Category Archives: dentist

Human Teeth Healthier in the Stone Age Than Today

Something to think about next time you’re in the dentist’s chair: Ancient humans had healthier teeth than people do today, researchers say.

This decline in oral health over the past 7,500 years is the result of changes in oral bacteria due to human evolution and industrialization, the study authors said. These changes have led to chronic oral and other health problems, according to the report published Feb. 18 in Nature Genetics.

“The composition of oral bacteria changed markedly with the introduction of farming, and again around 150 years ago,” explained study leader Alan Cooper, a professor and director of the University of Adelaide’s Australian Centre for Ancient DNA, in a center news release. “With the introduction of processed sugar and flour in the Industrial Revolution, we can see a dramatically decreased diversity in our oralbacteria, allowing domination by caries [cavities]-causing strains. The modern mouth basically exists in a permanent disease state.”

The international team of researchers examined DNA that had been preserved in tartar — calcified dental plaque — found on 34 prehistoric northern European human skeletons. They used these samples to analyze how oral bacteria changed from the Stone Age to the last hunter-gatherers, medieval times and later with the introduction of food manufacturing in the Industrial Revolution.

The evolution of human behavior and diet have had a negative impact on oral health, the investigators said.

“This is the first record of how our evolution over the last 7,500 years has impacted the bacteria we carry with us, and the important health consequences,” Cooper said. “Oral bacteria in modern man are markedly less diverse than historic populations and this is thought to contribute to chronic oral and other disease in post-industrial lifestyles,” he pointed out.

Study lead author Christina Adler, now at the University of Sydney, added that “dental plaque represents the only easily accessible source of preserved human bacteria.” And, she said in the news release, “Genetic analysis of plaque can create a powerful new record of dietary impacts, health changes and oral pathogen genomic evolution, deep into the past.”

The researchers said their research is being expanded to include other periods in time, other areas of the world and other species, such as Neanderthals.

Tooth Loss Associated With Higher Risk for Heart Disease

For adults, losing teeth is bad enough, but tooth loss is also associated with several risk factors for heart disease, a large international study suggests.

These heart disease-related risk factors include diabetes, obesity, high blood pressure and smoking.

For the study, researchers analyzed data from nearly 16,000 people in 39 countries who provided information about their remaining number of teeth and the frequency of gum bleeds. About 40 percent of the participants had fewer than 15 teeth and 16 percent had no teeth, while 25 percent reported gum bleeds.

For every decrease in the number of teeth, there was an increase in the levels of a harmful enzyme that promotes inflammation and hardening of the arteries. The study authors also noted that along with fewer teeth came increases in other heart disease risk markers, including “bad” LDL cholesterol levels and higher blood sugar, blood pressure and waist size.

People with fewer teeth were also more likely to have diabetes, with the risk increasing 11 percent for every significant decrease in the number of teeth, the investigators found.

Being a current or former smoker was also linked to tooth loss, according to the study scheduled for presentation Saturday at the annual meeting of the American College of Cardiology (ACC), in San Francisco.

Gum bleeds were associated with higher levels of bad cholesterol and blood pressure.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

The researchers added that it is still unclear what is behind the association between tooth loss, gum health and heart health.

“Whether periodontal disease actually causes coronary heart disease remains to be shown. It could be that the two conditions share common risk factors independently,” Dr. Ola Vedin, from the department of medical sciences at Uppsala University in Sweden, said in an ACC news release. “Those who believe that a causal relationship exists propose several theories, including systemic inflammation, the presence of bacteria in the blood from infected teeth and bacteria invading coronary plaques.”

Are You Brushing Your Teeth the Wrong Way?

It’s something we all learned as kids, and we do it twice (or more) a day. So when it comes time to brush teeth, surely we’re not making any toothbrush mistakes … or are we? Actually, dental health experts say that improper brushing technique is more common than most people realize. And the result is that healthy teeth are not as common as they should be.

One of the first things you can do, says John Dodes, D.D.S., a dentist in Forest Hills, N.Y., and author of Healthy Teeth: A User’s Guide, is recognize that brushing isn’t the only requirement for having healthy teeth. “A common misconception with oral care habits is that brushing is enough, when in fact brushing alone misses more than half the germs in your mouth,” he says. “People also forget that it’s important to clean between the teeth, as well as your tongue, cheeks, and the floor of your mouth. Your mouth has more germs than [there are] people on earth, so it’s important to make sure you brush, floss, and rinse to ensure you’re cleaning every surface.”

