental crowns, a gold dental crown

May 6, 2009 Posted by | Cavities, Dental photography, General dentistry, Porcelain Crowns, Restorative dentistry, Why Dentistry Fails | , , , , , , , , , , , , , , , | Leave a comment

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