Anticoagulant Therapy - How It Can Affect Your Dental Appointment

Today, I would like to tell you about how anticoagulant drugs can affect your dental appointment if you forget to mention that you are taking them.

The first time you go to a dental office you are always asked to fill out some forms. Some of the information that you are asked to provide is your medical history.  It is important for the dentist to know if you are healthy, or if you have health problems such as diabetes, high blood pressure, heart problems etc…  

It is also important to provide a list of all the medications that you are taking, since some medications may cause problems with procedures done by the dentist.  Let me give an example:

Many mature adults take daily anticoagulant medicine to prevent a stroke caused by a blood clot.  A blood clot could travel through the circulation and cause an obstruction not only in the brain, but also in other parts of the body, like the heart, the lungs, the legs, etc…

There are many drugs currently used for this purpose, with names like Plavix, Xarelto, Pradaxa, and others, but the most commonly prescribed is called Coumadin (the generic name is Warfarin).  Since these medications affect the coagulation of the blood, the person taking it is likely to bleed more and longer than normal, and they need to make the dentist aware that they are on this medication.

When a person taking an anticoagulant needs an extraction or some surgical procedure, they need to consult with their physician in order to modify or stop the anticoagulant therapy about a week before their dental procedure in order to get their clotting ability back to normal to avoid bleeding during or after the procedure.

Other substances that have anticoagulant effects are natural remedies such as ginger, fish oil and vitamin E.  It is prudent to discontinue these a week before any dental surgery.

One more related drug that is very important to mention is Aspirin.
Many individuals today take a daily aspirin, and aspirin also has anticoagulant properties.  It should be discontinued one week before the dental surgery.

So whenever you go to your dentist for a surgical procedure, please update your health history with a list of all the medications you are taking (prescription and non-prescription) and this will help him (or her) plan your procedure in the safest way possible.

I hope this information will be useful to you in the future.

Dentist In West Palm Beach
Carlos Boudet, DDS,  DICOI
1840 Forest Hill Blvd, Suite 204
West Palm Beach, Florida  33406
Phone: Call 561-968-6022

Website: http://www.boudetdds.com
Dental Implant Blog:  http://www.palm-beach-implants.com

Funny promotional Video I hope you will like

Hi there!
My name is Carlos Boudet, and I am a general dentist in West Palm Beach, Florida.
I am not doing any advertising presently, and I came across this short clip that I thought was very funny, so I decided to get this clip as a promotional video for my office.
I hope you like it as much as I.
Here is the clip:

Thanks for watching.

West Palm Beach Dentist
Carlos Boudet, DDS DICOI

Website:  http://www.boudetdds.com
Implant Blog:  http://www.palm-beach-implants.com
Spanish website:  http://www.palmbeachdentist.net

Dental Continuing Education Courses in Palm Beach County

Hello, and welcome to my blog!
As a member of the Atlantic Coast Dental Research Clinic for three decades, I would like to give my personal testimonial about this great organization, created and maintained through the years by volunteer dentists with the desire to help others.
When I graduated from dental school in 1980, I felt confident that I was adequately prepared to practice my profession.  Two years later, after serving as a commissioned officer for the Public Health Service in Indiantown, Florida, I opened my own office and settled as a general dentist in West Palm Beach, Florida, and I have been in private practice in the same location ever since.

Soon after I started practice, I realized that my dental school training was only a good foundation, and that I needed much more knowledge and training if I wanted to diagnose and treat my patients the best way possible.

I soon found out that training and continuing education courses were not cheap, and a new dental office with few patients coming in limited my spending on dental CE courses and travel expenses.

I was very fortunate that a group of visionary dentists in my area had created an organization called “AtlanticCoast Dental Research Clinic”.  The “Research Clinic”, as everybody calls it, was set up to offer continuing dental education courses to local and regional dentists that wanted to further their knowledge and training in all aspects of dentistry.

I have been privileged to be a member of the Atlantic Coast Dental Research Clinic for almost three decades.  In all the courses that I have attended, I have been able to learn many modalities of general dentistry that I wasn’t taught in my dental school training.

In my solo practice, I have to work with limited interaction with fellow dentists, but my participation in the Research Clinic has allowed me to make friends, learn from colleagues that are experts in their field, and keep up with all the latest advances in dentistry. 

The Research Clinic has made me more knowledgeable and more confident in my ability to provide the best care available for my patients.  It is local, you don’t have any travel expenses, the courses are fully AGD accredited and the membership fees are very low.  They are very responsive to your input and want your participation.

