Our team enjoyed a day at the track for the Louisville Dental Society's Day at the Downs on September, 16!

Go, Baby, Go!

Laura Fizer, DMD

Our team is growing! We are so excited about our newest team members. Even though they both joined us this summer and are no longer technically new to us, we are still thrilled to have Peyton and Naila on our team. We are also pleased to have Holly move from the back office to the front as our newest office manager. She has been with our team for five years and has filled this new role perfectly. We are so excited about what the future holds for our team!

Laura Fizer, DMD

We've updated our hours! We are offering some extended hour appointments, with patient appointments now available at 8 AM on Thursdays and Fridays, and 5 PM on Thursdays! Our patients mean the world to us and we hope to accommodate everyone's busy schedules. Call to schedule today!

Laura Fizer, DMD

Xyltiol is a sugar-free sweetener. But, don't confuse sugar-free with artificial… xylitol is actually a plant derivative!

Dentists are fans of xylitol because it breaks down differently than sugar. This difference means it doesn't cause tooth decay like traditional sugar, or sucrose. It can even prevent decay by interfering with the ability of decay-causing bacteria to stick to teeth. Less bacteria on the teeth means less chance of decay, and also reduced plaque and tartar buildup… so less gingivitis, too!

Compared to sugar, xylitol has 40% fewer calories, and doesn't cause spikes in blood sugar. Animal studies have even shown benefits for metabolic health. So, it is beneficial to overall health, as well as dental health!

Come in and try our xylitol-sweetened lollipops at your next visit!

Laura Fizer, DMD

We may have all heard that using a straw can keep your teeth white by keeping your drinks off your teeth… but there's a little more to it than that.

Things to keep in mind:

1. To keep the front teeth from picking up stain, the straw must be positioned behind the front teeth. Positioning the straw behind the front teeth can spare them from acid erosion due to acidic drinks and prevent decay from sugary drinks.

2. The back teeth will still be exposed to the drinks, so don't expect the stain, erosion, and decay prevention to include those teeth.

3. If you swish your drinks or hold them in your mouth, all the teeth that come in contact with the drinks will be subject to staining, erosion, and decay.

4. Your teeth may still stain, erode, and decay because these things are all multi-factorial and not due to beverages alone.

5. If a straw always directs sugary drinks to the same back tooth or teeth, those areas may be more likely to stain, erode, or decay.

6. Disposable straws are wasteful. If you decide to use straws to protect your front teeth, invest in some reusable ones! I like stainless steel ones with silicone tips. The silicone protects my teeth from chipping on the hard straw.

Laura Fizer, DMD

Tooth decay is caused when the mouth develops an acidic environment. This is a multi-factorial process that begins with "bad" bacteria in the mouth. These bacteria feed off of sugar and use it to produce acids that wear away at the teeth, causing cavities. This is why we often think of sugar as the culprit for decay but the problem is really how bacteria uses the sugar to make the acid. Too much sugar equates to too much acid. In addition to the acid from sugar metabolism, acid from the digestion process or intake of acidic food/drink contributes to the decay. process. Saliva is the body's natural defense against an acidic environment. It contains buffers that can counter the acid and protect the teeth. This is why dry mouth can be such a concern and why we often see a sharp spike in the amount of decay present when the mouth become too dry, either from chronic dehydration, medication side effects, or a combination of causes. When sugar and acidic food intake is too great and too frequent, saliva is not an adequate defense. Brushing and flossing regularly and properly is essential for removal of "bad" bacteria and decay prevention. When bacteria buildup sits on the teeth too long, plaque becomes tartar (it hardens) and must be removed with scalers in the dental office. So, it is important to come in for regular check-ups so we can do our part in keeping your teeth healthy!

Laura Fizer, DMD

I've said it before and I'll say it again... I feel so lucky to live in the time of modern medicine. From local anesthetics in dentistry and epidurals for childbirth, to readily available antibiotics and access to VACCINES... we are so #blessed ! It can be easy to take it for granted. Thankful for all the researchers and healthcare workers that labored to make this possible. Pfizer for this Fizer!

Laura Fizer, DMD

Laura Fizer, DMD

I hope everyone had a wonderful and safe Thanksgiving holiday, no matter how you chose to spend it. While 2020 has been a weird one for all of us, let's remember all that we have to be thankful for! I know I'm thankful, among many other things, for a wonderful work place to return to after a long weekend!

Laura Fizer, DMD

Our dental office is not contracted with insurance companies. Patients are sometimes hesitant when they hear this. But, what does it really mean?

1. We will still file through ANY insurance company because we want to help our patients use their benefits. Most insurance plans will still pay towards the dental bill. Whatever portion of a fee is not covered by insurance, is billed to the patient.

To find out what an insurance plan pays for out-of-network services, just check with the plan! This is usually listed in the Explanation of Benefits.

2. We spend time with our patients!

By avoiding the pressure to rush through patients, we can provide more individualized care and get to know our patients. We are able to keep a lot of our lab work in-house, too, which helps keep costs down for our patients.

3. We get to be conservative with our treatment plans.

We only recommend treatment that is clinically necessary. We don't feel pressure to "sell" dentistry.

4. We use high quality products and labs.

Our lab cases that aren't kept in-house are sent only to local labs. We send our cosmetic crown and bridge cases to a lab just down the street for customization.

Still have questions or concerns? Let us know! We are here to help.

Laura Fizer, DMD

The goodie bag is one of the best parts of dental checkups! We tailor ours to individual patient needs but what are the base components?

Everyone gets...

1. An awesome case to keep their oral hygiene products in. These are great for staying organized in your bathroom, to toss in your purse, or for travel!
2. A soft-bristled toothbrush. Soft bristles are kind on the teeth and gums and the only kind we recommend!
3. Toothpaste. Right now we have Crest 3-D white. Whitening toothpaste is helpful in removing surface stains. Toothpaste should always include fluoride!
4. Waxed dental floss. Glide is my favorite!

Goodie bags may be supplemented with flossers, tongue scrapers, proxabrushes, denture brushes, or soft picks, based on individual needs.

Laura Fizer, DMD

We love our patients and think YOU are the sweetest!

Laura Fizer, DMD

When people come to the dentist they think about coming to have their teeth checked. But, there is a whole lot more to the mouth than just teeth. What about the tongue, cheeks, gums, and throat? What about the jaw bones and the sinuses? It is important to have ALL of these areas checked regularly.

Oral cancer screenings are an important part of a dental check-up. All patients in our office are visually screened at the initial visit and at every recall appointment. Even dentures patients, who have no natural teeth left, should have dental check-ups at least once a year for a cancer screening.

In addition to visual inspection, routine x-rays are an important component of oral cancer screenings. Radiographs allow us to check for so much more than tooth decay. They help us assess what's under the surface. X-rays allow us to check the jaw bones, the jaw joint, the maxillary sinuses, and tooth roots, as well as other surrounding structures. This is part of why we recommend routine x-rays even in our patients with no teeth or no history of tooth decay.

If we notice something that looks suspicious, we may take a photo and monitor the area for two weeks. Many innocuous oral lesions will resolve on their own in that time. When lesions are persistent, especially concerning, or a patient has certain risk factors, we may make a referral for a biopsy.

Risk factors for oral cancer include, but are not limited to:

• Previous oral cancers, especially if recurrence is common
• Tobacco use (current or previous)
• Heavy alcohol consumption
• Age > 55 years
• Male gender
• HPV

As with any type of cancer, early detection is ideal. So, between appointments, if you notice something "funny" in your mouth, when in doubt, seek us out!

