Hi everyone! This last weekend I took a 3 day class in Toronto entitled "Advanced Cardiac Life Support for Dentists". It was offered by DOCS (I belong to the Dental Organization for Conscious Sedation - www.docseducation.com ) and this is the 3rd 3 day class I have taken from them. The teaching staff was from Life Support Services, Inc., out of Ann Arbor, MI, and they were excellent! (Find them online at: www.LifeSupportServicesInc.com . They handle the emergency medical services for the University of Michigan Hospital, Washtenaw and western Wayne Counties.) The subject of the training were the additional procedures that are recommended by the American Heart Association beyond CPR and AEDs (defibrillators) to support life in the event of a heart attack, stroke, or similar. This included lectures on physiology, pharmacology, diagnosis, as well as intubating/establishing airways with King tubes, accessing EKGs on advanced AEDs with monitoring displays to determine when to shock and when not to, delivery of emergency drugs such as epinephrine, atropine, lidocaine, etc.and all manner of decision making needed in a emergency.
Essentially we were taught to do what paramedics and advanced emergency medics do when they pull up in their ambulances and transport patients to the emergency room. The 3 days consisted of lectures and hands on practice with a computerized dummy who talked, breathed, and had a pulse (sometimes!). It ended with a practical and written exam on which your dentist scored 100%. We plan to continue our training by having them come to our office and spend a day with our entire staff running mock drills and "codes" to make sure we are able to function as a team at the highest level to insure the safety of our patients in the unlikely event of an emergency!
Until next time!
Mark W Langberg, DDS
No, in most instances, adults with conditions such as exposed root surfaces (which make them more susceptible to decay or sensitivity), periodontal (gum) disease, significant restorative dentistry (veneers, crowns and bridges), or significant decay issues can benefit from fluoride treatments. The University of Michigan Dental School is now advising fluoride treatments in the dental office at hygiene visits for adults with these problems. Home applied topical fluorides (prescription high fluoride toothpastes or rinses) are a very effective alternative. In our office we prescribe 5000 ppm Sodium Fluoride toothpaste both with and without 5% Potassium Nitrate (the active ingredient in Sensodyne toothpaste) to manage tooth and root sensitivity. The brand we prescribe most often is Prevident 5000 Plus by Colgate. For those patients that do not have prescription coverage or have prescription copays greater that $15, we dispense Flouridex toothpaste (another 5000 ppm Fluoride toothpaste by Discus Dental with or without the Potassium Nitrate) for $15 (our approximate cost) to our patients as a convenience. Prevention is always cheaper that treatment, and ultimately the use of topical fluoride in adults saves time and money and reduces sensitivity. It makes good sense to protect your investment in your teeth!
Until next time,
Mark W Langberg, DDS, FAGD
Waterpiks do a great job of flushing food and debris out from between teeth, under braces and arch wires, and especially under and around fixed (non-removable) bridges. They are also helpful in washing away accumulated bacterial toxins in hard to get and chronically under-cleaned areas around restorative dentistry , tight spaces between teeth, or shallower periodontal (gum) pockets. Unfortunately, they DO NOT remove plaque (bacterial colonies) like floss does because effective flossing literally "wipes" the sticky plaque off teeth and Waterpiks can only "rinse" these areas. However, combining both flossing and Waterpics can achieve great results! Folks with dexterity problems or people who will just never floss will greatly benefit from Waterpik use and it is definitely better than doing nothing to clean in between your teeth. If you are not a flosser and are unwilling to put forth the effort to floss daily, then Waterpic use is a hugely beneficial alternative to just brushing, which does not clean in between your teeth where most dental disease occurs. And if you have fixed bridges you will find that regular Waterpic use will make your breath smell fresher, your food taste better, your mouth feel cleaner, and your bridgework last longer! More on Are Waterpiks a substitute for flossing?
In addition to completely sterilizing all instruments we use, liberal use of disposables and barriers, we have also responded proactively to concerns about bacteria which inevitably live and grow in water lines from municipal water supplies. All of the coolant water which comes out of our dental units in our handpieces is isolated from city water by a separate system of tubing which allows us to supply our own water, distilled and sterile, to our dental units. In addition, at night the water lines are purged to insure that bacterial counts are always well below tap water and your visits to our office will always be safe!