Here are more top toothbrush mistakes people make:

  • Using the wrong style of brush. “Some people still like medium or hard toothbrushes, but soft, round-ended bristles are the way to go,” says Matthew Hyde, D.D.S., a dentist in private practice in Plainview, N.Y. “When the plaque is soft, it will come off with a soft brush. Once it hardens into tartar or calculus, it won’t come off with brushing no matter how hard the brush, but you can damage the delicate gum tissue by using those types of brushes.”
  • Not replacing an old brush. You should replace your toothbrush every three to four months for dental health, but many people let it go way beyond this point. “When the bristles become splayed out, they cannot properly clean the various surfaces of your teeth,” says Shawn Frawley, D.D.S., a dentist in private practice in Beverly Hills, Calif. “In addition, many of the power brushes lose cleaning power as the brush head ages.”
  • Brushing back and forth. Often, the brushing mistake has to do with brushing technique itself. “You should brush in a circular motion, angling the bristles of the brush at a 45-degree angle to the gumline and focus on a couple teeth at a time,” says Dr. Frawley. “This enables you to clean under the gums, where most plaque is present and causes the most harm. This also helps avoid over-brushing.”
  • Moving all around. People don’t always follow a set order as they move around their mouth brushing. “When we brush in this fashion, we tend to miss various surfaces of the teeth because it is hard to know where we have and have not brushed,” Frawley says. “You should brush your teeth with a systematic approach. There are four quadrants of the mouth and three surfaces to brush per tooth. You should brush all the surfaces of one quadrant of the mouth at a time.”
  • Brushing too aggressively. Not a lot of force is needed to do a good job brushing, says David S. Keen, D.D.S., a dentist in private practice in Beverly Hills, Calif. “Most people forget that bacteria and food particles that remain on the teeth after eating a meal are very soft in texture,” he says. “Therefore, gentle brushing is all that is needed to remove the bacteria and food.” If you use an electric toothbrush, keep in mind that it was designed to do it all. “Vigorous movement of the electric toothbrush against the teeth and gums and using heavy arm pressure can negatively affect the condition of your teeth and gums and can even cause gum recession,” explains Dr. Keen.
  • Not brushing long enough. According to Keen, this is a big problem. “Most people, when asked how long they brush, typically say about one to two minutes, when in reality they typically brush for only 30 seconds,” he says. “It is important to access all the areas of the mouth and all surfaces of the teeth to effectively clean the tooth surfaces of bacteria and food, and to coat each tooth surface with the cleansing toothpaste.”
  • Using too much toothpaste. The flip side of the previous tip is that most of us slather way more toothpaste onto our toothbrush than we actually need. “You just need a pea-sized amount for most toothpastes,” says Dr. Hyde. “The rest is wasted.”
  • Not using an electric toothbrush. For the most thorough brushing job, most dentists agree that it’s time to make the switch if you haven’t already. “Power brushes are very affordable these days and are certainly worth the investment,” says Frawley. “There is no possible way to brush your teeth as effectively or thoroughly with a manual toothbrush as compared to a powered brush. Many of these brushes indicate if you are brushing too hard and have timers on them to ensure you are brushing for long enough. It makes brushing easier because you just need to hold the brush in the proper position and let the brush do the work.”

7 Biggest Causes of Tooth Sensitivity

Does drinking an ice cold beverage cause dental discomfort? Or do you find yourself wincing when you brush or floss? You could have what’s known as tooth sensitivity.

You don’t have to put up with the pain, however. There are things you can do to lessen tooth sensitivity and improve your oral health, says Leslie Seldin, DDS, a dentist in New York City and an associate professor of dentistry at the Columbia University College of Dental Medicine.

Here’s why you could be experiencing this mouth malady — and steps you can take to find relief for sensitive teeth:

1. You brush with too much gusto. Sometimes tooth sensitivity comes from brushing with too much force or using a hard-bristled toothbrush. Over time, you can wear down the protective layers of your teeth and expose microscopic hollow tubes or canals that lead to your dental nerves. When these tubes are exposed to extreme temperatures or acidic or sticky foods, tooth sensitivity and discomfort can result. The simplest solution is to switch to a toothbrush with softer bristles and to be gentler when brushing.

2. You eat acidic foods. If the pathways to your nerves are exposed, acidic foods such as tomato sauce, lemon, grapefruit, kiwi, and pickles can cause pain. But avoiding these foods can help you avoid any tooth discomfort.

3. You’re a tooth-grinder. Even though tooth enamel is the strongest substance in your body, grinding your teeth can wear down the enamel. By doing so, you expose the dentin, or the middle layer of the tooth, which contains the hollow tubes that lead to your nerves. Talk to your dentist about finding a mouth guard that can stop you from grinding. The best guards are custom-made to fit your bite, Dr. Seldin says.

