Smiles by Payet Dentistry – Beautiful Smiles. Lifetime Care

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

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

Is There a Comfortable Treatment for Periodontal (Gum) Disease? YES!

I just got off the phone with one of our patients from yesterday for whom we had done LANAP, also known as Laser Periodontal TherapyTM, as I wanted to check and see how she is doing today.  And even though I have heard the same exact story practically every single time, I still find it wonderful to hear, and so I wanted to relate it to you (I’ll ask her at her first follow-up appt. next week if she wouldn’t mind doing a short video herself):

Bear in mind……this lady has moderately advanced periodontal (gum) disease, and so when we were doing her treatment yesterday, we had to do a LOT, not just with the Periolase itself, but also with the ultrasonic scaler/cleaner that we use to remove all of the tough tartar build-up; to treat her whole mouth took about 2.5 hours, so she was in our office for quite some time.  Fortunately, she was able to watch Dr. Phil during the procedure, which kept her pretty well distracted LOL.

So what did she say when I asked her how she felt immediately afterwards and also today?  Basically, she said that she took just 1 (ONLY ONE!!!!) 800mg Ibuprofen tablet yesterday “just in case,” but since then, she has had practically no pain, and only a tiny bit of soreness, and she has not had to take ANY further pain medication of any kind!  That is one of the things I simply LOVE about doing LANAP — even though we are treating the gum disease very aggressively, the physical properties of the laser stimulate healing so much and soothe the body so much, that patients are always amazed at how well they feel afterwards. Seriously……think about it…….we really did laser gum surgery for 2.5 hours, and she is having ZERO pain today.

She’s also excited because we will be starting her 6MonthSmiles Clear Adult Braces in just a couple weeks, too, in order to correct the spacing between her front teeth and give her a beautiful smile back.  When I finally get to post the Before/After pictures in just a few months, it will be just incredible to see the difference, so stay tuned!

June 11, 2010 Posted by | 6-Month Smiles, LANAP - Laser Surgery for Gum Disease, Periodontal (Gum) Disease, PerioLase dental laser, Short-Term Orthodontics, Six-Month Braces | , , , , , , , | Leave a comment

Complete Smile Makeover with Porcelain Crowns

A Full-Mouth Smile Reconstruction

Quite some time ago, I showed this case as an example of how badly teeth can be damaged by grinding them, whether at night, in the daytime, or both, and why something as simple and inexpensive as a nightguard (my recommendation is a NTI-tss).  It is especially inexpensive in comparison to the cost of rebuilding a smile that is so broken down.  This gentleman came to us in 2008, looking for options to feel good about his smile again for various reasons.  After plenty of discussion, we agreed that the only option that would truly give him the smile that he wanted was a Total Smile Makeover/Reconstruction with porcelain crowns. After showing the Before-After pictures of his smile, I’ll discuss some of the issues you need to consider if you are thinking about significant cosmetic dentistry for yourself.

Frequently Asked Questions about Smile Reconstruction

When rebuilding a smile such as this, it is crucial to establish a proper bite relationship of the top and bottom teeth.  Sometimes this can take a little while to figure out, because – when the teeth are so worn, the patient has long since adapted to a very bad bite relationship.  The muscles have to be relaxed, accurate records taken, and excellent communication is necessary among the patient, the doctor, and the lab, to ensure that the crowns are made to look good, feel good, and last a long time. However, in severe wear cases, we always remind the patient that s/he already did a pretty good job destroying their natural set of teeth, so a nightguard is an absolute requirement as “insurance” to protect their investment, and even then they are more likely to break or chip the porcelain than others who don’t have that history.  Simply put, these cases are far more complicated and require a great deal of time to get right, so you need to be absolutely committed to proceeding and working closely with your dentist to get a good result.

  • How Much Does a Smile Reconstruction Cost?

