Just think about it.  Would you let someone “experiment” on your knee to see if a screw was going to work or fail?  I would not.  Most people do not understand that it was in dentistry that many of these now common technologies were developed.  I call the 1980′s and 90′s the “age of human experimentation” in dentistry.  There are still some dentists practicing today that pioneered questionable technologies in patient’s mouths to see if they could restore their dentition to a more natural state after their teeth were lost to decay/trauma.  Unfortunately, we have all heard of dental implant failures in someone’s mouth in the past.  Fortunately, today failures in dental implants are at an all time low.

Today, it is now routine in oral surgery, periodontal and trained general dental offices to remove non-restorable teeth and place inside the extraction site a dental implant.  Depending on many factors, the implant is either restored immediately or allowed to heal over a period of time before it is restored.  We prefer the latter in most cases because we feel the success rate is much higher. Waiting a few months to allow the bone to heal and osseous integrate to the implant is essential for a long term success rate in most cases.

In general, the implant is placed and then allowed to heal.  Then an abutment is placed into the top of the healed implant so a crown can be cemented in the mouth.  Meanwhile, the implant came be temporized.

Temporization of a missing tooth can come in many different forms.   Commonly, a transitional partial denture is used to replace any missing teeth.  It essentially looks like an orthodontic retainer without the front wire and has a tooth attached to replace the missing teeth esthetically.  I call these teeth “Hollywood” teeth because they are just for smiling and not to be used in chewing food.  They are made of plastic and have the possibility of breaking.  Another popular way is to make an Essix to replace the tooth/teeth.  This is a suck down retainer with a tooth placed in the missing areas and acts as “Snap-on” teeth.  In certain situations a temporary post type abutment can be fixed to the immediate implant and a temporary crown placed on the newly placed implant.  This is only done if there is a good deal of quality implant supporting bone and the temporary is taken out of occlusion.

Care must be taken when removing the tooth from the socket.  The extraction should be as “atraumatic” as possible.  This will allow as much bone to contact the implant and increase the implant survivability.  In many cases, bone grafting material is placed around the neck of the implant(s) and a membrane is placed to insure that the gum tissue will not invade into the socket before the bone grafting material can begin to heal.

During the healing phase it is important to eat healthy foods and clean the area properly.

After the healing phase is completed the implant is exposed and a temporary healing collar is placed onto the implant and allowed to heal.  This allows the gum tissue to heal in a circle around the opening to the implant(s).  We use a laser to access the implant in some cases and in others we push the gums back and suture the tissue around the healing collar.  It usually depends on what the tissue looks like.  It is very important that the implant has the proper type of gum tissue around the final restoration or problems can arise over time like receding gums that can expose the metal implant body and be unattractive during smiling.

After the tissue has healed properly we unscrew the healing collar (without anesthetic) and replace it with a scanning jig.

This is a small part that screws into the implant.  We then scan the mouth with our iTero machine which does a digital laser scanning impression of your mouth.

It is the most accurate impression known to mankind.  We also take a digital laser bite to insure an accurate fit of the final restoration.  The healing collar is replaced and all of the scanning information is sent over the internet to Tel aviv, Israel.  There they clean up all the raw scanning data and remove artifacts like cotton rolls and dentist’s fingers.  They then send the scanning data to either Ontario, Canada or California, depending on the type of scanning jigs used.  There they manufacture a custom abutment attachment that screws into the implant and the crown that cements over the custom abutment.

The restoration process usually takes two weeks to come back from around the world and be placed into the patient’s mouth.  At the time of delivery the healing collar is removed (without anesthetic) and the custom abutment is placed.  An X-ray is taken to make sure it is all the way seated into the implant body before it is torqued into place.  The crown is then cemented in place.

Implant dentistry has advanced a long way since those experimental days of the past.  Today, implant dentistry enjoys some of the highest success rates in medicine.  More general dentists enter practice having some sort of training in dental implants.  Many of them go to post-graduation training programs to learn the subject to the level that in the past only specialists achieved.

The age of dental implants has arrived and has become the first line of treatment for replacing missing teeth.  The days of fixed (bridges) and removable (partial and complete dentures) prosthetics are in decline thanks to the marvelous advancements in dentistry over the past decades.

