The 4th of July is one of our favorite holidays in the Rogue Valley! The Ashland Chamber of Commerce does such a fantastic job of organizing the parade, fair booths, music performances - they blow us away! We love being a sponsor for the festivities and enjoy putting together a fun photobooth as part of our involvement. The photos are free to keep and always entertaining! Below are a few of our favorites (we even got Kelsey, the event organizer herself, in the photo booth with us). If you took photos at the booth this year, you can find digital copies on our Facebook album. As always, a huge thanks to Matt at Smile Photo Booth for providing excellent service. We highly recommend him for your next event or wedding!
Invisalign has become one of the most popular treatments in the world since its debut in May of 2000. It easily enables patients to straighten their teeth without uncomfortable and unsightly metal. You can learn a lot about the basics of how it works throughout our website, but we’ve noticed most patients are really interested in how it will affect their day-to-day lives. So, today we are answering lifestyle-related questions to help you discover what you can expect during treatment.
Will Invisalign affect what and when I eat?
We joke around at Soulsmile about going on the “Invisalign diet”. In the big picture, eating whatever you want is one of the advantages of Invisalign (compared to traditional braces where food gets stuck easily), but it does take a moment to remove your aligners, eat, and then MOST patient will feel more comfortable if they do a quick brush before putting the aligners back on. Because of this process, many patients find they snack less and thus dub this reduction in food intake the “Invisalign diet”. When I personally did Invisalign, I didn’t eat less food, but I did consolidate my meals a bit more.
A couple more considerations - drinking only water when the aligners are in will keep your teeth clean and your trays nice and clear. Colored beverages can stain them a bit. I was known to occasionally drink white wine with them in, but I wouldn’t say that’s an “approved” tactic.
Will brushing my teeth be the same?
You’ll be able to brush and floss as normal, which is great! You just take your trays out. However, you’ll be adding a bit of time and effort to your routine to clean your aligners. You simply brush them with your toothbrush. My advice is to use an electric toothbrush (which you should already be using on your teeth anyway!). I once traveled with only a manual toothbrush and was shocked at how much more stained my aligners were during that time.
Invisalign also makes some cleaning crystals that you can use to soak your aligners in that work wonders!
Can I whiten my teeth while using Invisalign?
In most cases, patients will need small bumps adhered to select teeth (Invisalign calls them “attachments”) to help move the teeth. Because of this, whitening during treatment is not advised. You can definitely begin your treatment with a round of whitening and we certainly encourage a tune-up after you complete treatment and are ready to show off your beautiful new smile.
What if I have a special event? Can I leave my aligners at home?
Compliance is the number one factor in Invisalign success. It is essential that you wear your aligners for 20-22 out of 24 hours every day. That said, if you have an hour-long job interview, you’ll probably be just fine leaving them out. You can even try to keep your other eating periods shorter that day to make up for it. On the other hand, a day-long wedding may not be appropriate for skipping your aligners. Use your best judgment and wear them as much as possible. The rewards will last a lifetime!
Is Invisalign Comfortable?
Although there may be occasional discomfort due to the snug fit of starting with a new set of aligners, this usually subsides in a couple days and patients find them to be significantly more comfortable than metal braces. The new-aligner discomfort also seems to diminish a bit as treatment progresses.
What Is the Invisalign Treatment Process Like?
- First, a free consultation with Dr. Kivel is scheduled to discuss treatment and ensure that you are a candidate for Invisalign.
- Once treatment has been agreed upon, the Soulsmile team will take X-rays and impressions of your teeth. These will be used to create a 3-D image to map out the exact movements your teeth.
- Next, we will make a customized series of aligner trays from virtually invisible (and BPA-free) plastic that will gradually re-align your teeth!
- You will progress through the series (or change out) about every two weeks.
- You will need to wear your aligner trays for 20 to 22 hours daily, removing them only to eat, brush or floss.
- You will visit Soulsmile about every six weeks to make sure you’re teeth are moving as planned.
- As with braces, you may need to wear retainers after your Invisalign treatment in order to keep your teeth in their new position.
Is there an age restriction for Invisalign?
We only recommend Invisalign for patients 18 and up for compliance issues. Fortunately, there is no upper-age limit! Invisalign is great for adults who previously thought they were “too old” to be wearing metal braces.
Hopefully, this answered questions you might have about Invisalign. If you live in Ashland, or Medford/the greater Rogue Valley, and have more questions, we would love to answer them - in person! Give us a call to schedule your free Invisalign consultation.
Lots of studies in recent years have been proving the connection between dental health and overall health. But a study released at the end of last year explored the link between dental health and childhood obesity. The study researched the habits and stats among 271 Swedish children. They found that children with a higher amount of carries bacteria (which is responsible for cavities) also had significantly higher body mass index (BMI) and unhealthier eating habits. Their eating habits more frequently and consumed more foods rich in sugar.
Because weight can be a sensitive subject, registered dietitian Louise Arvidsson advises focusing the conversation on dental health and the type of foods that can help or harm your teeth. Foods high in carbohydrates (starches and sugars) contribute considerably to the production of plaque and acids that break down tooth enamel which can eventually lead to cavities.
Food suggestions for dental health AND overall health:
- leafy greens
- lean sources of protein such as lean beef, skinless poultry, and fish
- dry beans, peas, and other legumes
- plenty of water
Tooth decay is actually the single most common chronic childhood disease, but the good news is that we can prevent it and impact children's overall health when we educate them and teach them healthy hygiene habits. Remember to teach children to brush twice a day, floss daily and visit their dentist regularly. If you have any questions or would like to make an appointment for your own child, please contact us or give us a call at 541-482-4995.
We know it can be very hard to understand dental benefits. At Soulsmile, we are happy to bill insurance as a courtesy to our patients. Our team encounters dozens of different insurance providers, all with multiple plans and “levels” making it impossible to know the details of each one. We always encourage our patients to get to know their dental plan to have the best estimate of what is covered. The only problem with this is also needing to know what many of the insurance terms they throw around even mean. In this blog, we are going to help you understand some of the terms and ideas behind dental insurance so you can feel confident in understanding your benefits.