It’s not unusual for a patient to ask why it costs so much to do a Smile Reconstruction like this; it often seems like there should be a “volume discount,” so-to-speak, when doing a lot of crowns instead of just 1 or 2.  The difference between such scenarios is the amount of time involved, the skill, training and experience required to successfully diagnose, complete, and treat, and that your dentist will have to work with a highly knowledgeable lab to make the crowns to not just look good, but fit properly and work smoothly in eating motions.  Your dentist will likely spend at least a couple hours just in the planning stages!  It’s usually a case of “You get what you pay for.”  IOW – if you want a cheap smile makeover, you should reasonably expect a cheap outcome.  To get excellence……it won’t come cheap.  Depending on various factors, a case such as this will be the equivalent of buying a fairly nice car.  The main difference, of course, is that you should expect to be “driving” your smile for a lot longer than most people keep a car!

  • How Long Will This Take to Finish?

When doing so many teeth, you need to plan on a minimum of several appointments that could take 1/2-day to a full day each, as well as several other appointments to refine, modify if needed, polish, etc.  From beginning to end, if everything goes perfectly, you might be done in as little as 1 month.  That would be somewhat rare; more likely, you should plan on the entire process taking at least 2 months, and maybe many more.  Extremely complex cases that involve implants, different specialists, and very complicated lab work may take a year or more due to the time needed for healing, verifying each stage is correct, and even just the time needed for lab technicians to do the custom work.

  • What kind of Crowns will/should you get?

Due to improving materials and with the right techniques, in most cases nowadays you can have all-porcelain crowns made to rebuild a smile.  The crowns used in this case are made of E.max porcelain, which is extremely strong and resistant to breakage.  Numerous studies now show that this type of porcelain will likely last for 15-20 years, and quite possibly longer.  For certain cases, though, and for patients who are even worse grinders than this gentleman was, gold crowns might still be necessary for the back teeth, simply because they are the strongest, longest-lasting crowns available.  They can also take more abuse than any other material.  Porcelain-to-metal crowns are also an option and have a long track record, but it is very important for the lab to be highly skilled so that you don’t see dark grey lines at the gum from the metal showing through.

  • How Do I Choose the Right Dentist?

This is one of the trickiest questions, because the public doesn’t usually know enough about the training necessary beyond dental school that trains dentists to handle complex full-mouth reconstructions with skill and confidence.  But here’s my recommendation: ask to see pictures of their other cases that might be similar to yours.  That’s one of the reasons digital photography is such an instrumental and daily part of our dental practice – you will be able to see similar cases and know how the outcome will be before ever committing.  The large majority of dentists who are well-trained in these cases also use digital photography, both for communicating with you as well as for documenting and tracking their own work over time.  If you meet a dentist who can show you pictures of cases that were completed 5-10 (or longer) years ago AND s/he has recent follow-up pictures to show how well it has held up, THEN you should feel very confident that your dentist can take good care of you.

And then start imagining how much better you’ll feel when you can smile like Wayne does now!

Please feel free to ask questions or post a comment below, or to share with your friends!  If you’re interested in a Complimentary Consultation in our office, please call 704-364-7069 or Request an Appointment Online.

March 7, 2010 Posted by | Bruxism & Parafunction, CEREC CAD/CAM, Cosmetic dentistry, Dental photography, Porcelain Crowns | , , , , , , | 1 Comment

2.9 Month Braces by Charlotte dentist Dr. Payet

As much as people are often amazed at the idea that we can give them a straight smile with Six-Month Braces, there really are times when it doesn’t even take THAT long.  Take a look at Karim’s before and after pictures — literally, we put her brackets on back on September 9th, and we took them off today, November 24th.  That’s NOT EVEN 3 months with braces on, but look what a difference!  As she put it….”I love the results!”

November 24, 2009 Posted by | 6-Month Smiles, Cosmetic dentistry, Short-Term Orthodontics, Six-Month Braces, Teeth Whitening | , , , , , , , , , , , , , , | 1 Comment

Six-Month Braces: Case in Progress

People often have difficulty believing that we can really move teeth to create a more beautiful smile in only 6 months. Here’s a case to show just how well it works – Lynn has only had her almost invisible braces on for 2 months, and look how far the gap between her front teeth has closed already!