References:

1.  Clin Oral Implants Res. 2012 Feb;23 Suppl 5:80-2. doi: 10.1111/j.1600-0501.2011.02370.x. Evidence-based knowledge on the biology and treatment of extraction sockets.Hämmerle CH, Araújo MG, Simion M; Osteology Consensus Group 2011.

2.  J Am Dent Assoc. 2012 Feb;143(2):124-33. Immediate postextraction implant placement with immediate loading for maxillary full-arch rehabilitation: A two-year retrospective analysis. Mozzati M, Arata V, Gallesio G, Mussano F, Carossa S. Dr. Mozzati is an oral surgeon and the chief, Oral Surgery Department, Dental School, San Giovanni Battista Hospital-Molinette, Turin, Italy.

3.  J Periodontol. 2012 Jan 20. [Epub ahead of print] Immediate Loading of Dental Implants Placed in Severely Resorbed Edentulous Maxillae Reconstructed With Le Fort I Osteotomy and Interpositional Bone Grafting. Pieri F, Lizio G, Bianchi A, Marchetti C, Corinaldesi G. Resident, Department of Oral and Dental Sciences, University of Bologna, Italy, Research assistant, Department of Oral and Dental Sciences, University of Bologna, Italy, Professor of Maxillofacial Surgery, Department of Oral and Dental Sciences, University of Bologna, Italy, Researcher, Department of Oral and Dental Sciences, University of Bologna, Italy.

4. Clin Implant Dent Relat Res. 2012 Jan 17. doi: 10.1111/j.1708-8208.2011.00437.x. [Epub ahead of print] Immediate Occlusal Loading of NanoTite™ Tapered Implants: A Prospective 1-Year Clinical and Radiographic Study. Ostman PO, Wennerberg A, Ekestubbe A, Albrektsson T. Assistant professor, Department of Biomaterials, Institute for Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg and Department of DentalMaterials, Malmö University, Malmö, Sweden; professor, Department of Biomaterials, Institute for Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg and Department of Dental Materials, Malmö University, Malmö, Sweden, and Department of Prosthodontics, Malmö University Faculty of Odontology, Malmö, Sweden; professor, Department of Oral and Maxillofacial Radiology, Institute of Odontology, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.

5.  Clin Implant Dent Relat Res. 2012 Jan 11. doi: 10.1111/j.1708-8208.2011.00412.x. [Epub ahead of print] Immediate Postextractive Dental Implant Placement with Immediate Loading on Four Implantsfor Mandibular-Full-Arch Rehabilitation: A Retrospective Analysis. Mozzati M, Arata V, Gallesio G, Mussano F, Carossa S. Oral surgeon-Implantologist, Dental School, San Giovanni Battista Hospital Molinette, Turin, Italy; prosthodontist, Department of Biomedical Sciences and Human Oncology, Università di Torino, Turin, Italy.

6.  Clin Oral Implants Res. 2012 Feb;23 Suppl 5:39-66. doi: 10.1111/j.1600-0501.2011.02372.x. A systematic review on survival and success rates of implants placed immediately into fresh extraction sockets after at least 1 year. Lang NP, Pun L, Lau KY, Li KY, Wong MC. The University of Hong Kong, Faculty of Dentistry, Prince Philip Dental Hospital, Hong Kong, SAR, China.

7.  Implant Dent. 2012 Feb;21(1):62-6. Buccal bone plate in the immediately placed and restored maxillary single implant: a 7-year retrospective study using computed tomography. Degidi M, Nardi D, Daprile G, Piattelli A. *Private Practice, Via Spina, Bologna, Italy. †Full Professor of Oral Pathology, Dental School, University of Chieti, Via F. Sciucchi, Chieti, Italy.

8.  Clin Oral Implants Res. 2012 Jan 6. doi: 10.1111/j.1600-0501.2011.02394.x. [Epub ahead of print] Changes in soft tissues around immediate full-arch rehabilitations: a prospective study. Covani U, Ricci M, D’Ambrosio N, Quaranta A, Barone A. Department of Surgery, University of Pisa, Pisa, Italy.

9.  J Oral Implantol. 2011 Dec 28. [Epub ahead of print] Implant Placement and Immediate Loading with Fixed Restorations in Augmented Sockets. Five-year Results. A Case Report.

