West Palm Beach Dentist Carlos Boudet, DDS DICOI
Cosmetic Implant and Laser Dentistry
Phone (561) 968 6022
Located at 1840 Forest Hill Blvd Suite 204
West Palm Beach, Florida. 33406
From left to right: Marlen, Gladys,Yohanka, Jeannie and Dr Boudet
I have never been more proud of my office staff than I was
today.I can be a little demanding
sometimes with office matters, and some of my ideas have met with some
resistance before, but when I told everyone that I wanted to open the office
for a whole day of free dental care to needy individuals in the community,
everybody was supportive and excited about the idea of giving a little bit to
others without expecting anything in return.
I consider myself lucky to have found these individuals
because they help me make my day run smoother and allow me to still be in love
with my work.
My staff today worked non-stop and I saw a genuine interest
in their eyes to help everyone and make them comfortable.When we first got to the office and saw the lobby
was full of people sitting around waiting to be seen I wondered whether we had
bitten more than we could chew.Then I
saw my staff go to work without a word from me.
Gladys became the patient coordinator and interviewed each person to
determine what services they needed.I
did not think we could do it, but thanks to her great scheduling, at the end of
the day we had seen 36 patients.
Marlen was incredible and I have no idea how she could clean
and setup the operatories, run the autoclave constantly to replenish the
sterile instruments and assist chairside with the procedures.
My wife Jeannie helped everywhere and kept things running
smoothly taking radiographs and working in the front desk.
Our hygienist for a day, Yohanka, volunteered her Wednesday off
to provide cleanings and was very much
appreciated by the patients and all of us.She was a real asset, blended right in even though the cavitron leaked
and she worked in an unfamiliar environment, all with a smile on her face.
Last but not least was the wonderful help that we received
from periodontist Phil Kohn who worked side by side with us in the morning.Phil is not only a great periodontist, but a
great person as well.
I would also like to thank the media that helped spread the
word and brought so many people to our door that made this day a success and
made us at the end of the day a tired bunch of happy people.Thanks to El Latino weekly newspaper and Channel
12 news!
Here is the channel 12 video coverage:
Best wishes to all for a happy and healthy Christmas and new
year!
Free Dental Care Day in West Palm Beach
As a West Palm Beach Dentist our office has given away free dental care before and although it has been a very rewarding experience, we have found it very hard to select one individual to receive free dentistry from among the many that contact us.
This year we have decided to open the office December 19th to provide free dental care all day long to needy individuals.
The office will open at 8:30 AM for registration on a first come first served basis and will provide free dental services for those that cannot afford dental care. Free dental services will be provided until 5:00 PM.
Our office is located at 1840 Forest Hill Blvd Suite 204 in West Palm Beach, FL 33406.
You can find additional information about our office at our website.
Merry Christmas and best wishes for the new year.
Carlos Boudet, DDS, family and staff
Antibiotics are among the most useful drugs available today, and also some of the most commonly prescribed.They are a type of drugs called antibacterials, and can either kill bacteria, (Bactericidal) or stop their growth (Bacteriostatic).
There are many diseases caused by bacteria such as tuberculosis, pneumonia, syphilis, etc… and antibiotics have been used with great success against these infections.There are however many infections such as the common cold (and many upper respiratory infections) that are caused by viruses.Antibiotics do not work against these viral infections, but many of us still go to the doctor and pressure him or her into prescribing antibiotics.
Sometimes antibiotics are prescribed to prevent an infection (prophylactically) such as before orthopedic surgery or to prevent endocarditis in cases of artificial heart valve recipients.
Taking an antibiotic unnecessarily can increase the chances of creating resistant bacteria that are not affected by these drugs anymore,it can also kill the normally harmless bacteria in the gastrointestinal system and lead to infections by opportunistic organisms such as yeast infections.Taking them for only two or three days can also be harmful, as it may not be enough to get rid of the infection, and it may leave bacteria that are resistant to that antibiotic in the future.
One common misconception about antibiotics is that it is ok to take an antibiotic you found in the medicine cabinet that was prescribed to you or a family member.The truth is that antibiotics need to be selected according to the bacteria you need to kill.Taking the wrong antibiotic for an infection will not help to control it and may actually do more harm than good.
Let’s talk about side effects.Like many other drugs, even the mildest antibiotics can have side effects.The most common side effect happens when you take antibiotics for a long time.The antibiotic starts to kill the naturally occurring bacteria in your digestive system that helps with food digestion and results in diarrhea.Also associated with long term use is superinfection with opportunistic organisms such as yeast which can cause oral candidiasis (thrush) and vaginitis.
Another potential concern is the interaction with food and other drugs, for example, antibiotics may reduce the effectiveness of oral contraceptives, and drinking milk or antiacids may reduce the absorption of the tetracyclines .
In order to get the best results when taking antibiotics you should do the following:
·Read the instructions on the label and take as directed
·Read the accompanying information for side effects, precautions and interactions
·Take the antibiotic until it is all gone
By taking antibiotics properly and only when indicated, we will be able to keep relying on these drugs to do a great job helping our bodies fight infections that at times could be life-threatening.
Carlos Boudet, DDS DICOI
1840 Forest Hill Blvd Suite 204
A patient presented to my office seeking help for a loose anterior bridge on implants. He goes to another dentist, but had come to my office previously for another implant related problem.