Laura Fizer, DMD

It's National Dental Hygiene Month, so it's time for a shout out to our hygienists! Both Susie and Ashley were dental assistants before becoming hygienists and both are graduates of the University of Louisville Dental Hygiene Program. We are so lucky to have them as part of our team! We are thankful for all you do!

But really, some dentists (ahem, me) have a sweet tooth, too. It's okay! I would never tell someone they can't EVER eat sugar. We all deserve to indulge a little sometimes. The key is to be smart about it.

It is important not to eat (or drink) sugar constantly throughout the day. If you need a little sugar fix, eat it and be done with it. When sugar consumption becomes dangerous for teeth is when the exposure occurs all day long.

For example: you drink one can of coke. Do you drink it with your lunch or do you sip on it throughout the afternoon? Doesn't matter because it's still just one can, right? Wrong! It's SO much better to drink it with lunch and then brush or rinse your mouth out after.

Constant exposure of the teeth to sugar throughout the day creates an environment in which decay-causing bacteria thrive (not to mention it upsets the acid-base balance in your mouth, which is a whole other topic for discussion).

So, go ahead and have a treat. But, don't treat yourself ALL day long!

Laura Fizer, DMD

Permanent teeth, especially molars, often develop with deep grooves on the chewing surfaces. While this is normal anatomy, these deep grooves are fantastic bacteria traps! When especially deep, it can be hard for the toothbrush to get into and clean these grooves adequately. This is why, most commonly in our young patients, dental sealants may be recommended. A sealant is basically a flowable resin that fills deep grooves and prevents bacteria accumulation, thus preventing tooth decay in the grooves. Sealant placement requires no numbing and no drill. They can be done in a single pain-free appointment by first placing a blue gel to prime the tooth, rinsing off the gel, flowing in the resin, and then hardening the resin with a special blue light. Permanent first molars usually come in around 6 years of age, and permanent second molars around 12 years of age. During these times, we will evaluate the teeth and make any necessary recommendations for sealant placement so we can be proactive against tooth decay!

Laura Fizer, DMD

Parents are tired. They want their babies to sleep. I get it! I'm there! But, unfortunately, this sometimes translates into putting children to bed with a bottle of milk or juice when parents aren't properly informed. Giving babies and toddlers bottles at night is a very dangerous habit because of the risks of baby bottle tooth decay (not to mention setting them up for poor long-term sleep habits). Baby bottle tooth decay is tooth decay that occurs (most often in the front teeth) because of too much exposure of these teeth to sugars. Even breastmilk, nature's miracle food, contains some sugar and should not be given to children to soothe them during the night.

Even though baby teeth are only temporary, it is important to care for them properly. Proper care of these teeth creates healthy habits that continue when permanent teeth are present, helps permanent teeth come in appropriately, allows children to chew properly, and maintains a nice looking smile that helps kids feel self-confident.

As I watch my 5 month old daughter's two lower front teeth come in, I know I am going to do everything I can to properly care for these adorable little things!

Laura Fizer, DMD

Crowns, often referred to as caps, are common dental services offered. But what are they, why are they necessary, and how are they made?

What Are They?

Crowns are porcelain or gold caps that are cemented over the top of a natural tooth. Crowns can last a long time when they are taken care of. It is important to note, however, that even though a crown is a "fake tooth", the natural tooth is still there. So, recurrent decay is possible. Brushing and flossing around crowns is very important to prevent decay and gum disease. For crowns on front teeth, it is important to avoid biting into hard and tough foods directly with them, because they can chip or break when not treated cautiously. If a crown is custom-stained, it is also important to avoid using abrasive toothpaste that could remove the staining.

Why Are They Necessary?

Crowns are a way of restoring form and function to teeth or protecting them from breaking down.

When teeth have large areas of decay (and subsequently large restorations), the integrity of the teeth may become compromised. Thin walls of natural tooth structure adjacent to these areas become weak and are more likely to break. Large restorations can be prone to chipping, wearing down, or may have too many margins that can be subject to recurrent decay to have predictable long-term success. For teeth with limited remaining natural tooth structure, crowns are often the best solution.

Teeth with cracks are also planned for crowns in order to attempt preservation of the teeth. When biting down on a natural tooth or using it to chew, different areas of the tooth may be subject to greater forces than others. This can propagate a crack. By completely covering the tooth with porcelain or gold, the forces on the tooth are more evenly distributed, making the crack less likely to spread.

Back teeth that have been treated with root canal therapy are always recommended for crowns. This is because root canals can make teeth more brittle. The back teeth are subject to the greatest forces in the mouth and crowns help to protect them from falling apart. No one wants to have root canal therapy on a tooth, only to crack the tooth and end up losing it.

How Are They Made?

Treatment with a crown involves two appointments in our office. During the first appointment, the top and sides of a tooth are cut down to make room for the restorative material. Most crowns in our office are porcelain, but gold may still be recommended when space is limited. An impression is made that goes to the lab, and patients leave with a temporary crown in place. This temporary is worn for about 2-3 weeks. At the lab, our technician designs the new tooth to match and fit with the existing teeth. For front teeth, we often send our patients to meet with our lab technician for custom shade matching. At the second visit, the temporary crown is removed, the new one is tried in and adjusted, and then the new one is cemented in place.

If you have any questions about crown services in our office, please reach out!

Laura Fizer, DMD

It is our obligation as a dental office to protect our patients against COVID-19 in every way possible. One of those ways is with our fogging machine. Our office space is fogged regularly with hypochlorous acid (HOCl). Check out our video of Dr. Wilson demonstrating the fogger!

HOCl is a nontoxic, effective, and practical disinfectant that is being used to supplement our regular infection control procedures. Studies have shown that hypochlorous acid has a high predictability for COVID-19 disinfection. The disinfectant destroys virus particles by selective binding to the unsaturated lipid layer of the cell walls and disrupting their integrity. It is also an oxidizing agent that can denature proteins and it breaks viral DNA strands by means of chlorination.

Hypochlorous acid is currently recommended by the US Environmental Protection Agency and can be made in our office in 8 minutes time. When used in a fogger, HOCl is effective at surface disinfection and can disinfect large areas quickly.

For more information on disinfection via HOCl, check out
https://www.ncbi.nlm.nih.gov/
pmc/articles/PMC7315945/.

Laura Fizer, DMD

We've all seen the commercials for toothpaste with the big fancy swirl of paste across the toothbrush bristles. But is that how much we really need? For our kids, definitely not!

Kids under 3 years (or those not able to spit out excess toothpaste) should use only a small smear of toothpaste- think, the size of a grain of rice. That's it!

Kids 3-6 years old (once capable of spitting out excess) should upgrade to the size of a pea. Again, the ability to spit out excess rather than swallow it is key here. We love and support fluoride, but don't want our kiddos to get too much of the good stuff!

Laura Fizer, DMD

Do you ever brush and THEN floss? Try it. You'll see what your toothbrush is missing! There are just some places that the toothbrush CANNOT reach, even in the most dexterous hands. First, (unless you have wide spaces between your teeth) the contacts between adjacent teeth go untouched by the toothbrush. Without proper cleaning of the contact (combined with other factors), this often causes tooth decay in these contact areas. Second, the area at and below the gumline between teeth goes untouched by the toothbrush. Just as you need to clean the teeth AND gums when brushing the broad surfaces of teeth, you also need to clean the teeth AND gums between the teeth.

