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Tooth Talk Holidays 2012 Steven R. Fudge, DDS. 419-882-6896 Holiday Hours Because Christmas falls on a Tuesday this year, we will have a limited number of office hours during the holidays. If you’ve been waiting to get the school kids or the college kids in during break, call us soon. Wedding Presents More, please Many thanks come your way for supporting our practice. We’ve met many new friends and neighbors in the past six months but still have room for more new patients. Thank you for your confidence in referring us. Musically Many opportunities exist for you to enjoy performances by the UMS Choral Union, a group in which Dr. Fudge is a member. On December 1 & 2, the Choral Union will present its annual performance of Handel’s Messiah. Officially the start to the Christmas season, these performances are in Hill Auditorium in Ann Arbor. Tickets are available at UMS.org. On January 13, the Detroit Symphony and the Choral Union will collaborate in one of the many celebrations of Hill Auditorium’s 100th Anniversary. McMillan’s Tu es Petrus, a composition written to celebrate Pope Benedict’s first visit to England in 2010, will be featured. If you like pomp and circumstance, this concert is for you. On February 21 through 24, the Choral Union will travel to Orchestra Hall in Detroit to sing the Beethoven Ninth Symphony with the DSO. Many think there is no greater choral work than the Ninth. And finally, on April 4, the Choral Union, University Orchestra, and School of Music Choruses will present the Milhaud Orestean Trilogy in a recorded session at Hill Auditorium. The last time the Choral Union recorded in 2005, four Grammys were the result. Come join us. Phone Lines Many of you have taken to using your cell phones and have abandoned your land line phones at home. Often, your preferred number in our computer system is that land line. Please let us know if you’ve disconnected your land line phone number! When one of our patients is getting married, we offer them all the materials to do some at-home tooth whitening. This also includes your fiancé even if he/she is not one of our patients. So if you’re getting married, let us know and we will arrange for impressions, bleaching tray fabrication, and bleaching gel for the bride and groom to be. This is our complementary wedding present for you. Factoids The average U.S. general dentist’s expenses in the year 2009 were $459,860. For the year 2010-2011, dental school tuition in the U.S. averaged around $32,000 for state residents and $49,000 for nonresidents. Dental school is four years long and follows four years of undergraduate education. Dental schools in the U.S. in the year 20102011 received an average of 2000 applications for their entering class. 44% of the applications were female applicants. 80% of all U.S. dental hygiene programs were located in public educational institutions. Completion times of postgraduate dentistry: General practice residency—12 months. Pediatric dentistry—24 months. Dental Anesthesiology—25 months. Endondontics—26 months. Orthodontics—31 months. Prosthodontics—32 months. Periodontics—35 months. Oral Surgery—54 months. Medical History Apps We routinely ask patients to bring their list of medications to their first appointment and to every checkup visit. To my surprise one day, one of our new patients handed me his Blackberry, opened to a file, which contained a list of medications (properly spelled) and their dosage and administration. What a great idea! Then, to take it a step further, I wondered if the patient’s medical history could be put on their phone. THERE’S AN APP FOR THAT! Several apps exist for the Android phones and there’s a good one for the iPhone. Transferring all that information to our office could be as easy as sending an email. Check it out and use one. Oral Cancer Oral cancer, part of the head and neck cancers, is a concern in every dental office. The rate of oral cancer is 10.5 persons per 100,000 in the U.S. It affects males more than females and more blacks and Hispanics than Caucasians. 40,000 persons in the U.S. will be diagnosed each year. Once diagnosed, 57% will survive 5 years. The reason for the relatively low 5 year survival rate is that it is often diagnosed in its late stages and that the surgical treatment is often complicated by the vital structures in the region. Dentists speak of the “terrible triad” of high alcohol use, tobacco use, and lack of good oral hygiene as risk factors. Other risk factors are occupational and exposure to HPV, human papillama virus. Dental offices are always on the alert for oral cancer and examine for it at every checkup. The most common areas for oral cancer are the lateral border of the tongue, soft palate, and tonsil area. If a suspicious area is found, it is often biopsied to determine whether a problem exists. Once a microscopic diagnosis is made that a cancer exists, treatment can be initiated. Surgical treatment is often performed by an ENT cancer specialist; radiation to the area is done by a radiation oncologist. Chemotherapy for oral cancers is not often effective. The general dentist is involved in order to determine whether teeth in the line of radiation should be removed and to provide palliative relief for any of the treatment side effects. Oral cancer is very survivable if caught in the early stages. This is why we do oral cancer exams at every dental hygiene visit. patient expect? How long should the teeth be? Should they be age appropriate color or toilet bowl white? How much tooth enamel is left on which to bond? How much grinding and destructive force do the teeth experience every day? How much tooth sensitivity does the patient have now and what can be expected later? How much treatment time is needed? Does the patient want to go through a long, extensive treatment? How long can these veneers be expected to last? How much will it cost? By now, you’re wondering why anyone does this at all, except for the Hollywood types. Veneers are an excellent way to accomplish an esthetic result with a minimum of tooth structure lost in the process. A typical case would start with an interview with the patient. Photos and models of the teeth would be taken. Sometimes, a computer simulation of the finished smile will be done. Other times, the case will be done on the models and presented to the patient. The patient may choose to do a temporary veneer “mock up” in order to determine the right shade and right look for their mouth. The patient might wear the mock up for a month. Then the appropriate alteration to the teeth is done and an impression taken. When the veneers are back from the lab, they are trial bonded to show the patient, then bonded to the individual teeth in a very meticulous process. Achieving an incredible result takes precise planning and a complete understanding of the patient's desires and a complete understanding of the process. Through lots of hard work, time, and patience, much can be achieved. Veneers Many times during your visits we hear of a patient’s desire for “veneers.” So a little discussion of veneers is indicated. Veneers, also called laminates, are very similar to the false fingernails that some women wear. In our case, small, precisely made porcelain coverings are made to be bonded to individual teeth. Veneers can be used to hide irregularities, change colors and shapes of teeth, fill in gaps, and to replace tooth structure that has been worn or broken away. Patients’ typical thought on veneers run toward the “smile makeover” that was popular more than a few years ago. The smile makeover requires a great deal of planning and a thorough examination of what the expections of the patient are. What does the patient want? What color does the Happy Holidays Happy New Year