I.C.E. - I.C.E. - Baby

7/22/2013

In Case you are wondering, I.C.E. is an important abbreviation for In Case of Emergency!

Over the weekend, our team took a CPR renewal class together. We like to be prepared for anything that may come up and your safety and health are our top priority at McAdams Dental. It was interesting to learn that the American Heart Association (AHA) has made a few changes to the recommended emergency response protocol and we thought we could share these with you to help spread the word!

Once you have identified a crisis situation because a person or patient is non-responsive and is not breathing, the AHA recommends that you first activate the emergency response system. This means either do it your self or make someone else call 911 and alert the authorities that help is needed. After you are sure help is on the way you should check for a pulse to determine if the person’s heart is working. If not proceed with CPR as follows:

The new acronym for CPR treatment is C-A-B meaning Compressions-Airway Maintenance-Breathing (which is a big difference from the previous recommendation you may be familiar with). In this situation you would begin chest compressions alternating 30 chest compressions with two breaths delivered mouth-to-mouth. If the situation is not conducive to mouth-to-mouth contact don’t worry, it is totally acceptable to now deliver “hands-only” CPR in which you would provide constant compressions only stopping to take a rest if/when another person is available to take over compressions.

High quality compressions are required to depress the chest approximately 2” to be effective so you will most likely have to press as hard as you can to achieve a good result. Many injuries are possible during CPR, but like our instructor said…if the patient tells you that you hurt them, you saved their life!

For more information on "Hands-Only CPR" visit the AHA website at:

https://www.heart.org/en/affiliates/hard-hats-oregon-cpr-resources

If you are in the Phoenix area and looking for a dental home where your providers are ready for any situation, maybe we are the office for you…we would love to meet you!

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The Whole Enchilada

5/9/2013

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I received an email last week that has had me thinking quite a bit. In this letter, a prospective patient asked the unexpected question, “ARE YOU A HOLISTIC DENTIST?” I’ve been thinking about how to answer this all week and I’ve decided that the answer to this question in my case is a resounding yes. My research tells me that holistic dentists consider a patient’s dental health as it relates to their overall health, and this captures the goals of our practice perfectly.

Our dental team is proud to focus on a person’s overall health and systemic health issues as they relate to the treatment of their oral condition. Lets examine the top 3 holistic aspects of dental care at McAdams Dental:

1.     Medical History Review – Believe us, it IS important that your dentist know your most current medical information, including what types of prescriptions you may be taking. Are you aware that some very common bone density medications can lead to a very severe adverse reaction when teeth are extracted? Or that a dentist can save you years of agony by handling teeth issues before entering chemo and radiation therapy? Did you know that many common prescriptions cause dry mouth that can devastate your oral health if not addressed with prevention in mind? We review all of this information to help you develop a personal preventative care plan that is specifically tailored to your needs.

2.     Thorough Oral Evaluations – We are sticklers for good records at McAdams Dental. These records help us track trends in your teeth and gums that are telling of many common diseases. During routine evaluations, we have identified signs of many systemic conditions that our patients were not aware of. We commonly find characteristic erosion of teeth that suggest patients are suffering from severe nocturnal G.E.R.D. (heartburn), among other conditions. Additionally, our low radiation digital imaging allows us to identify abnormally calcified arteries in the head and neck, and we have treated infected teeth that have been misdiagnosed as recurrent sinus/ear infections for years. As discussed previously in our blog, we also screen every mouth for early signs of oral cancer and many of our patients tell us that our dental chairs are the only place they ever have their blood pressure checked. All of these aspects of your systemic health are evaluated before we ever look for cavities, because we know the importance of a healthy mouth.

3.     Periodontal Assessment and Treatment – Our hygienists carefully check your gum pockets and monitor your trouble areas with prevention in mind. Many patients in our practice benefit from a thorough cleaning schedule specifically designed for each patient’s gum condition(s). Perhaps a deep cleaning or a more frequent recall schedule can save you from one of the most prevalent types of persistent bacterial infection and sources of chronic inflammation in the human body. Did you know that your gums may show signs of a wide array of health conditions; ranging from fungal infections to more serious issues like leukemia or HIV. More and more recent medical research correlates the presence of gum disease with other systemic health conditions, such as glucose regulation in diabetics or cholesterol and arterial plaque levels in patients with heart disease. We truly believe that your mouth is the gateway to your overall health and we strive to help you maintain the healthiest body you can by keeping your mouth and gums in top shape.

