Growing up, I can always remember the lessons in my grade school health classes telling me that I should brush for the length of a song. The teacher went over flossing, too, not that I ever did it. I never flossed (despite my juvenile gingivitis). Dental school and seeing all the gum disease out there changed that in a matter of months!
The ADA has now changed its protocol for home care. Adults should now brush for two minutes, floss, and then brush again for two minutes. Two minutes just happens to be the run time for a Sonicare toothbrush. Coincidence? I think not. The Sonicare is the #1 recommended powered brush in the USA. The ADA is also recommending that you do not rinse your mouth before flossing. I've always said that flossing that fluoride in between the teeth is the only way to get fluoride there. You can't "swish" fluoride in between your teeth, and you can't "brush" fluoride in between your teeth. Why do so many of my patients that floss daily still get cavities in between their teeth? Its because they're not getting the fluoride to the parts of the teeth that need it.
Also, the ADA says that flossing with a little toothpaste pushes the toothpaste under the gumline. This allows the abrasivity of the toothpaste to remove more biofilm (bacteria). That makes sense to me so I'll go with their recommendation, even if it is for a slightly different reason.
So, what are my recommendations? Brush 2 minutes and spit (no rinse). Floss, floss, floss, Spit. Brush again for 2 minutes and spit (no rinse). Do not rinse out all that fluoride. You need to give it time to soak in and do its magic. If you have to rinse, if you can't stand that grittiness, then rinse with a fluoride-containing rinse. All the major brands have a flavor with "anti-cavity" protection.
About mouthrinses: I am not a fan of them. If you are brushing and flossing properly then I don't believe you need to routinely use a mouthrinse. Now if I am feeling sick and I have a sore throat I will use a bit of Listerine for a day or two, but I do not use them daily or even weekly.
If you have any questions, feel free to visit my website and shoot me an email.
thanks
Greg Watson
Austin Smile Center
Thursday, May 1, 2014
No dental insurance? What to do if you get put on an HMO plan.
I had a patient come in today for a routine dental cleaning. We have been seeing this patient for years. I would recognize him by name if I saw him in the grocery store. Anyway, as he sits in the chair he tells us he has new insurance and hands us a Cigna card. No problem. I give the card to Cristina and she attempts to verify his new insurance (it takes over an hour to get through!) No xrays needed this time, so we jump right into the exam. I remind him of a couple of fillings that are needed (1 new, 1 replacement) and we proceed to clean his teeth. Cristina tells me "no adult fluoride" for this insurance company. Too bad, he could have used it. We like to use the new high-tech "sticky" fluoride that hangs around all day long, and we floss the fluoride in between the teeth for even more effectiveness.
LUNCHTIME! As I'm microwaving my steak sandwich, Cristina tells me the bad new: Our patient now has an HMO and has to see a certain clinic to get any benefits. We call our patient and let him know about our online coupon, as he now considers himself to be "uninsured". We don't normally accept our coupons after the work has been done, but he had no idea his boss put him on one of those plans.
We have been seeing more and more patients being put on these HMOs. In an effort to keep profits from dipping during this eternal recession, companies are cutting benefits left and right. Spouses and families are being dropped from the list of covered individuals, or patients are being scuttled onto the exchanges. Many of the plans avail in the aftermarket are HMOs. The available PPOs all seem to have lengthy waiting periods and minimal coverage for the services you need.
An HMO is a plan where a clinic receives a small check (maybe $10) every month that you are signed up with them. Its not a lot. In return, they provide many of their services like exams and cleanings for free. The problem is that the longer the clinic can avoid seeing the patient, the more money they make. If they only see the patient once a year, then the clinic can honestly say they made $120 on that cleaning. If they see a patient twice a year, that production drops to $60. When a clinic in Austin, TX pays $35-40/hour (plus taxes. plus overhead) for a dental hygienist, you can see why the less the clinic sees patients, the more money they make. Preventive dentistry is a loser for these clinics. I have a real moral problem with a business model like this, and have refused to sign up with these plans.
If you've been dropped or switched to an HMO, don't panic. There are other offices out there like Austin Smile Center that are trying to catch this dental market with online coupons and cash offers. Instead of paying $50 a month for a PPO dental plan, ask your bank if they can create a separate account for you and have that $50 transferred once a month. That account would be there for up to $600 in dental work a year. That would pay for a couple of cleanings and maybe 50% of a filling or two. Most PPOs only offer $1000 in annual benefits anyway, which is really only $400 in benefits after you subtract your monthly payments. This is assuming that the waiting periods allow you to use all your benefits. These insurance companies do not exist to be philanthropic. Their mission is to make as much money for their stockholders as possible.
Its like being happy that you won $1 on a $2 lottery ticket! It doesn't make sense.
To help our our non-insured patients, Austin Smile Center offers an online coupon for 25% off your dental work (except for dental implants and Invisalign). We even offer coupons for $99 routine teeth cleanings and exams, new or existing patients. Our credit card company charge us 4% for credit cards, so we still offer 5% cash discounts. I would rather give the patients the money than the banks.
BEWARE: some offices will offer a low initial fee for an exam and cleaning, then try to stick it to you for any other dental work you may need. They may even employ high pressure sales tactics to get you to commit to the treatment or use your credit to prepay for your treatment. I don't feel this is a good way to develop a long-lasting doctor-patient relationship. Austin Smile Center prefers to give you a good service at a good price, all day, everyday. If you're in the Austin area, look us up. If you're not, then hopefully there will be some progressive dentists in your area that can help. Click HERE if you would like to see our current coupons.
thanks
Greg Watson, DDS
LUNCHTIME! As I'm microwaving my steak sandwich, Cristina tells me the bad new: Our patient now has an HMO and has to see a certain clinic to get any benefits. We call our patient and let him know about our online coupon, as he now considers himself to be "uninsured". We don't normally accept our coupons after the work has been done, but he had no idea his boss put him on one of those plans.