Today, most dental offices offer nitrous oxide as a means to calm down the patient and to provide some anesthetic and amnesic properties to routine dental treatment.  Unfortunately, many of our older patients grew up before local anesthetics were common place in dentistry and still have extreme fears of going to the dental office.  Fortunately, modern dentistry has a good armamentarium to prevent discomfort and pain in the dental patient:

• Onpharma Onset local anesthetic
• Nitrous Oxide gas
• IV sedation

Nitrous oxide gas is usually used on small children with behavior problems or fearful adults.  Everyone of our rooms has it piped in and is already set up so it can be used at a moments notice.

• No talking, laughing or sighing.  This can blow the gas out into the room.
• If we are to ask you a question, you are to answer with a nasal “ah-huh or uh-uh” so not to pass gas over your vocal cords and subsequently breath nitrous oxide gas into the room through their mouth.
• If you hear ringing in your ears, raise your hand (assistant side hand only) to your ear.  This means you are getting too much gas and we will turn it down.
• If you begin to feel nauseated raise your hand and point to your stomach.  This means you are getting too much gas and we will turn it down.
• When you first start to feel the gases affect, raise your hand so we will know when to begin.
• We will be giving you gentile reminders if you do not follow these instructions and if you do not follow them after that, then we will discontinue the gas and recover you from its effect.

The occasional breath of nitrous oxide into the dental operatory is usually not be a problem, but having a regular conversation is to be discouraged.  Chronic exposure to nitrous oxide by the dental staff is not recommended and may cause long term problems:

• Reproductive - Chronic exposure to nitrous oxide may affect a women’s ability to become pregnant.  Males exposed to chronic nitrous oxide gas wives have an increase rate of spontaneous abortions.
• Neurological- Numbness
• Hematological-  Bone marrow suppression
• Hepatic-  Liver problems
• Renal- Kidney problems
• Possible increased cancer risk

The harm to the patient is very minimal due to the frequency of exposure.  They usually either love or hate the effect they feel while experiencing the properties of the gas on their consciousness.  The following are general responses to using nitrous oxide in the dental office:

• Elated, altered state of consciousness
• Paranoia
• Nausea
• Sexual stimulation
• Claustrophobia
• Ringing of the hears
• Some patients no matter how high a percentage of nitrous oxide you give them they feel they are not getting enough.  This is an indication for recommending IV sedation.

After administering nitrous oxide it is important to wash it out of the body with a period of high oxygen and no nitrous oxide to prevent a transient period of hypoxia.  This period of low oxygen is caused by the nitrous rushing out of your lungs and interfering with the uptake of oxygen.   Giving a few minutes of oxygen immediately after the cessation of nitrous will prevent any adverse affects of the low oxygen levels like post-operative headaches.

Ultimate Goal of Nitrous Oxide therapy:

The main goal of nitrous oxide therapy in a dental office should be to relax the dental phobic patient to a point that on subsequent dental visits they will feel more comfortable and not require nitrous oxide for further dental treatment.

References:

We are very excited about this software because it will allow our newly formed sleep apnea company, Dental Sleep Medicine of Southwest Florida, LLC, to serve our patients at a very high level. The software also allows patients to conveniently register online, which eliminates all the paper forms in the waiting room. Once the online forms are submitted, they are automatically downloaded into our office software for review.

Humans have lived with bacteria in their mouths for a very long time.  Some of these bacteria are beneficial and some are not.  The beneficial bacteria usually help occupy niches in the mouth so that the bad bacteria cannot populate them in sufficient numbers to cause an unwanted infection.  Unfortunately, the good bacteria cannot always protect us from the bad bacteria and this is when we can develop gingivitis, and periodontal disease.  Brushing and flossing helps keep our mouths disease free, if done properly, but few people have the dental IQ or manual dexterity to actually pull this off.  This is why the World Health Organization estimates that 85% of adults have some form of periodontal disease and 5-20% have severe periodontal disease (loss of tooth/teeth).

When bacteria are left unchecked too long around the necks of your teeth, they can use the calcium from your saliva and build solid “homes” that are very hard to remove with regular home care.  These homes are called calculus or tartar and are hard to remove. Professional cleaning can get rid of them.  When calculus is found above the gum-line it is called supragingival calculus and is scaled off.  If it is found below the gum-line it is called subgingival calculus and it is root planed off. The process of removing both supra and subgingival calculus is called scaling & root planing.

In Florida, a simple cleaning can be done by an expanded duties dental assistant, but scaling and root planing can only be preformed by the doctor or a state licensed dental hygienist.