4. You use tooth-whitening toothpaste. Many manufacturers add tooth-whitening chemicals to their toothpaste formulas, and some people are more sensitive to them than others. If your toothpaste contains whitening agents, consider switching to one that doesn’t.

5. You’re a mouthwash junkie. Like whitening toothpaste, some over-the-counter mouthwashes and rinses contain alcohol and other chemicals that can make your teeth more sensitive — especially if your dentin’s exposed. Instead, try neutral fluoride rinses or simply skip the rinse and be more diligent about flossing and brushing.

6. You’ve got gum disease. Receding gums, which are increasingly common with age (especially if you haven’t kept up with your dental health), can cause tooth sensitivity. If gum disease or gingivitis is the problem, your dentist will come up with a plan to treat the underlying disease, and may also suggest a procedure to seal your teeth.

7. You have excessive plaque. The purpose of flossing and brushing is to remove plaque that forms after you eat. An excessive buildup of plaque can cause tooth enamel to wear away. Again, your teeth can become more sensitive as they lose protection provided by the enamel. The solution is to practice good daily dental care and visit your dentist for cleanings every six months — or more frequently if necessary.

8. You’ve had a dental procedure. It’s common to experience some sensitivity after a root canal, an extraction, or the placement of a crown. If symptoms don’t disappear after a short time, you should schedule another visit to your dentist, as it could be a sign of infection.

Tooth sensitivity is treatable. In fact, you might find that using toothpaste specifically made for sensitive teeth helps, Seldin says. However, these formulas don’t work for everyone.

If your sensitivity is extreme and persists no matter what steps you take, be sure to see your dentist for an evaluation. Only an office visit can determine the most likely cause of your tooth sensitivity and the best solution for your particular situation.

The Best Home Remedies for Dental Pain

Toothaches may be small in size — but they can cause a colossal amount of pain.

“Pain is your body’s way of telling you to go to a doctor,” says John Dodes, DDS, a dentist in Forest Hills, N.Y., and author of Healthy Teeth. If you have a severe or persistent toothache or other mouth malady, you should visit your dentist in case it’s a serious dental health issue that needs treatment.

However, some minor toothaches and pains can be treated right at home (or at least mitigated while you wait to see your dentist). Next time your mouth is troubling you, give these home remedies a shot.

Toothache Cures From Your Kitchen Cabinet

Grab some clove oil. Oil of clove is an age-old home remedy. It works thanks to the chemical eugenol contained in the oil, which has anesthetic and antibacterial properties. To use it for tooth pain, soak a cotton ball with a mixture made of two to three drops of clove oil and ¼ teaspoon of olive oil. Put the cotton ball in your mouth near the tooth that hurts and bite down to keep it in place. One caution: Don’t go to sleep with the cotton ball still in your mouth. The FDA no longer considers this treatment effective enough to recommend it, although some dentists still believe it has benefits.Clove oil is available at pharmacies and health food stores.

Pop in a cough drop. Cough drops or lozenges usually contain a small amount of anesthetic (menthol and sometimes benzocaine) — which means they may relieve minor tooth pain, too. Pop one or two in your mouth and suck on them (don’t chew!). Another solution? Apply a dab of Vick’s VapoRub on the outside of your cheek where your tooth hurts, then place a paper towel on your pillow and lie down on that side.

Flush it out. Sometimes, the root of your toothache is food that’s trapped between your teeth. In this case, try flossing, rinsing with mouthwash, or using interdental brushes (small brushes shaped like Christmas trees that work between the teeth). In fact, this home remedy can save you a trip to the dentist’s office — but if food is constantly getting stuck in your teeth, talk to your dentist, because there could be an issue with your gums that needs medical attention.

Try these other kitchen staples. Some other home remedies that have proven to help toothaches include applying a hot tea bag directly to the tooth. Tea contains tannic acid, which reduces swelling. Other solutions: A cucumber slice placed on the tooth or a cotton ball soaked in brandy – alcohol has numbing properties, too. Some people also report that garlic, onions, spinach, wheat grass, or a simple salt water rinse relieves tooth pain.

Home Remedies for Your Other Mouth Maladies

Canker sore? Use these OTC concoctions. Canker sores usually go away on their own — but the pain can be excruciating in the meantime. While you’re waiting for one to heal, you may find relief by applying a mixture of half hydrogen peroxide and half water to the sore with a cotton swab, then follow with a dot of Milk of Magnesia; you can repeat this up to four times a day. Another home remedy to try is a mixture of equal parts Milk of Magnesia and liquid Benadryl; gently swish the mixture around your mouth for 60 seconds and then spit it out.

