I am a long term Mentor with the Kois Center in Seattle, Washington.  The Kois Center is a didactic and clinical program with the latest advances in esthetics, implant, and restorative dentistry.  I attend courses and symposiums several times a year in order to keep up with advances in dentistry through science.  In addition to attending these courses, I mentor other dentists in these programs.

2011  Functional Occlusion II:  Complex Restorative Management
2011  Kois Center Symposium
2010  Functional Occlusion I:  Science Driven Management
2011  Kois Center Symposium
2009  Kois Center Symposium
2008  Lioness Principle:  Becoming Educators Who Awaken Instinctive Greatness
2008  Kois Center Symposium
2008  Implants:  Removable Retained
2008  Direct Resin Bonding:  Creating Anterior Masterpieces and Transitional Bonding
2008  Treatment Planning I
2007  Kois Center Symposium
2007  Treatment Planning I
2007  Implants:  Fixed Retained
2007  Biomechanics II
2006  Occlusion II
2006  Kois Center Symposium
2006  Placing Implant Surgery Into Your Comfort Zone
2006  Restorative/Periodontal Interface
2005  Biomechanics I
2005  Regaining Pleasure and Success with Complete Denture Services
2005  Esthetic Gingival Surgery for the General Dentist
2005  Kois Center Symposium
2004  Implants:  Removable
2004  Kois Center Symposium
2003  Occlusion II
2003  Biomechanics I
2003  Kois Center Symposium
2002  Treatment Planning I
2002  Functional Occlusion I
2002  Kois Center Symposium
2001  Implants:  Removable
2001  Kois Center Symposium
2000  Implants:  Removable
2000  Treatment Planning II
2000  Kois Center Symposium
1999  Functional Occlusion II
1999  Treatment Planning II
1999  Kois Center Symposium
1998  Implants:  Fixed
1998  Restorative/Periodontal Interface
1996  Functional Occlusion I
1998  Restorative/Periodontal Interface

Aren't All Dentists Created Equally?

All dentists are created equally in that they graduate from dental school with similar skills and knowledge.  However, dental school is just the start of a dentist's education during a long career.  Each dentist decides for him or herself how far they want to grow as a dentist.  The Kois Center based in Seattle, Washington enables motivated dentists to achieve extraordinary levels of knowledge and skill of restorative dentistry.  As a long time member and graduate of the Kois Center, I am committed to providing a high level of comprehensive services to my patients offering them treatment options and not one-size-fits-all dentistry.  As a Mentor of the Kois Center, I am committed to helping other dentists to become the best that they can be.

The following are excerpts from the publication The Kois Center Graduate: Pursuing Dental Excellence:

"The Kois Center is an advanced graduate didactic and clinical program for practicing dentists. The Center features a comprehensive nine-course curriculum, with the latest advances in esthetics, implant and restorative dentistry.  The Kois Center is unique in that it is part of an educational network inspired by John Kois and populated by dentists who have made a commitment to a rigorous program of continuing education. The network is a living, maturing postgraduate educational think tank. Collaboration of these members creates an ever-expanding knowledge base at the Center and is a pathway for extraordinary professional growth of all its members."

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A black line at the gumline or a tooth that looks fake because of a flat or bright unnatural color or a tooth that is too bulky compared to the adjacent teeth are sure indications of a crown that is an esthetic failure. With appropriate materials, procedures, and skill lifelike crowns will blend in naturally with adjacent natural teeth. A black line at the gumline of a crown is caused when the underlying metal framework supporting the porcelain shows through. A properly done crown with an acceptable margin should have no black line. A crown that appears too large or out of scale for the adjacent teeth is caused by inadequate reduction of the tooth before the crown is fabricated. Flat and superficial looking crowns that don't match the adjacent teeth are often caused by inadequate reduction and preparation of the crowned tooth. The use of a quality dental lab is also critical for natural looking crowns.

Beauiful, natural looking crowns (commonly referred to as caps) are a hallmark of skilled dentistry. If you would like a consultation regarding a more natural smile, contact our office.

If you have been told you do not have enough bone for tooth implants or you chose not to do implants for financial considerations, mini implants may be exactly what you need.