If you are looking to further your knowledge and obtain additional training and skills in a particular procedure, I invite you to look at their website http://www.acdrc.com/courses-and-instructors/ browse through their courses and enroll in a course that interests you.  You won’t be disappointed.

West Palm Beach Dentist
Carlos Boudet, DDS DICOI

Website:  http://www.boudetdds.com
Implant Blog:  http://www.palm-beach-implants.com
Spanish website:  http://www.palmbeachdentist.net

Intraoral Scanning of Implants

Intraoral scanners have been available for decades, but the scanning of implants intraorally instead of taking a conventional elastomeric impression has not been practiced for several reasons:   First, the software and dedicated scan bodies were not available, and second,  the cost of the available intraoral scanners was very high.  With the introduction of more intraoral scanners and the trend to reduce the costs of the hardware in the past couple of years, the use of intraoral scanners to replace a conventional impression has allowed more dentists to incorporate this new technological advance in their practices, and the laboratory to do the restoration of  implants accurately from the intraoral scan.

I recently published an article in collaboration with a local periodontist that explains a new protocol for the intraoral scanning of implants at the periodontist's office.  The article appeared in Glidewell's Chairside magazine, and it is available online here:  Chairside Volume 11 Issue 1.

This protocol is ideally suited for the general dentist that wants to work with a specialist who places the implants and sends the patient back to the general dentist for restoration.  It improves treatment planning, communication and efficiency.

The simplicity of the procedure for the GP is evident by the fact that the only thing the restorative dentist needs to do is deliver the crown.  There is no need to order parts like impression copings or schedule chair time to take conventional impressions.

Intraoral scanning will be replacing the conventional impression technique in the future because of the many advantages available with the digital workflow.  At present, the price of the equipment seems to be the biggest obstacle to its adoption by more dentists.

West Palm Beach Dentist
Carlos Boudet, DDS DICOI

Website:  http://www.boudetdds.com
Implant Blog:  http://www.palm-beach-implants.com
Spanish website:  http://www.palmbeachdentist.net

Dental Care For Our Children

Dental Care For Children

I would like to talk a little today about the oral health of our children.

The American Pediatric Dentist Association recommends that the first visit should be when they are one year old.
At the first visit the dentist will examine the mouth to determine:

•    If there are caries present
•    Check that the bite is developing normally
•    Show the parents how to care for the child's mouth 

Let me give you an example why it is important to take your child early to the dentist.
In our community, it is not uncommon to see a family with three or four children.  The young mother tries to take care of all of them equally, but many times it is difficult.  Also she sometimes gets advise from friends or family that may not be good advice.  Take for example the same young mother with four children and the baby starts to cry.  The mother gives the baby the bottle with some juice, milk or sweetened liquid, and the baby soon quiets down and goes to sleep with the bottle still in his mouth.  What happens now?  Yes, mom solved the problem of the crying baby, but if this happens often, the child will be in trouble with his teeth. When the baby falls asleep with the bottle often, he holds that liquid in his mouth for long periods of time, and the sugar that it contains causes the baby's teeth to be destroyed by caries. This is seen so often that it has been given the name of "Baby Bottle Syndrome".

The child's nutrition is also very important in order for the teeth to grow healthy and strong.  Children need calcium for the teeth and bones during their development.  Milk, cheese and yogurt are examples of good sources of calcium in the diet.  Sugar, candy and other sweets are used by bacteria to form decay in teeth, and should be reduced or avoided to prevent cavities.
One question that I get asked often is "Is there a pill that I can take to prevent decay?  Well, the answer is no sorry, but there are a couple of chemical compounds that come pretty close.
The first one is fluoride.  Fluoride gets incorporated in the enamel of the teeth and makes them more resistant to cavities. Research has shown that children that grow in communities with fluoride in the water, grow to have very few cavities.  Pediatricians often prescribe vitamins with fluoride to children living in communities without fluoride in the water.  Fluoride is also present in the toothpaste that we use every day.
The other compound is xylitol.  Xylitol is a sugar substitute that bacteria cannot use to produce acids that cause decay.  There are European countries that have laws requiring all candies to be made with xylitol.  In the United States you can find xylitol in some chewing gum, mints and in powder form as a sugar substitute that is ok to use even in diabetic patients.