So, while we value our toothbrushes, it's important to pick up their slack and clean the areas between teeth in another way.

Flossing is the most common option, but not the only one! Some options are discussed below.

1. Floss.
   Why so many people hate it, I'm not sure. Maybe it's too hands-on. Maybe the technique is difficult to master. Keep practicing! Floss is a great tool when used the right way. If you have trouble getting your fingers far enough into your mouth to properly use floss, try a flosser with a handle. Even then you have options for finding the right tool. There are single-use flossers and flossers with longer handles that you load and re-load yourself. Keeping trying new tools until you find what works for you. The trick here is to be sure you clean the sides (dentists call them the interproximal) of each tooth under a contact, rather than just popping through a contact quickly and moving on. Run the floss up and down the interproximal of each tooth, below the contact and down under the gumline. The toothbrush isn't getting in the contact and it isn't getting under the gums below the contact, either, so the floss must do BOTH.
2. Soft picks.
   Soft picks are the toothpick reinvented. These are great for cleaning the gums. Use these to clean under tight contacts where it's hard to get floss through. Use them when food is packed between teeth, to push debris out through the side (sometimes floss can just pack it down deeper if you aren't careful). Use them under bridgework or around implants. Soft picks are a great adjunct to flossing and a great way to keep your gums healthy. But, remember, you still need to clean the contact between the teeth to prevent decay.
3. Proxabrushes.
   Proxabrushes are an alternative to soft picks. Use these best in wide spaces. These can also be used where food packs, to push it out the side. Use them where there has been bone loss. Put them in a long handle to get to hard-to-reach areas.
4. The Waterpik.
   These are great around implant restorations! Implants can't decay, go the only concern is the gums around them. The Waterpik (or any off-brand competitor), can flush out debris and bacteria around and between implants.

Whichever method you use, don't get discouraged if your gums bleed when you initially start the habit. It doesn't necessarily mean you are hurting them. In fact, bleeding gums are an indicator that they CRAVE better cleaning. The bleeding is the result of inflammation. Inflammation is the result of too much bad bacteria in the gums. Inflammation and bleeding of the gums are markers of gingivitis and are reversible. If you start and maintain good hygiene habits, you should be fine. Prolonged gingivitis leads to periodontitis (or gum disease) and destruction of the bone around your teeth. This damage is irreversible!

Long story short: don't ignore your toothbrush's dirty little secret. Clean BETWEEN your teeth, too! Check out my videos on proper flossing technique and alternatives to flossing for more guidance!

Laura Fizer, DMD

If you haven't been to our office since reopening, be prepared to see some new accessories in the office. One thing you will notice new in all operatories and around the office are our air purifying units. These units use true HEPA filters to remove airborne contaminants!

No one likes to see those pesky brown stains appear on their teeth between cleanings. These often come from coffee, tea, or something else we are putting on our teeth. But, never fear, a good cleaning in our office can clear those stains right up! That's because they are superficial. Because the stain doesn't go deeper than the surface of the enamel, our scalers and polishers can take them off. Sometimes, however, they build up more than we'd like in the time between routine cleanings and exams. What should we do? That's where whitening toothpaste comes in.

Whitening toothpaste works on SUPERFICIAL stains (it doesn't BLEACH the teeth) because it is abrasive and can scrub off stain-causing build-up better than non-abrasive options. It's a great solution if you are looking to clean up the look of your teeth between appointments! If you are looking for a true bleaching of your teeth, however (i.e. to correct yellowing), check out my blog post from January 9, titled "Bright Whites".

The DO's of whitening toothpaste:

1. DO choose an option that contains fluoride.
2. DO use proper brushing technique and brush for 2 minutes twice a day. If the toothpaste isn't getting applied to all surfaces and for long enough, it won't do its job.
3. DO floss regularly. The toothpaste can't work miracles and won't be able to make all stains go away, especially those between your teeth where the toothbrush can't reach.
4. DO have realistic expectations. Remember, whitening toothpaste only addresses superficial stains. Depending on your desired result, you may need to consider bleaching.

The DON'Ts of whitening toothpaste:

1. DON'T use whitening toothpaste if you have custom stained porcelain restorations (on natural teeth or implants). These have "stains" that you want to keep!
2. DON'T go crazy with the whitening toothpaste if you have sensitive teeth. The abrasiveness of the toothpaste may increase your sensitivity. You can still use it, but use it sparingly.
3. DON'T overdo it if your teeth have erosion. The abrasiveness of the toothpaste could accelerate erosion and tooth wear.
4. DON'T use whitening toothpaste on a denture or other removable prothesis. The toothpaste can cause scratches on acrylic.

Laura Fizer, DMD

Sensitive teeth are a pain. Literally. I can't tell you the last time I was able to chew something cold on the right side of my mouth- ouch!

Teeth can be sensitive for many different reasons and treatment depends on the cause. Some of the most common causes and solutions include:

1. Gum Recession. When the gums recede to expose the root surface, teeth are often more sensitive. This can be addressed with products like Sensodyne (or prescription strength Prevident toothpaste), fluoride treatments, or by covering the exposed roots with bonding or gum grafts.
2. Clenching and Grinding. I am a self-proclaimed clencher AND grinder. I've noticed that when I'm more stressed, I clench and grind more often and my teeth become SO MUCH more sensitive. This sensitivity tends to fade as my jaw habits improve. I've had patients come in thinking they were going to need root canals or extractions because their teeth hurt so bad, only to discover the tooth pain was actually the result of clenching or grinding. This can often be addressed with a biteguard.
3. Tooth Decay. Untreated cavities can cause sensitivity. Usually the sensitivity doesn't occur in decayed teeth until the decay starts to get big. So, hurry in if you feel this is the case for you!
4. Dying Nerves. When sensitivity becomes pain in a specific tooth, the nerve in that tooth may be dying. Watch out for discomfort that lingers on the scale of minutes rather than seconds. This could mean you need a root canal.
5. Cracked teeth. Cracks in teeth can cause sensitivity. The sensitivity may occur when biting or from exposure to extreme temperatures (think ice cream). These teeth often need crowns to protect the teeth from breaking. They may even need root canals. In the most extreme cases, cracked teeth may require extraction.
6. Recent dental work. If you have a deep cavity filled, a tooth prepared for a crown, or even a cleaning, your tooth/teeth may become more sensitive. This should be a transient sensitivity that resolves with time (usually days, but, sometimes weeks or even months). If not, we should take another look at the area causing trouble.
7. Bleaching. Tooth sensitivity is a common side effect of bleaching. Don't worry, the sensitivity will resolve on its own. Sensodyne, fluoride, or Prevident can help in the mean time.
8. Acids. If your sensitivity coincides with an increase in consumption of acidic food and beverages (think orange juice, lemonade, wine, citrus fruits), your sensitivity may be diet-related. This should improve with a diet change.

Tooth sensitivity can be frustrating. Let us know if you suffering and we will be glad to help!

Laura Fizer, DMD

How do you know when your mouth is too dry? I once heard it explained that if you cannot eat a single saltine cracker without a drink to wash it down, your mouth is probably too dry. Sometimes this describes me and sometimes it does not. Most often, oral dryness waxes and wanes like this. If it is not chronic, it is usually not a problem.
But, a chronically dry mouth (also called xerostomia) CAN be a problem and can be the result of a lot of different things. It is often multi-factorial.