Sensitive teeth? Try this toothpaste. If your tooth feels sensitive to pressure, or when it’s exposed to hot or cold temperatures, whitening toothpaste is a no-no (it can just make your teeth more sensitive). Instead, try this simple solution: Switch to a no-frills toothpaste or consider buying toothpaste made especially for sensitive teeth, Dr. Dodes says. “They have chemicals in them that desensitize the tooth,” he explains. If sensitivity persists, talk to your dentist, who can investigate the cause.

Got jaw pain? Eat this. Until you can get an appointment with your dentist to check out your jaw pain — or while you wait to see if the pain resolves on its own — switch to a diet of softer foods. “Don’t eat big, overstuffed sandwiches or hard bagels,” Dodes says. “Give yourself five or six days of eating a soft-food diet and see if it gets better. If you twisted your ankle, you wouldn’t run hurdles, would you? If it hurts, give it a break.” Just be sure to call your dentist if the jaw or tooth pain doesn’t go away.

Got swelling? Take these steps. Mouth pain is sometimes caused by swelling of soft tissues in the mouth. Swelling should be checked by a dentist because it could be a serious dental health issue, Dodes says. In the meantime, try taking an over-the-counter anti-inflammatory medication such as ibuprofen (Advil or Motrin). “Still, if you’re in enough pain that you need a pill,” Dodes says, “you better get to a doctor because dental pain tends to get worse and worse.”

Broken tooth? Do this ASAP. If you break a tooth, get to your dentist as soon as possible — this pearly-white problem needs immediate assistance. If you find the piece of tooth that broke off, you can preserve it at home by putting it in water or milk — don’t leave it on a counter, for instance, and never scrub it with cleanser, Dodes says. Sometimes dentists can bond the tooth back on. “By putting it in milk, you’re helping to keep the cells alive so that they will re-grow when it’s reattached.”

The Tooth-Friendly Diet

What you eat affects your mouth not only by building healthier teeth and gums, but also by helping prevent tooth decay and gum disease. Learn how to eat the best diet for your teeth, including the foods to eat, beverages to drink, and what to avoid.

What you eat affects your mouth not only by building healthier teeth and gums, but also by helping prevent tooth decay and gum disease. While a healthy diet rich in fruits and vegetables, whole grains, lean proteins, and unsaturated fats will benefit your overall oral health, there are a few standout foods and nutrients that can really boost it.

Teeth and Calcium

Mom said it when you were in grade school, and she was right on this one: Drinking milk builds strong bones and teeth. Calcium is vital in childhood and through your teens, when teeth are formed, but the value of this nutrient doesn’t stop once you get your wisdom teeth. A diet with adequate calcium may prevent against tooth decay, says Dr. Leonard Anglis, DDS. When a diet is low in calcium, as a majority of Americans’ diets are, the body leeches the mineral from teeth and bones, which can increase your risk of tooth decay and the incidence of cavities. A study that appeared in the Journal of Periodontology found that those who have a calcium intake of less than 500 mg, or about half the recommended dietary allowance, were almost twice as likely to have periodontitis, or gum disease, than those who had the recommended intake.

The jawbone is particularly susceptible to the effects of low calcium. It can weaken because of low calcium intake, which in turn causes teeth to loosen, leaving you at greater risk for gum disease.

The Food and Drug Administration recommends 1,000 mg of calcium daily for women younger than 50 and for men of any age, and 1,200 mg for women over 50. Calcium is found in dairy foods like milk, cheese, and yogurt; in fish, including sardines with bones and salmon; and in some vegetables, including kale and broccoli.

Eating two to four servings of dairy per day will help you meet the RDA for calcium.

Teeth and Vitamin C

The body needs vitamin C to repair connective tissue and help the body fight off infection. No surprise then that a study at the State University of New York at Buffalo showed that those who eat less than the recommended 75 to 90 mg per day are 25 percent more likely to have gingivitis than those who eat three times the recommended daily allowance. Gingivitis is the mildest form of periodontal diseases, and it causes the gums to become red from inflammation, swelling and bleeding easily.

Eating one piece of citrus fruit (oranges, grapefruits, tangerines) or a kiwi daily will help you meet the RDA for vitamin C.

Teeth and Fruits and Vegetables

Crunchy fruit and veggies — like apples, pears, celery, and carrots — are excellent for your teeth in two ways. The crisp texture acts as a detergent on teeth, wiping away bacteria that can cause plaque. Plus these foods require a lot of chewing, which increases the production of bacteria-neutralizing saliva.