This is the grand total that your plan will pay for dental services for an individual or a family (if you’re under a family plan). Most “years” reset January 1st, but occasionally we see them reset at the enrollment date, so you’ll want to check on this for your plan.
Basic or Minor Services
This is one of a few common categories of dental services defined by insurance companies (along with Preventative and Major, each explained below). Basic services typically fillings, sealants, extractions, periodontal treatment and sometimes root canals. Usually, the same coinsurance (patient payment portion) percentage applies to all services in a group such as Basic.
Closed Network Plan
If you are enrolled in a closed network plan you must see a preselected dentist in order to receive benefits. If you go to an out-of-network office with this type of plan, you’ll need to pay for 100% of your services. More commonly, you’ll find a breakdown of coverage for both in-network and out-of-network dentists.
This is your share of the cost of services, typically marked as a fixed percentage, of the contract allowance or “usual and customary” fee (see definition below). For example, a benefit paid at 80% by the plan leaves a 20% coinsurance obligation for the patient. This coinsurance applies after a required deductible is met (if necessary).
A dentist who has a contract with your network. In this case, the dentist agrees to accept the insurance carrier’s fees as payment in full for services to plan members. Sometimes referred to as network dentist or participating dentist.
A dollar amount that each patient enrolled in a plan (or family under a family plan) must pay before the insurance company begins paying benefits.
Diagnostic and/or Preventive Services
A category of services that usually includes exams, routine cleanings, X-rays and fluoride treatments. These fees are usually covered at 100% for in-network plans and 80% for out-of-network plans. Often times the difference for a patient to choose a dental office like Soulsmile, that might be out-of-network, for a normal exam and cleaning can be ~$20.
The date that benefits begin for an enrolled patient. Please be sure to get this information from your insurance company if it is a new insurance plan. We often see patients’ plans with a wait period (often 6 months or 12 months after starting a new job and insurance plan). Sometimes the wait period only applies to selected categories of services.
Circumstances or conditions that determine who and when a patient is covered by the insurance plan. These may include the length of employment, job status, length of time an enrollee has been covered, dependency, dependents’ age.
The total dollar amount a plan will pay for care for the life of the enrollee or the plan. This type of limitation usually applies to a specific service such as orthodontic treatment.
Limitations and Exclusions
Dental plans often opt to not cover every dental procedure. Each carrier can provide you with a list of conditions that limit or exclude coverage under your plan. Limits are often related to frequency (for example, no more than two cleanings in a 12 month period).
This category of services usually includes crowns, dentures, implants and oral surgery.
Any amount the patient is responsible for, such as coinsurance, deductibles, costs above the annual maximum or cost for services not covered by the plan.
Pre-treatment estimates are a written estimate of benefits provided by an insurance company in advance of proposed treatment. These are a very reliable way of finding out for a patient exactly what payment they would be responsible for at the time of service. Sometimes referred to as a predetermination.
Any licensed dentist who performs dental health services for the patient. This can also include dental specialists.
Usual and Customary Fees
This refers to the dollar amount set by an insurance carrier as a reasonable cost for a service. This term only comes into play when you are seeing a dentist who is out-of-network. This may also be referred to as the “allowed amount”. Let’s say your plan has an allowed amount of $98 for a cleaning, and your dentist’s fee is $111. The plan will pay 80% of $98, not $111. The difference in price will be the patient’s responsibility.
It's no secret that the Soulsmile crew LOVES Mt. Ashland. You'll find most of us there all winter long enjoying the wonderful terrain and awesome atmosphere. If you haven't been to Mt. Ashland yet, you have to check it out! Even if you go just to get a bite or a drink in the newly renovated lodge, its worth it just for the incredible views and to experience this fantastic little slice of our Southern Oregon community. You can even time your visit with one of the many fun events, like the Downhill Dummy (see our video below), they put on throughout the season. Experience some local mountain fun!
Thanks to the Mt. Ashland team for everything you do!
We are always so grateful to Shields and the LocalsGuide crew when they want to interview us and help people get to know Soulsmile and the people behind it. This is the full transcript of the article that ran in the December 2017 issue of the LocalsGuide in Ashland, OR ...
Hi Aron, it’s been a year since we last spoke. Tell us, what’s new with Soulsmile?
Shields, thank you for this interview opportunity. This type of support from the community has helped Soulsmile get its message out and boosted it beyond the business startup phase. Having moved mid-career from the Bay Area three years ago to start anew - I can’t express my thanks enough! We are committed to providing one patient at a time, high-tech, high-touch general dentistry with an emphasis on complex dental conditions and cosmetics. We deliver this service at a great value by really listening to our patients to come up with a treatment plan based on the patient’s wishes, and then performing in an efficient, predictable manner to achieve excellent results.
New for 2018 will be a monthly membership plan for uninsured patients, laser-assisted hygiene at no additional charge, cone beam 3D imaging for critical diagnostics, and 3D printing of diagnostic models for accurate planning and enhanced patient communication.
And personally? Congratulations on your baby girl. How is fatherhood?
Thank you! Siena is six months old and it has been absolutely wonderful. I’m most blown away by motherhood. My hat is off to my wife, Ryann, and moms everywhere. Second, I’m in love. I think about Siena all of the time and can’t wait to see her. I’m a softie already!
Starting a business brings about unexpected challenges. Would you share yours?
Right, these challenges are lifelong learning in an organic sense, as opposed to more academic learning. The two most significant areas where this has occurred for me with Soulsmile have been, first, the earning of trust in a new practice and in a new community, and, second, the development of my leadership skills.
I see that, as your “Modern Dentistry - Classic Values” slogan touches on trust.
Yes, absolutely. That motto is eight years old now, stemming from our San Francisco office. It’s easy to write a strong message into a vision statement, but trust is earned the old-fashioned way in dentistry. It doesn’t matter to a new patient if you’ve been practicing for a dozen years. Making a solid connection with everyone walking through the door who values our services is at the heart of earning that trust. So I have spent a good amount of thought on earning and maintaining trust rather than assuming years of service, academic background, technology or past success will speak for themselves.
