Gum Disease a significant health concern

Gum Disease more prevalent than first thought.

While some estimates of the prevalence of gum disease in adults are as high as 80% , some studies by the Centers for Disease Control CDC) apparently had indicated a much lower rate. These earlier studies are now being called into question. The rate may be as much as 50% higher than reported earlier according to the CDC and the Journal of Dental Research JDR and the American Association of Periodontists (AAP)

See attached article from Science Daily.

Periodontal disease is one of the most common communicable diseases known to man. It has medical implications beyond simply the gum tissue as the inflammatory process associated with this disease is implicated in several other potentially life threatening conditions like heart disease, stroke, diabetes low birth weight in children and rheumatoid arthritis.

Periodontal disease is an infection of the gums associated with inflammation, bone loss and is mediated by hygiene, heredity, anatomy, bacterial type, stress on the periodontal ligament (biting forces), and restorations present. It is usually chronic and can greatly drag down the body's immune system.

Detection usually requires a dental and medical health history probing, x-rays, and observation by a dentist and /or hygienist.

To learn the signs and symptoms' of periodontal disease, click here.

Periodontal disease can easily go undetected until late stages when teeth loosen and fall out or begin moving. Early detection and regular dental follow up are key in controlling this devastating disease. Treatments can vary depending upon the location, severity of the disease.

With the advent of Laser treatments, periodontal disease now has a great new tool to help control the process.

We at Crystal Lake Dental Associates take great pride in being the only office in McHenry County to offer the Periolase© Laser gum treatment called LANAP.

To learn more about periodontal disease click here.

To learn more about laser gum treatment, click here.

I welcome your comments.

Sincerely,

Phillip C Neal DDS

Crystal Lake Dental Associates

20 B Memorial court

Crystal Lake, IL 60014

815 4596 2202

www.DrNeal.com

Looking for a Dentist in Crystal Lake?

If you are looking for a dentist in the Crystal Lake area, I have some suggestions.
Often the first question a potential new patient asks is do you take my insurance, or are you in my network?
While this is important to know, it does not have any bearing on the quality of the experience you will have.
If looking for a dentist in Crystal Lake here are a few of questions you should be asking.
1. Is the dentist using state of the art equipment?
2. Does the dentist take continuing education classes?
3. If so what classes has the dentist taken in the past 5 years?
4. Does the dentist require the staff to take continuing education classes?
5. Does the dentist do follow up phone calls to check on patients?
6. Does the dentist have digital ”super low dose” x-rays?
7. Does the dentist do a comprehensive dental examination and take complete records?
8. Does the dentist submit insurance electronically?
9. Does the dentist offer payment plans?
10. Does the dentist offer cash and senior discounts?
11. Does the dentist take children and at what age?
12. Does the dentist have special methods for anxious patients?
13. Are there any special amenities to make patients comfortable during their visit?
14. People hate getting numb, so does the dentist do anything special to make the numbing process more comfortable?
15. When was the last time the office staff was trained in CPR?
16. Does the dentist offer a free consultation?
17. Has the dentist had advanced training in cosmetic dentistry?
18. Does the dentist provide CAESY patient education materials?
19. Does the dentist extract teeth, do root canals, place implants, use precision attachments, use lasers, screen for and treat sleep apnea, do periodontal probing, treat TMJ, do minor orthodontics including Invisalign, offer ZOOM in office whitening?
20. Can the dentist make a crown in one visit “CEREC”?
21. Does the dentist offer laser gum treatments?
22. Does the dentist confirm appointments via phone/email/text?
Look through the list of sample questions and pick out the ones that fit your situation. We at Crystal Lake Dental Associates provide all of these services and much more. You will find that Crystal lake Dental Associates is the only dentist that provides these services in the entire McHenry County area.
I hope this helps you choose the perfect dentist for yourself and your family in the Crystal Lake area!

Respectfully,

Phillip C. Neal DDS
Crystal Lake Dental Associates

Core values "It's what you stand for"

We have spent the past 9 months reviewing the values we hold dearest to us in our lives.

We will continue to hone them over the next year as well as list minor core values our mission, vision, and purpose.The top 5 are listed below.