A visual inspection and a periapical x-ray showed a 4 unit bridge retained by implants placed in the maxillary central incisor positions 8 and 9 respectively (the two upper front teeth). The implants were placed extremely deep under the bone and needed 7 mm long standard abutments (posts) to bring the connection to the correct revel about 1 mm subgingivally. The bridge was loose, and the radiograph showed that the screw that attached to the left implant was broken inside the implant. The abutment had fallen out and the patient brought it in his hand.
This is a rare occurrence with today's dental implants, but these implants were the original Branemark implants and had been placed 23 years ago in 1989, and were more prone to screw loosening and fracture than the implants we have today.
Fortunately for the patient, the screw was not threadlocked and was fairly easy to remove, allowing the patient to repair the bridge with a new screw, which I was surprised it was still available from the manufacturer.
Below is a video of the procedure taken through the surgical microscope:
Carlos Boudet, DDS DICOI
1840 Forest Hill Blvd Suite 204
The article discusses the importance of propper treatment planning in dental implant cases to avoid situations where the patient is given a prosthesis that is problematic and how upgrading from a removable overdenture that kept breaking to a fixed partial denture supported by implants provided the patient with a solution that was both durable and comfortable.
A link to the digital edition of the article can be viewed on page 113 here:
The latest edition of Chairside Magazine (digital version) has just been posted, and in it is my new article on Digital Impressions For Implants Using Scannable Abutments.
Digital impressions using intraoral scanners are going to be the way impressions will be done in the future. They are here today, but due to the high cost of equipment and training, it is difficult for most dentists to afford them.
We have had digital impression systems since 1987 when the first Cerec machine became available, but we have not had the ability to scan implants the same way until recently.
The article explains the simplicity of the process using the Cerec red cam system of digital impressions.
The Relationship Between Snoring, Sleep Apnea And Your Health
I have been suddenly awoken more than once by my wife’s gentle nudging saying that I am snoring loudly and the noise wakes her up or doesn’t let her go to sleep.Luckily it only happens when I have a problem with nasal congestion and I end up breathing through my mouth at night. Sometimes snoring is so severe that it affects relationships and your sleeping partner chooses to go to another room in order to get a good night's sleep.
It is estimated that about half of the population in the states snore, and that percentage increases with age and obesity, so this is a very common problem.
So what! You might say, what is a little noise during sleep, it is only an annoyance that my wife (or husband)has been able to accept about me and does not complain about it any more.Well, it is well documented in the medical literature that a percentage of those of us that snore, do so because of a condition called Sleep Apnea.In Sleep Apnea the individual stops breathing during sleep at frequent intervals, and this causes lack of oxygen to all parts of the body.Over time the circulation to the brain is affected and leads to narrowing of blood vessels that can cause a stroke and even death.This is not a minor nuisance anymore.
Sleep Apnea is diagnosed with a Sleep Study or polysomnogram requested by your physician that records the number of times that you stop breathing during the night, and how long your breathing stops.Signs that may indicate that you suffer from sleep apnea are sleepiness during the day, irritability, lack of focus and decreased libido to name a few.If you are diagnosed with sleep apnea, your physician will recommend a CPAP machine.It looks like a small reversible vacuum cleaner and has a hose with a mask that attaches to your nose and forces air under pressure to keep your airway from closing so you can breathe without interruptions.
Those persons that have severe sleep apnea, need that machine and CPAP works great for them,however, those with mild to moderate sleep apnea find the machine cumbersome and difficult to tolerate.It is those individuals that can benefit from oral appliance therapy.The appliance is made by your dentist, and moves the jaw forward opening up the airway to prevent an obstruction.Many persons that tried and stopped using the CPAP machine resort to and do well with the oral appliances.
The purpose of this writing will be fulfilledif I have made you aware of the fact that snoring may be an indication that you, your friend or relative have an undiagnosed condition called sleep apnea that may lead to serious and even life threatening health problems, and that this condition can be easily treated by your physician and dentist and result in an improved quality of life.
Please talk to your physician or dentist if you think you are at risk.
The recent publicity given to the subject of radiation exposure in dentistry and the new CBCT scan technology prompted the ADA's Council on Scientific Affairs to come up with a statement and principles for the safe use of CBCT scans in dentistry.
The statement explains that although CBCT scans produce a higher radiation dose that routine dental x-rays, this dose is significantly lower than the one produced by a medical CT scan.
The dental CBCT units are also capable of further reducing radiation exposure by reducing the area exposed ( also called FOV or field of view).
There have been many measures taken to provide guidance in the safe use of CBCT in dentistry, such as position statements6,7 and professional guidelines for CBCT use.4,8 Recommendations for adequate operator education have been published.1,6
The guidelines state that children are more sensitive to radiation so "Additional considerations should be weighed prior to the exposure of children and adolescents". Also that CBCT scans should be prescribed only when the diagnostic yield will benefit patient care, enhance patient safety, and significantly improve clinical outcomes.
Another term you may have heard is the ALARA Principle which means “as-low-as-reasonably-achievable” , so the radiation dose for dental patients should be optimized to achieve the lowest practical level for a specific image.