When the mouth is chronically dry, it can set up a bad situation where the mouth is predisposed to tooth decay. Saliva is an important buffer for teeth against acids and disease-causing bacteria. Without it (or without enough of it), large areas of decay can often pop up seemingly overnight (though, in reality not QUITE that fast). If your mouth is dry all the time, it is extra important to seek dental care and radiographs regularly to keep an eye out for early signs of decay. It is also prudent to be a little more aggressive with treatment. Small areas of decay that can be monitored in other patients should be filled as early in the decay process as possible for dry mouth patients. It may also be important to discuss options for fluoride treatments, including a prescription strength toothpaste, a fluoride rinse, or a varnish treatment. Rigorous at-home oral hygiene and dietary considerations are also a MUST.

Dry mouth is also a problem for our denture patients. While these patients don't have to worry about tooth decay (because they have no natural teeth!), upper dentures, especially, are retained like a suction cup. They require moisture to stay in place. If you struggle with dry mouth and wear a denture, be sure that your denture is always wet when you put it in. If you continue to struggle, you may want to consider dental implants for additional stability and retention.

Some of the most common contributing factors to chronic dry mouth include (but are not limited to):

1. Medications. Dry mouth is often a side effect of medication. If your recent development of dry mouth coincides with the start of a new medication, check the side effect list and ask your prescribing physician about alternatives.
2. Mouth breathing. This could be the result of airway issues and is an important topic to discuss with your dentist and/or physician. Patients with airway issues may require a sleep study, orthographic surgery, orthodontics, or tonsil removal, among other things.
3. Chronic dehydration. Drink lots of water if this is you!
4. Radiation therapy. Radiation to the head and neck for cancer treatment can harm or destroy salivary glands, creating a chronically dry mouth. Sometimes saliva function returns, sometimes it does not.

Often, the causes of chronic dry mouth can't be changed. For example, if dry mouth is a side effect of an important medication that is necessary for health, it is important not to stop taking that medication. Always consult with the prescribing physician before discontinuing any medications. In these instances, we strive to combat the dryness by other means. Drinking lots of water is critical. We also recommend over-the-counter products, like Biotene. The Biotene brand makes multiple kinds of products that I encourage my patients to try, but the most commonly used one is the oral rinse. While it will not correct dry mouth, it helps to soothe the oral tissue. Patients may also consider sucking on sugar-free candy or chewing gum with xylitol (always choose a sugar-free option!). When all other measures fail, we may recommend a prescription to treat chronic dry mouth.

If you are currently suffering with xerostomia, we are happy to discuss the best options for you!

Laura Fizer, DMD

Do you have pending dental treatment, but the out-of-pocket expense is intimidating? We get it! Finances are especially tough right now for many of us. To help, we offer financing with CareCredit!

CareCredit is a health, wellness, and personal care credit card. The company pays your dental bill for you and then you make monthly payments to CareCredit to pay it off. They offer the option of NO INTEREST if paid in full within 6 months. Many other healthcare providers offer financing through CareCredit, as well. Visit the CareCredit website or call our office for more information!

Visit www.carecredit.com to apply.

Laura Fizer, DMD

Facemasks! Don't have one? Learn how to DIY your own without sewing...

Laura Fizer, DMD

We are preparing to fill our schedule with patients, both NEW and existing, beginning on June 3, 2020!

Our patients have always been loyal and complimentary and we welcome the opportunity to extend our services to their friends and family, as well.

New patients welcome!

Do you have a bag full of dentures made by different dentists and none of them work for you? Sorry to say, it's probably not the dentists… it's you. Every patient is different, with different needs and different things that will work for them. Dentures require enough bone to support them. If you've been missing teeth for a long time, you may lack adequate bone to support a conventional denture. If your muscle attachments are low, you may lack restorative space for a conventional denture without gum surgery. If you have too much bone, with undercuts, you may not be able to have a conventional denture without surgery. Basically, if you've been trying the same old thing, i.e. dentures on repeat, it's time to try something else.

This "bag of dentures" concept is most common for lower dentures. Upper dentures tend to have better retention because they function like a suction cup. Lower dentures have to be U-shaped to accommodate the tongue, which prevents them from obtaining suction. They also have to deal with the constant movements of the tongue, and are much less likely to stay put.

If good old-fashioned denture glue isn't your cup of tea and you've been through it all with your dentures that you just can't wear, it's time to consider dental implants. Come in for a consult to discuss your best options, as there are multiple ways to approach implants that secure dentures. In the mean time, head over to our implants page to read more about it!

Laura Fizer, DMD

We are committed to providing high quality care that includes offering state-of-the-art therapies and equipment when available and indicated.

LASER BACTERIAL REDUCTION

We are using our diode laser to eliminate infection associated with periodontal disease, or gum disease, including gingivitis, in conjunction with our cleaning appointments. This therapy, called Laser Bacterial Reduction (LBR), may be recommended due to bleeding gums and/or for pocketing greater than 3mm. These are markers of gum disease, which is caused by bacteria in the pockets of the gums. During cleanings, we mechanically remove the buildup and bacteria. Rather than "monitoring" deep pockets after cleanings, we can now include laser therapy to disinfect the pockets and kill any residual bacteria to get improved results rather than just maintenance.

Bacteria cause inflammation, which is why gums bleed, and that inflammation in turn causes destruction in the form of gum disease and increasing pockets. By disinfecting the pockets, we hope to reduce or eliminate your bleeding and halt your disease process. It should also make your gums feel better and make future cleaning appointments more comfortable for you. You may even notice a difference in as little as one week. Our goal in halting the disease process is to prolong the life of your teeth. We hope to keep our teeth forever, don't you? If your gum disease progresses, you could eventually have loose teeth and even lose teeth.

AFTER LASER BACTERIAL REDUCTION

Not only does the laser disinfect the pockets, but it stimulates the body's own healing capability via the applied laser energy. After laser therapy, there should be no discomfort, but the pockets develop what is, essentially, a sticky "scab, which heals like any other scab. Just like we don't want to pick a scab while it is healing, it is important to leave the pockets alone (i.e. no rigorous brushing or deep flossing for one week post-op; no waterpik for one week) to allow proper healing. For the first 24hrs, avoid any rough, crunchy, or acidic foods that can aggravate or disrupt the healing process, as well.

OTHER USES FOR THE LASER

ULCER AND COLD SORE THERAPY

Do you get painful mouth ulcers or cold sores? Our laser, when used at the appropriate settings, can also be used to treat these areas to eliminate the pain instantly!

GUM SURGERY

Dr. Wilson and Dr. Fizer may use the laser at dentist-only settings to trim the gums, when indicated. This may done for cosmetic reasons or to access areas of teeth that need to be restored. The laser can also be used to remove fibromas or other soft tissue lesions.

Our laser: Precise LTM diode

LASERS ARE SAFE!

The laser produces a specific wavelength of light (810nm) that is not absorbed by the bone or tooth, so it is not capable of causing damage to these structures, just to the bacteria. Our doctors can change the settings to allow gum surgery, when indicated, but these settings are not used by our trained and laser-certified hygienists.

*Specific laser safety eye protection is provided for patients and clinicians.

Still have questions?
Contact our office!

Laura Fizer, DMD

Most of our patient know by now that Dr. Wilson is an avid scuba diver. Just walk in to our office and this becomes pretty obvious. But, what many may not yet know, is that he is also a knife maker! This beautiful knife is a handmade creation of Dr. Wilson's, made as a gift for his wife, Debbie, to use for chopping in the kitchen. While many may not readily appreciate the artistry and craftsmanship that dentistry requires, it was a logical transition into this knife-making hobby for our handy-man dentist. We can't wait to see what he makes out of the material he's showing off in the picture below!

