My Blog
By John G. Keeton, DDS, PLC
January 15, 2021
Category: Dental Procedures
EndodonticTreatmentCouldSaveaToothinCrisis

Dental patients have amazing options for tooth replacement. Dental implants, for example, can replace the entire tooth, root and crown, giving patients a new tooth nearly as good as the old one.

Nearly—but not exact. Even implants can't match the full benefits of a natural tooth, including one in less than perfect shape. Our first goal as dentists, then, is to save a diseased tooth if at all practical before considering replacing it.

That often involves a root canal treatment to address decay threatening a tooth's interior. The procedure requires drilling into the tooth to access its innermost pulp, cleaning out the pulp and root canals, and then filling the empty spaces. Since all dentists are trained in basic root canal treatment, your general dentist may be able to perform it.

But some dental situations call for more advanced endodontics, the dental specialty for treating disease and other problems inside a tooth. So, in what situations would you see an endodontist?

When your dentist refers you. Your dentist wants you to receive the level of treatment necessary to save your tooth. After examination, they may determine your situation would be better served by the advanced training, equipment and techniques (including surgery) of an endodontist.

When your tooth has complications. Patients often need an endodontist when existing factors complicate treatment of advanced tooth decay. A patient may have dental pain that's difficult to pinpoint, requiring the diagnostic resources of an endodontist. It's also common for a tooth's root canal network to be highly intricate, and which respond better to treatment with specialized endodontic tools and techniques.

When root canal treatment fails. Most root canal treatments are successful in protecting the tooth from further infection. That said, it's still possible for a root-canaled tooth to become re-infected or develop more problems. Again, an endodontist and their “tool chest“ re-treating a root-canaled tooth may be the best option for saving it.

You also don't have to wait for a referral—you can see an endodontist if you believe they would be best to treat your decayed tooth. You can find one near you by visiting an online endodontist directory at www.aae.org/find. An endodontist may be the lifesaver your diseased tooth needs.

If you would like more information on saving a tooth through endodontic treatment, please contact us or schedule an appointment for a consultation.

By John G. Keeton, DDS, PLC
January 05, 2021
Category: Oral Health
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YourGumsNeedExtraCareAfterPeriodontalDisease

We all benefit from regular dental care, regardless of our state of oral health. But if you've experienced periodontal (gum) disease, those regular dental visits are even more important in making sure your healed gums stay that way.

Gum disease is a bacterial infection caused by dental plaque, a thin film of bacteria and food particles accumulating on tooth surfaces. The infection triggers inflammation in the gums that quickly becomes chronic. That's why people with gum disease have reddened and swollen gums that bleed easily.

The infection can aggressively spread deeper below the gum line, eventually affecting the bone. The combination of weakened gum detachment from the teeth and bone loss may ultimately cause tooth loss. But we can stop the infection by thoroughly removing all plaque and tartar (hardened plaque) from the teeth and gums. As the plaque is removed, the gums respond and begin to heal.

It's possible then even with advanced gum disease to restore health to your teeth and gums. But although the infection has been arrested, it can occur again. In fact, once you've had gum disease, your susceptibility for another infection is much greater. To stay on top of this, you may need to visit the dentist more frequently.

These upgraded visits known as periodontal maintenance (PM) are actually a continuation of your treatment. Depending on the extensiveness of your gum disease, we may need to see you more than the standard twice-a-year visits: Some periodontal patients, for example, may need a visit every two to three months. Again, the state of your gum health will determine how often.

In addition to standard dental cleanings and checkups, PM visits will also include more thorough examination of the teeth and gums, particularly the health of the tooth roots. We'll also check how well you're doing with daily plaque removal and if there are any signs of gum infection. We may also prescribe medication, rinses or topical antibiotics to help control your mouth's levels of bacteria.

A patient's periodontal “maintenance schedule” will depend on their individual condition and needs. The key, though, is to closely monitor gum health for any indications that another infection has set in. By staying alert through dedicated PM, we can stop a new infection before it harms your dental health.

If you would like more information on gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Periodontal Cleanings.”

By John G. Keeton, DDS, PLC
December 26, 2020
Category: Oral Health
HeresWhatToDoIfYourChildComplainsofaToothache

Perhaps the only thing worse than having a toothache of your own is when your child has one. Tooth pain can be a miserable experience, especially for children. It can also be confusing about what to do to deal with it.

Fortunately, a toothache usually isn't a dental emergency, so take a deep breath. Here's what you should do if your child is experiencing tooth pain.

Get the 411 from them. Before you call the dentist, find out more first about the tooth pain from your child with a few probing questions: Where exactly does it hurt? Do you feel it all through your mouth or just in one place? Is it all the time, or just when you bite down? When did it start? You may not get the same level of detail as you would from an adult, but even a little information helps.

Take a look in their mouth. There are a lot of causes for toothache like a decayed tooth or abscessed gums. See if any of the teeth look abnormal or if the gums are swollen. You might also find a piece of food or other particle wedged between the teeth causing the pain. In that case, a little dental floss might relieve the problem.

Ease the pain. While you're waiting on your dental appointment, you can help relieve some of their discomfort by giving them a child-appropriate dose of ibuprofen or acetaminophen. You can also apply an ice pack on the outside of the jaw for five minutes on, then five minutes off to decrease swelling. Under no circumstances, however, should you give your child aspirin or rub it on the gums.

See the dentist. It's always a good idea to follow up with the dentist, even if the pain subsides. In most cases, you may be able to wait until the next day. There are, however, circumstances that call for a visit as soon as possible: if the child is running a fever and/or has facial swelling; or if the tooth pain seems to be related to an injury or trauma.