#1 Integrity

We are our word. We will be trustworthy in all circumstances..Will be honest at all times, keep our commitments, and do everything possible to do what is right under any circumstance. We will be fair is our dealings with each other, our affiliates, referring doctors, and our patients. If for some reason we cannot help a someone, we will go out of our way to guide them to the help they need.

#2 Courage

We will do the right thing because it is the right thing to do even when it is hard or costly. We will cross the river of fear and speak truthfully in a kind and loving way to correct a wrong when necessary.We are open to criticism as we can learn of blind spots. We will try new ideas, embrace change, and personal growth. We will support team member growth through trials and failures. We recognize that failure is a great teacher.

#3 Excellence

We will constantly strive to provide the highest possible quality and service. We will attempt to WOW our patients every day by doing the unexpected and going beyond. Achieving excellence requires constant training and feedback, and we will seek both. We are committed to continuing education of ourselves, and our patients. We want team members, partners, and patients to reach their highest potential. We will be a positive force for good in every life we touch.

#4 Respect

Relationships are very important to us and we will make every effort to have great ones with everyone. Gossip and slander have no place in our practice and will not be tolerated. A Patient's private information is to be protected at all times. We will communicate respectfully to each other and to our patients, business partners, referring doctors, labs, and vendors. We will believe the best about everyone. We will be great communicators and even better listeners. We will seek to understand before we seek to be understood.

#5 Teamwork

Teamwork is vital in everything we do. We will have fun at work and try to brighten every person's day. No one person is more important than another. We will help and support each other when needed. We are team members with our patients as we plan a strategy for their oral healthcare goals. We are team members with other referring doctors, vendors, labs, and other business affiliates. We will seek to be the best team member possible and will be humble servants.

Respectfully

Phillip C. Neal DDS

Which toothpaste and toothbrush do I recommend?

Toothpaste

Before I answer, let’s look at the history of these items and reason we are using them in the first place.

The history of toothpaste goes back to 4000 BC in Egypt. Toothpaste or tooth powder did not become popular in the western world until the 19^th Century. Many concoctions were used for various supposed remedies. In Germany, fluoride was added to prevent decay in the 1890’s. In America toothpaste containing fluoride was first introduced in 1929, but was given a bad rap by the American Dental Association because the safety had not been studied. Research continued on fluoride and in 1960 Crest toothpaste received the ADA approval. Since then fluoride had been established as safe and effective in reducing tooth decay.

Toothbrush

Toothbrushes have been around since the beginning of time. Early man used chewed up twigs to clean teeth. The first manufactured toothbrush recorded was made of horsehair in China in the 1200’s.For the next several centuries till the 20^th century, toothbrushes utilized animal hair attached to a handle. In 1930 nylon replaced animal hair in toothbrushes. Tooth brushing did not become popular in the USA until after World War II as the soldiers were required to brush daily.

Floss

The history of floss is very short.

Many people may have used cotton thread, string, and fishing line, along with any other suitable object to help pick food out off their teeth. Floss had not been officially invented until the 19^th century. The first commercial floss was made of silk. Later this was replaced by nylon, polyethylene and Teflon. Flossing did not become popular until after World War II in the US and the rest of the world. Only 10 to 14% of the population flosses regularly.

Why do we use these products?

Historical perspective

For millennia toothbrushes and toothpaste were used for flavoring, breath control, beauty, rituals, and some assumed health benefits. Flossing was used to remove chunks of food only. Up until the last century, no real health connection between using a toothbrush, toothpaste, and floss had been scientifically established.

Today

Today, people are looking for products that freshen our breath, whiten our teeth as well as improve our oral health. It is estimated that people US the US spend over 10 billion of dollars on oral healthcare products. Thanks to modern mass marketing, oral hygiene products are highly commercialized. Cutting through the hype to find products that are truly beneficial is challenging. The main “hygiene” products are touted to, prevent decay, freshen breath, kill bacteria, whiten teeth, reduce plaque, reduce gingivitis, reduce tarter, and reduce sensitivity. To some degree different products can do this. The problem is how well they do this and what are the risks. I am not convinced that enough research has been done on many of these additives and their long term safety.

What are some of these additives?