Laura Fizer, DMD

Advertisements for at-home/DIY orthodontics are all over the place. A cheap and convenient way to straighten your teeth seems like a no-brainer, right? But, I would caution anyone against such methods.

As Benjamin Franklin once said, "The bitterness of poor quality remains long after the sweetness of low price is forgotten."

Orthodontists complete years of additional specialty training after dental school to learn to do what they do. There is a reason that orthodontics is expensive. It takes expertise, supervision, and regular appointments for monitoring progress. At-home dentistry promises to do this with photo submission and DIY impressions. But, I assure you, nothing can adequately replace a chairside exam. Most likely, if you decide to invest in at-home dentistry, you will later invest in professional in-office dentistry to correct what went wrong with your previous investment… or at least to complete what it did not.

Don't say you haven't been warned.

Here are some links to news articles toting the risks of DIY orthodontics, if you want to read further.

https://www.nbcnews.com/health/
health-news/things-didn-t-feel-right
-some-smiledirectclub-customers-
report-problems-n1134056

https://www.ada.org/en/publications/
ada-news/2019-archive/july/association
-files-complaint-with-ftc-fda-agains
t-smiledirect-club

Laura Fizer, DMD

Dr. Boyer was a valuable member of our dental team for years, until she retired from practice in 2017. Please help her out- she has been nominated to walk in the 2020 Kentucky Oaks Survivors Parade and she needs your votes! Read her story below and follow the link to vote. You can vote daily until voting ends March 22!

LISA Boyer of Crestwood, KY

My name is Lisa Boyer. I was diagnosed with breast cancer in September 2014. I found a nodule and a mammogram confirmed it as Stage 2. I had surgery and chemotherapy, and after 6 months, I returned to my work as a dentist. In August 2017, I sought help from an orthopedist for back pain. After an MRI, I returned to their office for the results. The diagnosis was earth-shattering – cancer in my spine. After numerous tests, my oncologist confirmed Stage 4 breast cancer.

I began planning for my funeral, my living will, and power-of-attorney, and had my will finalized and notarized. I asked my oncologist about survival statistics. She looked me in the eye and said, " You are not going to die!" I couldn't return to work due to my back and I really did not know how I would fill my days. I began an oral regimen, and after 3 months, I had the next round of scans - Good news! The cancer was stable. I began planning the beginning, instead of the end.

I volunteer with an organization called "Friends for Life", which matches the newly diagnosed with mentors that have similar cancers. I have had one of my matches for over 2 years! I also take yoga classes with other cancer survivors, have learned to play the ukulele, and I practice gratitude on a daily basis. Cancer has taught me that life is not just about the ending; it's about the journey.

https://survivors.kentuckyderby.com
/survivors/4227

Thanks for your help in getting her votes!
Laura Fizer, DMD

As a dental office, we are very familiar with germs and protecting ourselves and others from them. With the advent of the coronavirus, the basic measures to prevent the spread of viruses remain the same. Wash your hands. Use hand sanitizer (check for at least 60% alcohol content). Cover your nose and mouth when you cough or sneeze, using something other than your hands. And, again, wash your hands!

Laura Fizer, DMD

Cracked teeth can be one of the most frustrating phenomenons for patients. Teeth can fracture around an old restoration, after having a root canal, or just because they weaken over time (especially in our clenchers). Sometimes a cracked tooth presents itself when a cusp breaks off. If the break is clean and doesn't approach the nerve of the tooth, this is the easiest scenario to address. A porcelain or gold crown can be placed to replace the lost tooth structure and hold the remaining tooth together, preventing future fractures. If the crack involves the nerve of the tooth, a root canal treatment will be necessary prior to fabricating the crown.

If a crack is detected due to symptoms (often pain on chewing), it can be difficult to assess how deep the crack is. These teeth also need crowns to hold them together. But, if the crack extends into the nerve space, which we cannot visualize either clinically or radiographically, the tooth will require root canal treatment as well. We may perform tests to assess the vitality of the nerve in a cracked tooth at the time it is discovered. However, even if a nerve tests vital at the initial crack presentation, I always warn patients that the potential need for a root canal in the future remains. Because I cannot tell if the crack is slowly allowing bacteria into the nerve space and killing it over time, I cannot predict the future for the health of the nerve.

It the most extreme cracked teeth cases, a tooth may split right down the middle. If this happens, the tooth will need to be removed. If this is the case, tooth replacement options will also be discussed.

This photo shows an example of a tooth that cracked at the base of the silver amalgam filling. The tooth in this depiction would require a root canal due to the involvement with the nerve space, as illustrated by the red pulpal area. The lower photo shows how a tooth is protected by a crown. Full coverage crowns distribute the bite force evenly across a tooth rather than isolating cusps and propagating cracks.

Laura Fizer, DMD

No one likes bad breath. Are you doing what you need to to reduce it? One of the primary causes of bad breath is bacteria on the tongue. The papillae on the tongue pick up stains and bacteria, so it is important to brush your tongue and keep it clean, too, just like the rest of your mouth! A good tongue scraper is a must for getting to the back of the tongue where much of these bad breath bacteria reside.

Bad breath can also be predominant when you have a lot of sinus drainage. This is a tough one for those of us in the Ohio River Valley where seasonal allergies are so common. Treating the allergies helps!

Dental disease (decay, periodontal/gum disease, acute infection) can also cause bad breath and sometimes even bad tastes. If you are keeping your tongue clean, managing your sinus allergies, and your bad breath persists despite that, come see us to check for these potential sources of bad breath.

Laura Fizer, DMD

Do you wake up with pain in your jaws or commonly have headaches in the morning? Are you feeling extra stressed lately? Stress is a common trigger for night time clenching and/or grinding. People often don't realize how hard they are on their teeth at night and may brush off symptoms like a sore jaw, a headache, or sensitive teeth. If you have these symptoms and they are worse in the morning when you wake up, the cause is most likely parafunction of the jaw (clenching and/or grinding) during the night. While biteguards don't always stop this activity, they can be important for easing the strain on your temporomandibular joint system (the TMJ jaw joint and all associated structures) to help it heal. Biteguards also prevent tooth wear and breakage from the parafunction. Sometimes parafunction occurs because of issues with the airway. In these cases, a biteguard may open up your airway and eliminate the parafunction altogether, as well as improving sleep. If you think you may be a candidate for a biteguard, let us know and we would be happy to evaluate your TMJ system and discuss the best option for you!

Laura Fizer, DMD

Going for a run or a workout when you aren't in shape can be uncomfortable. Your body gets sore. But, the more you run, workout, and train, the better it feels. For some, it can be hard to skip a day at the gym because the body gets used to how good it feels. It's the same with flossing! Do your gums bleed when you are flossing? That's okay! While it can be uncomfortable, it does not mean that you are hurting your gums. Rather, you are training them.

Occasional bleeding while flossing can be quite normal. Bleeding is a marker of inflammation, known in the gums as gingivitis. Inflammation is the body's response to bacteria, plaque, food debris, and calculus or tartar. The gums get puffy, can feel sore, and bleed easily. Chronic inflammation causes bone destruction. Once bone destruction occurs, the diagnosis changes from gingivitis to periodontitis, or gum disease. This is irreversible.