How has leadership become a learning opportunity for an experienced dentist?
To get Soulsmile where we want it, I need to become a better leader. Simple as that. Podcasts and audiobooks, which were already in my regular diet, have been perfect for improving my shortcomings in this area. Of the ten or so audiobooks I have listened to this quarter, Extreme Ownership, written by a couple of Navy Seals, was my favorite. In a nutshell, it’s about taking full responsibility for every condition, situation, and outcome.
Beyond the application of building and maintaining a high-performance team, I now see what an amazing dynamic my team members bring to our business since taking full ownership of training, working through our vision, being vulnerable to them about my own dreams and concerns, giving them a safe and fun place to work, and allowing them to express themselves and own their personal connection with patients. It’s really exciting for me to see this team becoming one of our greatest strengths.
Those points make sense, as your patient reviews often mention being very trusting of you and your team. Do you have a particular philosophy to credit?
We feel lucky to have such great reviews from patients and humbled by their generosity. The patient experience is always on our mind. We actually have a six-star goal: a five-star review plus a willingness to refer a friend. Our patient exams are at the heart of this trust, I believe. A quote from the famous martial artist, Bruce Lee, might shed light on our approach: “No way as way, no limitation as limitation.” Lee’s philosophy rejected the idea of a preconceived response (in our application, a predetermined dental treatment plan) and mandates an open mind with no perceived limitation of what is possible. I can’t tell you how many times being open-minded, curious and communicative has uncovered a wide range of really important dental considerations, from a patient’s unexpressed desires to big life events - good or bad, to finances, to hidden dental conditions. We believe that every patient has a unique view of their dental health. Safety, comfort, dignity, beauty ... whatever the objective, it is in flux depending on a person’s situation. So our sincere goal is to have patients feel (“soul”) these positive ways (“smile”) about their dental experience.
So trust stems from focusing on listening before the big-picture plan?
Exactly. We combine what we have learned from our patients with a myriad of dental solutions - from simple to complex- to come up with an ideal plan for that patient at that specific point in their life. Sometimes the plan is even to do nothing; whatever fits the patient’s desire. Each team member is highly trained and crossed-trained so we can be nimble, often pivoting to a patient’s request while plugging in the relevant standard operating procedures that apply. This feels flexible, understanding and compassionate to the patient. But there is also an efficient and methodical backbone which gives the feeling of safety and comfort. It also allows us to see one patient at a time and to keep fees at a good value. A patient leaving a review may not directly notice these things. Such is the case with many of our favorite businesses.
You barely mentioned technology, yet many reviews comment on this as a strong characteristic of the practice.
As Jim Collins stated in his business book, Good to Great, technology can accelerate a business beyond good, but it will not in and of itself make a business great. People will. I love technology in dentistry. It’s great for patients and the progress keeps us all engaged. Using new technology is a state of mind; it keeps you in the loop. At Soulsmile, we don’t use technology before it is practical, tried and true. But we do continue to look for the slightest application for affordable technologies in order to stay in the mental game so that when the application of use say, 3D printing, comes full circle, we are on the train instead of looking for the station.
In your opinion, what is the least understood area of dentistry?
Dental implants. Implants are actually a group of components that are combined to create the part that the patient cares about: the tooth. Understanding the parts, prices and prognosis can be confusing. Also, a natural tooth is still the best implant. Implants are a fantastic solution for an empty space or a completely empty dental arch, but I think we need to respect mother nature and the patient’s desire to keep their natural teeth when possible and practical to do so.
What’s a question people don’t usually ask, but you wish they did?
“Here is my budget today and here is my projected budget, can you make me a three step treatment plan that will allow me to look and feel my best and keep my teeth healthy forever?”
Any particular observations from this mid point in your career?
It’s a great view from which to look around. I’ve been thinking about how my “n=” is getting high enough that what were anecdotal observations as a younger clinician have now become a large enough sample size to amount to bona fide professional experience. As mentioned, I like entering each exam and treatment with an open mind, a “beginner’s mind” in the yoga sense, and yet good clinical judgment and planning stems from solid experiences from which to confidently draw diagnosis and treatment proposals.
Lastly, I know you are an outdoor enthusiast and adventure athlete. Any new projects?
My wife and I love the Rogue Valley as a base for outdoor activities. The dirt is perfect for riding bikes right now and there will certainly be a good amount of backcountry and Mt. Ashland shredding in the months to come. We love paddling performance stand-up paddleboards and rowing at Emigrant Lake. There are fantastic adventure motorcycle routes all around. The list goes on, and yet, I have to say, that taking Siena for simple walks in the woods might be my new favorite outdoor pursuit.
Apparently, the five-year-old son of a friend recently confronted her just prior to his school-driveway departure. He said, "Don't even fink about kissing me when you drop me off at school. Your breff smells like coffee."
Unsurprisingly, caffeine is America's drug of choice. We consume a total of 700 million cups in a single day! We at Soulsmile love our coffee. There's always a fresh pot brewing in the team lounge and don't even get us started on all the awesome coffee joints in town (looking at you, Case, Noble and Mix!). Yes, it stains teeth. Yes, added sugar can contribute to cavities. But we are big believers of enjoying life's treats, especially when coupled with a proper hygiene routine.
We do, however, care about coffee breath. Coffee breath is not simply the smell of coffe. If that were the case, "coffee breath" flavored ice cream would sound just as appealing as coffee ice cream. Any takers? Not here. Coffee breath is actually the smell of sugar-eating bacteria in your mouth laced with coffee.
So how does your gorgeous cappuccino become a menacing platform for bacteria? It turns out the chemicals in coffee contribute to a slow down in the release of saliva. Saliva production is usually one of our mouth's best defenses, sloshing around to disrupt bacteria. With coffee, this lapse in saliva flow creates the perfect breeding ground for the more than 500 species of bacteria in your mouth. Studies have shown that showing milk in the mix can increase these effects even more.