Are you looking for a dentist who is interested in more than just diagnosing fillings and crowns? Call to schedule an appointment if you are in the Phoenix area and think we might be the office for you. We would be happy to meet you and proud to help you take care of your mouth.

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Keep It In Check!

4/27/2013

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Here are several reasons that your routine dental checkup is important! In this update, we discuss the things we are screening for during your routine dental examinations that you may be unaware of.   As members of your overall healthcare team, we want you to be aware of the benefits of your regular dental checkups beyond just fresh breath!

Case #1:

Earlier this year Dr. McAdams discovered something in a patient’s mouth during a routine dental examination that concerned him enough to order a biopsy. Pathology reports indicated that a small white bump in the area where a molar had been extracted recently was an uncommon form of carcinoma. When caught early (like this was), oral cancers can be removed entirely and without complication. When allowed to progress unchecked, oral cancers can lead to complete removal of the tongue, lower jaw or in severe cases can be fatal.

Case #2

In early 2013, a patient presented for a routine cleaning with a blood pressure in the range of possible stroke or heart attack. We gave him time to determine if he was suffering from “white coat syndrome” and decided that he should see a physician for a proper diagnosis of his cardiovascular health. The patient hadn’t had his blood pressure checked in years and within days was on a blood pressure control regime with his doctor and his BP is within normal limits during his dental visits now.

The ADA reports that there are over 42,000 cases of oral cancer diagnosed each year in this country. This number is up over 25% from estimates in 2010. With the incidence of oral cancer on the rise, your dental team is a critical piece of your healthcare team who offer you screening services during each exam.

Some things we are checking that you might not be aware of:

1.    Medical History Review: Some commonly prescribed medications have a possibility for severe dental interaction. With current information we can keep you informed about your risks of anaphylaxis, dry mouth, osteoradionecrosis (ORN), periodontal hyperplasia, or bisphosphonate related oral necrosis of the jaw (BRONJ) amongst other things. Also, some conditions require pre-medication with antibiotics to prevent infection following routine dental treatment.

2.    Blood Pressure Screening: Many of our patients have no idea what their typical blood pressure is, at each checkup we are monitoring your pressures and can compare to our historical records to help you determine if you should see a physician for help with the issue.

3.    Oral Cancer Screening: When we ask you to say aahhhhh, or grab your tongue to look underneath it, we are looking for signs of oral cancer, which can include white patches, red bumps or non-healing ulcerations. If we find something, we can help you decide if it warrants further investigation. In almost all cases in our office, patients are unaware of the early beginnings of oral cancer. This is when you want it stopped.

4.    Radiographic Evaluation: Routine diagnostic xrays help to determine the health of your teeth and supporting bone. In the standard, low radiation, digital series that we prescribe, your dental team can identify sinus obstruction, potentially metastatic lesions from colon, breast or prostate cancer, and calcification of blood vessels in your neck and jaw that could indicate blockage in blood flow.

Hopefully this information sheds a little light on the importance of routine dental evaluations. We aren’t just checking for cavities, we are evaluating the health of your mouth, which is the gateway to your overall health. We can’t understate the importance of the health connection between your mouth and the rest of your body.

For more information about oral cancers visit the ADA website:

https://www.mouthhealthy.org/all-topics-a-z/oral-cancer.aspx/

We perform all of these tests during each checkup because we care about the health of our practice and our patients. If you are looking for a Phoenix dental team where you can trust that we take great care of each patient, consider visiting our office. We would love to meet you!

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So Fresh And So Clean

4/18/2013

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Dental sterilization is a hot topic lately, so we thought it was a good time to explain how the good guys handle this very important issue.