Teeth and Tea

While tea may stain teeth, studies at the University of Illinois College of Dentistry have shown that compounds in black tea can destroy or suppress the growth of cavity-causing bacteria in dental plaque, which can help prevent both cavities and gum disease.

Teeth and Water

Drinking plenty of water benefits teeth as it helps rinse away both bacteria and the remnants of food that bacteria turns into plaque. Tap water is better for teeth than bottled because it contains fluoride, which prevents tooth decay.

Foods to Avoid

Sugary snacks, especially gummy candies and hard candies that stick in your teeth, are at the top of every dentist’s list of foods to avoid. Regular soda provides a double hit to teeth, combining sugar with acids.

Even foods and drinks that are good for your teeth, like milk, contain sugars. No matter what you eat, it’s important to brush and floss afterward — or at least to rinse your mouth with water. Brush twice a day using either a manual or power toothbrush, and remember to visit a dentist at least twice a year for checkups.

Choosing a Mouth Rinse That’s Right for You

Anti-plaque, anti-gingivitis, alcohol-free — your pharmacy’s oral health section has dozens of mouth rinse products to choose from, all promising to protect your teeth and gums and freshen your breath.

But how can you know which claims are true? And do you really need to use a mouth rinse — or is good brushing and flossing enough?

“There are three major categories [of mouth rinses], from a consumer perspective,” says Michelle Henshaw, DDS, MPH and assistant dean for community partnerships and extramural affairs at Boston University, Henry M. Goldman School of Dental Medicine. These include mouth rinse products that contain fluoride, anti-gingivitis and anti-plaque mouth rinses, and cosmetic mouth rinse products. Some of these mouth rinses are available over-the-counter; others will require a prescription.

Here’s what you should know when shopping for a mouth rinse.

Fluoride-Containing Mouth Rinses

Fluoride helps prevent tooth decay by helping your body strengthen enamel — the white, harder-than-bone substance that covers teeth. But most people will not require fluoride-containing mouth rinses, says Dr. Henshaw. “You pretty much get that from your fluoridated toothpaste,” she says. But, there are some exceptions.

“People with xerostomia (abnormal dryness of the mouth) might use this kind of mouth rinse, and there are other reasons, like dental caries (cavities),” says Henshaw. Severe dry mouth can lead to a change in the bacterial balance of your mouth, while too much bad bacteria can lead to tooth decay. Fluoride mouth rinses can help prevent these problems.

Check with your dentist if you’re not using fluoride toothpaste. In this case, it might be a good idea to supplement your oral health routine with a fluoride mouth rinse.

Mouth Rinse to Freshen Your Breath

Many mouth rinses are available that make your breath smell good, but, they don’t necessarily offer any long-term dental health benefits.

“Cosmetic rinses reduce mouth odors, or halitosis,” Henshaw says. “Some do kill bacteria for a short time, but there is no lasting health impact that you could ascribe to them.” The bacteria killed by these types of mouth rinses will grow back eventually, and while you’ll have fresh and minty breath in the short-term, these rinses don’t actually improve your oral health.

Anti-Plaque or Anti-Gingivitis Mouth Rinses

“For adults, it’s a good idea to include this kind [of mouth rinse] with brushing and flossing,” Henshaw says. Although brushing and flossing are the key components of good oral health, we don’t always do as good a job with these tasks as we should. Anti-plaque and anti-gingivitis mouth rinses can give a boost to your dental care habits by killing potentially damaging bacteria.

“If it has the American Dental Association (ADA) seal of approval that means that the claims made on the bottle have been verified by an independent scientific body,” Henshaw explains. “These rinses work by killing a different spectrum of bacteria than the breath-freshening rinses,” Henshaw says. Oral bacteria can cause gum disease, so using a rinse that eliminates some of these organisms will help your overall oral health.

For people with more serious oral health concerns, dentists can prescribe stronger mouth rinses. “Another level is available by prescription to fight advanced plaque and gingivitis. This will keep inflammation down,” Henshaw says.

Mouth rinses do serve a purpose, whether to freshen your breath or help fight plaque and gingivitis. But, mouth rinses are not a substitute for regular and effective brushing and flossing. Don’t get lazy with your toothbrush and dental floss. And when choosing a mouth rinse product, pick one that has the ADA seal of approval.

FDA’s Warning to Mouthwash Makers

In September 2010, the Food and Drug Administration (FDA) warned a number of mouthwash producers — including Johnson & Johnson, CVS, and Walgreens — that they needed to stop making “unproven” claims in their packaging. The mouth rinses targeted were mainly those containing sodium fluoride, which has found to be an effective cavity-fighter but ieffective at removing plaque or preventing gum disease.