In our dental office, as it should be in general, we try to taylor the recommendations for radiographic images to each individual patient's needs, and patient safety.
HornerK, et al. Basic principles for use of dental cone beam computed tomography: consensus guidelines of the European Academy of Dental and Maxillofacial Radiology. Dentomaxillofac Radiol 2009;38(4):187–195.
PauwelsR, et al SEDENTEXCT Project Consortium. Effective dose range for dental cone beam computed tomography scanners. Eur J Radiol 2012;81(2):267–271.
LudlowJB, IvanovicM.Comparative dosimetry of dental CBCT devices and 64-slice CT for oral and maxillofacial radiology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106(1):106–114.↵
The SEDENTEXCT Project. Radiation Protection: Cone Beam CT for Dental and Maxillofacial Radiology: Evidence Based Guidelines 2011 (v2.0 Final). www.sedentexct.eu/files/guidelines_final.pdf. Accessed May 11, 2012.
LudlowJB, Davies-LudlowLE, WhiteSC.Patient risk related to common dental radiographic examinations: the impact of 2007 International Commission on Radiological Protection recommendations regarding dose calculation. JADA 2008;139(9):1237–1243.
CarterL, et al.American Academy of Oral and Maxillofacial Radiology. American Academy of Oral and Maxillofacial Radiology executive opinion statement on performing and interpreting diagnostic cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106(4):561–562.
Joint Position Statement of the American Association of Endodontists and the American Academy of Oral and Maxillofacial Radiology. Use of cone-beam computed tomography in endodontics. www.aaomr.org/resource/resmgr/Docs/AAOMR-AAE_postition_paper_CB.pdf. Accessed July 10, 2012.
Academy of Osseointegration. 2010 guidelines of the Academy of Osseointegration for the provision of dental implants and associated patient care. Int J Oral Maxillofac Implants 2010;25(3):620–627.
ScarfeWC“All that glitters is not gold”: standards for cone-beam computerized tomographic imaging (published online ahead of print Feb. 3, 2011). Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;111(4):402–408.doi:10.1016/j.tripleo.2011.01.006.
National Council on Radiation Protection & Measurements. Radiation Protection in Dentistry (Report No. 145). Bethesda, Md.: NRCP Publications; 2003.
National Research Council of The National Academies, Committee to Assess Health Risks from Exposure to Low Levels of Ionizing Radiation, Board of Radiation Effects Research, Division on Earth and Life Studies. 2006. Health Risks From Exposure to Low Levels of Ionizing Radiation: BEIR VII phase 2. Washington: National Academy of Sciences, National Academies Press; 2006.
International Commission on Radiological Protection. The 2007 Recommendations of the International Commission on Radiological Protection (publication 103). Ann ICRP 2007;37(2–4):1–332.
National Council on Radiation Protection & Measurements. Structural Shielding Design for Medical Imaging Facilities (Report No. 147). Bethesda, Md.: NRCP Publications; 2004.
The FDA has recently published a recommendation and warning against the use of Benzocaine topical anesthetic ointments that could result in a rare condition called methemoglobinemia.Since their original report in 2006 there have been 29 cases of methemoglobinemia reported and of those, 19 were children, 15 were under two years old.
Benzocaine is a local anesthetic and can be found in such over-the-counter (OTC) products as Anbesol, Hurricaine, Orajel, Baby Orajel, and Orabase.
Mothers with babies that are teething may resort to some of these gels or ointments in an effort to soothe their babies gums, but this can result in the rare but almost always fatal condition.
The FDA recommends that parents and caregivers not use benzocaine products for children younger than 2 years, except under the advice and supervision of a health care professional.
The symptoms can be confused with other problems, here is a list of the signs of methemoglobinemia:
• pale, gray, or blue-colored skin, lips and nail beds
• shortness of breath
• fatigue
• confusion
• headache
• light-headedness • rapid heart rate
If your child has any of these symptoms after using benzocaine discontinue using it and call 911.
As an alternative to ointments, you can use a chilled teething ring or gently rub your child’s gums with a clean finger.
Children present a higher risk, but adults can be affected also.
For the original article by the FDA please see the link below:
• store any products containing benzocaine out of the reach of children.
• use benzocaine gels and liquids sparingly and only when needed. Do not use them more than 4 times a day.
• read the label to see if benzocaine is an active ingredient when buying OTC products. Labels on OTC products containing benzocaine are not currently required to carry warnings about the risk of methemoglobinemia. If you have any concerns, talk to your health care professional before using them.
Is Oral Bacteria Responsible For Your Failing Joints?
Dentists have been well aware for several decades that patients that have a prosthetic joint need special precautions1.A consultation with the orthopedic surgeon usually results in a recommendation for prophylactic coverage with a large dose of an antibiotic taken one hour before the procedure, and only one dose is necessary2.
The precautionary antibiotic prior to the procedure is given in order to protect the patient from transient bacteremia (bacteria in the bloodstream) as a result of the instrumentation, since the mouth harbors many bacteria, and these bacteria can travel through the circulatory system and end up in the joints.The high level of antibiotic present in the bloodstream reduces the chance of seeding the joints (bacteria creating an infection that will cause damage to the joint that could result in prosthetic joint failure).