We have been seeing more and more patients being put on these HMOs. In an effort to keep profits from dipping during this eternal recession, companies are cutting benefits left and right. Spouses and families are being dropped from the list of covered individuals, or patients are being scuttled onto the exchanges. Many of the plans avail in the aftermarket are HMOs. The available PPOs all seem to have lengthy waiting periods and minimal coverage for the services you need.
An HMO is a plan where a clinic receives a small check (maybe $10) every month that you are signed up with them. Its not a lot. In return, they provide many of their services like exams and cleanings for free. The problem is that the longer the clinic can avoid seeing the patient, the more money they make. If they only see the patient once a year, then the clinic can honestly say they made $120 on that cleaning. If they see a patient twice a year, that production drops to $60. When a clinic in Austin, TX pays $35-40/hour (plus taxes. plus overhead) for a dental hygienist, you can see why the less the clinic sees patients, the more money they make. Preventive dentistry is a loser for these clinics. I have a real moral problem with a business model like this, and have refused to sign up with these plans.
If you've been dropped or switched to an HMO, don't panic. There are other offices out there like Austin Smile Center that are trying to catch this dental market with online coupons and cash offers. Instead of paying $50 a month for a PPO dental plan, ask your bank if they can create a separate account for you and have that $50 transferred once a month. That account would be there for up to $600 in dental work a year. That would pay for a couple of cleanings and maybe 50% of a filling or two. Most PPOs only offer $1000 in annual benefits anyway, which is really only $400 in benefits after you subtract your monthly payments. This is assuming that the waiting periods allow you to use all your benefits. These insurance companies do not exist to be philanthropic. Their mission is to make as much money for their stockholders as possible.
Its like being happy that you won $1 on a $2 lottery ticket! It doesn't make sense.
To help our our non-insured patients, Austin Smile Center offers an online coupon for 25% off your dental work (except for dental implants and Invisalign). We even offer coupons for $99 routine teeth cleanings and exams, new or existing patients. Our credit card company charge us 4% for credit cards, so we still offer 5% cash discounts. I would rather give the patients the money than the banks.
BEWARE: some offices will offer a low initial fee for an exam and cleaning, then try to stick it to you for any other dental work you may need. They may even employ high pressure sales tactics to get you to commit to the treatment or use your credit to prepay for your treatment. I don't feel this is a good way to develop a long-lasting doctor-patient relationship. Austin Smile Center prefers to give you a good service at a good price, all day, everyday. If you're in the Austin area, look us up. If you're not, then hopefully there will be some progressive dentists in your area that can help. Click HERE if you would like to see our current coupons.
thanks
Greg Watson, DDS
Dental implants are easy!
Many of my patients are
nervous about getting dental implants placed in their jaw. Often, they
put off treatment for months or even years, perhaps hoping that a new
tooth will miraculously appear in their mouth when they awaken. Their
fear of the surgery or their fear of post-surgical pain holds them
back. I like to call my patients the day after surgery and ask them
how they are doing. Nine times out of ten they tell me they're doing
great. They are NOT taking the prescription pain meds (only the Advil)
and they aren't in excruciating pain. Many times the patient
disregards my instructions, and they are out in the garden working or
perhaps going to gym class!
When a bad tooth is removed from the mouth, there is frequently an open sore that has to heal. The blood needs to solidify in the extraction socket, and the gums have to grow over the opening at 1/2mm to 1mm per day. If the blood clot is lost, then the bone is exposed to the oral environment. All these processes make healing after an extraction difficult.
When an implant is placed using a closed surgical technique, there is no open sore. The gums are a little sore, and the bone feel tight like there is pressure inside. Because of this, most patients do very well after surgery. On occasion, a patient will have more inflammation than expected. I've always been suspicious that they didn't follow my protocol for Advil as I prescribed, maybe delaying their first dose until the following day when they actually feel sore. At this point, they just have to tough it out. Fortunately, even without Advil, the inflammation will subside and the soreness will go away. My implant patients routinely return after their tooth is restored to have more implants placed later. I think that is the best thank you that any patient can give a dentist!
Austin Smile Center has the best prices on dental implants. Hopefully that takes away one more fear that keeps you from getting the treatment you deserve. For more information visit austin smile center
Greg Watson, DDS
When a bad tooth is removed from the mouth, there is frequently an open sore that has to heal. The blood needs to solidify in the extraction socket, and the gums have to grow over the opening at 1/2mm to 1mm per day. If the blood clot is lost, then the bone is exposed to the oral environment. All these processes make healing after an extraction difficult.
When an implant is placed using a closed surgical technique, there is no open sore. The gums are a little sore, and the bone feel tight like there is pressure inside. Because of this, most patients do very well after surgery. On occasion, a patient will have more inflammation than expected. I've always been suspicious that they didn't follow my protocol for Advil as I prescribed, maybe delaying their first dose until the following day when they actually feel sore. At this point, they just have to tough it out. Fortunately, even without Advil, the inflammation will subside and the soreness will go away. My implant patients routinely return after their tooth is restored to have more implants placed later. I think that is the best thank you that any patient can give a dentist!
Austin Smile Center has the best prices on dental implants. Hopefully that takes away one more fear that keeps you from getting the treatment you deserve. For more information visit austin smile center
Greg Watson, DDS
Subscribe to:
Posts (Atom)