Everyday in our practice we hear from new patients that they never have had such a good cleaning.  The secret?  Taking the time to do it the right way.  Each of our 3 Registered Dental Hygienists only take 8 patient per day.  This insures that they have enough time to do a completely thorough and comfortable job.  Not some hurry up, turn and burn, buff and shine “cleaning” that you get from most chain dental clinics who are just looking at the numbers and not patient care.

Health History:

New patients can expect a complete dental exam which includes a complete health history review.  This is a very important part of the dental visit.  With our population living longer, we often run into poly-pharmacy issues, artificial joints and heart valves, blood thinners, diabetes, and psychiatric problems just to name a few.  Each of these conditions need to be considered when customizing any treatment plan.

Hard and Soft Tissue Charting:

Hard tissue charting is where we write down into your chart the different fillings, crowns, bridges, implants, root canals, dentures, missing and impacted teeth in your mouth at that moment in time you started at our office.  Soft tissue charting involves the gums.  Gum problems like muco-ginvival defects, bleeding, purulence, and periodontal disease pocket probing depths help in the decision making process and treatment planning for your mouth.

Periodontal disease:

During the complete exam process it may be found that you have periodontal disease.  This is where bacterial have set up colonies around the necks of your teeth.  Calculus or tartar can build-up and invade down the side of your teeth causing pocketing.  If these pockets get deeper that you can clean on your own (>4mm) then they will have to be cleaned out professionally.  In our office a registered dental hygienist would be prescribed the task of scaling and root planing your teeth.

Scaling and Root Planing:

Scaling the calculus above the gum line in usually not a difficult task for most hygienists.  It involves using a ultrasonic scaler such as a Cavitron or Pro-Select to vibrate off the deposits off the teeth.  Root planing, on the other hand, can be quite involved and difficult to do a good job.  It involves using instruments specially designed to be inserted deep below the gum line and “plane” the calculus and necrotic dentin off of the root surfaces.  Pockets any deeper that 6mm are usually not well cleaned by ordinary root planing.  At this point the patient is usually referred for periodontal surgery.

Compromised Maintenance:

Scaling and root planing is also used in compromised maintenance.  This is where a patient knows they have periodontal disease but has chosen to not have periodontal surgery.  It is called compromised because root planing is not enough treatment to completely stop the progression of the disease, but it is usually enough to slow it down to a crawl.  Eventually, the teeth will succumb to the disease process if the disease process is present long enough.

References:

1. Adv Dent Res. 2011 May;23(2):221-6. Global oral health inequalities: task group–periodontal disease. Jin LJ, Armitage GC, Klinge B, Lang NP, Tonetti M, Williams RC. Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.

2. http://www.nlm.nih.gov/medlineplus/news/fullstory_118663.html

What is dental insurance?  It certainly isn’t insurance.  It would be better described as an allowance.  An allowance that is really your money paid back to you by very stingy parents.  You would be much better off putting the money you spend on dental insurance into a savings account than giving it to an insurance company. They run a large-scale business, and they have to pay dividends to their shareholders from it.  The problem most people find is that it is very difficult to put money aside for rainy-day dental needs.  If the money isn’t put away “safely” with the dental “allowance” company, it would most likely be spent on the kids, the car, the house, the vacation, etc.  Instead, billion dollar corporations get fat off of managing the money for you.  Isn’t this a crazy world where an entire industry parasitically sucks the life out of your wallet so you can think you are staying healthy?

We at Cape Dental Care, like many other dental offices,  hold ourselves to a standard that is very high above most insurance companies. We do not compromise our scientifically-backed treatment protocols to dance to the song of the insurance companies bean counters. This blog will be dedicated to exposing some of the tricks of the dental insurance trade that are designed to stifle dental offices from filing claims for their patients.  After all, if the insurance companies can discourage the dental profession from filing claims for their patients, then the insurance companies have won BIG! Because if we in the dental field suddenly throw up our hands in disgust, and quit hiring front desk workers to sit on the phone for hours at a time to figure out these tricks of the dental insurance trade, then who would file claims for the patient?  I am convinced that this is exactly the strategy of the dental insurance companies at large.