It seems that marketing of toothpaste and for that matter most oral hygiene products requires that the manufacturer REINVENT their products constantly. In my opinion, these reformulated products are not necessarily better than the original. The addition of fluoride to a toothpaste is the only one that I am in favor of due to its ability to reduce tooth decay. The addition of Triclosan (an antibacterial agent) to reduce gingivitis and plaque formation may be harmful as well as leading to genetic mutation of bacterial strains that are resistant. The addition of sodium lauryl sulfate (a foaming agent) can lead to mouth sores and other problems with sensitive mouth and gums as it dries out the tissue. There is some promise with the addition of remineralization agents like tricalcium phosphate (TCP) which mimics the composition of tooth enamel. For sensitive teeth, there are a few products that use TCP, strontium chloride or potassium nitrate to seal up sensitive dentinal tubules in exposed tooth roots. These work fairly well. Flavoring, coloring and various abrasive agents are not necessary if you brush regularly. Whitening agents may have a minimal effect on tooth color but in my opinion are not necessary.

What is going on in your mouth?

Your mouth is like a garden filed with microorganisms. You usually inherit these from your parents at birth. You will always have bacteria in your mouth, and the goal of good oral hygiene is to control this garden and prevent it from damaging your body (teeth and gums etc.).

The bacteria form plaque on the teeth. Bacterial plaque that damage your tooth and gums live in a very sophisticated community called a biofilm. In this biofilm community, the various bacteria live synergistically helping and protecting each other. It takes about 24 hours for plaque to turn into a mature biofilm. The disruption of this plaque a couple of times a day by brushing and flossing keeps it from getting organized enough to do any damage.

What is the best way to disrupt the plaque?

The best method for this is a sonic toothbrush and flossing. Tongue scraping can also reduce the bacterial load in your mouth.

Saliva

Your saliva acts as a buffer (diluting and neutralizing agent). Saliva also has some antibacterial proteins to fight some bacterial infections. If you have low saliva flow (a dry mouth) due to a medical condition, or a medication that you take, the bacterial byproducts do more damage. Mouth breathers due to airway restrictions in the nose or allergies have the same problem with saliva not buffering and protecting the teeth and gums. Diet and hygiene are more critical for people with low saliva flow or dry mouth.

So what do I recommend and use?

For a toothbrush, I use and recommend a Sonicare® toothbrush as the sonic motion disrupts the biofilm on and between the teeth. Any floss will do. I prefer a xylitol and fluoride toothpaste by Carifree®. To kill germs and freshen breath, either a xylitol mouthwash by Carifree® or Listerine® mint are my favorites.

The Sonicare® disrupts biofilms on and between the teeth better than any toothbrush. It also can be useful in preventing gum recession and root notching due to its motion. Patients in our practice using Sonicare® brushes show improved gum health. Xylitol (a natural product) interferes with the acid producing bacteria’s function and helps reduce decay. It also is a great low calorie sweetener. I like Listerine® for its antibacterial properties and the ability to really freshen my breath.

If you cannot afford the Sonicare®, a soft bristle toothbrush is the next recommendation. Do not use any other powered brush that has a rotating head (these cause damage to tooth roots and gums and are very difficult to use properly).

Keep an open mind

In the future, I may change my opinion as scientific research provides new evidence for or against these and new products and additives. It is my continued hope that manufacturers will conduct proper studies on products prior to hyping them and bringing them to market.

Phillip C. Neal DDS

Fluoride benefits vs risks

While I believe that Fluoridated drinking water, Fluoride in toothpaste and periodic Fluoride applications at the dentist office are beneficial, I will address the opposing view as well.

Fluoride and teeth.

Fluoride is incorporated into the matrix of the enamel forming a compound called Fluorapatite. This Fluorapatite is less soluble in acid than the hydroxyapatite normally found in enamel. Consequently the tooth is more resistant to decay.

This Fluorapatite can be incorporated throughout the tooth enamel during its development if Fluoride is present in small quantities during the developing years for the teeth (age 0 to 13). Topical Fluoride can also be incorporated into the surface layers of a tooth by daily use of a Fluoride toothpaste and a supercharging twice a year with a professional application of Fluoride in a dental office.

