Problems with Posts

Posted on: May 15th, 2012 by Dr. Mitchell Josephs No Comments

Q: Two years after I left my old dental office, my new dentist took some check-up X-rays. He pointed out that a tooth my former dentist worked on two years ago showed an incorrectly placed post, perforating through one of the roots. I remember this tooth had a root canal, so I have not felt any pain. I now need to have the tooth removed and replaced with an implant and crown. Is this malpractice? I.M. Shyster

A: Another subject for my book’s chapter: “Don’t Shoot Your Dentist.” A poor outcome is not necessarily malpractice. If the doctor’s chart notes show that he followed all the proper protocol in treating the tooth, but due to the pre-existing, frail condition of the tooth, the tooth fractures or the post perforated through a curved root, than most likely, no negligence was committed. Most dental offices have patients sign an informed consent, not to eliminate the ability to litigate, but to make sure the patient knows all the risks and possible negative outcomes to a procedure.

There are numerous dental journal studies that show that root perforations and fractures are “common complications” on teeth that have had root canals; especially on neglected teeth that were full of decay before the treatment was rendered. My suggestion is to speak to your former dentist, as he might be willing to reimburse your fees that were invested in that tooth.

Dr. Mitchell Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts “Tooth Talk” on WBZT AM1230 (www.radiotoothtalk.com) Dr. Josephs is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry and completed his residency at Manhattan’s Beth Israel Medical Center and Mt. Sinai Hospital.

____________________________________________________________

drjosephs@palmbeachdentist.com
44 Cocoanut Row, Palm Beach, FL 33480
888-DRTOOTH (888-378-6684)
www.palmbeachdentist.com

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Removal of Lip Hemangiomas

Posted on: May 8th, 2012 by Dr. Mitchell Josephs No Comments

Q: For several years now, I have had a growing purplish bump on my lower lip. I had consulted with a plastic surgeon, but he said it is not dangerous and did not want to attempt to remove it. I really hate the way it looks. What can be done about it?  Marge in Wellington

A: I’m with you Marge. A recent survey performed by a group of social psychology researchers showed that the first part of the human body that one human looks at upon meeting another human is the mouth and teeth. I believe it goes back to our ancestors who had to make sure a fellow cave dweller was not sporting a growling attack face. We all look at each other’s mouths first to see if we can trust that person and to see if we are attracted to that person for possible procreation and continuation of our species. (Postal workers are trustworthy and usually have decent teeth.)

You are probably describing a hemangioma, or venous lake; a pooling of blood under the translucent skin of the lip. Many surgeons are cautious to remove these due to excessive bleeding and possible scaring from incisions and sutures. The fastest, least invasive way to remove these puppies is with a diode laser, which many dentists already use in the mouth on a daily basis for periodontal treatment and just before crown and bridge impressions along the gum line. Within 45 seconds the lesion will turn white and in about four weeks, your little purple friend will be gone. For some great before and after photos of these cases, contact us.

Dr. Mitchell Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts “Tooth Talk” on WBZT AM1230 (www.radiotoothtalk.com) Dr. Josephs is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry and completed his residency at Manhattan’s Beth Israel Medical Center and Mt. Sinai Hospital.

____________________________________________________________

drjosephs@palmbeachdentist.com
44 Cocoanut Row, Palm Beach, FL 33480
888-DRTOOTH (888-378-6684)
www.palmbeachdentist.com

 

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Synthetic Bone Grafting Before Implants

Posted on: May 1st, 2012 by Dr. Mitchell Josephs No Comments

Q: I need to have several teeth extracted, followed by dental implants and permanent crowns. I notice on my treatment plan estimate, my doctor has listed “bone grafts” in each area that I am losing the teeth. This sounds complicated and adds additional costs. Is this always necessary? Martino in Jupiter Farms

A: What separates the “men from the boys” (and the girls from the women, as 52% of dental school grads are female) is “judgment”.  The surgical part in dentistry takes mechanical skill and dexterity, it’s the decision on “what to do and when” that is even more critical. You either have to trust your doctor, or not. (Or, get a second opinion.)