A similar recommendation for antibiotic prophylaxis has been used for prevention of bacterial endocarditis3 for decades, but anatomy, microorganisms and mechanisms of infection are different.
Also joints with plates, pins and screws do not need antibiotic prophylaxis, only orthopedic hardware that is bathed by synovial fluid is at risk of developing an infection.
Bacteremias can occur during the course of our daily lives, in the presence of acute infections of the oral cavity, gastrointestinal, urogenital and other systems, and may happen during dental and medical procedures such as dental extractions, colonoscopies, and some urologic and endoscopic procedures.
A recent study shows a possible relation between patients with arthritis and failed prosthetic joints and bacteria found in the oral cavity using sophisticated DNA tests4.The authors conclude that patients with arthritis or failed prosthetic joints should be examined for the presence of periodontal disease and given appropriate treatment if necessary.The results of this article and others like it give support to the increasing evidence of a relationship between oral bacteria in periodontal disease and systemic disease.
It is our responsibility as dentists to make sure that we do not get so involved in the technical and mechanical aspects of our profession that we forget to look at the health status of our patients.
Bibliography:
1 Ching DW, Gould IM, Rennie JA, Gibson PH: Prevention of late haematogenous infection in
major prosthetic joints. J Antimicrob Chemother 1989;23:676-680.
2 Antibiotic Prophylaxis for Bacteremia in Patients with Joint Replacements. Information statement. http://www.aaos.org/about/papers/advistmt/1033.asp.
3 Guidelines for the prevention of endocarditis with valvular disease. http://circ.ahajournals.org/content/118/8/887.full.pdf.
4Identification of Oral Bacterial DNA in Synovial Fluid of Patients With Arthritis With Native and Failed Prosthetic Joints. Journal of Clinical Rheumatology: April 2012 - Volume 18 - Issue 3 - p 117–121
Chairside Magazine, published by Glidewell dental laboratories Recently published an article by West Palm Beach Dentist Dr. Carlos Boudet in their spring 2012 issue on dental photography.
The article is an introduction to a simple system of intraoral photography that dentists can use to document their cases, show patients their work and promote their practice.
Dr. Boudet also talks a little about camera choices, patient positioning and gives some tips for better pictures.
The system uses a sturdy digital camera from Pentax and describes the basic shots needed for documentation.
Here is a link to the article: An Introduction To Dental Photography .
Dr. Boudet still uses the camera described in the article, but since the article was written, new models of the camera have come out, so look for the new models now.
The Best Hands On Implant Courses In South Florida
Where can I find a course about dental implants where I can get some experience in treatment planning and placing implants that won’t cost me an arm and a leg?
I get that question from fellow dentists very often, and I am very fortunate to be able to provide them with an answer.
For more than a decade I have been a member of the Atlantic Coast Dental Research Clinic in Palm Beach County, Florida. A non-profit organization started by area dentists over fourty years ago to provide continuing education for it’s member dentists. Today the The Atlantic Coast Dental Research Clinic membership has increased to well over a hundred and allows the dental professional the opportunity to participate in accredited, hands-on courses in modern facilities with state of the art technology located at the Palm Beach State College campus. The goals of the Research Clinic are to provide an opportunity for continuing education of dentists, hygienists and assistants, contribute to the clinical education of the Dental Assisting students enrolled at the college, and to provide low cost dental care for the community.
The twelve dental continuing education courses presently offered give the participants up-to-date, state-of-the-art instruction in practical procedures which will enhance the dentist’s skills and experience in areas such as Periodontics, TMD, Endodontics, Oral surgery, Prosthodontics, Pediatric Dentistry, Orthodontics, Dental Marketing and more, including two participation courses in dental implants.
I have taken almost all the courses and they are great, but let me talk a little about the implant courses since that is an area that I have a special interest in.
The first course is Implants: The Surgical and Prosthetic Management of the Endosseous Root Form Patient. This is a one-year course designed to teach the general dentist how to place and restore implants. Because implants should be treatment planned and placed with the best prosthetic result in mind, the course exposes the dentist to the treatment planning, placement and restoration of endosseous root form implants and does not involve complicated implant placements, sinus lifts, etc….
The course is chaired by Dr. Roy Blake, a prosthodontist with over 25 years of experience and a great teacher.
The second course is Oral Implantology. The Oral Implantology course is a comprehensive three year program consisting of a one year prosthetic and two year surgical residency. There are 21 full days of instruction consisting of a morning didactic seminar and an afternoon clinical session where the general dentist or specialist can gain experience performing surgical or prosthetic procedures on patients. It is patterned after the AAID Maxicourse. This program is also designed to prepare the doctor for AAID, ABOI, and ICOI fellow/diplomate exams.
Also if research interests you, this may be an opportunity to publish a paper as a coauthor in your subject of interest.
These two implant courses will give dentists the chance to get some experience with actual patients in treatment planning and placing implants in a supervised environment, allowing the participating dentist to feel more comfortable implementing these modalities in their own private practice.
It hasn’t even been a year since I wrote an article about a statement by Dr. Oz saying that dental x-rays were related to an increase in the incidence of thyroid cancer.
Now a new study is being quoted saying that there is a higher incidence of meningioma, a benign brain tumor, in people that had dental x-rays and the media is running with it.