The bone underlying a denture deteriorates because there are no longer teeth present. This results in dentures slipping and wobbling which lets food underneath the base and can create sore areas especially a with lower denture. The lips have to work harder to keep the denture in place, and this makes a natural expression difficult and can even affect speech. The loss of jawbone results in an aged facial shape. These problems rob many denture wearers of their confidence in social situations.

Conventional implants have been used to provide stable denture anchorage and maintain remaining jawbone. However, they require sufficient bone volume in order to be placed, and it will take three to six months for bone to grow around the fixture before the denture can be anchored to the implants. These restrictions used to mean that not everyone was a suitable candidate for implants.

A mini implant is only 1.8 millimeters in diameter (about the size of a toothpick) which means that there is always enough bone in the front of the jaw to place them and much less surgery needed to accomplish the placement. In addition they have been designed so they can be secured to the lower denture during the same office visit. Mini implants are placed in the morning, the denture immediately attached, and the patient will be comfortably eating lunch that same day. As an added bonus, the simplicity of attachment components and reduced surgery means lower costs compared to the conventional implant process.
Mini implant technology means everyone can have a well fitting, comfortable lower denture. Contact our office for a consultation.

Last month I discussed some ways of making dentistry more affordable and this month I want to add ideas for those who don’t have dental insurance. Again, I cannot emphasize enough the value of prevention--you save 100% of the cost of any dentistry that doesn’t need to be done because you've taken care of your teeth regularly. Teeth must be regularly cleaned on all four sides; that means using floss daily. If treatment is needed, get it done in a timely manner, as dental problems tend to grow in difficulty and costs with time. Avoidance is only more costly later.

We are fortunate to have two dental schools across the bay, UCSF School of Dentistry and UOP Dental School. All dental schools have clinics where dental students in their last two years treat patients under supervision of their dentist instructors at reduced costs. While students strive to do good dentistry and pass their requirements, treatment will often take longer and require more visits than in a private setting. Also, students may not be the best place for treatment of complex problems or patients that are extremely fearful.

Many dentists have financing available through outside sources. Lately finance companies have been marketing to dentists for consumer loans to patients. As incentives they may offer “teaser” rates that will keep interest costs down. Lastly, if you have a long term relationship with your dentist, ask if they will allow you to extend payment over a couple of months by putting payments on an automatic credit card deduction.

In many ways maintaining your teeth is no more expensive than maintaining an automobile, and with basic preventive care you don’t have to replace your teeth every few years like you would an automobile.

These days everyone is looking to manage health care costs. According to a recent New York Times article, more than 100 million Americans do not have dental insurance. Dental plans are not typically available to individuals because the only people who would purchase such plans would have expenses beyond the cost of the premium. All employer-based plans have limits because they are intended to help defray only a portion of your dental costs. These plans are not really insurance in that they are generous with twice-yearly checkups, usually only cover a fraction of higher cost procedures, and often provide no coverage for common dental procedures like implants. Cost is one of the reasons why 35 percent of Americans have not visited a dentist in the last 12 months according to a March 2009 Gallup poll.

So how can people reduce their dental expenses? Prevention is the most effective means. A small cavity detected on a routine check-up can cost $100 to $200 to treat, but allowed to further weaken a tooth; and a crown will cost around $1000. Wait until it hurts when a root canal will be required, in addition to the crown, and it will add roughly another $1000 in dental repair costs. Just like your car, routine maintenance is less expensive in the long run than driving until the car breaks down. An even better strategy is to avoid the need for dental repairs with daily flossing to keep the gums and supporting bones healthy. Additionally, products like Cari-Free can prevent new cavities. Of course consistent cleanings at the dentist can prevent gum disease--the leading cause of tooth loss.

Dental treatment can often be done in phases. Sometimes this may mean doing temporary treatment now and later doing a more definitive treatment when finances permit. There may be a downside, however, in esthetics (appearance), risk of something breaking, or additional costs. Most dentists are willing to spread the work over time if it is appropriate. Discuss the pros and cons with your dentist before phasing extensive treatment.

Next month I will write more about controlling dental costs for those people without dental insurance benefits.

James R. Hinkle II DDS MAGD
Advanced Dental Excellence
2229 Santa Clara Avenue
Alameda CA 94501
www.alameda-dentist.com
521-3344