Closing the gap between front teeth with 6-Month Braces

October 28, 2009 Posted by | 6-Month Smiles, Cosmetic dentistry, Six-Month Braces, Smile Makeover | , , , , , , | Leave a comment

Best Treatment for Gum Disease

It’s easy for me to tell you that Laser Periodontal TherapyTM is both effective and comfortable, but we both know that it’s easier to believe when you talk to someone who has actually been through it.  So, right after we finished up treating a really sweet patient yesterday, we asked her if she wouldn’t mind recording a short video so our other patients could hear directly how easy it was.  That said, let me introduce you to Milli:

October 25, 2009 Posted by | LANAP - Laser Surgery for Gum Disease, Patient Testimonials, Periodontal (Gum) Disease, PerioLase dental laser | , , , , , , , | 1 Comment

Periodontal disease and Erectile Dysfunction? Seems crazy, but just maybe connected!

Wow – this one even surprised me!  Check out this summary of a recent study from the Journal of Sexual Medicine:

Erectile dysfunction might be associated with chronic periodontal disease: two ends of the cardiovascular spectrum.

Zadik Y, Bechor R, Galor S, Justo D, Heruti RJ.

Center for Health Promotion and Preventive Medicine, Medical Corps, Israel Defense Forces, Zrifin, Israel. yzadik@gmail.com

INTRODUCTION: Both chronic periodontal disease (CPD) and erectile dysfunction (ED) are associated with cardiovascular disease and its risk factors, including smoking and diabetes mellitus. However, the association between ED and CPD has never been studied. AIM: To study the association between ED and CPD. MAIN OUTCOME MEASURES. Prevalence of ED, prevalence of CPD, ED severity. METHODS: The study population consisted of 305 men who filled the Sexual Health Inventory for Men (SHIM) questionnaire in order to detect ED and assess its severity, and underwent a pair of standardized posterior dental bitewing radiographs in order to detect CPD. SHIM questionnaire scores 21 or less represented ED. Alveolar bone loss of >or=6 mm represented CPD. RESULTS: The mean age of included men was 39.5 +/- 6.7 years. Overall, 70 (22.9%) men had ED and 13 (4.3%) had CPD. CPD was significantly more prevalent among men with mild ED (P = 0.004) and moderate to severe ED (P = 0.007) in comparison to men without ED. CONCLUSIONS: ED might be associated with CPD. These preliminary findings are consistent with theories that associate these conditions with systemic inflammation, endothelial dysfunction, and atherosclerosis.

Ohhhhh, and I apparently forgot to mention (Oops! 😉 ): if periodontal disease is something you need treated, and you want the absolute best treatment currently available, please request a Consultation/Exam with us by either of the following ways:

Call 704-364-7069,

OR

Request an Appointment Online

September 18, 2009 Posted by | ANNOUNCEMENTS, LANAP - Laser Surgery for Gum Disease, Periodontal (Gum) Disease, PerioLase dental laser | , , , , , , | Leave a comment

Want more info on LANAP, the PerioLase, and Gum Disease Treatment in North/South Carolina?

Ok, then you’re in luck!  Here is a video that will give you pretty good information about periodontal (gum) disease in general, as well as about conventional non-surgical and surgical treatment options, and then about LANAP (Laser-Assisted New Attachment Protocol).

Something very important to know: the Periolase MVP-7 dental laser, made by Millenium Dental Technologies, and for which the required training is provided by the Institute for Advanced Laser Dentistry (IALD), is the ONLY dental laser available that can be used with LANAP.  DON’T BE FOOLED INTO THINKING THAT ANY OLD LASER CAN DO THIS! There are only 4 doctors in Charlotte, NC (as of today September 17th, 2009) who can offer this treatment to you, including me; make sure it’s the real deal.   Dr. Robert Gregg and Dr. Delwin McCarthy, who founded Millenium Dental and developed the Periolase and LANAP, are passionate about protecting patients from harm by dentists who don’t have the right background or understanding of lasers, which is why they patented the protocol with the FDA.  Only doctors who complete the initial 3 days of training receive a license and laser.