A Guide to Flossing Your Teeth

 Cleaning the spaces between your teeth and along your gums with dental floss is as important to your oral health as cleaning your teeth with a toothbrush. Just like you brush your teeth every day, flossing should be part of your daily routine.

To better understand why flossing is so important, Richard H. Price, DMD, spokesperson for the American Dental Association (ADA) and a former clinical instructor at Boston University Dental School, compares it to cleaning your home: “You cannot effectively vacuum a house with only one attachment,” he says. “You need other attachments to get into the nooks and crannies. That’s what floss does.”

The Benefits of Flossing to Your Oral Health

There are many benefits to regularly flossing your teeth. Dental floss can help clear food debris and plaque from the spaces between your teeth, where your toothbrush can’t reach. As a result, flossing helps prevent gum or periodontal diseases, tooth decay, and bad breath.

There are certain things to keep in mind to get the most out of flossing:

  • Use dental floss or an interdental cleaner every day.
  • Floss at least once a day.
  • Be gentle when using dental floss so you avoid damaging gum tissue.
  • If long threads of regular dental floss are too hard for you to hold, use a floss holder.

A Variety of Dental Cleaning Products

Drugstores offer a mindboggling variety of dental cleaning tools. These include:

  • Waxed dental floss
  • Unwaxed dental floss
  • Interdental cleaning aids, including picks and special sticks
  • Oral irrigators, which use water to remove plaque caught between teeth
  • Mouth rinses

Both waxed and unwaxed dental floss work well to clean the spaces between your teeth. If the spaces are tight, waxed floss may glide more easily between them. The bottom line, says Price, is that flossing every day is more important to your oral health than which floss you choose.

“Any floss that slips easily between teeth without hurting and damaging the gums is the floss for you,” says Price. “Ask you dentist for a recommendation. Some have samples you can try. Waxed, unwaxed, high-tech teflon types, nylon types? Just use it!”

A floss holder or other interdental cleaning tool may be helpful if you have trouble handling long pieces of floss due to arthritis, vision difficulties, or discomfort, but you must follow instructions or ask your dentist how to use them properly so you don’t hurt your gums.

Oral irrigators can help remove food caught between your teeth, too; but they shouldn’t replace dental floss and toothbrushing. Likewise, most mouthwashes won’t do an effective job of keeping your mouth healthy on their own. Many are used simply to cover up breath odor, although some over-the-counter fluoride mouth rinses approved by the ADA can help prevent decay, and some anti-gingivitis or anti-plaque mouth rinses can help fight periodontal diseases.

Offering ‘rock and roll’ dentistry to time-poor patients

 With a prestigious London postcode and situated only a stone’s throw away from the world famous music studio, Abbey Road Dental has a location and name that’s world renowned.

The clinic is small but perfectly formed and sits above a café and bar in the road made famous by the Beatles. Whilst respecting the privacy of any rock star clients – ‘we do see the occasional celebrity who uses the recording studios down the road, but our lips remain sealed’, says practice principal Diana Spencer – the bijou practice is anything but anonymous when it comes to its approach to patient care.

‘We are small, but very special,’ Diana says of the practice that opened its doors in June 2011. ‘We offer everything that could be asked for in a modern practice but, because of our size, we are a close-knit and mutually supportive group. We know all our patients by name and they are part of our family. No one is an anonymous face – neither staff nor patients – and I pretty well know all of the patients, whether I treat them or not.’

Preventative care

Abbey Road Dental is a clinic that places preventative care at its heart, while offering complementary cosmetic dentistry and Diana is proud of its ability to combine aesthetic treatments with a more nurturing and holistic approach to dental health.

She says: ‘We are in a wonderful period of development in medicine and dentistry. It is hard to believe that, only a few generations ago, extractions with no anaesthetic were the solution to dental disease. Prevention of disease is key for a healthy and fulfilled life – and not only in dentistry.

‘The technological advances of the last few decades have revolutionised the practice of dentistry. These days, minimally invasive dentistry is the song we dentists sing. The high tech approach – with intraoral cameras and computer-aided technology and so on – not only allows us to achieve fabulous results without pain, but also educates and empowers patients.’

High expectations

The practice has a mixed patient base and attracts a large number of patients from across the Home Counties as well as a number of American families who live in the area due to the proximity of the American School in London. Diana explains: ‘They love the kind of practice we have – preventative orientated and child friendly. We also see a high number of young professionals who work in central London but live locally.’

With this comes a multitude of challenges, not least of which is the cohort of professionals in the early stages of their career who work hard, play hard but with their dental health sometimes taking the brunt.