After reviewing digital, computerized X-rays of teeth and bone, we make an assessment of the quantity of bone we have to sink our implants into. If bone levels are insufficient due to proximity of the sinus, less than 9 millimeters in height and thin in cross sectional width, we will often recommend adding bone graft material into the socket, right after extractions to “bulk up” the bone. I prefer to use a synthetic material called OsteoGen, which stimulates your own bone making cells (osteoblasts) to start doing what they have been programmed to do. Some docs will use cadaver, bovine or even your own bone for grafting.  For free consumer info on OsteoGen, contact us.

Dr. Mitchell Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts “Tooth Talk” on WBZT AM1230 (www.radiotoothtalk.com) Dr. Josephs is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry and completed his residency at Manhattan’s Beth Israel Medical Center and Mt. Sinai Hospital.

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drjosephs@palmbeachdentist.com
44 Cocoanut Row, Palm Beach, FL 33480
888-DRTOOTH (888-378-6684)
www.palmbeachdentist.com 

 

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Dental X-Rays Do Not Lead to Tumors

Posted on: April 24th, 2012 by Dr. Mitchell Josephs No Comments

Q: The news reported last week that Dental X-rays can lead to brain tumors. Is this True? Joanne in Deerfield

A: One of the most flawed studies ever to hit the medical journals surfaced last week, scaring people into thinking that dental X-rays contribute to forming brain tumors. According to John Graham DDS, MD (dual degrees) and Mathew Massina DDS of the ADA, the study by Dr. Elizabeth Claus, an epidemiologist, is so fraught with troubling variables, that the validity of data “degrades the veracity of any of its findings. Absolutely no cause and effect link was found”. This single study was useless and only instilled fear in the public.

The biggest flaw is how the data was gathered. They made phone calls to 1433 patients, age 29 to 79, with a certain, benign (non-cancerous) brain tumor and simply ASKED them to recall how many X-rays they have received over lifetime. They never checked the actual dental charts, which would have shown exactly how many X-rays were truly taken.

In my research, one hundred percent of all dentists surveyed stated that when they “ask” a patient: “When were your last X-rays, what type and how many did you have?, most patients answer incorrectly, compared to what the patient’s dental chart from their previous dentists actually shows”. There is no way I could possibly answer this question myself! Also, they did not take into account how many CAT scans, chest X-rays and sun exposure these patients had; all creating significantly more radiation than digital dental X-rays.

Avoiding safe DIGITAL dental X-rays used with lead aprons will only result in missing dental problems, which rarely cause pain, leading to extremely expensive and extensive dental treatment.

Dr. Mitchell Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts “Tooth Talk” on WBZT AM1230 (www.radiotoothtalk.com) Dr. Josephs is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry and completed his residency at Manhattan’s Beth Israel Medical Center and Mt. Sinai Hospital.

____________________________________________________________

drjosephs@palmbeachdentist.com
44 Cocoanut Row, Palm Beach, FL 33480
888-DRTOOTH (888-378-6684)
www.palmbeachdentist.com 

 

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Failed Implant, Not Doctor’s Fault

Posted on: April 17th, 2012 by Dr. Mitchell Josephs No Comments

Q: I had two implants placed on my upper back jaw. One failed and needed to be removed. I am very upset at my dentist. What did she do wrong? Melvin in Green Acres.

A: Melvin. The human body is not like building a deck in your back yard. There are no guarantees how human tissue will react to any insult. Heart surgery patients die in the O.R., cancers recur, pneumonia is not always curable, skin growths often grow back even after several attempts at removal and biopsy (Just ask the back of my neck).

Dental implants actually have one of the highest success rates for surgical procedures, between 90 and 95%, however if you are one of the 5 to 10 patients out of 100 who have an implant that is rejected, you wont be happy. The main reason why dental patients are less tolerant of failure of their dental work is because it hits them in the pocket. If all dental procedures were covered by health insurance, you would not have to pay to have the first implant performed AND you would not have to pay for its removal, bone grafting and placement of a new implant. Not to mention the abutment posts and crowns that connect to the implant to give you some choppers to chew on. For free consumer information on incision-free dental implant surgery, contact us.

Dr. Mitchell Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts “Tooth Talk” on WBZT AM1230 (www.radiotoothtalk.com) Dr. Mitchell Josephs is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry and completed his residency at Manhattan’s Beth Israel Medical Center and Mt. Sinai Hospital.