Tricks of the Dental Insurance Trade:

1. Only reimbursing for the “Usual and Customary Rates” (UCR):  These are the biggest joke!  Completely made up figures from the very distant past that the dental “allowance” companies use to deny patient claims.  This is a ploy they use to drive a wedge between the patient and the doctor’s office.  They are essentially saying to the patient, “Look, it is not our fault you have to pay more for this procedure, everyone else charges only this smaller amount”.  This implies, of course, that the patient has gone to a high priced dental practice.  The only problem with this is that NO ONE in the area could survive in the dental business with such low fees, and that the fees they are quoting are from the 1960′s. Insurance companies have been sued by dental organizations in the past to find out where in the world they came up with these figures, but the practice is still used with impunity.
2. Not doing certain combination treatments:  The patient comes in for a routine cleaning.  In the middle of getting a cleaning the patient tells the hygienist that they also have a toothache.  The dentist is called in and gives them an emergency exam and finds an abscessed tooth.  The dentist has an opening after the cleaning, BUT NO! The insurance company will not pay for the emergency or the required treatment to relieve the toothache because it is done on the same day as a cleaning. Really?
3. Sealants time periods: Some insurance companies will pay for a certain tooth’s sealant only during certain ages.  For example, permanent 1st molars can be sealed only from ages 6 to 8.  This means the patient cannot have all their teeth sealed at the same time.  This obviously ONLY benefits the insurance companies bottom line.  Bean counter!
4. One of my personal favorite tricks of the trade is when we send several claims to a dental insurance company in one envelope to save on postage.  Did you know the dental insurance claim adjuster gets paid by the number of pieces of mail they handle?  You may have sent in 5 claims in one piece of mail, but some how only one gets processed and the other 4 are mysteriously lost.  Laziness!
5. The patient comes in for an appointment for a broken front tooth.  The tooth is non-restorable.  The dentist quickly makes a transitional partial denture (flipper) so the patient can look normal when they smile.  This is a temporary denture designed to be in the mouth only up to a year.  After that a more definitive permanent restoration needs to be made which in some cases is a cast metal partial denture.  This is a very logical treatment plan to take care of this problem that the dental Insurance company says they will “insure”.  However, since this temporary denture was filed with the insurance company, they will not pay for another partial for 5 years because they consider it to be permanent.  This is why we make sure if the patient wants to file for the much cheaper temporary denture or do they want to wait and file for the definitive cast metal partial denture at a later date. The insurance company is of course banking that you will want to file for the less expensive temporary denture to help their bottom line.  Pirates!
6. Guardian will not pay for a diagnostic PA x-ray during a limited exam for a toothache if a follow-up root canal is done within 14 days.  They consider this part of the root canal treatment.  What a joke!  Example:  A patient came in for a toothache and we gave him the usual options of either saving the tooth or not saving the tooth.  He didn’t want the tooth extracted so we opted for a palliative pulpectomy.  Days later he scheduled for a root canal for which we performed a week and a half later.  The insurance company wrote off the original diagnostic x-ray because they consider this part of the root canal treatment.  When called they said their policy was not to pay for a PA x-ray if it was done within 14 days of the root canal treatment. Ridiculous!  Even the patient thought that was the stupidest thing he had ever heard.
7. A patient comes into our office with a sore tooth.  The tooth just had a CERAC crown made by another dentist.  It was  diagnosed as irreversible pulpitis, and needed Endo.  I did the Endo, and a week later filled the occlusal access with the “Vertise composite technique”.  Her Delta Dental Insurance is now refusing to pay for the Endo access fill through the CERAC because they are now including this filling with the Endo treatment.  We had to send the patient the bill telling her that her insurance is weaseling out of paying for her treatment with a NEW technique of decreasing her benefits. Cheats!
8. We at our office do not usually take 2 or 4 bitewings on adults.  We feel that the front teeth deserve the same attention as the back teeth.  Instead we take 7 vertical bitewings.  If we were to send in the code for 7 vertical bitewings to an insurance company and they refused to pay, they are now refusing to let us down grade the code to 4 bitewings even though they are due for those radiographs.  Their reasoning is unclear and are telling us that once it is sent in for consideration, it cannot be reconsidered.  Boo!

Please add your “Dental Insurance Story” to this website in the comments section below!

“When I was a child, I had a dentist that hurt me so bad I never got over it.”

“I’d rather have a baby than get dental work.”

“I have a really high pain tolerance for everything but dental work.”

“Can you just put me out, I really cannot stand that needle.”

“Doctor, do you have gas?”