Diana says: ‘We have quite a high proportion of patients who are time poor but with high expectations. It is paramount to us we keep our promises to patients to be able to offer late-night openings and to understand the problems involved with working in high stress environments while trying to fit in some time to take care of health needs.’

She explains: ‘We insist on a full-hour assessment with the hygienist and another hour with the dentist for all new patients, so we can investigate fully – and at leisure – the current state of health of the patient, as well as their needs and desires. The aesthetics of a smile is very important to all of us – but oral hygiene is first and foremost and a beautiful smile can only be achieved once that is perfected.

‘I believe there is nothing better than a natural tooth, so invasion into that tooth is always kept to the absolute minimum.’

The home care toolkit she recommends to all her patients is always evidence based and up to date, taking in any developments in dental technology and research.

She explains: ‘We always recommend power brushes to all our patients, including children. The latest models are brilliant at motivation and preventing over-brushing as well as making the patient aware of the need to brush all surfaces of the teeth, not just the visible areas. When our patients return for follow-up care, they are usually amazed at the change in the appearance and feel of clean healthy teeth and gums – and we can show them the pictures to prove it!

‘We always recommend the Oral-B Genius powerbrush, Satin tape and the Pro-Expert toothpaste. The powerbrush is good for assisting in patient compliance and the patients see the results very quickly.’

Children’s dentistry

Abbey Road Dental also has a special interest in children’s dentistry, the source of which lies in Diana’s own childhood.

She explains: ‘I had awful dental experiences as a child – Sherbet Dip Dabs were my downfall – and, consequently, needed fillings every dental visit and it always hurt, even when they said it wouldn’t.

‘I want children to see the dentist as a friend and teacher who have their best interests at heart and is fun to be with and always keeps her promises, whatever happens. A visit to the dentist should be easy and relaxed and just a normal part of life, not a crisis.’

And this translates across all age groups, too. Diana says: ‘We endeavour to create a calm, relaxed and friendly practice so that all our patients are able to just slow down and have some “me” time and know that they will be cared for professionally.’

The most common lies dentists tell themselves

 As humans, we tend to believe things that may not necessarily be true because they fit our view of the world. These “lies,” or innocent self-deceptions, may seem harmless, but can in fact be very costly to a professional practice in terms of time, money, and satisfaction. As advisors to dentists, we have found the following to be the most common “lies” dentists tell themselves:

1. I am a doctor, not a business owner. Success is guaranteed.
Many dentists struggle with the challenges of owning a business. Some will proudly tell you that they didn’t become a dentist to make a profit, but rather to help people by treating dental diseases. Being a financially successful dentist and being a good doctor are not mutually exclusive. In fact, in order to be there to treat your patients, you or your employer must make a profit. In today’s world you must devote time to the business side of your practice.

9 practice management tips from dental industry experts
On dental technology in the first quarter

2. Budgets are a waste of time. I just check whether I’m doing better than last year.
Just the sound of the word “budget” sounds confining and restrictive. We all want the freedom to spend as we please. Ironically, when budgeting is proactive, the process “frees
up” money that tends to get wasted. Budgets provide the dentist three significant benefits:

  • Budgets set revenue and expense goals. Studies have shown that people are more likely to accomplish goals that are written compared to those that are not.
  • Budgets ensure the efficient use of resources. Setting and reaching revenue goals ensures that cash is available to meet all obligations. Expenditure goals ensure that resources are directed toward those activities that will move the practice forward toward a well-defined goal. Finally, a dentist is less likely to impulse buy because expenditures have been determined in advance.
  • The budgeting process helps the dentist internalize the practice goals, resulting in better practice management decisions.

Simply depending upon last year’s numbers to manage one’s practice is like driving a car by looking in the rearview mirror. Start budgeting and experience the freedom.

Five ways to improve your endodontic business

3. Scheduling for production is all about money.
One of the most dramatic improvements you can bring to your practice is to learn to schedule for productivity. Often, practices confuse being busy with being productive. Scheduling for productivity is about time management. A good scheduling system maximizes the efficient use of both doctor and staff time. Done well, scheduling can reduce stress of patients and staff, improve patient satisfaction and reduce the time a patient will need to spend in your chair. A few dollars spent with a qualified consultant can pay big dividends.

“One of the important lessons doctors must learn is that each and every one of their staff contributes to their success or failure. […] Being appreciated is one of the top reasons employees continue to work for a  particular employer.”