____________________________________________________________

drjosephs@palmbeachdentist.com
44 Cocoanut Row, Palm Beach, FL 33480
888-DRTOOTH (888-378-6684)
www.palmbeachdentist.com 

 


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Lack of Saliva After Inner Ear Surgery

Posted on: April 10th, 2012 by Dr. Mitchell Josephs No Comments

Q: After undergoing inner ear surgery to correct my hearing loss, I notice my mouth is constantly dry. Would this be related? Stan in Palm Beach Gardens

A: “Oh, the head bone is connected to the….neck bone…..and the neck bone is connected to the…etc. etc.” (You know the song.) There is actually a connection of nerves that if damaged from ear surgery can cause inadequate stimulation of the salivary glands resulting in a dry mouth (xerostomia). A condition known as otosclerosis (loss of mobility of one of the inner ear bones that transmit vibration) warrants a procedure called a stapedectomy which can involve severing this special nerve, called the chorda tympani. (A classic question on the gross anatomy, head and neck exam in medical and dental school.)

The dry mouth often manifests itself during resting periods when the back-up salivary glands located in the inner cheeks decrease their flow. We recommend that patients use sugarless chewing gum or sour candy frequently to stimulate these extra glands and use oral lubricants and sip water as needed. Pass this on to your favorite ENT doc!

Dr. Mitchell Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts “Tooth Talk” on WBZT AM1230 (www.radiotoothtalk.com) Dr. Josephs is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry and completed his residency at Manhattan’s Beth Israel Medical Center and Mt. Sinai Hospital.

____________________________________________________________

drjosephs@palmbeachdentist.com
44 Cocoanut Row, Palm Beach, FL 33480
888-DRTOOTH (888-378-6684)
www.palmbeachdentist.com

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Internet Doctor Background Checks, Flawed

Posted on: April 3rd, 2012 by Dr. Mitchell Josephs No Comments

Q: I was referred to a doctor for dental work. On the Internet, I saw his malpractice insurance carrier settled a case with a patient. Should this be of concern? Larry in West Boca

A: This is one of those columns that I hope finds its way on many refrigerators and in doctor’s waiting rooms. (as apposed to the kitchen floor for puppy training.)

The more years in practice, the more patients a doctor will treat and the more possible complaints, disciplinary actions and law suits he or she will have, especially in this litigious society. (on average; one every 9 years.) I know a dentist who was sued and disciplined due to a patient who complained that she was “not able to perform oral sex on her husband while undergoing several weeks of dental treatment”. The dentist could not fight the case due to losing the patient’s chart as it was inadvertently thrown out with the retiring dentist’s old filing cabinet.

Many celebrity heart surgeons and dentists will have “negative” issues on the un-regulated cesspool of information, called the Web. Advertising violations, like using signage that has letters that are “too big”, can result in disciplinary actions. Don’t let a few bad web pages over a three-decade career of a doctor hold you back.

EDITOR’S NOTE: Dr. Mitchell Josephs will be giving a FREE LECTURE on Incision-Free Dental Implant Surgery, Digital Crowns & Veneers and Choosing a Dental Office, at the The Palm Beach Towers, 44 Cocoanut Row  in Palm Beach, on Wednesday April 4th at 4:00 pm. Attendees will receive a FREE copy of his book: “Tooth Talk”. Seating is limited. Call 561-832-2917 to register.

Dr. Mitchell Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts “Tooth Talk” on WBZT AM1230 (www.radiotoothtalk.com) Dr. Josephs is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry and completed his residency at Manhattan’s Beth Israel Medical Center and Mt. Sinai Hospital.

____________________________________________________________

drjosephs@palmbeachdentist.com
44 Cocoanut Row, Palm Beach, FL 33480
888-DRTOOTH (888-378-6684)
www.palmbeachdentist.com

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Dental Treatment Pain; No more

Posted on: March 27th, 2012 by Dr. Mitchell Josephs No Comments

Q: Dear Doctor Josephs: I am an avid reader of your column and am a retired surgeon myself. As you may already know, doctors can sometimes be the worst patients. I require major dental implant treatment, crowns, bridges and extractions and am wondering how much pain this endures. Am I just being an octogenarian baby? Dr. Lou in Palm Beach Gardens

A: Don’t sell yourself short, Doc; my physician patients are great, it’s my retired dentist patients that can be a handful!  A recent study in Consumer Reports surveyed readers who had dental procedures in the previous five years. Here’s the skinny: The percentage of patients who reported zero to mild pain or discomfort,  was 90% for root canals, 91% for extractions, 91% for implants and 93% for crowns, inlays or veneers. At my next seminar, I will be presenting the hi-tech methods and equipment that our profession has to make dental treatment comfortable.

