Announcement: Dr. Fletcher Teaching

We are excited to report that Dr. Fletcher has started teaching in the Dental Assisting program at Heald College in Modesto.

For the past fifteen years, our office has been involved with the education process. Dr. Fletcher has regularly invited dental assisting interns from the Modesto Junior College's Dental Assisting Program to work chairside with him. However, last year MJC chose to terminate the dental assisting program.

Looking for a new way to engage in education, Dr. Fletcher contacted Heald College last Fall and found a good match. He teaches at the college on Tuesday mornings and then returns to see patients in the office on Tuesday afternoon.

Dr. Fletcher says, "I have enjoyed the opportunity to teach, I've been teaching patients, staff and interns since I've been in practice, so this is a natural fit for me to teach in the classroom. At this point in my career, part-time teaching at a local school seems to work well."

For more information about Dr. Fletcher's schedule and what he's doing outside of the office, stay up to date with FletcherDentistry.com.

New Office Manager at Fletcher Dentistry

I am very pleased to announce that we have hired a new office manager at Fletcher Dentistry (our first!). The best news is that we were able to hire from within our own office.

Trudi Santini has been with my office for more than 10 years. In that time she has served in a variety of office jobs including scheduling coordinator, billing coordinator, and insurance coordinator. I am very excited to see her succeed in this new role as well. If you get a chance, leave a comment on this blog post or on facebook welcoming Trudi to her new position.

Keep smiling,

Dr. Fletcher

End of the year - Plan Now and Save Money!

The end of the year is quickly approaching, so I asked our scheduling coordinator and insurance coordinator what our patients should know before 2012 comes rolling in.

From our scheduling coordinator, Susie:

"This is the perfect time to schedule appointments for you and all your family. By scheduling during this season you can take advantage of when children are home for the holidays as well as preventing them from missing school or sports. It is already November, so availability of appointments is very limited. Give me a call as soon as possible to reserve an appointment for yourself or a family member."

From Trudi, our insurance coordinator:

Did you know that you can save hundreds of dollars by using your dental benefits before the end of the year? Few dental plans run on a contract year, however the majority of the plans run on a calendar year.  By scheduling your necessary treatment before the end of the year you can actually SAVE yourself some money by doing the following:

• Using your yearly maximum benefit this year, so that all of your next year's maximum is available to you for dental emergencies.
• You may have already paid your deductible this year and if you put off necessary treatment until next year you will have to meet the deductible all over again.
• Employers often make changes to the dental plans they offer each year, which may not benefit you, making it advantageous to you to use your benefits to the maximum with the plan that you currently have.
• Small dental problems can get worse. Postponing necessary treatment can often end up costing you more than you originally planned. 

Contact our office today to get your unfinished treatment scheduled or let me provide personal advice on how to use your dental benefits to the maximum!!!

Keep smiling,

Dr. Fletcher

Cleanings, Root Planing, Maintenance...Oh My!

We are asked often about the differences in treatment and cost for getting teeth cleaned. Since it has become such a common question, I thought we'd answer it simply in a blog post.

Dental Cleanings
According to the American Dental Association, this is the definition of an adult dental cleaning (technically a prophylaxis): "A dental prophylaxis performed on transitional or permanent dentition, which includes scaling and polishing procedures to remove coronal plaque, calculus, and stains. Some patients may require more than one appointment or one extended appointment to complete a prophylaxis. Document need for additional time or appointments." 

Dr. Fletcher's No-Nonsense Explanation: I realize that is a lot of words, so let me break it down. A dental cleaning is done for people with healthy gums. It removes plaque and calculus (also known as tartar) from above the gum line. This is typically completed by a hygienist in one visit. The hygienist may use a scaler/curette (patients refer to them as metal picks) or an ultrasonic scaler (commonly referred to as the tool that "vibrates, buzzes and shoots water"). Lastly, the hygienist will polish your teeth with an air-driven slow-speed prophy cup filled with flavored pumice.

The key: the patient has healthy gums (meaning no bone loss, no periodontal disease) and the teeth are simply cleaned in one visit.

