An Ounce of Prevention

Few Westchester dental offices place as much emphasis on preventing dental problems as we do.
Our prevention efforts start very early. We begin to evaluate whether or not your child is prone decay at his or her first visit. Semi-annual cleanings, check-ups, and fluoride treatments are critical to preventing early decay. If we see that your child may be prone to cavities (one cavity in any tooth or deep stains or grooves in the back teeth), we will recommend over-the-counter fluoride rinses, such as PhosFlur. When 6-year molars come out, we will frequently recommend sealing them to prevent cavities in the future. Sealants are thin protective flims that cover the grooves in the chewing surfaces of teeth, practically eliminating any chance of cavities on those surfaces.
We are just as mindful of prevention when it comes to our adult patients.
We mostly deal with 3 common problems – gum disease, tooth decay, and fractures of teeth and old restorations. Gum disease is a bacterial infection of gums and underlying bone and is the chief cause of tooth loss in the US.

While gum or periodontal disease has a strong genetic component, it is entrirely preventable. Frequent cleanings, check-ups, good home care, and healthy lifestyle can almost guarantee you will not get gum disease. We make sure that your gums are healthy with gum measurements done every year. If you have been our patient for years, you had it done many times – Dr. Polevoy or Danielle measuring your gums and calling out the numbers from 1 to hopefully as low as possible. The patients that joined our family recently tell us that many of them have never had it done in the past. We believe that this no-cost periodontal examination is crucial to keeping your gums disease-free. But if your home care wasn’t as good in the past, or you haven’t had proper or frequent dental care, you may have periodontal disease. Studies suggest that as many as 75% of Americans have some form of gum disease, so you are certainly not alone. We discover the problem by measuring your gums. If the numbers are high, 4 mm or more, we will generally recommend gum treatments such as scalings.

Sometimes called “deep cleanings”, these treatments are designed to reduce or eliminate gum infections. In severe cases, we will also recommend antibiotic treatments with Arestin. If the gum disease is allowed to continue, scalings alone may not solve the problem, and periodontal surgeries may be necessary. We have had excellent results with scal-ings and Arestin treatments, and very few of our patients require surgery after their course of therapy. While Arestin and scalings may seem expen-sive at first, the cost of gum surgeries is much higher, and the pain and discomfort are avoided as well.

Tooth decay is another common problem with which we deal on a daily basis.
We strongly believe that cavities are NOT a normal part of life, especially in adulthood. The best way to prevent cavities is fluoride treatments. Sometimes it’s as easy as prescription-strength toothpaste. If we need something stronger, we use fluoride appliances. These are mouthtrays that are custom made for your teeth, to ensure a snug fit. Fill them up with fluoride, wear them just 10-15 minutes per day, and you may never get another cavity.

Our goal is to deliver the maximum amount of fluoride to your teeth, making them much more resistant to decay.
Another problem that comes up every day is breaking or decaying old silver fillings. As any metal, silver fillings expand or contract every time you place something hot or cold in your mouth. Over the years, these expansions and contractions produce cracks in teeth, often resulting in decay forming in them. If left untreated, the tooth will often fracture, needing additional treatment. In some cases, the break is so severe the tooth is extracted.
We frequently recommend that fillings with cracks around them be replaced, often with crowns to strengthen the tooth. Because these teeth often do not hurt, some of our patients feel these fillings don’t need to be replaced. “If it ain’t broke, don’t fix it” is a phrase we hear every day. But just because it doesn’t hurt doesn’t mean it’s not “broke”. In fact, when the tooth breaks, most often new fillings or crowns aren’t enough to bring this tooth back to health. Once fractured, these teeth will frequently need twice as much work to restore them, and sometimes cannot be salvaged at all. Our goal is to fix these teeth BEFORE they break, when we can restore them more economically and predictably. If we wait for them to start hurting or fracture, most of them will need root canals as well, doubling the cost.

So please, keep your visits regular!
 

Fact:

87% of kids who have been in our practice 2 years or more have not had a cavity and are unlikely to get one later.

Fact:

Last year, 96% of our patients with periodontal disease who had gum treatments did not require subsequent gum surgeries.
DO THE MATH

Extra-strength toothpaste per year-$60
Fluoride trays, one time cost – $400
2 cavities per year – at least $400
DO THE MATH

Old fillings replaced with fillings or crowns -$200-1,300, insurance 50-80%
Root canal, post, and crown – $2,000-2,400, insurance coverage 50-65%
Tooth replaced with implant – $3500-4000, not covered by insurance

Fact:

Last year, only 34% of our patients who needed crowns also required root canals.
DO THE MATH
Scalings and antibiotics, entire mouth
– $1,000-1,300, insurance coverage up to 80%
Periodontal surgeries, entire mouth – upto $6,000, insurance coverage 50% or less.