Last month I discussed the concept of “dental age” vs. chronological age. The key to keeping dentally young is to change the process of dental diagnosis. It must move from tallying up disease present and treatment to reading signs of beginning disease and taking preventive measures. This can be simplified by considering that there are just four basic processes by which dental health breaks down. The four processes are: decay, aging dentistry, loss of tooth structure, and loss of foundation. Each one of these areas needs to be taken into consideration during examinations. If breakdown is beginning, intervention can prevent further damage. For instance if tooth surface is being lost, the cause needs to be determined in order for prevention to be effective. Loss due to heavy-handed tooth brushing would be treated differently than loss due to acid erosion. Worn teeth due to uneven bite forces might require straightening to evenly distribute forces, while wear from grinding might be managed with a night guard.

By using a dental examination to evaluate for various risk factors a dentist can largely predict your dental health in twenty years, for example. By using modern preventative dentistry we can then change the likely outcome to healthier (more youthful) teeth in twenty years. In the long run, this will minimize dental treatment and costs. Decay and gum disease are almost completely preventable. Wear and aging can be evaluated and taken care of before becoming significant. As we age, we don’t have to see more and more dentistry, ever-increasing expenses, and dentition aging. With appropriate intervention, the aging of teeth and reparative dentistry would be minimized.

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

Dr. Hinkle is a Fellow of the International Congress of Oral Implantology and is in private practice in Alameda, California.


The loss of a tooth can cause a series of irreversible changes in your mouth if left untreated including the risk of additional tooth loss. Dentistry reduces these effects by replacing the missing tooth. There are three basic methods: removable bridge, fixed bridge, and dental implant.

The removable bridge is the least expensive, but this option may be esthetically unappealing because the clasps that hold it in place are often visible. There is a also a tendency for food to get underneath the removable bridge. A fixed bridge is cemented in place and has no clasps. However, the downside of this method is that teeth on either side of the gap must be cut and crowned to anchor the fixed bridge. The major drawback to both types of bridges is that without a tooth root the jawbone shrinks ultimately leading to significant changes in the facial structure and resulting in a premature aging affect.

A dental implant is a small anchor inserted in the bone that replaces the missing root. A crown is built on this anchor and no clasps or cutting and crowning of neighboring teeth is necessary. Once an implant has been placed in the bone, it will maintain the jawbone and facial structure just the same as a natural tooth. An implant feels and looks like a natural tooth. A dental implant must be done while the patient has adequate bone left in which to place the anchor. If the bone is not adequate (perhaps because an implant was not done soon after a tooth root was lost) a tiny amount of bone is grafted to the site and then an anchor is implanted and a crown built. For additional information go to Dr. Hinkle’s blog: www.alameda-dentist.com/blog.

James R. Hinkle II DDS, MAGD
Advanced Dental Excellence
2229 Santa Clara Avenue
Alameda CA 94501
www.alameda-dentist.com
510 521-3344

Dr. Hinkle is a Distinguished Mentor with the Kois Center for Advancing Dentistry Through Science in Seattle, Washington and is in private practice in Alameda, California.

Dr. Oz on the Oprah Winfrey Show talks about Real Age in which our behaviors affect our wellbeing. For example, we all know that what we eat and regular exercise can improve our vitality and lifespan while smoking or not wearing seat belts can reduce the quality or even shorten our life. For years I have talked to my patients about the concept of chronologic age vs. “dental age”. Chronologic age is based on our birth date, but dental age is based on our level of dental health. A twenty year old typically has a full complement of teeth, with minimal repairs, unworn, good bone level below the gums, etc. It would be highly usual for a twenty year old to have dentures, but not so unusual for a seventy year old to have dentures. But, a seventy year old could very well have all of his teeth, in good repair, with minimal wear, and firm in the jawbone which would make his “dental age” closer to the twenty year old. The goal of modern preventive dentistry is to minimize the destructive forces that age the dentition instead of just repairing problems after they have occurred. This means that dental examinations need to be geared to determining which components are susceptible or beginning to break down and intercept to keep the teeth as close to the youthful parameters as possible. While our bodies will fail over time (Dr. Oz’s recommendations can only affect the rate of failure to a degree) our teeth can literally stay youthful until we die. Our goal as your dental professionals is to help keep you dentally as young as possible.