September 17, 2009 Posted by | LANAP - Laser Surgery for Gum Disease, Laser Dentistry, Periodontal (Gum) Disease, PerioLase dental laser | , , , , , | 6 Comments

New tooth-colored fillings sensitive? They should not be!

When most people think of “bonding,” they are thinking of tooth-colored dental fillings, or composite fillings.  To be completely technical for a moment (I try to avoid that as much as possible to not bore you 😉 ), “bonding” is actually the series of steps and the products we dentists use to make the tooth-colored fillings actually STICK to the teeth.  OK – technical moment is over.  Whew, aren’t you glad of that?

An issue that many patients have experienced in the past, is that their new tooth-colored fillings seem to be mildly or even extremely sensitive to cold, and sometimes hot, foods and drinks, even just to tapping your teeth together.  Naturally, it’s not a fun experience, and one that all conscientious dentists try to avoid for their patients, but even in 2009, when one would imagine there is a solution, many patients still run into this problem.  Here’s the thing, though……..THERE IS A SOLUTION!

OK, you’re probably asking, if there’s a solution, why is it still a problem?  Well, it’s simply a matter of technique, really, and getting the technique for bonding is actually more difficult than it might seem to be.  In addition, just as in the rest of the world, there are MANY bonding products that dentists can use when doing tooth-colored fillings, but just because the companies that produce them supposedly have research behind these products, they’re not all they’re always promised to be.  Some work better than others in strength, sensitivity, durability…..and it can honestly be rather tough to sort through all the stuff that companies throw at us, just like for physicians with all the stuff pharmaceutical companies throw at them.  So it is CRITICAL that dentists really stay up on the latest research, but here’s the thing…..just because something has the “latest and greatest, newest and most improved,” labels all over it, that doesn’t mean it actually works as well as the old stuff all the time.

There’s one other REALLY CRITICAL FACTOR for long-term success of composite fillings, and that is keeping the teeth DRY while the bonding is placed and activated, then the filling material is layered into the tooth. Saliva contamination is one of the most common reasons for bonded fillings to be sensitive, and it’s also one of the most common reasons bonded composite fillings fail earlier than they should.  There are a couple techniques dentists can and SHOULD use to do this – a Rubber Dam or something like the Isolite2 Dryfield Illuminator system.  Both are pretty inexpensive for the dentist to have (we have both and use them as appropriate), both are pretty easy to use, and to tell the honest truth, they actually make it EASIER for us to complete your dental work faster and with better results.  I really don’t know why not all dentists use 1 or the other; I can’t imagine practicing without them, ’cause it’s a lot harder to get good fillings!

So there you go: 2 of the most common reasons why bonded, tooth-colored, composite fillings are often sensitive to hot and cold foods/liquids or even just tapping your teeth together.

The good news in our office?  I’m fortunate to actually know the man who basically INVENTED bonding, and I not only use the techniques he teaches, but I even use the most current materials that he himself has developed and/or recommends, and I can honestly say that ALMOST NOONE who gets tooth-colored fillings in my office ever has hot/cold sensitivity afterwards.  There are rare exceptions, ’cause I’m not going to claim perfection, but they’re quite rare indeed.

September 3, 2009 Posted by | Composite/Tooth-Colored Fillings, General dentistry, News You Can Use, Restorative dentistry | , , , , , , , | Leave a comment

Treating Gum Disease with a Laser – Effective, Comfortable, and No Scalpel or Stitches!

I’ve been really updating my website to reflect the exciting new technologies that we’re implementing here at Smiles by Payet Dentistry in Charlotte, NC, so I wanted to let people know about that here so they can be updated: Laser Treatment for Gum Disease in Charlotte NC.  In addition, now you can visit our website devoted strictly to Periodontal (Gum) Disease Treatment with LANAP.

August 17, 2009 Posted by | ANNOUNCEMENTS, LANAP - Laser Surgery for Gum Disease, Laser Dentistry, Periodontal (Gum) Disease, PerioLase dental laser | , , , , , , , | Leave a comment

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