The study was based on answers to questions in a survey of over a thousand patients with meningioma. One of the questions asked was whether the patients remembered having dental x-rays taken. The implication here is that x-rays can cause cancer.
In my opinion, this type of study should not even be published, since it does not prove anything, and it only serves to fuel concerns in the general public that, although legitimate, they are often fuel for those that take an exaggerated or extremist point of view.
Let me explain why I say that the study is useless as a scientific paper.
The method by which the study was conducted was a survey where the author asked questions to patients diagnosed with meningioma about their recollection of how many dental x-rays they received during their life including childhood. Also what types of x-rays they received. This type of survey is prone to a tendency of overreporting by the participant. Take my office as an example. I routinely ask a new patient if they had recent x-rays done at another office to avoid unnecessary exposure to radiation and they typically say they had a full series of x-rays, but when we request them, it turns out that they only had two or four bitewings taken.
The study also says that the risk of meningioma rises 3 times more with panoramic x-rays compared to bitewings, but in the same article the author states that panoramic equipment and digital x-rays in use today (which significantly reduce the amount of radiation exposure to the patient) were not available for the participants of the study.
Please watch a news report about the study below:
The reporter correctly describes some of the faults in the reasoning behind the study such as asking persons to recollect the types of x-rays in childhood, getting data from memory and not dental records, subjects exposed to radiation from equipment from 30 years ago. I should add that a the author of the study (I read it!) admits that most data on radiation exposure she found was from exposure to nuclear blasts(atomic bomb) and radiation therapy for cancer, both of which are so much higher than the levels of exposure for diagnostic x-rays that it is ridiculous to even mention it.
I could understand the reason to conduct a study for persons exposed to CT scans of the head and neck, as this exposes them to a higher dosage of radiation and includes the brain, but the study does not involve CT scans, instead it focuses on bitewing x-rays that we as dentists rely on to diagnose cavities. These small x-rays are highly collimated (the beam is focused to a small circle in your mouth) and does not expose the brain or tissues around it to any levels of radiation worth worrying about.
As a dentist, I cannot overemphasize the importance of taking periodic x-rays to detect caries. Those small bitewing films allow me to find decay when it is small and has not damaged the tooth to the point where there is pain or other signs. What this means to the patient is that I can fix the tooth before it reaches the point where they may need more extensive work such as a root canal or a crown.
I should also mention that while reading the x-rays for a "routine" initial examination for my patients, I have discovered cancer in the mouth that the patient was never aware of because it was small and in doing so was able to help the patient avoid the radical disfiguring surgery that would have been needed it the tumor had been allowed to grow. Maybe even saved his life...
I try to be optimistic in my thinking and I think that something good can always be found in everything. This publicity should make us (dentists) more aware of the need to tailoring our treatment to the individual patient and not tend to fall in a routine that may lead to unnecessary exposure to radiation. Dentists should use their judgement in determining how often x-rays need to be taken, as dental conditions are different for every person, and recommend these radiographs only as necessary for diagnosis and treatment of their patients.
Dentists have always taken an important role in early cancer detection, since they are more likaly to see their patients more often than the physician. In order to increase awarenes of the importance of early detection of cancer, I have written an article in VOXXI, an internet based newspaper/blog site. Here is a copy of the article:
As general dentists we see patients that are healthy, feel fine and may not go to see their physician unless they get sick. Many individuals do not realize the importance of regular visits to the dentist to help them stay healthy.
One of the many services or added benefits that our office provides is oral cancer screening. As part of our initial and periodic exams, you may notice that Dr Boudet palpates your neck, looks at your throat, at the sides and under your tongue, and many other areas of your mouth that are not just the teeth.
As a Dentist in West palm beach , Dr Carlos Boudet has been providing these services to the community for almost three decades now and in that time has been able to keep his patients healthy by detecting many lesions that would have gone undetected and untreated, resulting in more severe problems for the patient.
Cancer awarenes month was created to make individuals aware of the benefits of early detection. Dentists are in a position that allows them to detect oral cancer lesions early and this makes a big difference in the treatment of oral cancer. Some oral cancer is very agressive and if not detected early can result in damage that can leave the patient disfigured and totally change his quality of life. The same cancer detected early can prevent those disfiguring surgeries and make a tremendous difference in the life of a person.
The most common causes of oral cancer were listed as tobacco and alcohol, but recent research has found a link between the human papilloma virus (HPV) and cancer. The papilloma virus is a virus that produces papillomas or "warts" in squamous epithelial cells that cover the surfaces of many areas of the body, such as the inside of the mouth. Most papilloma viruses produce the benign warts, but there are several of these viruses that are "high risk" because they produce the pre-cancerous and cancerous lesions. The cancerous warts cannot be distinguished from the benign ones by simple visual observation, and the dentist needs to remove the lesion and send it to a pathology laboratory to be looked at under the microscope. A trained pathologist then makes the final diagnosis.
As part of the of modern technology that we have incorporated in our office, we can now detect and remove these lesions with the use of the dental laser in a manner that is most comfortable for the patient. the removal is done without a scalpel, does not need sutures or stitches and results in faster, more comfortable healing for the patient.