But, good news! At the early gingivitis stage, when bleeding is light or localized, the disease process is reversible. You can go from gingivitis back to healthy gums with proper care… proper training! Removal of calculus is the first step. Calculus is hard and attached to tooth structure. Its removal usually has to be done in the dental office with a scaler. This is why it is so important to come see our hygienists regularly. Removal of plaque and food debris, which are soft, can be done with a toothbrush and floss. Removal of bacteria, which is unseen, is done with the brush, floss, and can be supplemented with mouthwash. We also kill bacteria with our laser gum therapy. This may be recommended at your check-up visit.

If your gums are bleeding at the start of your flossing routine, never fear! As you convert the gingivitis to healthy gums with your home care, and possibly also our laser therapy, the bleeding will slow and eventually stop. This can take a couple weeks. Don't get discouraged. Just remember that you are training your gums to be healthy for the long run, and pretty soon you won't be able to fathom how you ever skipped it for even a day.

Our hygienists, Susie and Ashley, are here to help keep your teeth and gums healthy! Seeing them regularly, in addition to your home care, is important for reducing the inflammation in the gums that causes bleeding. Talk to them about our laser gum therapy while you are here!

Laura Fizer, DMD

*I have an artificial joint.*

Healthcare recommendations are often changing. For a long time, it was agreed that patients with artificial joints would take an antibiotic pre-medication, or "pre-med" prior to invasive dental treatments. Then, the recommendations changed to say the antibiotics were only necessary for the first two years after an artificial joint was placed. The theory is this: if oral bacteria is introduced into the bloodstream, it could colonize an artificial joint and cause infection. Newer research, however, suggests that there may actually be no significant relationship between oral bacteria and joint infections after all. One point being, at-home oral hygiene can cause bleeding just the same as dental work. It has never been recommended that patients take antibiotics every time they brush and floss at home. So, what's the big deal?

In light of this, the American Dental Association (ADA)'s latest guidelines state that the risks of prescribing pre-med antibiotics for artificial joint patients may actually outweigh the benefits because overprescribing antibiotics contributes to drug resistance. However, the ADA does recommend considering the pre-med for immunocompromised patients (those with poorly controlled HIV, diabetes, or taking immunosuppressant therapy, for example) who have artificial joints "just in case".

If you are unsure if you need to take an antibiotic prior to your dental work, please consult with both your orthopedist and our office. Some orthopedists still prefer the pre-med for their patients, despite the latest research. It is important that we discuss the topic and select the best option for you.

*I have an artificial heart valve or other heart condition.*

If you have an artificial heart valve, no matter what type it is, both the American Dental Association (ADA) and American Heart Association (AHA) recommend antibiotic pre-medication prior to invasive dental work. The traditional prescription is 2g amoxicillin taken 1 hour before the appointment, or up to 1 hour after. If you allergic, we will select another option that suits you. Please let us know if your cardiologist makes a differing recommendation.

This same regimen is recommended for our patients with a history of infective endocarditis, an infection in the lining or valves of the heart; a heart transplant with a defective valve; an unrepaired cyanotic congenital heart disease; for 6 months after the repair of a heart defect; or an incomplete repair of a heart defect. If you are unsure if any of these conditions apply to you, please consult with your cardiologist. If you have any other heart condition not listed, a pre-med is not necessary. This includes mitral valve prolapse which we used to pre-med for, but no longer need to.

Laura Fizer, DMD

In my opinion, the hardest part of keeping wisdom teeth is keeping them clean and healthy. We typically recommend removal of the third molars, or wisdom teeth, while patients are young and heal easily… and before problems arise. Wisdom teeth are seldom functional because of their location in the back of the mouth. Thus, retaining them, even when "there's room", isn't always beneficial. Decay can start to form once the teeth begin to erupt. Because the wisdom teeth erupt low in the gums and so far in the back, they often go unbrushed and unflossed. This causes decay and periodontal problems more readily. When these problems arise, they are more difficult to treat due to limitations with accessibility.

If extractions are postponed, the tooth roots may begin to impinge on the major nerve in the jaw, the inferior alveolar nerve. When extractions are attempted with roots close to the nerve, there is risk of damage and injury to the nerve. When wisdom teeth are impacted horizontally and left in place, significant bone defects and decay can form around the erupted second molar. This damage can be irreversible. It is important to consider all these things and pursue wisdom tooth removal when it is recommended.

Laura Fizer, DMD

It's that time of year… Cold sores got you down? Let us help! We have a laser treatment that can take the pain away and help your cold sores heal up faster. Call to inquire! It's a short procedure that we are excited to be able to offer our patients. The laser treatment works best when done at the FIRST signs of a lesion. Got that tingly prodrome feeling? Call! Feel a little blister popping up? Call! We are here to help.

Laura Fizer, DMD

Are you interested in that Regis Philbin smile? Ok, ok… maybe not that bright white. Let's aim for more of a realistic glow.

In our office, we offer multiple different options for teeth whitening.

1. Take-home trays.

I like this option the best. Our take-home trays are made from custom impressions of your mouth so they help bleach get into all the nooks and crannies that make your mouth unique. We offer two varieties of bleach for the trays. Most commonly, we include a kit of Opalescence 10% carbamide peroxide. This solution is made to wear for 8-10 hours, or overnight for convenience. This solution is the kindest on teeth, and my favorite, because it causes the least amount of tooth sensitivity. Plus, when your kit runs out, you still have the trays and can get touch-up kits whenever needed. This makes it very cost effective! If you do experience some sensitivity, take-home trays also give you the flexibility to space daily use into every other or every third day use. This will help your teeth adapt and reduce the sensitivity. Tooth sensitivity from bleaching is temporary and will subside with time after the whitening procedure is complete.

The second solution we can offer with trays is Lumi-Brite take-home whitening. This is a 32% carbamide peroxide that is worn for 10-15min twice daily. Some patients see a result faster with this solution but it can also cause more sensitivity than the weaker solution. So, I usually recommend starting with the Opalescence and upgrading if necessary.

2. In-office bleaching.

For those looking for same-day/instant results, we do offer an in-office treatment using the Opalescence Boost system. While this is a great option for some, it does seem to cause the most tooth sensitivity, so I do not usually recommend as a first choice. If this is an option you are interested in, inquire with our office to determine if you are a good candidate.

With all bleaching procedures, it is important to first make sure your teeth are strong and healthy. Whitening over cavities or compromised teeth is not a great situation, so you should be up-to-date with x-rays, exams, and cleanings. One must also keep in mind that existing restorations, whether composite resin, porcelain, or metal, do not whiten. Some restorations may need to be replaced after whitening procedures to have them match the whiter teeth.

Laura Fizer, DMD

Dentists and parents alike enjoy when a dental visit can be a pleasant experience for our young clientele. But, fear of needles when these youngsters have dental decay, or cavities, can quickly change a smooth-flowing appointment to a rough one. With this in mind, we offer a more conservative approach to managing dental decay in our child patients, when appropriate. This can be done with in-office application of silver diamine fluoride (SDF). The silver particles in this particular fluoride may infiltrate and solidify decay, halting the process. This is not 100% guaranteed, but can often arrest the decay process long enough for a child to mature to an age when they can better tolerate treatment and/or long enough for the baby tooth to fall out on its own. SDF, when indicated, is applied every 6 months for 2 years, in hopes of avoiding the pesky dental drill, and can be done in conjunction with regular check-ups. How convenient!

The silver particles that infiltrate decay turn the area a dark gray/black color. For this reason, it is primarily used on baby teeth, especially those in the back. If this is a concern for you, we are happy to discuss other options.