Our instruments are prepared for use by a three-step process. The sterilization process takes each and every tool from dirty to clean and requires careful attention to detail.

Instruments are cleaned manually, using wire brushes and visual inspection to remove all visible debris. Special safety equipment is used to protect our team during this step.
Second, instruments are placed in an enzymatic cleaning solution in an ultrasonic vibratory cleaning bath. In this step, debris is removed from the instruments mechanically.
Instruments are then sterilized in an autoclave that is proven to kill all living organisms by reaching a VERY high pressure and temperature.

No secrets here, just CDC approved sterilization methods! How do we know it works? Firstly, we purchased state of the art, modern sterilization equipment that has digital controls indicating the temperature and pressure reached during each sterilization cycle. We know that’s great, but we take it one step farther and use instrument pouches that have indicators further confirming that proper temperature and pressure has been reached by a color change. Double checked! But wait there is more, each week we use a test strip with a highly challenging microorganism contained inside. This strip is tested by an independent laboratory confirming that our sterilizer can take out any common microbial organism and eliminate your risk of cross contamination. Our autoclave has a 100% lifetime pass rate on these tests!

Furthermore, ALL operatory surfaces are disinfected with chemical wipes between patients and ALL plastic tools and piercing objects are considered strictly “one time use only” in our practice. These items are disposed of in red biohazard containers promptly after each patient.

We take all of these precautions because we care about the health of our practice and our patients. If you are looking for a Phoenix dental team where you can trust that we sweat the small stuff as much as you do, consider visiting our office. We would love to meet you!

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My Tooth Hurts!

3/16/2013

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My Tooth Hurts!

We saw a lot of emergency toothaches this week and Dr. McAdams thought it would be a good time to shed a little light on the testing we do to determine why your tooth hurts. You may remember the "cold test" where something cold is applied to your tooth to see how it responds:

Well, this is a very important test that tells us a lot about the health of your tooth. Dr. McAdams considers the following possibilities when looking at a toothache to determine how to proceed:

FIRST WE RULE OUT THE OBVIOUS SOLUTIONS:

1. Have you had a cold or allergies recently? Many tooth aches are caused by sinus pressure because the roots of your top back teeth are very close to your sinuses. If all else is normal, this type of toothache can be treated with over the counter sinus medication.

2. Do you have something stuck in your gums? It can be very difficult to tell if your tooth pain is coming from your tooth or your gums, but we often find things wedged in the gums and removal of it can relieve your toothache. We find all kinds of things from broken toothpicks to popcorn husks in there.

3. Do you have gum recession? Many times an overzealous brusher will cause themselves gum recession and this can cause minor sensitivity to temperature changes. In this case, the patient can relieve the issue by using a sensitive formula toothpaste to desensitize the exposed root surfaces. (It might take a couple weeks to kick in).

4. Is the tooth cracked or decayed? At times a piece of the tooth can be missing, and it might expose the sensitive inside layer of the tooth. This can require a simple filling to solve the problem, but the fix may warrant extraction depending on how close to the gums the crack gets. If this is the case, get it fixed quick!

ALL ELSE EQUAL, WE USE THE COLD TEST:

The cold test tells us the overall health of the tooth, and how to treat the problem. Generally a toothache proceeds like so:

1. A healthy tooth with no cavities, cracks or issues has what we call a "vital pulp." Cold stimulus on a vital tooth will cause an immediate reaction that will immediately dissipate when the cold is removed. The reaction shouldn't be terribly painful, but you should know your tooth touched something cold.

2. Minor pain will develop in response to damage. In this case the toothache is causing nerve irritation. If the tooth is highly sensitive but the pain does not linger for a while after it starts this is called "reversible pulpitis" and the tooth can be fixed at this point with a minor procedure. Think of this as a red flag, its time to see a dentist.

3. Major pain will then develop if the problem goes untreated and the tooth starts to respond to cold in a very painful way. At this point, the pain will linger after the cold is gone and this tells us that the nerve in the tooth is damaged beyond the point that it will heal. This is caused "irreversible pulpits." Unfortunately, at this point a root canal is needed if the tooth is to be saved.