So, to keep your pearly whites smelling fresh, there are a handful of tips to offset the effects of coffee after consumption:
- Brush your teeth
- Chew a piece of gum
- Drink water
- Eat something mouth-watering (think fruit, not bread)
Another factor to consider is your mouth's normal bacterial state. Bacteria grows exponentially. So the more bacteria that's present before coffee will contribute to more after coffee (and a worse smell). Come in for regular hygiene visits with Soulsmile, our Ashland OR dental office, and consult with our awesome team members on the best home care routines to keep your oral health in check at all times.
Hello and happy summer! We hope everyone has been enjoying the weather here in the Rogue Valley. We're particularly fond of afternoons at Emigrant Lake. Coming from the crowded state of California, we are always surprised at how few people are out on the lake, even in the middle of summer. Oh well - more fun for us!
We've noticed that we get asked a lot of the same questions by prospective patients when they first call in. We thought we'd gather a list to answer them in a blog.
Do you accept ______ insurance?
The easy answer is that we accept any insurance that allows you to choose your own dentist. My advice to friends and family when they have questions about their dental insurance is to request a copy of their benefits and become familiar with them. It is surprising how many patients are never given a copy of their benefits! Unfortunately, there are HUNDREDS of dental plans out there and they change yearly. A dental office will usually know the basics of your plan, but knowing the nuances yourself can answer a lot of questions. Most likely, you're looking for a section of your benefits titled "Out of Network". A lot of people are surprised to find that going to an out-of-network dentist may only cost them $20 more, but can mean a HUGE difference in the quality of care they receive.
Currently, we are IN network with Delta (aka Moda), Regence (aka Blue Cross Blue Shield) and Cigna. However, there are even some plans within those companies where they do not let you choose your own provider. So check out your benefits for the best answers! Feel free to ask us your questions too.
How much does _______ cost?
We are as transparent with costs for our services as possible and are certainly able to give you an estimate. The only problem is, without seeing what's going on in your mouth, its hard to know exactly what you need. Here are some common services we get asked about:
- A crown is usually $1,100. But in some cases, the tooth has worn down enough or has had a root canal and needs a $200 build up too. This is so the crown has something to secure it to.
- Fillings cost between about $100-300 depending on how many surfaces it needs to cover.
- Invisalign is $4700.
- A cleaning is $111. Unless you have periodontal disease and need a deeper cleaning called Periodontal Maintenance, that is $160.
Sometimes the best price to ask about is your initial exam (we usually run great specials!). From there we can see what you need and discuss costs. There are ways to work within any budget!
Do you offer payment plans?
Yes! We work with a third party service called CareCredit. They allow you to finance healthcare service, similar to using a credit card. They even offer no interest plans if its paid off within a certain time frame, usually a year. You can learn more or even apply on their website. We can also help you with the process in our office.
What will happen at the first visit?
First, you'll be greeted by our friendly team. Then, you'll be seated in our conference room to fill out welcome forms. We've had them laminated to eliminate paper waste. They are scanned into our computer when we're done and then erased for the next guest. You'll then be escorted to a treatment room by one of our awesome dental assistants. There, they'll take records. Most commonly this consists of not only xrays, but also digital images. Patients love that high resolution photography allows us to show you what we see. This way you can make more informed decisions about your dental care. Our assistants are highly trained and will often start the conversation about your dental health - if anything is bothering you, what they are seeing, your goals for your oral health, etc. Dr. Kivel will then do an in depth oral examination and review of records. He will present a comprehensive overview of your teeth and gums and if there is any recommended treatment. The main goal of this appointment is to give you any information you might want to know about your mouth, but most importantly - find out what you want and how we can help. Sometimes this means nothing at all! Other times, it means simply addressing any obvious decay or how your smile can look its best. It really is all up to the patient and what they want.
I just need a cleaning. Can I make an appointment for that only?
The state of Oregon actually requires that dentists perform an oral exam on a patient before assuming care for them. It makes sense! How can we even provide the best type of cleaning for a patient before we know what they need? So at Soulsmile, you'll first have an exam with Dr. Kivel and his assistants to see how things are going before booking a cleaning with our fantastic hygienists.
Do you offer consultations or second opinions?
Yes and yes! Anyone with more general questions about bigger treatment plans, cosmetics, treatment proposed by another dentist, etc, is welcome to come in to meet Dr. Kivel and an assistant for a free 15 minute consultation. This type of appointment is also useful for patients with dental anxiety who simply want to meet the team and check out the office before making their first appointment.
Have any other questions? You can contact us directly or leave it in the comments if you'd like us to add it to the blog article. Thanks for your interest in Soulsmile.
You may have seen some pictures on Instagram or YouTubers posting videos of the latest, greatest dental trend - charcoal toothpaste. Move over oil-pulling ... this DIY whitening trend consists of smearing a charcoal-derived black mixture on your teeth and brushing with it.
Proponents of the technique claim that because these mixtures are highly absorbent they can naturally solve surface stains. In fact, there are already medical applications for charcoal, like absorbing poisons in an accidental poisoning. Many "reviewers" online brush their teeth for 3-5 minutes with the mixture and then have seemingly whiter teeth afterwards.
Currently, the American Dental Association has not evaluated or approved of charcoal toothpaste. In fact, a representative for the ADA has commented saying the trend is concerning because its abrasiveness is not yet known and could be causing damage to people's teeth. Did you know, teeth are the only part of our bodies that does not replenish or heal itself. Once they are gone or damaged, it's a done deal. Of course, we can help correct any problems, but we'd rather see them avoided in the first place. But this means your teeth are usually not where you want to do any experiments. Fun new hair color or crazy nails? Yes! They grow back. Your teeth - not so much.
Whitening your teeth can happen in two ways. One, by scrubbing surface stains. Or two, by bleaching to actually change the color of the dentin. The later method is many times more effective. Charcoal tooth paste only claims to affect surface stains anyway, so if you're looking for real results, consider a professional whitening systems. These penetrate the enamel making teeth 3-8 times shades whiter, with effects that last years.
We've concluded that there is not enough evidence available yet to know if the supplement is hazardous, beneficial or benign. Our vote: wait until there are more studies (if that even happens before it falls out of favor). In the meantime, there are plenty of proven techniques and products for whiter teeth. Ask us at your next appointment about whitening options. We offer three levels to meet your needs and budget. As always, if you have any questions feel free to contact us or leave a comment below.
Walking the aisles of an Ashland drugstore will reveal a plethora of mouthwashes and rinses. These products tout dozens of features like germ eradicating ingredients, fluoride or even teeth whitening. Many of our patients wonder about the benefits and if they should make mouthwash a part of their daily routine.
Our short answer is that brushing and flossing are the two most critical habits that will affect your dental health. If you're doing a good job of these two, mouth wash is not a necessity.
On the other hand, it simply doesn't hurt to add an additional aspect to your routine, like mouth wash. While it may not live up to every promise advertised, it can be beneficial. We like to advise mouth rinse after flossing to help wash away any excess particles of food which may have been dislodged during your flossing.
One thing to keep in mind is that mouth wash will not necessarily help with bad breath. Often, bad breath is a result of dryness and the harsh alcohol content of many mouthwashes can worsen this condition. If fresh breath is one of your primary goals, we'd recommend selecting an alcohol-free variety. Plus, its easier to handle! Additionally, chronic bad breath is often a result of plaque build -up. Ask Jordon (or your own fabulous hygienist) at your next cleaning if she thinks this may be contributing to bad breath. If so, improving your brushing and flossing is much more likely to help.
The bottom line is that you should never substitute proper flossing and brushing with mouthwash. But feel free to supplement your routine with a little rinse! If you have any specific questions, feel free to contact our Ashland dental office. If you want to make an appointment for a check up, you can call us at 541-482-4995.
We know all the list of things that can be bad for your teeth - soda, gummy candy, smoking, etc. But there are a handful of habits with the potential to wreck your chompers that may not be quite as obvious. Here's the low down ...
1. Chewing Ice
Ice can easily be thought of as harmless - its juts H20 after all. But crunching down on hard, frozen cubes can cause cracks, chips and wear on your teeth. If you chew ice regularly enough, you may even cause aches in the soft gum tissues around your teeth. Often times a habitual ice-chewer gets "shorter" tooth appearance from all the wear. Dr. Kivel can fix this cosmetic issue but will only do so after the patient has curbed their ice habit!
2. Playing Sports (Without Proper Protection)
We love sports! All of us here at Soulsmile not only grew up playing many sports, but still take part in a myriad of outdoor sports including biking (motorized and non-motorized, running, surfing, kayaking - you name it! But we are also huge proponents of mouth protection! Mouth guards are a piece of molded plastic that protects your teeth. Without it, contact sports can easily result in chips or even a full tooth knock-out. We can make these for you or your whole team. Just contact us to schedule an appointment.
3. Bottles Past Bedtime
Just like adults, a baby's teeth should be cleaned before bed. Putting a baby to sleep with a bottle of milk, formula or juice can put new teeth in harm's way. This can basically bathe the baby's teeth in sugars overnight. Its best to keep them out of the crib and establish a good hygiene routine.
4. Tongue Piercings
Dentists have long lamented tongue piercings. Accidentally bumping a metal stud along teeth for years can definitely pose a risk to your teeth. In a study published by the Journal of Periodontology, "nearly half of the participants who wore either long or short barbells for four or more years had chipped teeth." The study also found receding gums in up to 50% of participants who had worn long-stemmed barbells for two or more years. Furthermore, the mouth is a haven for bacteria, making tongue piercings a likely candidate for infection and sores. Bottom line - research the health risks before you decide on a tongue piercing.
Bruxism (the fancy name for teeth grinding) wears teeth down over time. It is most often caused by stress and sleeping habits, making it a hard habit to control. We just wrote a whole blog on teeth grinding if you want to find out more about diagnosing an treating this condition.
6. Cough Drops
We'd like to think that anything you find in the medicine aisle is healthy, but that's just not the case. Most cough drops are packed with sugar. We still love them, but recommend that after you sooth a sore throat with a lozenge, break out the toothbrush. Think of them like hard candy!
Have any questions for us about habits that you suspect may be compromising your oral health? Feel free to write them in the comments section below or feel free to make an appointment with our Ashland, OR dental team here at Soulsmile. We'd love to have you in as a new patient!
Do you ever wake up in the morning with headaches or soreness in your jaw? Have you or your dentist ever noticed chips or small cracks in your teeth? If so, you may be grinding your teeth while you sleep. Don't worry - you're not alone. Its estimated that about 30 million people in the US do the same.
This condition, known in dental as bruxism, is not life-threatening, but it can definitely cause damage to your teeth. It is probably also disrupting your sleeping habits. In this blog we'll discuss the causes, symptoms and solutions for bruxism and how the latest dental products can help you.
Bruxism is not typically hard to spot. Most people suspect they grind their teeth. They usually either looked up their symptoms online or have been told by friends or family that they're grinding.
During a dental exam, we can usually tell a patient has been grinding. We look for chips and damage to the tooth enamel as well as smoothly worn surfaces. We will also ask questions about jaw pain and/or headaches. One of the most significant concerns related to bruxism is that it often is an indicator of a sleep apnea - a very serious condition.
Identifying Signs of Bruxing and Clentching
Treatment with Nightguards
The most common way to treat bruxism is with a nightguard. In fact, up to 70% of our regular patients use a nightguard. It's one of the easiest methods of prevention! This appliance is worn in the mouth during sleeping hours to prevent grinding. Nightguards are similar to athletic guards, but thicker and more rigid. These custom appliances are made with acrylic using a professional impression, ensuring a perfect fit.
Another advantage of a custom-made night guard is the material. Acrylic is hard (opposed to store-bought "boil and bite" type of nightguards that are soft) and discourages further biting, clenching and grinding. These are the behaviors we're trying to eliminate! An over-the-counter biteguard isn’t made specifically for you, it’s meant to fit a wide variety of jaw and mouth sizes. Unfortunately, it will never fit perfectly.
Ask Us About It!
If you suspect that you’re grinding, ask your regular dentist for help. He or she can confirm a diagnosis and work with you to develop a treatment plan. If you're in the Ashland or Rogue Valley area, contact us at Soulsmile. You can call us at 541-482-4995 to schedule an appointment. We'd love to help you sleep better.
On a daily basis we are making recommendations to patients regarding products to improve their oral health care routine at home. We decided to consolidate our list for patients' easy access. Have any additional questions? Drop us a line!
We like the fluoride version to help prevent cavities, but they offer non-flouridated version too. In general, our hygienist, Jordon, recommends looking for the ADA seal when deciding on a toothpaste. She says, "It means the product is scientifically supported. It has met the safety criteria and is proven to be effective."
Winner: Phillips Sonicare (Any model! You don't necessarily need all the bells and whistles)
We love Sonicare toothbrushes! We don't even go on vacation without them. They are great for getting below the gum line which lowers plaque levels. They are also great for people with a loss of dexterity due to age or health conditions, as the toothbrush does most of the work for you through its unique sonic technology.
Go with a soft bristle head. Contrary to popular belief, hard bristles are not more effective and can cause damage to gums. Remember to replace your toothbrush (or toothbrush head if using Sonicare) every 3 months or sooner if bristles look worn.
Electric Dental Flosser
Winner: Sonicare AirFloss
This product is great for flushing out debris. It is a fantastic options for patients with deep periodontal pockets (periodontal disease), complex restorative work, food traps or braces. Just remember that it is not meant to take the place of regular flossing. Another popular option is the brand Waterpik - we like these too, we just happen to prefer AirFloss.
Mouthwash + Rinse
Winner: Listerine Total Care Zero Alcohol
Adding a mouth rinse to your hygiene routine is a great idea. We suggest rinsing after you floss to help remove any debris that was dislodged. Our favorite is the Listerine Total Care Zero Alcohol. It contains fluoride to help fight cavities and getting one that does not contain alcohol takes the harsh alcohol "sting" out of the process which can dissuade a lot of patients from using it regularly.
Winner: POH No Wax Floss (great reviews online)
The bottom line with floss is that any type of floss is better than none! Our recommendations are light in this category as it is mostly up to personal preference. Some tips from Jordon:
- If reaching the back teeth is difficult, try floss with a handle
- If shredding around crowns or fillings, try Glide floss
- Superfloss is great for under bridges, implants and braces
- A floss threader-aid can help get floss under bridges or braces as well.
Winner: Interprox Plus
Interproximal brushes are great for larger spaces where floss is too thin. Also great for complex restorative areas.
We're a little late with this recap, but still thought it would be fun to share our Maker experience! On November 19th Soulsmile helped sponsor and participate in the Rogue Valley Mini Maker Faire here in Ashland. Maker Faire is billed as "the Greatest Show (and Tell) on Earth" and its true! Its a family-friendly showcase of invention, creativity and resourcefulness. A place where people can share what they are making and learning.
We brought our CEREC machine to show people how we are using CAD/CAM technology in the dental office to make teeth! With this technology, we can provide patients with inlays, onlays, crowns and veneers in only one appointment. Worldwide, more than 30 million teeth have been produced with CEREC.
We wanted to share some of the great questions (and answers) we discussed that day for all you science-minded folks out there.
How do you design the new tooth on the computer?
Answer: The wand you'll see as part of the unit is call the Omnicam. It is actually a camera that records a streaming video to capture both 2D and 3D data. The data then produces a digital replica of a patient's dentition, accurate down to just a few microns.
Is this a 3D printing technology?
Answer: It is not. 3D printing is an additive process while the CEREC milling unit uses a subractive process. We start by putting in a full block of material. Then, two opposing diamond burs reduce the material to its final shape.
How long does it take to mill a tooth?
Answer: On average, about 12 minutes.
Why are the blocks purple?
Answer: Many of our restorations are milled from a material called Emax. The material, lithium disilicate (LS2), is the strongest, most durable porcelain available. The block appears purple in color throughout the milling process because they are in a slightly softer state. Once they are the correct shape for the restoration, they are baked in an oven at 900 degrees, allowing the material to crystallize. This turns the material to the final tooth color and hardens it.
These are just a few of the fun facts. If you're interested in learning more, call us to make an appointment and Dr. Kivel can show you how it works.
Background and Diagnosis
Periodontal disease is a bacteria-related inflammatory disease of the gums, the cementum that covers the root, the periodontal ligament and the bone around the tooth. Periodontitis can lead to pain, smell and tooth loss; in addition, it has been linked to heart disease and several other dangerous systemic conditions.
To determine if you have periodontal disease, and the extent of its progression, we begin by using a dental instrument to measure the pocket depth between your gums and your teeth. Ideally, the pocket depths around the teeth will range between 1 and 3 millimeters (mm). Gingivitis will appear as swollen gums and reveal pockets up to 4 mm. Both can be remedied by a simple cleaning.
Periodontitis, however, will be accompanied by red, irritated, bleeding, sometimes sore gums or pus and pockets deeper than 5 mm. Xrays of periodontitis will often show hardened calculus around the teeth and may even show the bone loss itself. A more detailed cleaning is in order to address periodontitis.
A great deal more is learned about the specific causes and circumstances surrounding each patient’s condition during the treatment itself.
To treat periodontitis, we remove the deposits of calcified plaque called calculus or tartar and any other bacterial toxins which become ingrained under the gumline and into the root surfaces. The process, known as scaling and root planing (“SRP”), utilizes ultrasonic and hand scaling instruments, ideally while the patient is under local anesthesia. Just a few areas are focused on at a time until a “deep” cleaning is achieved.
In addition, the placement of a medicine called Arestin into pockets 5mm or greater is recommended. This medicine eliminates the harmful bacteria for 45 days following SRP.
Immediately following SRPs, it is recommended that patients use a Chlorhexidine Rinse, an antibacterial mouthwash that helps to control and kill the bacteria in your mouth that cause gum disease. We recommend that you rinse with chlorhexidine after brushing your teeth for one week following SRP and after future dental visits.
Existing bone loss related to periodontitis will not return with SRP. But, SRP’s and a few changes to your routine cleaning protocol described below will help you keep your teeth for life.
Instead of a simple cleaning (“Adult Prophylaxis”), Periodontal Maintenance describes the type of routine office cleanings following SRP. It is considered a basic service by insurance.
Periodontal Maintenance removes plaque and tartar from above and below the gumline, down the length of each tooth to where the root, gum and bone meet. Rough areas of the roots are maintained smooth, pocket depths are carefully monitored, and inflamed pockets are irrigated with antibacterial medicines if necessary.
After SRP treatment, most patients choose to have their teeth cleaned every 3 or 4 months to match the complexity of their dental condition that led to the periodontitis in the first place. These factors include their natural plaque and tartar accumulation, bleeding, inflammation, pocket stability, the quality of their anticipated home care and their overall health risk factors.
Lastly, with a few meaningful changes to your at-home cleaning routine, periodontitis can be kept under control. Brushing for two full minutes twice daily with an Philips Sonicare toothbrush and flossing once a day is usually adequate. For difficult areas, christmas tree brushes (“proxy brushes”), enlarged floss (“super floss”) and Philips Airfloss are excellent aids. Consistent behavior change is the most important element in maintaining long term periodontal health. Smoking has also been shown to contribute to periodontitis.
*Dental insurance plans will often cover all or part of these costs.
Have more questions? We want you to have a complete understanding of your oral health and how to best maintain or improve it. You may want to do some research on your own. Here are several internet search terms to help you get started:
- Gum disease
- Link of periodontitis to systemic health
- Scaling and Root Planing
- Periodontal Maintenance
- Chlorhexidine rinse
- Philips Sonicare
- Philips Airfloss
- Scaling and root planing and insurance
- Reasons for tooth loss
- Cause of bleeding gums
- Risk of deep periodontal pockets
- Periodontal surgery
- Options for missing teeth
- Implants with periodontitis
The end of the year is quickly approaching and with it, the end of another dental insurance benefit year. You're probably thinking more about stuffing and cranberries than dental benefits, but we'd recommend putting aside a bit of time in between your holiday plans to make sure you are maximizing benefits which will be lost as of January 1st.
1. Don't Throw Away Money,!
Going into a new year with unused benefits is like tossing hard earned dollars you worked for all year. If you're like a majority of people, your insurance plan expires each calendar year. Unfortunately, your remaining benefits do NOT rollover - they expire! Trust us, your insurance company won't remind you of this. In fact, they bank on millions of Americans overlooking this and benefiting them instead of you.
2. Find Out About Your Annual Maximum
Each year, your insurance plan sets an annual maximum of dental work they will pay for. This is called the annual maximum. Each plan is different, but this amount is usually $1000-2500. You'll also want to find out how much you've already used this year (if you're a Soulsmile patient here in Ashland, call us - we can tell you!).
3. Consider Pending Treatment
You may already have a tooth that's nagging at the back of your mind and you know needs to be fixed. Other times, patients may forget about treatment that is not a huge priority (like preventatively replacing old amalgam fillings that are prone to leaking). Give us a call or come in for an exam if you'd like to find out if you have any pending treatment we can put towards your benefits.
If you have any questions, please call us at 541-482-4995. You can also call your insurance provider directly for more details regarding your unique plan. Our end-of-the-year schedule fills up quickly, so call us today to use up your benefits before its too late!
Today's blog post comes from our resident hygienist, Laura Houghton, RDH:
A growing number of patients are seeking a health conscious alternative to fluoride for cavity prevention. One of the products I recommend on a daily basis is MI Paste™. This product uses calcium and phosphate to remineralize teeth. It is a water based, sugar free, and fluoride free paste. It also contains RECALDENT, which is a milk derivative that binds the calcium and phosphate to the teeth.
There are many benefits to using this product, including non surgical treatment for a handful of dental symptoms. It helps alleviate dry mouth caused by many medications, and prevention of an acidic environment. Using this product during orthodontic treatment has shown to be one of the most effective ways to prevent white spot lesions around brackets, which is caused by lack of calcium.
Patients seeking tooth whitening frequently have concerns with sensitivity after whitening. We recommend MI Paste™ application before and after whitening procedures to minimize sensitive teeth.
How To Apply
MI Paste™ is easy to use. There two methods we usually recommend,
1. If you have custom-made trays (often used for teeth whitening) you can use a small bit of teh paste in them and leave undisturbed for three minutes. You would do this after brushing with your regular toothpaste.
2. Alternatively, you can simply take a small pea-sized dab of the paste on a cotton swap of finger and rub the paste all over the surfaces of your teeth. surface. Allow the paste to absorb into the surface by not touching or rinsing it for three minutes.
If you have any questions about the product or want to know if it might be right for you, let us know.
Most people's "wisdom teeth" (which we call third molars) begin to erupt around the late teens or early twenties. These will be the third and final set of molars to come in. Occasionally third molars can come in correctly aligned and offer more chewing power. In this event, you may decide to keep your wisdom teeth as long as you can maintain proper hygiene. More often, they are misaligned and can crowd other teeth.
Why Do We Have Wisdom Teeth?
A popular theory suggests that the human diet used to consist of more rough food like leaves, meat and roots which required better chewing power. There has also been a size reduction in the human jaw and face over the past 20,000 years.
More and more people born today never develop third molars.
Why Remove Wisdom Teeth?
While not every patient needs to have their wisdom teeth removed, the common situations will likely warrant their removal.
1. Impacted Wisdom Teeth
When a third molar is "impacted" it means that gum tissue is completely covering the tooth and preventing it from erupting successfully through the gum. This is usually the result of a mouth that is too small to allow the room the teeth need. At times, this leads to bacteria or food getting lodged under the gums covering the wisdom tooth and can create an abscess.
2. Partially Impacted Wisdom Teeth
Partial impaction means the tooth is only partially emerged from the gums. In this case, we almost always advise removing the tooth. Again, bacteria can be lodged underneath and because of the location in the very back of the mouth, a wisdom tooth is more susceptible to cavities and decay.
3. Additional Reasons for Wisdom Tooth Removal
The following dental issues may also increase the likelihood that we recommend removal for your third molars.
- Pain at or surrounding the third molar(s)
- Pain or swelling in the jaw or cheek area
- Infections of the soft tissues
- Gum disease
- Tooth decay
- Tumors or Cysts
If you are considering having your third molars removed, we are happy to consult with you on the topic. Dr. Kivel can address the health of your wisdom teeth, whether they have erupted and your overall oral health to determine the best next steps. Contact our Ashland, OR dental office to schedule an appointment with our friendly team.
Congratulations! If you’re reading this, it's likely that you or someone close to you is pregnant. Your body goes through many changes during pregnancy, including changes related to your oral health. These are primarily due to a surge in hormones like estrogen and progesterone. These same hormones which are integral to your growing baby can exaggerate the way your gums react to plaque.
If plaque is not properly removed, it can cause gingivitis - marked by swollen, red gums which are more likely to bleed. You may notice an increase of bleeding from brushing or flossing. There’s a condition referred to as “pregnancy gingivitis” which affects most pregnant women and can begin as early as the second month. If you have gingivitis prior to becoming pregnant, your condition is likely to worsen. If left untreated, this can lead to periodontitis, a more serious form of gum disease and, because it is incurable, it will continue to affect you long after pregnancy.
Occasionally, women also develop inflammatory, non-cancerous growths when their gums become irritated while pregnant. These growths, called “pregnancy tumors”, are usually harmless and can be left alone. They will generally reduce in size, until they disappear completely, after birth. If you have a tumor that is uncomfortable or interferes with your hygiene routine or chewing, let us know. Dr. Kivel may decide to remove it.
Of course, we recommend excellent oral hygiene at all stages of life. But we understand that pregnancy creates additional risks and additional motivation for staying healthy. During this time, you’ll want to keep your teeth very clean, especially near the gumline. Brush at least twice a day, and after every meal if possible. For some women, brushing can contribute to feelings of morning sickness. If this happens to you, rinse your mouth with water or with anti-plaque mouthwashes and brush when you can. Floss thoroughly each day.
Feel free to book more frequent than normal cleanings with Soulsmile at this time to supplement your own efforts.
“Can gingivitis affect my baby?”
Unfortunately, there is research that suggests a link between gum disease and preterm, low-birthweight babies. In recent years we’ve come to realize that bacteria can enter the bloodstream through your gums and is linked to many serious issues, including heart disease. So it is not surprising to find that this can affect your pregnancy as well. The current theory proposes that when the bacteria travels to the uterus it triggers the production of prostaglandins, which are suspected to contribute to premature labor. The best prevention for this is excellent hygiene!
“When should I visit Soulsmile?”
If you are pregnant or suspect you are, we’d encourage a visit right away! A checkup in your first trimester allows Dr. Kivel to assess your oral health and map out a dental plan for the rest of your pregnancy. A second trimester cleaning will let us monitor any changes and make sure the gums are being properly cleaned.
“Are there dental procedures I should avoid?”
Routine care can generally be performed throughout pregnancy, but the best time for treatment is the fourth through sixth month. Your obstetrician may be consulted for dental emergencies that require anesthesia or if medication needs to be prescribed. Elective procedures should generally be delayed until after birth.
Congratulations again! Please contact us if you’d like to schedule a visit or if you have any questions about related to your own pregnancy.
Let's Talk About Flossing
Surely you've seen the headlines - "Flossing is Nonsense and My Laziness is Vindicated" or "Flossing: Government's Latest Piece of Bad Advice". All this press about flossing stems from an article published this month by the Associated Press (Read it here). Their report points out the weak evidentiary basis for floss as a method of reducing plaque and tooth decay. The American Dental Association responded saying: Trust us, flossing helps.
In reality, the AP article is less about floss and more about evidence-based medicine. They are correct in that the published and proven evidence for the benefits of floss is poor. One reason for this is that floss has been around since the 19th-century! Recommendations for flossing are based on pretty obvious assumptions: it removes plaque from in between teeth and because plaque leads to gum disease and decay, flossing will improve these conditions. But because our medical standards have risen so greatly in the last centuries, assumptions are not enough - and understandably so.
Anecdotal evidence and long-standing traditions have been replaced with evidence-based medicine. This approach is dependent on well-designed, controlled studies. Thus far, nobody has tackled a flossing study with the academic rigor we now expect. Why? We can only speculate. Studies like this are expensive and there is no fame or monetary reward to be found in proving out flossing. Flossing is cheap, easy to adopt and no-risk. This leaves us with anecdotes and weak evidence. Two of our leading dental associations — the American Dental Association and the American Academy of Periodontology — cited other studies as proof, but most of these studies used outdated methods or had relatively small sample size.
Despite our agreement regarding poor studies and evidence around flossing, this does NOT mean it has been proven ineffective either. Each of your teeth have six surfaces and brushing can only clean four of them. You simply need a method for cleaning in between your teeth to properly remove all plaque causing substances that are proven to cause decay.
We always hoped more people would talk about flossing - but not like this! At the very least, we hope this exposure will inspire researchers to conduct better studies and counteract these claims made by the AP. Oh, and by the way - even the author of the article admits he still flosses. If you have any questions, feel free to contact us directly or leave a comment. We'd love to hear from you.
For Further Reading
This 2006 study titled, “Dental Flossing and Interproximal Caries: a System Review,” recruited 808 children age 4-13 and split them into three test segments: kids who were professionally flossed 5 days/week; kids who were professionally flossed once every 3 months; and kids who reported self-flossing at home. The research lasts 18 months and unsurprisingly, the participants who were professionally flossed 5 days/week saw a 40% decrease in the risk of cavities.