Friday, January 20, 2012

Lasers In Dentistry

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.

Carlos Boudet, DDS
West Palm Beach Dentist

Saturday, January 14, 2012

How To Find A Good Dentist In West Palm Beach Florida

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:

West Palm Beach Dentist
Carlos Boudet, DDS