In the past, a dentist’s nightmare was that patient who had a fear of the needle. We inject patients all day long, over and over again, exactly the same way, in exactly the same places. Most of the injections slip in without any discomfort at all, and you are a hero. Others sting like heck.  Go figure.

I always thought it was a factor of how fast you put the anesthetic into the tissue so we went out and bought a CompuDent (Wand) to help our pediatric patients.  It actually works great! I call it God’s gift to the pediatric dentist.  But the tubing costs a lot more than regular anesthetic, so we reserve it for only those real cry-babies who need it.

Now we no longer have to use fancy equipment to coax someone into getting numb because of the possible discomfort associated with the injection inside their mouth.  The newest technology in local anesthetics is called Onpharma Onset.  We were the first in SW florida to used this technology and have been using it since January 2011.  It is very simple technology and has been employed in other medical fields for many years.  It involved placing a small amount of buffering agent called sodium bicarbonate into the local anesthetic before we inject it into your mouth.  Because of storage problems, local anesthetics are made acidic.  This acid pH is what slows down the anesthetic and makes it sting upon injection.  Now that we are buffering our local anesthetic before each and every injection, the dentists at Cape Dental Care are improving the comfort of our dental patients.

Many of a patients dental problems stem from a poor bite.  Malocclusion can be cause from crooked teeth, post-orthodontic treatment, extractions, trauma and iatrogenic dentistry.  Iatrogenic dentistry means something the dentist did to the mouth.  The malocclusion of the patient’s teeth may have started off as a factor of their own genetics, but may have quickly escalated by the addition of high or low fillings, crowns, bridges or dentures.

Unfortunately, dental students are still learning in school primitive techniques for detecting these malocclusions such as biting on bite paper and asking the patient where they think they are touching first. Recent studies have proven that this technique is not adequate to determine where a malocclusion exists inside a patient mouth.

This is were the TekScan games into play.  It is a sensor that fits between the teeth and makes a movie of how the teeth come together.  When using bite paper and asks a patient to bite down hard you pick up not only the first place they touch their teeth together, but also the last.  There is no way to distinguish from the dots scribed onto the teeth from the bite paper where they touched first or last or in what order the teeth actually came together.  This knowledge is essential for diagnosing and treatment malocclusion.

Since malocclusion is a main contributor of chipped teeth, grinding, bruxing, broken restorations and myofacial pain syndrome it would benefit both the patient and treating doctor to know how to find out which teeth are involved in the malocclusion and adjust them appropriately.

The doctors at Cape Dental Care use the TekScan to treat all types of malocclusion and can find the slight malaligned tooth that may be causing dental discomfort.  This is another example of our office using advanced technology to assist our patient achieve proper dental health.

Thankfully, 85% of what people call TMJ problems are actually myofacial pain syndrome cause by a faulty bite.  However, to make sure the joints are not contributing to the problem each patient is tested with the Joint Vibration Analysis or JVA.  It is a sophisticated microphone that is placed on the patient like a pair of headphones.  The patient is coached to open and close very wide and quickly so the sounds of the joint can be heard by the computer.  After the patient has opened and closed several times an average is calculated for each joint and results are analyzed for disease processes such as disk displacement and derangements.  If disease is found in the joints the appropriate treatment is prescribed. If none are found then the next test moves onto the TekScan which is a movie of how you put your teeth together.

The JVA is another service provided at Cape Dental Care that few other dentists have even heard of or understand.  It provides a better understanding of our patient’s dental needs and is another example of just how far our doctors are willing to go to provide advanced dental treatment of our patients.

The Perio Protect process is simple.  If you have gum disease, upper and lower impressions are made of your mouth and sent off to one of 4 special dental laboratories in the USA.  Trays are manufactured and delivered 2 weeks later. The patient is instructed to use the trays from 2 to 6 times a day depending on the severity of their disease.  A hydrogen peroxide gel is placed inside the trays along with antibiotic drops to wipe out 99.98% of the bacteria around the teeth.  No bacteria, no active disease, resulting in a much more healthy mouth than you could ever achieve with a toothbrush and floss alone.

Cons:

Patient compliance is the most important factor in using the Perio Protect tray system.  It is simple, if you don’t use the trays, the treatment will not work.  Just like if you don’t brush and floss your teeth regularly you will have disease causing bacterial plaque throughout your mouth.

This is just another example of how the doctors at Cape Dental Care are providing advanced dentistry to our patient.