Root Planing
According to the American Dental Association, root planing (deep cleaning) is defined as follows: "This procedure involves instrumentation of the crown and root surfaces of the teeth to remove plaque and calculus from these surfaces. It is indicated for patients with periodontal disease and is therapeutic, not prophylactic, in nature. Root planing is the definitive procedure designed for the removal of cementum and dentin that is rough and/or permeated by calculus or contaminated with toxins or microorganisms. Some soft tissue removal occurs. This procedure may be used as a definitive treatment in some stages of periodontal disease and/or as a part of pre-surgical procedures in others."

Dr. Fletcher's No-Nonsense Explanation: Let me simplify it for this blog post. This is not a cleaning. The patient getting root planing does not have healthy gums. It is therapy or treatment for diseased gums. Your teeth are probed/measured for the purpose of diagnosis. Patients with good oral hygiene can manage pocket depths at 3-4mm. Probing depths 5mm and above with evidence of plaque, calculus, inflammation or infection require treatment of the tooth and root surfaces. This is done typically one corner of the mouth at a time with dental anesthetic. It is always followed up with a reevaluation, to make sure the treatment was successful.

The key: the patient has been diagnosed with periodontal disease (bone loss has occured and acute or chronic gingival inflammation is present). This treatment is completed 1/4 of the mouth at a time with dental anesthetic. The patient may leave with an antibiotic or an antimicrobial rinse. 

Periodontal Maintenance
This is the most confusing part of periodontal therapy. Periodontal Maintenance is defined by the ADA as follows: "This procedure is for patients who have previously been treated for periodontal disease. Typically, maintenance starts after completion of active (surgical or nonsurgical) periodontal therapy and continues at varying intervals, determined by the clinical diagnosis of the dentist, for the life of the dentition. It includes removal of supra and subgingival microbial flora and calculus, site specific scaling and root planing where indicated, and/or polishing teeth. When new or recurring periodontal disease appears, additional diagnostic and treatment procedures must be considered."

 Dr. Fletcher's No-Nonsense Explanation: This seems like a cleaning, except it's for patients who have previously had gum surgery or root planing...aka they do not have a healthy mouth. The hygienist will go after troubled spots, numb if necessary, and constantly evaluate the "state of disease." The name explains a lot: Periodontal Maintenance, in other words the dentist/staff are maintaining the current conditions and trying to prevent them from getting worse. They may be more frequent than dental cleanings too.

The key: Not a cleaning, but it sure feels like one, because the whole mouth is treated in one visit. It is more active, more thorough and more involved.

The comments are open on this post, so feel free to ask questions that you may have.

Keep smiling!
ARFDDS 

Summertime: Dental Injuries

With the warmer weather, increased activities and sports, we also see an increase in dental trauma. In our office, it is almost weekly that we treat patients with trauma to their teeth, lips and the face.  Here are a few basics for what to do if a dental injury occurs.

Fractured Teeth
For all fractures, a dental exam is very important. This will include an examination of the area and an xray to determine a fractured root like the one you see pictured above. (Note: the tooth looked fine above the gumline, the root which was unseen was fractured).
Small chips do not need to be seen immediately, but major fractures that are sensitive to temperature or anytime there is bleeding around the gumline, you should schedule a dental visit as soon as possible.

Tooth Knocked Out
Timing is important.  If a permanent tooth was knocked out and is clean, it can be reinserted. If not, than you need to be seen immediately (after 1 hour the tooth has a poor chance for successful reimplantation).
What to do? Do not clean the tooth off, but keep the tooth moist. You can put it in a cup of milk or even in the patient's mouth (but only if there is no risk of swallowing the tooth). Seek dental care as soon as possible.

Lip or Tongue Bite/Cut
If you cannot get the bleeding to stop with pressure on the lip, than it needs to be seen in the office for examination and possibly sutures. If it was cut on a tooth, than a dental exam and xray will be needed of the tooth as well.

Tongue bites can be nasty (and bleed a lot!), but rarely do they require treatment. They do require a dental exam and treatment is based on severity.

There are many other dental injuries. Trauma to the head/face/jaw, burns, and a variety of injuries to the teeth from normal behavior. When deciding what to do, the best idea is to call our office and speak with a staff member or connect after hours on our emergency line with Dr. Fletcher!

We hope you have a safe and happy summer!