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

Shots! I would say that this one word alone is the reason nearly 50% of the population does not go to the dentist on a regular basis. Yet, I will ask young adults with piercings if it hurt when they had it done, and I am usually told “no” or “not much”. Although a body piercing needle’s bore is huge and considerably more pain inducing compared to an anesthetic syringe.

Without good anesthesia, some dental procedures would be too uncomfortable for the patient. With knowledgeable finesse, anesthesia can be delivered to a patient with little or often no discomfort. The most honest feedback I receive comes from children who often ask at the end of procedures in which anesthesia was used “Am I going to get a shot today?” How is this possible? The answer is good equipment and good technique.

Don’t let fear of “shots” keep you from receiving regular dental care. We can provide you with all the benefits of modern dental treatment in complete comfort. For more information go to my dental blog at www.alameda-dentist.com/blog.

James Hinkle II DDS MAGD
Voted one of the Best Dentists in America
Advanced Dental Excellence
2229 Santa Clara Avenue
Alameda CA 94501
www.alameda-dentist.com
521-3344

Tooth decay is the number one childhood disease in the US. Although it is largely preventable, it is five times more common than asthma. As our knowledge of this disease process deepens, it is clearer that this is a complex disease. However, in order to prevent decay, it is obvious that simply fixing cavities does nothing to effectively treat the disease process.
Decay is an infectious disease located in the biofilm on teeth. Since teeth are the only non-shedding surface on the body, the biofilms on teeth tend to be more diverse and complex than previously understood. A healthy mouth will have around 113 different bacterial species present, while a person with high risk for decay will have an average of only 94. Why the lower number? It appears that mouths with lower pH (more acidic) will push the biofilm to destroy harmless species, cause harmful bacteria to multiply, and even cause some bacteria to change metabolism to become harmful and multiply in a more acidic environment. Thus fewer (but more harmful) bacterial species is a function of pH not sugar availability. The lower pH can come from type of diet (external), acid reflux (internal), or lack of ability to buffer the pH to prevent its lowering. The goal of raising the pH of the saliva may be the simplest, most broad sweep approach to preventing decay, overcoming the complexities of other methods like vaccines, gene therapies, or antimicrobials. Carifree.com is the only company to bring products to the market designed to improve the pH of the mouth to alter the composition of the biofilm. Their site has more in depth information on assessing your risk and the research behind the validity of this approach to reducing our most common disease.
The dental profession is beginning to recognize the value of diagnosing the disease risk as opposed to simply repairing teeth. Identifying individuals at risk and altering the pH of the susceptible to prevent decay is future of preventive dentistry.

James R. Hinkle II DDS MAGD
ADVANCED DENTAL EXCELLENCE
2229 Santa Clara Avenue
Alameda CA 94501
www.alameda-dentist.com
510 521-3344

Penny Wise and Pound Foolish With Your Health

More research has come out recently showing significant cardiovascular disease risk for those with gum disease. “We’re not talking about people with advanced periodontal disease,” said Dr. Kowolik of University of Indiana, “we’re talking about healthy people who simply neglect oral hygiene.”

In addition to regular brushing and flossing at home, good oral hygiene requires regular dental exams and teeth cleaning. The frequency of teeth cleaning (hygiene appointments) depends on the individual patient’s needs. Some patients require cleanings every six months. Many patients, however, require appointments more frequently due to the existence of other issues, i.e. health issues (like reflux), crowded teeth, a tendency to build up bacteria (plaque), or the existence of gum pockets. These patients require cleanings as often as every three months to keep their gums and heart healthy.

Unfortunately, some patients with dental insurance policies that only reimburse for cleanings every six months become “penny wise and pound foolish”. By foregoing the minimal out of pocket costs of additional cleanings or more extensive hygiene procedures, some patients may run the risk of a heart attack or stroke. The impact on the patient’s health, quality of life, and pocketbook can far exceed the lifetime costs of an effective regularly scheduled hygiene program.

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