We'd be happy to answer any questions or concerns you may have about SDF! It is exciting to be able to offer an alternative to the needles and drill, when we can!

Happy kiddos = happy parents = happy dentists!

Laura Fizer, DMD

You just got a new crown on your tooth, so it's done with dental work forever, right? Nope, sorry! I have found this is a common misunderstanding among patients. While the porcelain or gold of your crown cannot get cavities itself, the crown is cemented to natural tooth structure, which can. It is important to brush and floss around your crowns regularly for decay prevention.

Radiographs can show decay under crowns once they have progressed, but the x-rays do not go through the crown to reveal the true extent. Sometimes cavities under crowns can be patched with fillings if the decay can be readily accessed, but other times, removal of the crown is necessary to ensure complete decay removal prior to making a new crown. At check-up visits, we assess the margins of your crowns, because that is where the decay is most prone to develop, and it's best to catch it when it is small.

The arrow on the x-ray below points to decay under a crown. This crown had to be removed to allow proper restoration.

Has fear or anxiety kept you away from the dentist? Don't worry! You will receive no judgements here. Both Dr. Wilson and Dr. Fizer maintain Advanced Cardiac Life Support certification and Moderate Enteral Sedation licenses for patients just like you. This means we can offer oral sedation for those who need a little anxiety relief during restorative or surgical appointments. There are many advantages to having your dentistry completed this way.

Sedation allows us to get more dentistry done in a single visit by keeping you comfortable during longer appointments. Most patients remember nothing or very little from these visits. It is important to first schedule a consultation to ensure you are a candidate for sedation and to discuss the details. At that time, we will also evaluate your dental needs and formulate a treatment plan.

Download our sedation consent form today!

We welcome new patients of all ages! At your first appointment, you can expect to be greeted at the front desk by a member of our team. When your room is ready, Jalisa or Oksana will meet you in the waiting room. Your exam with Dr. Wilson or Dr. Fizer will include a full set of x-rays, a panoramic x-ray (that we do free of charge in conjunction with the full set), a periodontal exam, an oral cancer screening, and intraoral photos. This establishes a baseline for your dental health, allows us to check for pathologies, helps us diagnose decay and periodontal disease, and enables us to make appropriate treatment recommendations.

Want your appointment to start on time? Come in early to fill out your paperwork or complete the forms ahead of time by downloading them here: NEW PATIENT FORMS

Want a cleaning at the time of your initial appointment? Let us know and we will schedule a visit with Susie or Ashley before or after your visit with the dentist.

Are you nervous about seeing the dentist? Talk to us about it. We offer nitrous oxide (laughing gas) or conscious oral sedation during treatment, when appropriate. We provide pillows and blankets for those who need them in the dental chair. There are complimentary earplugs available to restorative appointments. We want you to be comfortable! Let us know what you need.

Ready to schedule? Call us and we will set it up! 502-583-4771.

Can't call during office hours? Send us an e-mail at info@jackwilsondmd.com.

Dental x-rays, or radiographs, are important because it is very difficult (sometimes impossible) to properly diagnose without them! X-rays allow us to see what we can't with our eyes.

Decay between teeth can often be undetectable by clinical exam alone because those areas are not directly visualized. Regularly made x-rays are important because decay can arise and spread fast! Wouldn't you prefer a diagnosis of a small cavity requiring only a minor restoration over a diagnosis of a large cavity nearing the nerve and requiring a root canal, post, core, and crown? Me too! We also use x-rays to assess existing dental work so we can make proper recommendations for replacement or repair. Bitewing x-rays, like the one shown below, are routinely taken once a year.

Chronic infection can show on x-rays, at times. This may appear as a radiolucency, or dark spot, around the root apex. Unless the area abscesses or develops symptoms, we cannot detect their presence without an x-ray. This is why we take periapical radiographs on teeth needing restorations, having pain, or even routinely to assess for health. Teeth are more than what shows in the mouth and the roots need to be seen too!

X-rays assess, not only teeth, but the area between them. We check for bone loss indicative of progressed gum disease or other problems, and for tartar buildup between teeth. Yes, tartar can show on our x-rays! Sometimes tartar buildup is below the gums and not visible when looking in the mouth. We can feel it but the x-rays allow us to see it too.

Boney pathologies can be detected with radiographs, as well. We look for cysts, growths, and tumors on routine x-rays. The panoramic x-ray shows the entire jaw and extends up through the maxillary sinus. These areas don't show on bitewing or periapical x-rays and are important to check regularly, too. The panoramic view is also great at assessing wisdom teeth, or third molars, and any other impacted teeth. By assessing and monitoring their development, we can make proper referrals and suggestions for treatment. Panoramic x-rays and a full mouth set of x-rays are routinely recommended every five years.

Convinced they are important but worried they aren't safe?

Digital dental x-rays have a significantly reduced amount of radiation exposure compared to past film x-rays. The lead apron and narrow x-ray tube keep the radiation only where it is supposed to be so there is no radiation exposure to other areas of the body. We step out of the room only because we are around the x-ray machines all day every day! It is much different than having x-rays only routinely or when problems arise as a patient. We have dental x-rays taken on ourselves, too!

Still have questions about our x-ray policy? Let us know!

Laura Fizer, DMD

Trick-or-treating and stock piles of candy don't have to be a recipe for tooth decay! Follow these tips to keep your's and your child's teeth healthy:

• Start the evening with a full belly. Eat a good dinner to avoid the temptation to fill up on the sweet stuff.
• Avoid the sticky and hard candies that stay in the mouth for longer periods of time. Chocolate is the safest because it washes off teeth easily.
• Eat candy in fewer sittings. It's the frequent exposure to sugar and the subsequent acid production that is most worrisome for teeth. (i.e. eat those 5 pieces… but eat them all at once, rather than spacing them out over an hour… or even eat them at meal time)
• Wash it down with fluoridated water.
• Brush, brush, brush! Don't crash for bed before brushing with fluoridated toothpaste! Floss, too!

Laura Fizer, DMD

There are a lot of different brushes out there on the market. I have used a bunch of them. I will give my feedback on some of the biggies below, but the basic concept is simple. PROPER USE of the toothbrush is so much more important than the brush itself. I want to you use the toothbrush that works best in your hands. You don't HAVE to have an expensive toothbrush. You don't even HAVE to have an electric toothbrush.

This is what you HAVE to do:

• Set a timer. If you don't you are likely kidding yourself about how long you are actually brushing. But, here again, there is nothing magic about the number 2. In reality, the reason we recommend brushing for 2 minutes is because that's the average amount of time it takes to make sure you are removing all plaque and covering all surfaces. It is certainly possible to brush for 2 minutes without brushing well, but sticking to this time limit is a great place to start!
• The upper molars where the cheeks are tight. If you have trouble getting there, try a kid's sized toothbrush.
• The lower molars where the the tongue is. Keep your tongue relaxed so your toothbrush gets all the way to the bottom of the teeth and the gum line.
• Under the lips. Keep your lips relaxed, otherwise they will push your brush out.
• Behind the lower front teeth. Angle your toothbrush accordingly. If you don't feel the bristles on your gums, you aren't getting the entirety of the tooth surfaces.
• Don't be overly aggressive in your brushing, even with a soft bristled toothbrush. This can wear teeth down over time, particularly when you have exposed root surfaces. You can also cause damage to your gums if you brush them too hard. All of the toothbrushes I discuss below have soft bristles.
• There are some charcoal bristle toothbrushes on the market now. There is reason to be concerned that these are too abrasive. The American Dental Association does not give any charcoal products its seal of approval. My advice: until more research comes out, stay away.
• Your toothbrush can harbor bacteria. Don't keep the same one too long. The bristles also splay over time and just aren't as effective at getting into the nooks and crannies of the mouth. If your's is looking rough before 3 months or you've been sick, replace it sooner! Again, nothing magic about the number 3, here, either. Maintain your brush so your time is well spent.
• Brush in the morning. It will start your day with fresh breath and a clean smile!
• Brush before bed. Don't let food/drink from the day sit on your teeth overnight. That's prime time for bad bacteria to go to town.
• Brush more than that if you like!