Another common question I get is this:  My child sucks his thumb or a pacifier.  Will this hurt him in any way?  The instinct to suck is normal in children and is seen as early as children two to three months old.  Neither the thumb nor the pacifier cause problems as long as their use is discontinued before the permanent teeth come out, at about five or six years of age.
There are many other questions that come to mind, but for the sake of brevity, they will be answered in future posts.  I hope this was informative.
Thank you for reading.



West Palm Beach Dentist
Carlos Boudet, DDS DICOI
Website:  http://www.boudetdds.com
Implant Blog:  http://www.palm-beach-implants.com
Spanish website:  http://palmbeachdentist.nethttp://www.palmbeachdentist.net

Talking About Gum Disease And Periodontitis

One of the biggest obstacles to dental health care is the cost of dental services.  But the second mayor obstacle is the lack of information about oral health.  I should rephrase this last statement and say, it is the lack of adequate dental education .

Today I would like to talk a little bit about gum disease or periodontitis.

In the Unites States approximately 70% of adults have some form of gum disease.  Many of these problems have simple solutions, but many also can cause a lot of damage.  This damage affects the gums and the bone around the roots of the teeth,  and can result in the loss of the affected teeth.

Periodontitis is caused by the bacteria that we have in our mouths.  We cannot sterilize our mouths, so we will always have bacteria in it.  Some bacteria is harmless and some is pathogenic and will cause problems.  When we brush our teeth daily, we are reducing the amount of bacteria in our mouth, and if this number is low enough, our body's  defensive mechanisms can keep everything under control and healthy.  Now,,, if I neglect the cleaning of my mouth and teeth for a while, the number of bacteria increase to the point that my body's defenses cannot keep them under control and an unhealthy or disease state develops.

Periodontitis is a silent disease, which means it does not give you a lot of signs that it is present.  There is usually no fever, pain or discomfort associated with it. 

If you brush your teeth and see a little blood on the toothbrush what do you think that means?  Do you think that it is an indication that you are brushing to hard and might be hurting your gums?  In reality, healthy gums don't bleed, and bleeding from the gums usually is a sign of inflamation.  Well, inflamation is the first sign of gum problems.

Inflamation of the gums is called gingivitis, and is the first step towards gum disease or periodontitis.   Gingivitis is many times completely reversible, which means that if you clean your teeth very well daily  and get rid of all the bacterial plaque on them, after a few days, the inflamation will be gone.  This all sounds very good, but bacterial plaque presents another problem.  When I neglect to clean my teeth and plaque builds up, after a few days, that plaque starts calcifying and hardening into something we call calculus or tartar, and then neither the brush nor the floss will be able to remove it.

Another thing that happens with time is that the gums start hardening  and they stop bleeding, causing you to think that everything is ok.  You may think that everything is ok because you are making an effort to clean well every day, but in reality the gums toughen up after  some time and they may stop bleeding.  The hard deposits continue to build up and the bacteria that is present there starts to cause bone loss around the roots of the teeth.  If this bone loss advances enough, the teeth can loosen, drift and eventually even need to be extracted.  A person that looses many teeth in this manner will have to  replace them with a removable denture and will have difficulty chewing normal food for the rest of his or her life unless able to afford costly reconstructions.

It's time to finish this article, but I would like to make sure that the message that I am trying to send is coming  across.

Dentists today are trained in detecting gum problems early, when they are easy to treat with something as simple as a good prophylaxis (cleaning).  Unfortunately, many individuals do not go to the dentist until they feel pain or some type of discomfort, and by then, the damage has advanced to the point that the treatment may require surgery which can be costly and uncomfortable.

The best service that I and other dentists like myself can offer our patients are preventive services.  Even if a person does not have dental insurance and cannot go regularly to the dentist, do not let years go by without an examination and cleaning.  The small cost that you will incur is nothing compared to the cost of treatment when the damage has advanced.

I hope that you have found something useful and somehow benefited from reading this information.

Thank you for reading!

West Palm Beach Dentist
Carlos Boudet, DDS DICOI
website:  http://www.boudetdds.com
Implant Blog:  http://www.palm-beach-implants.com
Spanish website:  http://palmbeachdentist.net

Intraoral Scanning For Your Crown And Bridge Practice

Intraoral Scanning For Crown And Bridge

New and exciting technology and equipment is allowing the progressive dentist to take digital impressions of crowns and bridges instead of using the traditional tray full of impression paste that has to stay for a couple of minutes in the mouth while it hardens, and can elicit gagging in succeptible individuals.

The technique is preferred by patients in well documented studies and it is also very accurate, eliminating some steps in the conventional technique that could introduce distortion and errors.