The vacuum, high heat, and steam used to autoclave each and every handpiece takes a significant toll on the bearings and the turbines. In order to thoroughly sterilize handpieces after each use we have accepted and absorbed significant costs to routinely replace these turbines and bearings. Each turbine/bearing assembly costs approximately $350. to replace, and this needs to be done quite often. Unfortunately, the technology of the bearings and fiber optics has not evolved to adequately cope with the stresses of frequent autoclaving. Unlike hospitals that can itemize and bill for all additional costs involved in patient treatment, there are many costs similar to this that we incur that are not separately charged to patients that figure into the cost of modern dental treatment and are absolutely essential to insure everyone's safety. We refuse to cut corners to save money on your safety!
Until next time,
Mark W Langberg, DDS, FAGD
Everything we use at our office on patients is either heat sterilized or disposable. In our office, all the doctor's and hygienists' instruments and handpieces are thoroughly cleaned in an ultrasonic cleaner before being placed in sealed sterilizer bags and placed in one of 2 autoclaves (hot steam sterilizers) and completely and totally sterilized. In addition, every other day our assistants run monitoring packets through the sterilizers which are analyzed by an independent service to be certain that the autoclaves are functioning properly to protect our patients and staff. Items which cannot be autoclaved are disposable. All surfaces in the treatment rooms are thoroughly disinfected with a hospital grade, EPA approved surface disinfectant and difficult to completely disinfect surfaces (such as headrests or electrical switches) are covered with plastic barriers which are changed between each patient. All of this is very time consuming (about 10 minutes added to each patient visit) and fairly expensive but is absolutely essential to keep our patients and staff safe and your dental treatment worry free!
Until next time,
Mark W Langberg, DDS, FAGD
We use only the best American dental laboratories and the best, highest quality materials for your crowns, bridges, veneers and dentures. The latest trend in dentistry is to outsource dental labwork to other countries to save on labcosts. Many dentists are using labs in China, Vietnam and India that will do dental labwork for 1/4 the cost of American labs. There is no regulatory oversight for these labs and you have no idea what kind of metals or ceramics are being used. As with most things, you get what you pay for.
We are extremely "picky" about who does our labwork, and our standards are very high. Since our reputation rides on all the restorative dentistry we place in your mouth, the choice of labs is 100% determined by the quality of the restorations, and 0% determined by the labfees our office pays. Anything else just doesn't work for us.
We use the best dental materials from such proven American companies as 3M, Kerr (Romulus, MI based) and Kodak. There are cheaper generics for almost everything. We don't use them.
Until next time,
Mark W Langberg, DDS, FAGD
Dear Patients:
This is a first for us, and I hope to make this blog a regular habit. It is always exciting to plunge into new territory and technologies, and I am grateful to have this blog forum available to us to further enhance the level of communication we have with our patients and potential patients. We pride ourselves on some of the things that are clear and evident to each of you that have visited our office:
- We pretty much stay on schedule!
- We keep you comfortable!
- We explain treatment and fees in advance.
- We see you promptly if you have an emergency.
- I am available 24/7 evenings and weekends for those "unexpected" dental problems and will gladly meet you at the office after hours.
- If you have significant treatment you will get a follow up telephone call from me within 24 hours.
- Our facility is clean, modern, and pleasant to be in.
- Our equipment is state of the art.
- We offer the best in treatment quality, and work with excellent specialists.
With over 30 years of experience, we are really good at what we do! Yet there are many things that you may never be aware of that go on behind the scenes in our practice. These are often even more important in providing safe, high quality dental care. In the next few blogs, I will briefly discuss these "behind the scene" things.
Thanks again for choosing us to privide you and your family with your dental needs. Just a reminder, Appointments can be requested on our website. For those patients that want to learn more about specific dental subjects and oral health, a helpful "Patient Education" section is also available.
See you next time! Bye!
Mark W Langberg, DDS, FAGD