If you have trouble with dexterity or just want to go the extra mile, this is when electric toothbrushes really make a difference. They are not a replacement for mechanical brushing, but an adjunct. It is possible to use an electric toothbrush and not do a quality job. And, no, electric toothbrushes are not replacements for flossing either.

Please keep in mind that the information below is a summary of my own personal opinion and experiences. I have nothing to gain or lose from these reviews. Just because I had a particular experience with a brush, does not mean your's will be the same. Every person and every mouth is different. That's why I advise that the BEST toothbrush, is the one that works best for YOU!

Old Faithful:

ORAL B COMPLETE HANDHELD

Amazon price: Brush: ~$3.25/brush

Heads: NA

These are what you find in the goodie bags from our office. Without any bells and whistles, they are tried and true. I grew up using these!

Pros:

• They're small. They fit in toothbrush holders, in a drawer, in your purse or suitcase, wherever you need. Super portable.
• When I was pregnant and nauseous, THIS is what I used.
• They are cheap.
• They have grips on the handles.
• Bristles are multiple lengths and fit the contours of the tooth well.
• If you follow the guidelines above, this is all you really need.

Cons:

• No built-in timer.
• Can be difficult for children or arthritic patients to use when the dexterity for proper brushing just isn't there.

My First Electric Toothbrush

ORAL B SMART SERIES

Amazon prices:

Brush: Smart Series $130, Pro $50

Head: ~$3.75/head

In full disclosure, I got one of these for free when I was in dental school. It was awesome! My teeth felt super smooth and clean after using it. Was it the toothbrush or the fact that I'd never timed my brushing before? Not sure. This is an effective toothbrush and a great option. I know people that swear by these. The newest model of the Smart Series even alerts you when you are brushing too hard. Pretty cool! We have these brushes available for purchase in our office. The Pro is a cheaper alternative under the Oral B umbrella.

Pros:

• The round shape of the brush head mimics the shape of the prophy angle (what we polish your teeth with at check-ups). This shape fits the contour of the teeth and gums nicely.
• The bigger handles can be easier for some patients to comfortably hold, compared to handheld brushes.
• Cheaper than Sonicare.
• Built-in timer. Alerts when using too much pressure.
• One handle can be shared by multiple family members by easily switching out the brush heads.

Cons:

• It can feel BULKY and somewhat aggressive. It can be hard to fit in small mouths or where lips/cheeks are tight. The bulk is the primary reason this is no longer my go-to.
• Requires a charger. It's one more thing to add to your pile of cords and cables. It's one extra thing to have on the counter.

The Fancy One

PHILIPS SONICARE

Amazon prices:

Brush: Diamond Clean $167, Protective Clean $40

Head: ~$8/head

I purchased the Diamond Clean brush years ago, despite the bigger price tag, and despite having the Oral B already. I loved it! This brush and brand has just as big a following as Oral B. The brush and head are both small enough that, to me, it felt more natural to use compared to the old school brushes I was always used to. It felt more delicate and gentle on my gums. This quickly became my brush of choice. But, admittedly, it was MUCH fancier than I needed. There are many settings offered on the brush, but I never utilized them. This brush is a great investment if it's what you are looking for, but it may not be necessary to go that pricey. Sonicare also offers less "fancy" options, like the Protective Clean. I can't imagine it's less effective… or at least $110 less effective.

Pros:

• My favorite of the big brands.
• Gentle, with a petite brush head.
• Built-in timer.
• The bigger handles can be easier for some patients to comfortably hold, compared to handheld brushes.
• One handle can be shared by multiple family members by easily switching out the brush heads.

Cons:

• Pricey. This is what eventually drove me away.
• Also requires a charger. Again, just one more thing to keep track of.

The Trendy One

QUIP

Quip website (www.getquip.com) prices:

Brush: plastic brush $25, metal brush $40

Head: $5/head (includes delivery)

I first heard about this brush from a patient, so I did my research and decided to give it a try. I have the copper metal version. This brush was developed by a dentist and their website has a lot of great information! It's a neat concept- replacement heads in the mail every 3 months to help keep you honest. Subscriptions for replacement heads can even include toothpaste refills, if you'd like. They make it easy. They are sleek and modern looking. I have been using this one for about a year. The only problem I encountered was that I broke the toothbrush when I removed the head for the first time, causing the toothbrush head to pop off during each use. However, once I contacted the company, they sent me a replacement right away. I have since successfully changed the brush head without breakage- I advise watching the tutorial video before attempting the change.

Pros:

• My current go-to.
• Very sleek and most like a handheld brush.
• No charger. This brush runs on a battery. Replacement batteries are delivered with the replacement heads. Again, easy! Because it has no charger, it fits down in my toothbrush holder.
• Refill subscriptions available (but not required).
• Built-in timer.

Cons:

• Every family member should have their own. The brush heads aren't meant to be changed out daily. The battery life is based on 2 brushings of 2 minutes daily by a single user.
• Can break if the head is removed improperly.
• I like that the handle is smaller than other electric toothbrushes, but I would NOT recommend this as the best electric brush for arthritic patients. It can be harder to hold because it is smaller and could pose a problem for some.

So, there's my two cents. I'd love to know, what is your favorite brush and why?

Laura Fizer, DMD

While many initially believed vaping to be a safe alternative to cigarettes, buyer-beware. Regulation of e-cigarettes is very minimal and many contain carcinogens (cancer-causing substances). This can be harmful for your lungs and also for your oral cavity. Such carcinogens can contribute to the development of oral cancers and gum disease.

Furthermore, e-cigarettes have been known to explode while in use in the mouth. While this may sound extreme, I witnessed the aftermath of such an explosion during my time working in the Emergency Department at University Hospital, right here in Louisville. We are talking about loss of multiple teeth and bone. Scary!

More recent reports, like the article in the New York Times (10/3, Grady), are coming out about vaping-related illnesses and even death. So, please use caution with these products and wait until more studies are available that allow us to better understand the health implications of these devices.

Laura Fizer, DMD

Many people have asked about our insurance policy. I would like to try and clear up three main points.

1. We still file your insurance company because we want to help you use your benefits. Whatever portion of a fee is not covered by your insurance, is billed to you.

Do you want to know what your insurance pays for out-of-network services? Just check with your insurance provider!

2. We spend more time with you!

By avoiding the pressure to rush through patients, we can provide more individualized care and get to know you. We are able to keep a lot of our lab work in-house, too, which helps keep costs down for you.

3. We get to be conservative with our treatment plans.

We only recommend treatment that is clinically necessary. We don't feel pressure to "sell" dentistry.

4. We use high quality products and labs.

Our lab cases that aren't kept in-house are sent only to local labs. We send our cosmetic crown and bridge cases to a lab just down the street for customization.

Still have questions or concerns? Let us know! We are here to help.

info@jackwilsondmd.com

502-583-4771

Laura Fizer, DMD