Scientists working in biological research have developed two vaccines for the most common cancer producing human papilloma viruses. You may want to go to the american cancer society website if you would like to read about the proposed guidelines for recommending and administering the vaccines. They also have information about the individuals at a higher risk, the cost of the vaccine, insurance coverage and how it is administered.
Dr. Carlos Boudet, a West Palm Beach Dentist has been using the latest Cad/Cam technology for several years now to fabricate porcelain crowns in one day.
The Cad/Cam technology that he uses is not new. It has been available for over a decade, but due to the high cost of the equipment needed to produce these crowns, few dentist are willing to invest in the technology.
Normally crowns have to be made in the laboratory, a process that takes about two weeks and requires the patient to wear a temporary that could loosen or fall out and would require a second visit to remove the temporary, try the new crown and if all goes well, cement it.
Dr. Carlos Boudet also does porcelain crowns in the laboratory for special cases that require it, but for those that want the convenience of not having to take time to schedule a second appointment having their porcelain crowns done in one day is great service.
The equipment that Cosmetic Dentist Carlos Boudet uses is Cerec from Sirona, which was the first cad cam system to be designed for dentists. With more than a decade of research and improvements, it is the system with the most experience and best track record in the market.
The way the system works is this:
The dentist prepares the tooth or teeth the same way, but instead of taking an impression with a paste inside a tray, a small camera takes a digital impression and transmits it to the computer, where the dentist designs the crown for the patient. Once the design is done, it is sent wirelessly to a milling machine that uses diamond bits to carve the crown out of a solid block of porcelain. Then when the crown is finished and polished, the dentist bonds it in place in the mouth and the whole procedure is done in one visit.
As a general dentist Dr. Boudet provides a variety of services for his patients such as dental implants with many years of experience both placing and restoring dental implants with great success. Dr. Boudet also provides orthodontic services including Invisalign clear aligners and laser dentistry that increases the comfort and speeds healing in many cases where surgery would be needed.
Dr. Boudet has been providing caring expert dental care for his patients since 1983 in the area of West Palm Beach and adjacent communities such as Palm Beach, Palm Springs, Wellington, Lake Worth, Royal Palm Beach and surrounding areas.
West Palm Beach Dentist Carlos Boudet, DDS, DICOI 1840 Forest Hill Blvd, Suite 204 West Palm Beach, Florida 33406 Phone: (561) 968 6022
Inside Dentistry is one of the leading monthly magazines for dentists with one of the widest circulation in the United States. The magazine has published an article by Dr. Boudet on "The Mandibular Bar Overdenture" in the April 2012 issue. The article describes the details of this well accepted dental procedure from treatment planning to completion including references from the dental literature.
The mandibular overdenture is indicated to correct or eliminate a loose lower denture. It helps the patient bite comfortably in cases where the lower denture is loose, uncomfortable or unstable.
If you would like to see the article please follow this link: http://www.dentalaegis.com/id/2012/04/the-mandibular-bar-overdenture
For a link to other articles published by Dr. Boudet, please click here: http://www.boudetdds.com/articles.htm
Thanks for reading our blog.
Recently I watched a presentation by marketing experts in Dentaltown that listed some of the things that new patients look for when they are selecting a dentist, and I was happy to see that one of the things they look for is whether the dentist is up to date and offers the latest technology in his office.
I don't consider miself a "gadget" person. I evaluate carefully the benefits that any particular technology or "gadget" offers and whether it is of value for me to offer it to my patients. I don't sell "dentist recommended" electric toothbrushes, pharmaceuticals, etc... and the items I dispense I consider important and necessary for succesful surgical outcomes.
But over the years I have invested in pieces of equipment that are considered advanced technology (quite expensive also, since only a small fraction of dental offices have them) and I do dot consider them "gadgets". Let me explain some of the benefits of some of these.
The "All Tissue Laser" : The laser is one of those pieces of equipment that dentists say "there is nothing that I can do with a laser that I could not do with the equipment I already have". And those dentists would be wrong. It is true that you can do many of the same things with existing equipment, but there are procedures that are done best with the laser, such as debriding and detoxifying the surface of an infected implant, and closed (no surgical flap) osseous crown lengthening in the anterior region for more comfort and quicker. healing. These are things that you can do in other ways with existing equipment, but I argue that not as well.
Another piece of equipment that has changed dentistry tremendously is the Cad/Cam technology that allows me to offer a patient a beautiful porcelain crown designed and fabricated in my office in an average of a couple of hours, eliminating the need for impressions that sometimes elicit a gagging reflex, eliminating temporaries that may loosen and come out and avoiding the need for a second visit to cement the crown.
Sure, you can get the same crown made in the laboratory and put up with the conventional impression and the temporary and then wait two weeks to spend more time at the dentist for a second appointment, but, I believe that in the not fo far away future all dentists will have to have cad/cam systems in their office.
I could go on, but you get the point.
If you are searching for an experienced, gentle, technologically advanced dentist in West Palm Beach, please visit my website and look no further.
Sincerely,
This is an article that was accepted for publication in Chairside Magazine and came out in print and online this month.
The article relates to digital impressions transmitted electronically to the lab using the Cerec system by Sirona.