It can be unsettling as a parent when your child has a toothache. But knowing what to do can help you stay calm and get them the care they need.

If you would like more information on pediatric dental care, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “A Child's Toothache.”

By John G. Keeton, DDS, PLC
December 15, 2020
Category: Oral Health
ListentoEllenDeGeneresDontThinkYouCanGetAwayWithoutFlossing

This year's Carol Burnett Award, presented at the Golden Globes, goes to Ellen DeGeneres for her “outstanding contributions to the television medium on or off the screen.” This is the latest in a long list of honors for the comedienne, talk show host and activist that includes Emmys, Grammys and Teen Choice Awards. And one not quite as well-known: a 2004 “Flossy” award.

DeGeneres received this honor from the National Flossing Council in recognition of her passionate promotion of oral hygiene, particularly flossing. She wrote about its virtues in her 2003 book, The Funny Thing Is…., saying, among other things, “Don't even think for a second that you can get away with not flossing.”

DeGeneres's motivational cheerleading for flossing is helpful and necessary because, well, many of us just don't like doing it. It requires more manual dexterity than its more popular sibling, brushing. And the tendency for the floss to gunk up with plaque residue for some is simply unpleasant.

Mainly, though, many folks think brushing is enough. Not so fast, according to dental professionals. While brushing removes disease-causing bacterial plaque from broad tooth surfaces, it can't effectively get into the spaces between teeth. It takes flossing to clear plaque from these more difficult areas.

But don't fret: There are ways to make flossing an easier—and more pleasant—task.

Ask us for help. As we said before, flossing does take some hand dexterity and coordination to perform. You may also wonder if you're doing it effectively. We can provide training and tips on how to be a more effective flosser at your next visit.

Practice, practice, practice. You probably think nothing of riding a bicycle, and yet it probably took you weeks or months as a kid to become proficient. Similarly, your first attempts at flossing might feel awkward, but you'll improve with practice, so don't give up.

Brush before you floss. Most people floss before brushing, but if you tend to encounter a lot of soft plaque debris that makes flossing “icky” for you, then try brushing first to clear a good portion of it out of the way before you floss. Just be aware, most professionals believe that flossing first is better because it loosens up debris between teeth so the bubbles from the toothpaste can carry it away. But any flossing is better than no flossing!

Try flossing tools. For some people, floss picks, small pre-threaded tools you can use with one hand, seem easier to maneuver than regular floss thread. If you have issues with manual dexterity, an oral irrigator can make the task easier: This handheld device uses a stream of pressurized water to loosen and flush away plaque between teeth.

So, follow Ellen DeGeneres's advice she gave Tulane University graduates during a commencement speech: “Remember to exfoliate, moisturize, exercise…and floss.” The latter, along with brushing, will certainly help keep your teeth and gums healthy.

If you would like more information about best oral hygiene practices, please contact us or schedule an appointment. To learn more, read the Dear Doctor magazine article “Daily Oral Hygiene.”

By John G. Keeton, DDS, PLC
December 05, 2020
Category: Oral Health
Tags: oral health  
BoostYourDentalHealthWithSoon-To-ExpireFSAFunds

If you're among the estimated 14 million families with a healthcare flexible spending account (FSA), New Year's Eve has an added meaning—that's typically the deadline for using any current year funds. Since any remaining money in your FSA could go poof at the stroke of midnight on December 31st, you might be looking for a way to spend it. If so, consider a dental health boost for you and your family.

FSAs were created in the 1970s by the U.S. Government as a salary benefit that employers could offer employees. Instead of receiving all of their pay as taxable income, employees could designate a portion of it (currently up to $2,650) in a non-taxable account to use for certain medical and dental expenses. An FSA thus provides families a way to pay for uncovered healthcare costs while saving on their taxes.

But because most FSAs expire by the end of the year and then restart with a fresh balance in the new year, there's a natural concern that you will “use or lose” remaining money. People thus begin looking for eligible expenses like treatments, prescribed medications or eyeglasses. They can't, however, use them for items like over-the-counter medical products (though some pain relievers get a pass this year because of COVID-19), as well as most things cosmetic.

The same generally holds true for dental expenses—you won't be able to use FSA funds for procedures like teeth whitening or veneers. Toothbrushes and other routine oral care products are also ineligible, although you may be able to buy items like a water flosser if your dentist issues you a Letter of Medical Necessity (LMN).

Still, there's a wide range of eligible dental items you could pay for with remaining FSA funds.

Prevention measures. Any procedures or treatments intended to prevent disease are typically FSA-eligible. These can include measures like regular dental cleanings, sealants or fluoride applications.

Disease treatment. FSAs cover procedures like fillings, extractions, gum surgery or root canals. This could include repairing damage from disease through dental bonding or crowns, which might also improve your smile.

Dental restorations. Missing teeth restorations like bridgework, dentures or dental implants are also covered. These may improve your appearance, but they primarily restore disrupted dental function.

Out-of-pocket expenses. Although you can't pay for dental insurance premiums, an FSA may be able to help in other ways. You can use FSA funds for co-pays or any remaining out-of-pocket expenses.

If you're not sure what dental expenses might be eligible for FSA funds, give our office a call and we can provide you guidance. If FSA funds can help, you'll be able to improve your dental health—and possibly your appearance—before you ring in 2021.

If you would like more information about managing your dental care, please contact us or schedule a consultation.





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