4. Suddenly the toothache goes away. Now the tooth can't feel cold at all and the test gives us no response. At this point most people think they dodged the bullet and that they will no longer need dental treatment. What they don't know is that the nerve has now died and the diagnosis now is "necrotic pulp." At this point, bacteria have killed the tooth and are now using the nerve of the tooth as a food source brew a large infection. After a few months of unchecked infection, the symptoms will return because the infection slowly deteriorates the bone around the tip of the tooth until the pain returns along with swelling, draining infection, and a terrible odor/taste in some cases. Depending on how long the infection goes untreated, patients may find themselves hospitalized by an infection that migrates to the heart, or worse, the brain. At this point, an antibiotic can relieve symptoms temporarily but treatment is absolutely necessary.

For more information, read about root canals on the ADA website:

https://www.mouthhealthy.org/all-topics-a-z/root-canals.aspx/

Dr. McAdams recommends seeking treatment for a toothache as soon as you can. Because the symptoms are difficult to identify on your own, he suggests you find a dentist you can trust and sort out the cause of the pain as a team. If you are looking for a Phoenix based dentist consider visiting our office. We would love to meet you!

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Will My Veneers Last Forever?

3/8/2013

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Will My Veneers Last Forever?

You may be surprised to learn that a porcelain veneer is not a permanent solution to improving your smile. In fact, it is common for a set of veneers to need replacement at some point between 5-10 years after bonding them to your teeth due to normal wear and tear.

Here is a perfect example of what to watch for: At McAdams Dental, we recently encountered a situation where a set of porcelain veneers had outlived their useful life. The patient enjoyed 13 years of showing off her beautiful porcelain smile, but you might notice that over time a few problems have developed. Notice the spacing between the front teeth, fading color, dark stained pitting, and yellowing/darkening along the gums at the edges of the veneers shown in the photo below:

Our patient was ready for an update to her smile and as a birthday gift to herself, we worked together to provide her a set of veneers that she was happy to show off, in fact….she couldn't stop smiling! After carefully assessing the patients concerns, we were careful to place the edges of the veneers in a more healthy and beautiful location, all spaces between the teeth were closed, and a more natural transition of color from a translucent tip to the natural shade near the gums was used to improve upon her flat, all white smile.

In the end, we achieved successful improvement by placing 8 porcelain veneers on her upper front teeth, compare before and after in the photo below:

BEFORE AND AFTER PHOTO: SMILE UPDATING WITH VENEER REPLACEMENT

The patient was quite happy with her more natural looking smile, and the improved health of her gums, Dr. McAdams felt that a more natural shade than flat white would complement the patients skin tone and facial features. See for yourself in the smile photos below.

AFTER PHOTOS: LEFT AND RIGHT SIDE SMILE PHOTOS

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Sports Safety For Your Mouth

1/19/2013

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Its not uncommon in any sport, that an athlete is injured by taking trauma to the mouth. Have you noticed how all of the NFL, NHL, NBA and other sports pros are always moving their mouthguard in and out of their mouth, sometimes even putting it back in their mouth after it falls on the boxing ring or in the grass? Gross! The point is, that it is a very normal, and very important accessory for the safety minded athlete of today.

It might be even more important for kids to wear mouth guards because their bottom jaw tends to grow last, leaving those big front teeth unprotected and exposed to danger from the time they are about 6 years old until they finish growing!

Dr. McAdams has had a lifelong battle with a dark front tooth resulting from a wrestling injury in high school and this is why we are promoting the use of sports mouthguards for all athletes. The easiest method to protect your teeth is to pick up a "boil and bite" guard at any sporting goods store. These are a good alternative for growing kids because they are inexpensive to replace and not the biggest deal if they get lost! A custom made dental mouth guard is a good idea for those who have a hard time breathing with the store bought guards because we can make them sleeker, however, there is a bit more cost involved. Regardless of which kind of guard you use…just use it! Your teeth will thank you later.