The biggest obstacle that dentists have encountered when acquiring this new technology has been the cost of the equipment, as the new technology is very expensive, but things are changing.  Recently, new intraoral scanners have been introduced with a more affordable price tag, and this allows interested dentists to aquire the technology  with a smaller investment.

One question that concerns these dentists is the following:  What if after buying the equipment they find out that it is not for them?  All training on this type of equipment happens after the sale, so the dentist has to make the investment with the hope that he or she has made the right decision.

This is the reason why a new course has been developed that allows interested dentists to get hands-on participation and experience with this equipment without the need to purchase the equipment.  The course is called Intraoral Scanning For Your Crown And Bridge Practice and is being offered by the Atlantic Coast Dental Research Clinic and Chaired by Dr. Carlos Boudet who has been involved in chairside scanning and Cad/Cam dentistry for many years.

Dentists attending the course will receive a maximum of 28 CE credits for attending the morning and afternoon sessions.  The program will allow the participating dentists to learn and use the equipment while treating actual patients that need crown and bridge work.

Interested dental professionals should go to the Atlantic Coast Dental Research Clinic’s website and select the course from the course listings, where they will have the opportunity to register online.  They can also contact Dr. Boudet for any questions they may have about the course.

Free Dentistry Day 2015 at the Atlantic Coast Dental Research Clinic

The Atlantic Coast Dental Research Clinic, located in the Lake Worth Campus of the Palm Beach State College, Held its First Annual Free Dentistry Day April 29th 2015 and provided basic dental services totally free of charge to the community.
More than a dozen dentists volunteered their time to provide these services. 
Many individuals were not able to receive services due to the fact that only a limited number of persons could be seen that day.
I would like to praise and recognize the dental assisting students at Palm Beach State College that helped the doctors provide these services.  They were the backbone of the operation. They were highly relied upon for every aspect of these services, registration, routing,triage, infection control, and patient care.  AND THEY SHINED!!!
This is also a great reflection of the quality and dedication of the faculty of the dental assisting program.
It is also worth mentioning that this event probably would not have taken place without the initiative of   Colleen Bradshaw,  Chair of the Dental Assisting Program, who suggested the idea.
I can honestly say that everybody that I talked to that participated (and I talked to a lot of people) felt enriched by the experience of giving.

My deepest thanks to all.

Carlos Boudet, DDS
Atlantic Coast Dental Research Clinic President

Maxillary Reconstruction of Terminal Dentition Following a Two-Stage Protocol

New article published in Vol 6 Issue 1 of Inclusive Magazine on a maxillary arch reconstruction with dental implants using a staged approach to allow the patient to continue to function while waiting for unloaded integration of the implants, instead of the immediate load protocol.
The article is also posted online by the magazine here:
http://www.glidewelldental.com/inclusive-magazine/volume6-1/reconstruction-terminal-dentition.aspx

I hope you find it interesting and informative.

My First Implant

I have a lot of admiration for the early pioneers of dental implants, such as Leonard I. Linkow, Carl E. Misch,  Gerald A. Niznick, and too many others to mention.  They had the intelligence and the courage to work with less resources and knowledge than we have presently, and learn at the same time.  It is because of their accomplishments that we have our implant practices today.

It was actually Dr. Niznick who introduced me to the surgical placement of implants in the late 1980’s with his Screwvent  implant, a part of the Corevent system. 

It is easy to show your best cases, but I am going to show you my first implant, done in the late 1980’s when implants were not as popular as they are today and our knowledge about them more limited.

My patient was an elderly gentleman that lost a maxillary canine which served as an abutment for a three-unit bridge.  I did not feel that a four or five unit bridge would be as good a service to him as a smaller three unit bridge if I could use an implant as the anterior abutment, so that is what I did.  

Here are the pre-op and post-op periapical radiographs:

 

Today of course, we prefer not to join implants and natural teeth, but it seemed a great idea at the time, and the bridge served him well for many years.  I lost contact with the patient, so I cannot give you more details about its longevity.

Introducing implants in my practice has allowed me to provide a higher level of care for my patients.  I can honestly say that I haven’t had a single implant patient that hasn’t  liked them.  Compared to other treatment alternatives, implants are usually the best solution.

If we can help you with implant related questions or services, please call us at (561) 968 6022.

West Palm Beach Dentist
Carlos Boudet, DDS DICOI
website:  http://www.boudetdds.com
Implant Blog:  http://www.palm-beach-implants.com
Spanish website:  http://palmbeachdentist.net