In the 1880’s it was noted that some people in certain areas of the US and Mexico had a condition called “mottled enamel” as well as less tooth decay. Subsequent studies indicated that a level of 1 part per million of fluoride added to drinking water seemed to reduce tooth e decay by as much as 64% while not causing the mottled enamel (called “dental fluorosis”)

Fluoride in high concentrations excess of 3-5 ppm in drinking water or in the diet can cause dental fluorosis as well as ostiofluorosis. Very high concentrations (14 ppm) and higher can lead to other conditions. Most of the uptake of fluoride takes place in childhood up to 90% uptake. Uptake drops to about 50% or less during adulthood. Fluoride in drinking water is useful in the developing dentition while teeth are still forming. This benefit drops off completely after age 13While there is controversy in the safety and efficacy in the use of Fluoride in drinking water for decay prevention, there is more evidence that it does protect teeth from decay.

History of Fluoride usage.

Fluoride was determined to reduce tooth decay decades ago. It was found to do so when people living in areas where drinking water had higher concentrations of Fluoride also had less decay.

Fluoride was first introduced into public US drinking water in the 1940's. It was met with opposition from the beginning claiming diseases, birth defects, and a Communist plot. The opposition continues even today. Some other developed countries have stopped water fluoridation programs due to studies showed inconclusive proof that it helped reduce decay in the population. Other studies linked fluoride with diseases and conditions in a higher frequency. When viewing all of the studies done to date, it is apparent to me that hardly any were performed in a manner that would show a statistical relevant trend in either direction. Since the newer studies have been undertaken, Fluoride is being incorporated into the lives of most people in developed and developing countries through toothpaste and processed foods. This new development is making it hard to determine to what extent fluoride in the drinking water is having an impact.

The changing picture of tooth decay.

Since the high use of fluoride and dental sealants, and super low dose x-rays, we are seeing a new decay pattern is children and young adults. There is significantly less decay however the decay is harder to detect. The Enamel can look pristine on the surface, but a tiny pit can be decaying below the surface is some cases. A new dental laser “DIAGNOdent” is highly effective in detecting this type of decay. With the aging population retaining more teeth and the myriad of medications (over 3000) that cause reduced saliva flow, we are seeing root decay on the rise in adults. Gum recession and extensive (expensive) restorations can exhibit recurrent and root decay.

Fluoride applications in adults will be more beneficial than ever as more adults retain more of their natural dentition. Topical Fluoride applications and high concentration fluoride toothpaste gels are often needed to reduce this problem.

My Conclusions.

Fluoride has been very beneficial on reducing or eliminating tooth decay, and will continue to be a valuable part of preventive dental care. Of equal value is a reduction in refined sugars and good oral hygiene. Fluoride has saved people from millions of fillings, root canals, crowns, bridges, partials, dentures, extractions and pain and billions of dollars in cost for treatment. It will continue to be used by the dental profession to promote healthier teeth unless any well controlled scientific studies can provide overwhelming evidence that its risks outweigh its benefits. As yet, I have not seen any; however I will keep an open mind.

After reviewing the studies and data available, it is clear that today more people are getting fluoride in the world by consuming commercially produced foods and beverages. These processed foods and drinks are usually produced in plants that use public drinking water as a component. This water will have fluoride in it in most cases. It is also clear that there is less tooth decay in the younger population, though it is on the rise in younger children as they are consuming an incredible amount of products with refined sugar.

Eliminating Fluoride from you diet.

There are many online resource regarding the dangers of fluoride

If you are not on well water, it is difficult to obtain water (including bottled) that does not have Fluoride in it to some degree. Filtering your tap water can eliminate Fluoride, but you must use a special (check with the manufacturer) filtration system.

Your comments are welcome

Phillip C. Neal DDS

Crystal Lake Dental Associates

280 B Memorial Court

Crystal Lake Il 60014

815 459 2202

www.drneal.com

Dental Insurance... What is going on?