Here is the editor's comments:
" Digital impressions are slowly catching on with our customers at the lab. The majority of the digital impressions we receive are from Sirona CEREC® owners, who typically use this digital impression system to design and mill a crown, such as IPS e.max® CAD, in their own offices. However, we are seeing more CEREC dentists who want to take advantage of high strength monolithic restorations that cannot be milled in the office, such as BruxZir® Solid Zirconia.
A common fear among dentists who purchase the latest technology in the form of a new piece of equipment is the uncertainty of how soon it will be made obsolete. This fear is greater when it is unclear if the manufacturer will offer system upgrades that allow the dentist to continue using the equipment when improved features and new options become available.
For years, the ceramo-metal restoration has been the gold standard in crown & bridge procedures. Although durable and time-tested, this type of restoration may not be the most esthetic. For years, patients have asked for metal-free restorations, and the industry has accommodated this request with various resin composite and ceramic systems.
THE CEREC CAD/CAM SYSTEM
There are two chairside CAD/CAM systems available today: CEREC (Sirona Dental Systems; Charlotte, N.C.) and E4D Dentist™ (D4D Technologies; Richardson, Texas). Also available are three chairside digital impression systems: Lava C.O.S. from 3M ESPE, iTero from CADENT1 and IOS FastScan from IOS Technologies Inc. (The last was recently released to a select group of dentists in Southern California. A fourth chairside digital impression system developed in Israel, Densys, is not yet available to U.S. dentists but is expected to be released stateside in late 2011.) I own a CEREC 3D Redcam system, which now has been replaced by faster hardware and better software with Sirona's CEREC Bluecam.
Soon after I purchased the CEREC Redcam system, I had the opportunity to test out the CADENT iTero.2 I liked the system's ability to create a very precise model that allowed me to choose virtually any material for the fabrication of crowns & bridges from a digital impression. This got me thinking: Wouldn't it be nice if I could take digital impressions with my CEREC unit and send them to the lab for cases that, because of the choice of materials3 or other reasons, cannot be fabricated using the compact milling unit?
The first part of a new course on Porcelain Veneers has been posted by West Palm Beach Dentist Carlos Boudet, DDS on youtube video form. The course is one hour long and is divided into three parts. The first part consists of a detailed description of the smile design principles used in creating beautiful smiles. Dentists interested in learning about porcelain veneers should find it useful.
The youtube video can be seen here: http://www.youtube.com/watch?v=2YDGR_jXo1Y
The embedded video is found below:
Is CVS Pharmacy Ripping You Off With Your Prescriptions?
I normally keep my mouth shut and will not write anything negative about anything or anybody, but I feel bad for those that have a problem paying for their medication, and rely on discount pharmacies and advertised low prices to stay within their budget on a fixed income like our elderly seniors. As a dentist in West Palm Beach, Florida I write many prescriptions and if my patients can benefit from this, then I think is worth my writing about it.
A month ago I went to a CVS pharmacy conveniently located near my house to fill a prescription. I gave it to the pharmacy staff and asked if he could tell me the cost of my medicine and if CVS would give me the lowest cost. I also gave him my insurance information. He checked in the computer and said that the prescription would cost $15. I then asked him to tell me what the medicine would cost without my insurance, he hesitated and said it would be the same $15. I thought it was strange, but went ahead and filled the prescription. When I received the medicine, I noticed that I was given only thirty capsules, even thought the doctor prescribed a quantity of ninety. When I asked the clerk, he said that my insurance would not pay for more than thirty capsules at a time. That was my second red flag.
I took all my medication like a good patient should and the following month I took the empty container to a different pharmacy (I had two additional refills) and asked the staff if she could tell me how much my medication would cost. She asked me for my insurance information and I gave it to her. She looked in her computer and quickly replied: “Ok, if you get the medicine through your insurance, I have to charge you a $15 copayment, but if you don’t use it the prescription will cost you $10.” Of course I did not use my insurance, but when I received the medication it was for the full ninety capsules and not thirty like CVS had given me. This means that if I had gone to CVS to fill the prescription (a total of 270 capsules, 90 caps X 3 refills) I would have paid $15 X 9 (they only gave me 30 at a time) or $135, while at the other pharmacy I would only pay $30. I called CVS and asked for an explanation, but they were unable to provide one for me.
This incident also helped me reinforce my conviction that insurance companies are ripping us off and they don’t care about the patient, they just care about making money. I was paying for expensive medical insurance which should have paid for prescription drugs and my copayment was higher than the cost of the medication without insurance. Go figure!
I have the prescription numbers and can verify everything I have written. I can afford the cost of the medicine in CVS, but I think they need to be more honest and give you all the information with your best interest in mind. The next time you need a prescription filled, you may want to think twice about taking it to CVS pharmacy.
There has been a tremendous amount of technological advances in dentistry in the past ten years. The dental laser is one of those advances that is causing a lot of excitement in the dentists that have adopted the technology, and skepticism and controversy in those that do not use it.
The main reason that more dentists are not using the dental laser is cost as some of the hard and soft tissue lasers can cast upwards of $60,000 dollars. These high end lasers are used for soft tissues and hard tissues also such as bone and teeth.
A more recent addition to the dental laser technology that has made the use of the dental laser more affordable to the dental practitioner has been the diode laser. The diode laser is very small in size compared to the all tissue lasers, and is meant for soft tissue applications and is gaining popularity due to their lower cost and better tissue response than the older technology of electrosurgery. The diode laser cannot be used for hard tissues such as bone and teeth.
