FAQ
Smoking has negative consequences for the body’s overall health, and periodontal health is no exception. Smoking has been shown in numerous studies to be related to periodontal disease.
Smoking can accelerate bone loss around the teeth, can contribute to calculus (or tartar) build-up, and decreases the blood supply to the gums and teeth. The body’s immune system is also repressed by smoking, which in turn represses the body’s ability to combat infection in the gums. Smoking can also result in staining of the teeth and bad breath.
Most importantly, smoking can lead to oral cancer which can be life-threatening.
On the bright side, research has indicated that a smoker’s risk of developing periodontal disease will be equivalent to a non-smoker’s approximately 10 years after quitting the habit.
It’s never too late to stop the smoking habit. Consult your physician or dentist today.
Dr. Aaron’s staff will file insurance pre-estimates on your behalf prior to undergoing any procedures beyond the initial exam.
The pre-estimate normally takes 4-6 weeks to be processed. You will receive a written explanation of your estimated insurance coverage once it is received by Dr. Aaron’s staff. Also outlined in the letter will be your estimated co-payment, which will be due at the time of service.
Should you not want to wait for the insurance pre-estimate, payment in full will be expected at the time of service. From there, an insurance claim will be filed, and you will be reimbursed for any insurance payment.
Dr. Aaron is a Delta Dental provider, which means he accepts their fee structure. Patients who do not have these insurances are expected to pay in full the cost for the initial consultation and any x-rays at the end of the appointment.
Dr. Aaron and his staff value your business, and we hope to gain your trust by providing excellent customer service in regard to handling insurance.
Bisphosphonates are a class of drugs that inhibits bone re-modeling (inhibit osteoclast activity). They are the essential component of most osteoporosis medications and intravenous drugs used to treat cancer. Concern has arisen because in rare cases, the bisphosphonates can result in severe bone necrosis after certain dental procedures.
Necrosis is when the bone dies and sloughs away due to a lack of blood supply. Osteonecrosis refers to sloughing of the bone. Theoretically, the inhibitory effect of the bisphosphonates on the osteoclast cells doesn’t allow the jawbone to re-model. Without the capacity to re-model, the surface layer of the jawbone loses its blood supply and dies away.
Osteonecrosis from bisphosphonates only primarily occurs after exposure of the jawbone to the outside environment. In other words, unless the jawbone is exposed, such as after tooth extractions or periodontal flap surgery, there is extremely minimal risk to experiencing bone necrosis. Undergoing root canal procedures, fillings, or crowns do not expose the underlying bone and thus are safe (however medical clearance is still needed prior to treatment).
Even after procedures where the jawbone is exposed, the risk of osteonecrosis is extremely rare. Research is beginning to show that patients taking oral bisphosphonates, like those used to treat osteoporosis, are safe to proceed with surgical procedures. It is the IV form of bisphosphonates that creates a greater concern and may be a contraindication to oral/periodontal surgery.
In any event, consultation and clearance from the physician is mandatory prior to proceeding with treatment. In addition, consent forms must be signed allowing the dental practitioner to proceed.
Overall, it is important to be aware of the risks associated with bisphosphonate medication; however, oral bisphosphonates are not an absolute contraindication to receiving dental treatment.
Lasers are becoming increasing used in dentistry, and periodontics is no exception. Many dental professionals are replacing the traditional scalpel blade with lasers during procedures which involve the removal of soft tissue or bone. Lasers are also being utilized during non-surgical procedures, such as scaling-and-root planing.
For surgical procedures, the primary advantage of lasers is that any bleeding is immediately cauterized (sealed off), which decreases the time of the procedure and arguably is less traumatic to the patient. Another advantage of lasers is that the tissue adjacent to the site that is being worked on is not as traumatized as compared to using a dental drill. On the other hand, the patient still has to be anesthetized regardless of whether a laser or scalpel is used. In addition, a scalpel allows for a tissue flap to be created, which can later be precisely sutured together for faster healing (primary intention), while the wound created from lasers has to “fill in” similar to an abrasion (secondary or tertiary intention).
When it comes to non-surgical procedures, evidence is mounting that lasers provide additional benefit. For instance, lasers used in conjunction with scaling and root planing (also known as a deep cleaning or deep scaling) can result in additional improvement. I am optimistic that lasers will replace the scalpel blade or curette as the instrument of choice for periodontal procedures. For now however, lasers are only employed in limited situations.
For the past several years, evidence has been accumulating which points toward a connection between periodontal health and one’s overall health. Correlations have been made between periodontal disease and heart disease, diabetes, pre-term low birthweight babies, and respiratory infections, to name a few.
The rationale behind all of the studies is based upon immunology. The pathogenic bacteria associated with periodontal disease, as well as the bacterial by-products, travel through the bloodstream and contribute to the digression of other organ systems. Furthermore, the body’s own immune system, in an attempt to combat the harmful toxins, releases antibodies and proteins which have been strongly linked to systemic disease.
It’s no surprise that the mouth is the gateway to the rest of the body, and science is merely confirming what many have suspected for decades. An important aspect to keep in mind is that all studies indicate a correlation, not a cause-and-effect relationship. So for instance, periodontal disease does not cause heart disease in itself; rather a significant number of individuals who exhibit severe periodontal disease also exhibit heart disease or the markers that predispose towards heart disease.
Regardless, the message is clear. The body is an interactive system, and maintaining excellent periodontal health is important for one’s overall health.