EDITOR’S NOTE: Dr. Mitchell Josephs will be giving a FREE LECTURE on Incision-Free Dental Implant Surgery, Digital Crowns & Veneers and Choosing a Dental Office, at the The Palm Beach Towers, 44 Cocoanut Row  in Palm Beach, on Wednesday April 4th at 4:00 pm. Attendees will receive a FREE copy of his book: “Tooth Talk”. Seating is limited. Call 561-832-2917 to register.

Dr. Mitchell Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts “Tooth Talk” on WBZT AM1230 (www.radiotoothtalk.com) Dr. Josephs is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry and completed his residency at Manhattan’s Beth Israel Medical Center and Mt. Sinai Hospital. 

____________________________________________________________

drjosephs@palmbeachdentist.com
44 Cocoanut Row, Palm Beach, FL 33480
888-DRTOOTH (888-378-6684)
www.palmbeachdentist.com

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Gum Use for Juvederm, Dermal Filler

Posted on: March 20th, 2012 by Dr. Mitchell Josephs No Comments

Q: After years of gum surgery, crowns, veneers, implants and “plain old “ aging, I have ugly black holes between my teeth at my gum line. What can be done about this? Mary Lou in Palm Beach

A: Nothing ruins a date more than when some one says: “…you have something stuck between your teeth.” (except when the date goes to the rest room, never to return.) These triangular spaces, called gingival embrasures often get larger as the gum in between, shrinks. We call this condition “blunted papillas.”

A novel use of Juvederm helps add plumpness to these areas, often filling the ugly black holes. Dentists in many states now, including Florida, are already trained and licensed and insured to perform this procedure as well as Botox and Dermal Fillers on the face. (Yet, at this point, only dentists, would be trained in the treatment of the gums with Dermal Fillers.) Email us for a link to a video of this procedure.

EDITOR’S NOTE: Dr. Mitchell Josephs will be giving a FREE LECTURE on Incision-Free Dental Implant Surgery, Digital Crowns & Veneers and Choosing a Dental Office, at the The Palm Beach Towers, 44 Cocoanut Row  in Palm Beach, on Wednesday April 4th at 4:00 pm. Attendees will receive a FREE copy of his book: “Tooth Talk”. Seating is limited. Call 561-832-4675 to register.

Dr. Mitchell Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts the “Tooth Talk” radio on WBZT AM1230. (www.radiotoothtalk.com) Dr. Josephs is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry. 

____________________________________________________________

drjosephs@palmbeachdentist.com
44 Cocoanut Row, Palm Beach, FL 33480
888-DRTOOTH (888-378-6684)
www.palmbeachdentist.com

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Silent Drills; Almost

Posted on: March 13th, 2012 by Dr. Mitchell Josephs No Comments

Q: I hate the dentist because of the sound of the drill. When will we have a silent drill? Artie in Boca

A: I’m sorry, could you speak up?  I couldn’t hear you over the sound of my drill! Most modern dental drills operate on an air turbine system. This causes a high-pitched whine that sends some patients through the roof and has kept half the US population from setting foot in a dental office.

For several years now, many offices use electric drills, which use a small electric motor within the drill itself. They are much quieter, faster, more efficient, cleaner and cooler when it comes to the cutting of tooth structure. Less noise and less vibration adds to greater patient comfort. They are expensive for the dentist, but I feel worth the investment for any modern, hi-tech dental office.

EDITOR’S NOTE: Dr. Mitchell Josephs will be giving a FREE LECTURE on Incision-Free Dental Implant Surgery, Digital Crowns & Veneers and Choosing a Dental Office, at the The Palm Beach Towers, 44 Cocoanut Row  in Palm Beach, on Wednesday April 4th at 4:00 pm. Attendees will receive a FREE copy of his book: “Tooth Talk”. Seating is limited. Call 561-832-4675 to register.

Dr. Mitchell Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts the “Tooth Talk” radio on WBZT AM1230. (www.radiotoothtalk.com) Dr. Josephs is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry.

____________________________________________________________

drjosephs@palmbeachdentist.com
44 Cocoanut Row, Palm Beach, FL 33480
888-DRTOOTH (888-378-6684)
www.palmbeachdentist.com


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