One statement that always comes up when dentists talk about lasers is “ all the procedures that I would do with a laser I can do with the equipment I already have”. The dentist that uses the laser knows that although a lot of the procedures done with the laser can be done with a scalpel or an electrosurgery unit, the laser has certain advantages, such as faster healing, less trauma to the surrounding tissues and less post-operative discomfort. With additional training, dentists can do procedures that are not possible with conventional dental equipment such as the LANAP procedure in periodontics.
This brings us to the most interesting and controvertial topic which is the use of the laser in the treatment of gum disease, a topic that has some periodontists very excited while the majority still resist with skepticism.
Gum disease in its moderate to advanced stages is routinely treated by periodontists with periodontal surgery. The purpose of the procedure is to eliminate the deep spaces between the gums and the roots called “periodontal pockets” that harbor bacteria and do not allow the individual to clean properly when brushing and flossing. Periodontal surgery is also used for regenerative procedures where the dentist tries to regain the lost bone and gum tissues with bone grafts or gingival grafts. When the dentist performs periodontal surgery an incision is made around the teeth with a scalpel in order to peel the gums away from the bone and allow visualization of the bone defects for remodeling or regeneration. The diseased soft tissue is also removed in the process. The surgery has some negative aspects such as moderate discomfort after the procedure, healing that takes several weeks, sensitivity to temperature changes, and gingival recession caused by the loss of soft tissue removed during the surgery.
Periodontal surgery is well accepted as the standard of care for the treatment of moderate to advanced periodontal disease.
The laser procedure uses a special laser to treat periodontal disease by first removing the diseased gum tissue in the periodontal pocket in layers so thin that are not possible with a scalpel, then the pocket is decontaminated and sealed with a "clot". This procedure has been show in literature reports to regenerate some of the lost bone from around the treated teeth, without the negative aspects of periodontal surgery.
The American Academy of Periodontology says that there has not been enough research published to substantiate the claims of successful bone and new attachment regeneration with the laser and additional studies are needed, but several well known and respected dentists have published excellent results, and more articles are being published all the time.
It is the opinion of this author that lasers such as the ND YAG and the Erbium YAG lasers will be increasing in popularity as they are minimally invasive and offer an alternative to surgery.
At the risk of being accused of writing biased information, I will discuss several things that I consider important in selecting a dentist in west palm beach to take care of your family.
I grew up with old fashioned ideas so when I started my dental office in West Palm Beach I thought that it would take more than five years for my practice to get busy, and advertising was not considered very ethical, so I did not advertise and I waited for word of mouth to bring patients to my doorstep.
While it is true that asking family and friends to recommend a dentist is a good way to help you select a dentist in West Palm Beach, today you also have local advertisements and tons of information in the internet easily accessible.
You may need a general dentist for your whole family, or maybe you need a particular service such as Orthodontics (Braces, Invisalign), or an implant dentist. Talk to your family and friends and get their input, then do some research. Here is some information that you should look into when selecting your West Palm Beach Dentist:
Background- What are the dentist's qualifications, license, special training, specialty. Some areas such as implantology are not recognized by the american dental association as a specialty in dentistry, so training or accreditation from reputable institutions are things to look for.
Experience- When I started my practice thirty years ago I would have disagreed with this, but experience helps. The more experience that the dentist has under his belt, the smoother the treatment is likely to be since experience has taugh him or her what things to avoid.
Ask to view their work- Dentistry is art with a science background. Great artists like to show their work. Before and after pictures of the type of dentistry that you need give you a good idea of the type and quality of the work that this dentist can do for you.
Accessibility- This is important to me. I hate calling my doctor and having to talk to his nurse instead. Call the office, see if he (she) returns your call personally.
Patient centered staff- Are they focused on your needs? Do they explain your insurance benefits. Help you get the most without running over? Work around your schedule? Get to know you as a person?
Time- Does the dentist takes time to talk with you and listen to your concerns or explain your options rather than force you to accept his proposed treatment?
Technology- The latest would be nice. Dentistry has advanced tremendously in the last ten years. Cad/Cam dentistry, all ceramic crowns, implants, ct scans, lasers, all have found applications in dentistry that benefitthe dental patient tremendously.
Now, you may have some concerns about costs involved and how expensive your treatment could be. I have seen many patients go to a dentist that advertises low prices just to find out that, after the work is done, it was not low priced; long waits, less than optimal treatment and treatment rendered in a rush.
If money is a problem, I suggest you select a dentist in west palm beach that will give you:
A recommended treatment plan with your needed treatment and any other alternatives
Work with you and your insurance to maximize your benefits and minimize your out of pocket expenses.
Send a predetermination to your insurance for expensive work before committing you to pay for it.
Treat problems early to reduce costs. Early treatment prevents major work like root canals and crowns.
Use and recommend preventive measures to avoid the need for more dental work.
A word about dental insurance: Choosing a dentist in west palm beach because he or she is on the list of providers of an HMO insurance is not the wisest thing to do (see above). If you are able, pick an insurance plan that is a PPO which allows you to pick a dentist even if he (or she) is not on the list.
If you have questions or comments about this writing, you can visit my website's contact information here:
