Lansing's Dental Discussion
By Holly Scott-Hetchler DDS
March 02, 2022
Category: Oral Health
Tags: oral health  
UnderstandingDentalInsuranceThe3TypesofPlans

Health insurance is an important part of life, helping to even out the high costs of medical treatment. Without it, many of us would find it extremely difficult to financially weather physical illness or injury.

But many also view health insurance as frustratingly complicated, including policies that cover dental care. Regarding the latter, people often view it as medical insurance's identical twin—which it's not. While insurance for clinical services and hospitalization manages cost in a comprehensive manner, the majority of dental plans function more like a discount coupon.

The great majority of dental policies today are paid for by employers as a salary benefit to their employees. There can still be differences in policies and it's important to know what kind of plan your workplace has provided you. Here's a rundown of the three basic types of dental insurance plans.

Fee-for-Service. This is the most common dental plan in which the employee is able to choose their dentist and the insurance company pays the dentist for services rendered. Each individual policy outlines the treatments covered, as well as the percentage of payment.

Direct reimbursement. With this approach, the employer pays employees' dental bills directly out of company funds. Even so, an insurance company is often still involved, but as a paid administrator for the employer, reimbursing the dental provider on behalf of the company.

Managed care. An insurance company may also create a network of dental providers that all agree to a set schedule of fees for services rendered. These dental health maintenance organizations (DHMOs) or preferred provider organizations (PPOs) can reduce patients' out-of-pocket expenses. But covered patients can only use dentists within the DHMO or PPO network to receive benefits.

You can, of course, purchase dental insurance as an individual rather than receive it as an employee benefit. If so, you'll need to weigh what you pay out for the policy and what you receive in benefits with what you would pay out-of-pocket without it to see if you're truly realizing any savings.

Either way, understanding a dental insurance plan can be a challenge for the average person. Fortunately, most dental offices are well experienced with these plans. Your dentist's staff can be a valuable resource for helping you get the most out of your insurance benefits.

If you would like more information on the financial side of dental care, please contact our office. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Insurance 101.”

SupermodelAshleyGrahamsUnpleasantDentalEncounterWithaFrozenCookie

Ashley Graham has a beautiful and valuable smile—an important asset to her bustling career as a plus-size model and television host. But she recently revealed on Instagram a “confrontation” between one of her teeth and a frozen oatmeal cookie. The cookie won.

Holding her hand over her mouth during the video until the last moment, Graham explained how she sneaked a cookie from her mom's freezer and took a bite of the frozen treat. Taking her hand from her mouth, she revealed her broken tooth.

Okay, maybe it wasn't an actual tooth that was broken: the denticle in question appeared to have been previously altered to accommodate a porcelain veneer or crown. But whatever was once there wasn't there anymore.

Although her smile was restored without too much fuss, Graham's experience is still a cautionary tale for anyone with dental work (and kudos to her for being a good sport and sharing it). Although dental work in general is quite durable, it is not immune to damage. Biting down on something hard, even as delicious as one of mom's frozen oatmeal cookies, could run you the risk of popping off a veneer or loosening a crown.

To paraphrase an old saying: Take care of your dental work, and it will take care of you. Don't use your teeth in ways that put your dental work at risk, tempting as it may be given your mouth's mechanical capabilities.

 Even so, it's unwise—both for dental work and for natural teeth—to use your teeth and jaws for tasks like cracking nuts or prying open containers. You should also avoid biting into foods or substances with hard textures like ice or a rock-hard cookie from the freezer, especially if you have veneers or other cosmetic improvements.

It's equally important to clean your mouth daily, and undergo professional cleanings at least twice a year. That might not seem so important at first since disease-causing organisms won't infect your dental work's nonliving materials. But infection can wreak havoc on natural tissues like gums, remaining teeth or underlying bone that together often support dental enhancements. Losing that support could lead to losing your dental work.

And it's always a good idea to have dental work, particularly dentures, checked regularly. Conditions in the mouth can change, sometimes without you noticing them, so periodic examinations by a trained dental provider could prevent or treat a problem before it adversely affects your dental work.

We're glad Ashley Graham's trademark smile wasn't permanently harmed by that frozen cookie, and yours probably wouldn't be either in a similar situation. But don't take any chances, and follow these common sense tips for protecting your dental work.

If you would like more information on care and maintenance of cosmetic dental work, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers: Strength & Beauty as Never Before” and “Dental Implant Maintenance.”

By Holly Scott-Hetchler DDS
February 10, 2022
Category: Dental Procedures
3WaystoCorrectaSmileWithMissingIncisors

In the classic holiday film, It's a Wonderful Life, George Bailey sees what life would be like if he'd never been born. In a variation on the theme, imagine your life if your teeth had never formed.

That's actually a reality for some—they're born without teeth, albeit usually only one or two. But even then, they're often more susceptible to problems with their bite, speech development and nutrition.

And if their missing teeth affects their appearance, their self-image could also take a hit. In particular, the maxillary lateral incisors on either side of the central incisors (those in the very front) can create an odd smile if missing.

Fortunately, we can correct the problem of missing lateral incisors with three possible solutions. The first is canine substitution, involving the pair of pointed teeth next in line to the missing incisors. In effect, we use orthodontic appliances like braces to move them toward the frontmost teeth and close the missing teeth gap.

It's a minimally invasive way to improve smile appearance. But because of their size and sharp edges, it's often necessary to alter the canines, perhaps even crown them. Some people may also need gum surgery to "blend" the gums with the repositioned teeth.

A second method is a fixed bridge, a series of fused crowns. Those in the middle replace the missing teeth, while those on the ends are bonded to the natural teeth on either side of the gap to support the bridge.

Bridges can function well for many years, but it does require permanently altering the supporting teeth for crowning. An alternative Maryland or bonded bridge doesn't require this alteration, but it's also less durable than a traditional bridge.

Finally, we could replace the missing teeth with dental implants, a titanium post imbedded into the jawbone with an attached life-like crown. An implant tooth can last for decades, and don't require alterations to other teeth. However, they're not suitable for younger patients who are still undergoing jaw development—a temporary restoration may thus be in order until the jaw matures.

Being born without certain teeth is something you can't do anything about. But you can change how it affects your appearance and life with one of these options for a new smile.

If you would like more information on correcting a smile with missing teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “When Permanent Teeth Don't Grow.”

AstheNewYearBeginsHeresaFreshLookattheEffectsofAlcoholonYourOralHealth

Throughout much of the world, January 1st signifies the first day of a brand new year. It's also commemorated by many as National Hangover Day—aptly so, as scores of New Year's Eve celebrants spend the day nursing their headaches and upset stomachs. It may also be an appropriate time to assess the health impact of alcohol—especially on your teeth and gums.

First, the bad news is that immoderate alcohol consumption increases your risk for tooth decay, gum disease and oral cancer. One of the reasons why has to do with sugar found in varying amounts in alcoholic beverages, often included during brewing or distilling to feed the yeast that produce the alcohol. Sugar is a primary food for oral bacteria, which can infect the gums and produce enamel-eroding acid, a prelude to both gum disease and tooth decay.

Along the same lines, alcoholic beverages are often paired with mixers, many of which like sodas and energy drinks contain sugar and high levels of acid. A mixed drink could thus contribute to an even more hostile environment for teeth and gums.

The frequency of your alcohol consumption may also contribute to enamel erosion. Ordinarily, saliva can neutralize oral acid in about thirty minutes to an hour. But saliva can't keep up if you're drinking one round after another, leading to sustained periods of acid contact with the teeth.

Alcohol—or specifically, too much—may also contribute to oral problems. Being under the influence increases your risk for tripping, falling and, shall we say, engaging in fisticuffs, any of which could result in traumatized teeth and gums. And, heavy drinking over a lifetime could increase your risk for oral cancer.

You could avoid these and other outcomes by abstaining from alcohol altogether. But if you do like the occasional wine, beer or spirit, here are a few tips to lower the risk of harm to your mouth, teeth or gums.

Limit your daily consumption. A rule of thumb, according to the Mayo Clinic, is to have no more than two drinks a day if you're a man, one if you're a woman.

Pause between drinks. Rather than downing one drink after another, wait at least an hour before your next round to allow saliva to neutralize any accumulated mouth acid.

Go easy on mixers. While it's fine to indulge in the occasional Old Fashioned or Margarita, choose unmixed beverages like beer, wine or straight spirits more often.

Brush and floss afterward. After a night on the town, don't turn in until you've cleaned your teeth and gums of any residual sugar or acid.

If you would like more information about how alcohol could affect your oral health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Nutrition—It's Role in General and Oral Health.”

By Holly Scott-Hetchler DDS
January 21, 2022
Category: Oral Health
Tags: dental records  
WhyYourDentalRecordsShouldFollowYoutoYourNewDentist

Some things you hear at the dentist don't surprise you: You have more plaque buildup or (yuck!) you have a new cavity. On a more positive note, you might hear your teeth look fine. But what you might not expect to hear is that your dentist—your longtime dentist—is retiring.

Then again, it might be you telling your dentist you're moving to another city—or you just feel like it's time for a change. Whatever the reason, there could come a time when you must find a new dental care provider. And when you do, it's very important that your dental records go with you.

And, yes, your dentist does have such records on you. Just like medical physicians, they're obligated legally and professionally to maintain a formal record of all your visits and treatments (including all your x-ray films). They may also include notations on your other health conditions and medications that could impact your dental care.

Without those records, your new dentist essentially starts from scratch, depending on what you tell them and what they may ascertain from examining your mouth. It means new x-rays and new treatment plans that can take time to form. But with your old records in hand, dental care with your new dentist hardly misses a beat.

Technically, those records belong to your dentist. You are, however, legally entitled to view them and to obtain a copy, although you may have to reimburse the dentist for printing and mailing costs. Usually, though, you can simply request they be transmitted to your new dentist, which can often be done electronically.

But what if, for whatever reason, you're not comfortable asking for your records from your former dentist? In that case, you can ask your new dentist to request them. Even if you still have an outstanding balance with your former dentist's office, they can't refuse a transfer request.

HIPAA regulations require dental offices to retain adult patient records for at least six years. But don't wait that long! The sooner your dental records are in the hands of your new dentist, the less likely your dental care hits any speed bumps.

If you would like more information on the importance of your dental records, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Why Your Dental Records Should Follow You.”

UnlikeBradPittYouDidntMeanToChipYourToothWeCanStillFixIt

It's not unusual for serious actors to go above and beyond for their roles. They gain weight (or lose it, like Matthew McConaughey for True Detective). They grow hair—or they shave it off. But perhaps nothing tops what Brad Pitt did to assume the character of Tyler Durden in the movie Fight Club—he had his dentist chip his teeth.

While a testament to his dedication to the acting craft, Pitt's move definitely falls into the category of "Kids, don't do this at home." Fortunately, people deliberately chipping their teeth isn't a big problem. On the other hand, accidentally chipping a tooth is.

Chipping a tooth can happen in various ways, like a hard blow to the jaw or biting down on something too hard. Chipping won't necessarily endanger a tooth, but the missing dental structure can put a damper on your smile.

But here's the good news: you don't have to live with a chipped tooth. We have ways to cosmetically repair the damage and upgrade your smile.

One way is to fit a chipped or otherwise flawed tooth with a dental veneer, a thin wafer of dental porcelain bonded to the front of a tooth to mask chips, discolorations, gaps or other defects. They're custom-made by a dental lab to closely match an individual tooth's shape and color.

Gaining a new smile via dental veneers can take a few weeks, as well as two or more dental visits. But if you only have slight to moderate chipping, there's another way that might only take one session in the dentist's chair. Known as composite bonding, it utilizes plastic-based materials known as composite resins that are intermixed with a form of glass.

The initial mixture, color-matched for your tooth, has a putty-like consistency that can be easily applied to the tooth surface. We apply the composite resin to the tooth layer by layer, allowing a bonding agent in the mixture to cure each layer before beginning the next one. After sculpting the composite layers into a life-like appearance, the end result is a "perfect" tooth without visible flaws.

Unlike Brad Pitt, it's pretty unlikely you'll ever find yourself in a situation requiring you to purposely damage your teeth. But chips do happen—and if it happens to you, we have more than one way to make your teeth as good as new.

If you would like more information about repairing dental flaws with veneers or composite bonding, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Artistic Repair of Front Teeth With Composite Resin.”

By Holly Scott-Hetchler DDS
January 01, 2022
Category: Dental Procedures
Tags: dental implant  
ShouldYouTakeanAntibioticBeforeImplantSurgery

Although getting an implant requires surgery, it's usually a minor affair. Chances are good that after just a few days recuperation you'll be back completely to your normal activities.

But like many other minor surgeries, an implant procedure does pose a slight risk of post-op infection. That's especially so with any dental procedure like implant surgery, since the mouth harbors numerous strains of bacteria that could escape into the bloodstream. For most people, though, a post-op infection doesn't pose a major problem since their immune system kicks in immediately to defeat it.

But some patients with less than robust immune systems or other health problems can have serious complications from an infection. Among other things, infected tissues around an implant may not heal properly, putting the implant at significant risk for failure.

If you have a condition that makes a post-op infection problematic, your dentist or physician may recommend you take an antibiotic before your procedure. Known as prophylactic (preventive) antibiotic treatment, it's intended to give a weakened immune system a head-start on any potential infection after a procedure.

Using antibiotics in this way has been a practice for several decades, and at one time were recommended for a wide list of conditions. That's changed in recent years, though, as evidence from numerous studies seems to show the risk to benefit ratio isn't significant enough to warrant its use in all but a handful of conditions.

Both the American Dental Association and the American Heart Association recommend prophylactic antibiotics for patients with prosthetic heart valves, past infective endocarditis, a heart transplant and some congenital heart conditions. Some orthopedists may also recommend it for patients with prosthetic joints.

Even if you don't fall into these particular categories, prophylactic antibiotics may still be beneficial if you have a compromised immune system or suffer from a disease like diabetes or lung disease. Whether or not a prophylactic antibiotic is a prudent step given your health status is a discussion you should have with both your physician and your dentist.

If they feel it's warranted, it can be done safely in recommended doses. If your health isn't as robust as it could be, the practice could give you a little added insurance toward a successful implant outcome.

If you would like more information about dental implant surgery, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Implants & Antibiotics.”

By Holly Scott-Hetchler DDS
December 22, 2021
Category: Oral Health
Tags: cosmetic dentistry   aging  
3WaysAgingCouldDimYourSmileandWhatToDoAboutIt

Know how to get the better of an age-guesser at the carnival? Smile! A recent study found that people tend to underestimate a person's age if they're smiling.

If true, smiling—naturally associated with youthfulness—might help you look younger than you are. Unfortunately, many older people smile less, self-conscious about the effects of aging on their teeth and gums. Their smile doesn't have the same zing as when they were younger.

If that's how you feel about your smile, a cosmetic dentist can help. Here are 3 common age-related problems a skilled dentist can help you improve.

Discoloration. After decades of eating, drinking and possibly smoking, teeth enamel can yellow and dull. But there are ways to brighten discolored teeth. One simple measure is to undergo teeth whitening with a bleaching solution. On a more permanent note, bonding tooth-colored materials, porcelain veneers or life-like dental crowns to teeth can mask stains and other imperfections.

Wearing. Speaking of all those meals, you can expect some teeth wearing later in life that makes them look shorter, and their shape and edges sharper rather than softer and rounded like a youthful smile. Dentists can improve the appearance of worn teeth by reshaping and contouring them to soften harsh edges. A procedure called crown lengthening can reposition the gums to display more of the teeth. Veneers or crowns can also transform the appearance of severely worn teeth.

Receding gums. There's also a contrasting gum problem. What some call "getting long in the tooth," The teeth look longer because the gums have receded from their normal coverage. This is often caused by gum disease, which older people encounter more than other age groups. After treating the infection, the gums may need help regaining their former position by grafting donor tissue to the area to encourage regrowth.

The effects of aging on teeth and gums are quite common, but you don't have to live with them. With a few appropriate techniques and procedures, your dentist can bring back the smile you once had—or one even better.

If you would like more information on maintaining a youthful smile, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How Your Dentist Can Help You Look Younger.”

By Holly Scott-Hetchler DDS
December 12, 2021
Category: Oral Health
Tags: sleep apnea  
YourDentistMayBeAbleToProvideYouWithaSleepApneaSolution

Morning tiredness, brain fog and snoring are just some of the indicators of a medical condition known as sleep apnea. And, it's worse than waking up on the wrong side of the bed—over time, sleep apnea could increase your risk for heart disease or other life-threatening conditions.

Sleep apnea occurs when air flow becomes restricted during sleep, usually by the tongue blocking the airway. As oxygen levels begin to fall, the brain signals the body to wake up to "fix" the air flow problem.

As this arousal may only last a second or two, you may not remember it when you awaken in the morning. But it can happen numerous times a night, depriving you of the deep sleep your body needs for rest and repair.

Fortunately, there are ways to treat sleep apnea. In extreme instances, you may need surgery to correct anatomical defects causing the condition. For most cases, though, the most common treatment is continuous positive airway pressure (CPAP) therapy, which consists of a portable pump delivering pressurized air through a face mask that keeps the throat open while you sleep.

Used by millions of patients, CPAP can be quite effective. Some patients, though, feel uncomfortable using a CPAP machine for various reasons. If you're one of those unhappy CPAP campers or you would like to consider a possible alternative, your dentist might have the answer: oral appliance therapy (OAT).

An OAT device is worn in the mouth during sleep to prevent the tongue from falling back against the back of the throat and blocking the airway. There are various forms of OAT appliances, but they're all custom-made by a dentist to fit an individual patient's mouth. They work best for mild to moderate sleep apnea in which the tongue is the primary culprit in airway blockage.

If you suspect you may have sleep apnea, you should undergo a complete examination by a doctor or dentist to confirm it. If you've been diagnosed with mild to moderate sleep apnea, talk to your dentist about an OAT device. You may find OAT can provide you the relief you need for a better night's sleep.

If you would like more information on oral treatments for sleep apnea, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “If You Snore, You Must Read More!





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