4. I have more important things to do than plan my equipment purchases. I can wait until it wears out and then buy what’s currently “hot” at the dental convention.
Planning equipment purchases seems like a mundane task. However, the money saved by doing this planning can be pretty exciting. Most practitioners finance the purchase of dental equipment if the amounts are significant. However, by planning ahead and saving rather than borrowing, the results are positive and dramatic. If a dentist expects to acquire $50,000 of dental equipment in three years, simply setting aside the funds in an equipment reserve account can save $8,200 (assumptions are 5% rate of return, 40% tax bracket, 7.5% interest rate, 60-month repayment term for equipment loan). Money-saving ideas occur when the dentist develops and works a good business plan in partnership with an accountant that understands the dental industry.

5. Staff are all overpaid and don’t appreciate their job – or me.
One of the most important lessons doctors must learn is that each and every one of their staff contributes to their success or failure. Studies have shown that 68% of patients that leave your practice do so because of something your staff has done. You need to create a culture where everyone works towards the practice success. Being appreciated is one of the top reasons employees continue to work for a particular employer.

6. Leadership training doesn’t apply to our practice. We’re all professionals and know what we’re doing.
How would you feel if you were boarding a flight to London and overheard the pilot say, “We don’t need a flight plan today; we can just ‘wing’ it?” Most people would feel nervous and uncomfortable because they want the pilot to know the best course, be aware of bad weather, and anticipate air traffic conflicts so they arrive at their destination safely and on time. Likewise, patients and staff want the dentist to have a clear idea of where the practice is going and to assume a leadership role. When everyone is pulling in the same direction, astounding results occur. If each person on your dental team cannot clearly articulate and enthusiastically support the practice goals, then the practice has a leadership vacuum. You are the person responsible to fill that vacuum. Improve your leadership skills and your practice performance will soar.

“Waiting even five years [to plan for your retirement] can cost you a large amount of money, and putting off funding retirement indefinitely will most assuredly put your ability to retire at all in jeopardy.”

7. Staff meetings are a waste of time and money.
One of the symptoms we see when a practice is struggling is the lack of communication between the doctor and staff. Well-run practices understand the value of staff meetings. Staff meetings take several forms. Each day should start with a morning huddle to review the day about to take place. At least monthly, the practice should set aside a couple of hours for a full staff meeting. The staff meeting is a great opportunity for training, problem solving, review of systems, and holding team members accountable.

8. Our practice is not experiencing any problems. We can afford to coast.
After working hard to build a practice, a dentist must guard against complacency. Little thoughts creep into one’s mind, “Everything is going well. I think I’ll coast for a while. I deserve it.” In times past, people manufactured horse drawn carriages, steam locomotives, slide rules, and typewriters. Today all of those once-useful products are obsolete. We sometimes forget that the world is constantly changing, and if we are not constantly changing, our dental practices become obsolete. If your practice looks the same as it did three years ago, is likely a red flag warning you to innovate, upgrade, and improve. A dynamic business plan will include innovation and improvements. Create or update your plan, and use it as a daily guide.

9. Our practice will never be embezzled. My bookkeeper has worked in our office for 20 years and is totally trustworthy.
Of course we trust our employees; we would never hire a person that we don’t trust. Trust is crucial to running a successful business. As prudent business owners, we always insist on honesty and ethical behavior. Despite the best of intentions, a substantial number of dental practices (15% to 20% by most estimates) unfortunately experience fraud or embezzlement. In order to protect business assets while simultaneously maintaining high employee morale through mutual trust and support, a dentist must implement and maintain “internal controls.” Internal controls are simply self-checking systems that constantly alert the owner whether business assets are being handled in a responsible manner. Internal controls can include a record like a day sheet, a procedure such as checking daily production totals against the schedule, or a policy such as “checks must always be signed by the dentist.” If you are unsure whether your internal controls are protecting you, contact your dental CPA.

10. I can wait until later to start funding my retirement.
We believe the first day a dentist should begin planning for his or her retirement is the first day of practice. Developing the discipline to save for retirement early is the best way to meet your retirement goals. Consider five different dentists who each contribute $25,000 per year towards retirement but started at different ages (35, 40, 45, 50 and 55) and earn a rate of return of 6%. The dentist who starts at age 35 contributes a total of $750,000 and accumulates $1,976,455. The dentist who waits until age 40 only accumulates $1,371,613. Waiting to start at age 45 only allows the dentist to accumulate $919,640. Waiting until age 50 results in accumulating only $581,899, and $329,520 if you wait until age 55. Waiting even five years can cost you a large amount of money, and putting off funding retirement indefinitely will most assuredly put your ability to retire at all in jeopardy. There are many qualified plan choices for dentists today that provide flexibility and tax advantages. Your dental CPA can help you choose the best plan for you to meet your retirement planning goals.