History of Dental Insurance
Did you know that dental insurance first came on the scene in the early 1960's. Did you also know that the typical annual maximum coverage for dental insurance was $1,000.00. The annual maximum has remained virtually the same for the past 50 years while dental costs have increased by a factor or about 700% since then. Interestingly, the rate if inflation or(CPI) for all consumer goods over this period is also $700%. So even though dental fees have matched inflation, coverage has not come close. I would also hazard a guess that the cost of the premiums have at least matched inflation.
What does it mean?
If the coverage was $1,000 per individual for a family of 4 in 1965, and the premium cost was about $10 dollars a month, and now premium cost is now say $7o.00 a month for the same $1000 per individual for the coverage for the same family of 4, where did the money go? Not to you the consumer, and not the dentist. It went to the Insurance company. Utilization has increased since your coverage does so little now. It now costs much more to process your claim even though we have electronic claims processing. Insurance companies also often employ a lot of delay tactics and loopholes to deny claims. In fact is seems that insurance companies spend more money and time trying to tie up, delay and deny claims than ever before.
We have to take unneeded x-rays and photos in order to document and justify more and more common treatment. More dental administrative time is being allocated to process claims and appeal denials. This drives up our costs.
Is Dental insurance important in your choice of Dentists?
One of the first questions new patients usually ask is if we accept their dental insurance. The question has been changing though more recently. Many patients have seen their traditional insurance plan changed to limited networks where they have to pick a dentist from a list, or risk paying a higher amount out of pocket.

History of Networks and HMOs
Back in the 1980's insurance companies tried to lower costs and called the plans HMOs (Health Maintenance Organizations) or DMOs (Dental Maintenance Organizations). HMOs turned out to be very unpopular due to the poor quality of care. These entities were very similar to the current "networks" being offered.
How is Healthcare Reform and the economy affecting Dental care?
Many Insurance companies have had to drastically increase their rates and find cost cutting measures as they gear up for "Healthcare Reform" These companies are being required to cover more people, with expensive "preexisting" conditions, and not deny coverage to anyone. This will drive up their operating costs. These costs must now be passed on. The recipients of this burden are:

1. The patient with a plan that pays less.
2. The employers who must pay more for the same coverage or opt for plans with poorer coverage.
   
3. The Health care care provider, who is faced with a choice to join networks that pay very little of the actual cost of care or risk fewer patients with adequate means of insurance coverage to pay for the needed care.

Often the result here is emergency and patchwork dental care as patient can only afford limited care. The risk of a "network" is long delays, inadequate, sloppy care and mistakes, as high volume and low overhead is the key for them to remain profitable. In an economic downturn, the problems of this situation are magnified. Nobody knows for sure how this will play out.
What are we doing?
We at Crystal Lake Dental Associates are committed to high quality personalized dental care. We are also constantly trimming unnecessary costs in order to offer affordable care. We welcome your comments and questions.

Sincerely,

Crystal Lake Dental Associates

280 B Memorial Court

Crystal Lake Il 60014

815 459 2202

www.drneal.com

Back to School checkups

Back to school checkups

It is that time of the year to get the children ready for school.

Clothes, books, and other supplies are on the shopping list. It is also time the schedule visits to the doctor and dentist and the eye doctor for many students.

We at Crystal Lake Dental Associates know the importance of a regular dental exam and routine cleaning and care means less dental problems in the future.

We check not only for decay, but developing problems like growth and form of the teeth and jaws. A review of dental hygiene and nutrition is important to dental health. After a thorough cleaning, we recommend fluoride is a special form “Vanish” to give long lasting protection. We also go over home care and check soft tissues for proper position to prevent future problems. We use a DIAGNOdent laser cavity detection system to look for decay below the surface where x-rays and even a visual exam with an explorer can miss cavities. We use digital x-rays with very low radiation as another safe diagnostic tool. We will recommend sealants on permanent back teeth in order to prevent future decay. Sealants are one of the most effective ways to prevent decay in the deep grooves of back teeth.

Children entering preschool, kindergarten, 2^nd grade, 6^th grade, 9^th grade, transferring into a new school, or participating in sports activities are required to have various examinations or physicals prior to starting school. A list of the examinations is included on the link below. Some of the common exam forms as well as waiver forms can be printed off here by clicking on the appropriate link. To check into the school system you are attending in the area, I have included links to the local school systems in McHenry county web sites.

Dental exam form

Dental waiver form

Medical exam form

Eye exam form

Eye waiver form

Athletic pre-participation medical exam form

Health record requirements for Illinois students

Immunization requirements for Illinois children

List of Public School districts in McHenry County

Illinois Department of Public Health

McHenry County health department

Have a great summer and a super school year!

Phillip C. Neal DDS

Crystal Lake Dental Associates

280 B Memorial Court

Crystal Lake Il 60014

815 459 2202

www.drneal.com