You never know when you might wish you'd been wearing a guard. You might be surprised at the causes of the top 5 dental sports injuries Dr. McAdams has witnessed in his career:

5. An unnamed dental school classmate of Dr. McAdams was out for a jog in San Francisco when she stepped off a curb and was hit by a car. Fortunately for her, she survived, but her front teeth required an extraction, Bone/gum grafting, an implant and a root canal before a lot of porcelain was used to put her back together.

4. Recently a patient in our practice caught a frisbee in the mouth during a game of ultimate frisbee. His tooth took a few weeks to show its injury, but a root canal and an internal whitening session were completed early enough that we bet you couldn't tell which tooth it was!

3. Dr. McAdams caught an elbow from a team mate at wrestling practice resulting in a re-positioned front tooth that turned black before he sought treatment. Multiple endodontic treatments and several internal whitening sessions have gotten it "almost back to normal." That injury ended his theory of wearing the guard only during competition.

2. Another unnamed dental school classmate of Dr. McAdams was at the beach and caught a mouth full of surf board on the recoil from his ankle strap. One broken incisor and several mis-aligned teeth resulted.

1. Dr. McAdams is a big MMA fan, and he watched as Lyoto Machida actually kicked one of Randy Couture's front teeth out at UFC 129. The most impressive part of this was that he WAS wearing a mouth guard, can you imagine how many teeth he would have lost otherwise?

Have more questions about sports mouth guards? Get them answered here:

www.mouthhealthy.org/all-topics-a-z/mouthguards.aspx/

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Xylitol is so Sweet!

1/13/2013

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Xylitol is so Sweet!

Would you be interested in using an ALL NATURAL sweetener that would actually help reduce your risk of cavities? Recent studies suggest that regular use of xylitol sugar (that same sweetener used in the lollipops at the front desk of our office!) can reduce your risk of cavities by up to 1/3! Although getting the benefit requires taking in about 6g per day, substitution of xylitol for your regular sweeteners can inhibit the ability of your plaque to produce the acids that cause cavities. Some easy ways to add xylitol to your diet: chewing gum, packets for your morning coffee, and mouthwashes and toothpastes that contain xylitol are easy to add to your routine! Xylitol can be tricky to find, but most health food stores carry several useful products. For more detailed information, visit dentist in Scottsdale.

Have more questions about xylitol? Get them answered here:

https://xylitol.org/faqs-questions-about-xylitol/

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Dental Care For Babies

1/5/2013

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Lately, our family practice is growing very organically…and by that we mean there are lots of new babies coming into our patients lives! Congratulations to all of the new moms and dads, and what better timing for a review of keeping your little ones mouth healthy. First, you can expect the first teeth to show-up around 6 months, which is why we recommend baby’s first dental visit at the 1st birthday. At this visit, we will make a friendly introduction to the dental office and work with the parents on the best ways to take care of the baby teeth. Most importantly, the little ones will find our pirate treasure box at the end of the visit! This important visit will set us up for a lifetime of comfortable dental care by starting him/her out with a fun, non-invasive introduction to the dental office.

Three key tips for taking care of baby:

1. Milk has sugar – so don’t put baby to bed with a bottle full of sugar every night.

2. Use a washcloth over your finger to brush until baby is big enough for the real thing.

3. You’ll have to help them brush until they turn 8, then they have the skills to take over.

Have more questions about pediatric dentistry? Get them answered here: https://www.mouthhealthy.org/all-topics-a-z/pediatric-dentistry-odontopediatria

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McAdams Dental Holiday Party 2012

12/13/2012

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Don and Jaime, Riding in style (Pictured Above)

Today we celebrated our accomplishments in 2012 by treating the team to a secret surprise holiday party. When you have a team as great as we do, they deserve a special celebration! All they were told was to bring some nice clothes to change into after work and to get a ride to the office. After work, we all went to the McAdams house to change and were promptly picked up by a limo that took all of us to Binkley's Restaurant in Cave Creek! Candice did her best to guess what we were up to…but she was way off! After our 28 course meal (no kidding), the car returned everyone home safely and a great time was had by all.