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Frequently Asked Questions and Potential Answers When Seeking Dental Care

Frequently Asked Questions and Potential Answers When Seeking Dental Care

The following information is lengthy yet, necessary to adequately cover this comprehensive subject and provide the details frequently asked.  Investment in oral health is a priority worth our time to research.

Most of us make the best decisions we can with the information we have so we may learn and move forward with better information.  We encourage individuals to evaluate their health priorities and formulate the questions they need to be answered to develop a trusting relationship so that the dental office has a clear understanding of expectations and any limitations.

Many independent health-conscious dentists do not accept insurance payments.  Generally, the office will give you all the information you need to submit for reimbursement. Some dental procedures may be classified under medical codes. Patients want to be able to decide what is best for their oral care and not have the insurance company be the primary influence on health decisions.

Many patients find that it is important to ask questions such as “how much time do you have for me today” and obtain answers before following a prescribed procedure. Writing down your questions in advance is a way to expedite the Q&A. Many of the services and procedures provided such as the New Patient Exam, 3D Scan assessment, minimally invasive surgical procedures and the PRF protocol take an enormous amount of thoroughness and time.  A dentist that provides a high-quality of care will take the time you need before, during, and after a dental procedure.

Most patients are anxious about seeing a dentist for several reasons and when doctors suggest that they may need to address dental issues to help resolve chronic pain and debilitation, the anxiety level can increase, and some may not see the relationship. Often, they have had significant dental care in the past and may put off seeing a dentist until they are motivated by tooth or jaw pain or a serious medical diagnosis they believe is related to their oral health.

Even if they are motivated to improve function or appearance, they may not be completely aware of the extent of their dental condition and require an initial consultation with a qualified dentist.  Because oral health tends to only deteriorate over time, if not addressed in a timely manner, it is wise to seek care as soon as possible

The doctors and dentists who are dedicated to their patients have a keen understanding of the relationship between oral and whole-body health. They have high standards and expectations regarding their patients' well-being. They encourage their patients to research and educate themselves regarding dental health and understand dental service options.

Unfortunately, some healthcare practitioners must follow the Standard of Care prescribed by the organization they are associated with or by what the insurance company will allow.  Those boundaries may also prohibit the amount of time they may be able to give you and time is the essential component for comprehensive, compassionate, yet thorough and complete dental care.

It is important to gain an understanding of what percentage of whole body health is affected by dental concerns, infection and etc. If it can be determined that it is possibly 100 percent, then generally a person experiences a discernible improvement. However, if there are additional potential causes, then there are additional areas needing to be addressed. There are generally multiple solutions to explore and apply and it is not a quick-fix solution.

The following is a compilation of frequently asked questions and some typical responses referring physicians want their patients to discover. Patients need to identify a dentist who will welcome these types of questions, understanding that a well-informed patient will be a patient that will follow through and together they will achieve positive results.

The answers to these questions need to be patient-specific, thus it is not the intention of this list of questions, to provide specific answers but rather to promote further research to enable patients to make informed decisions and encourage them to seek answers that are best for them. It is to the patient's advantage to understand the commitment and assemble a team of healthcare practitioners who will work together and provide the patient with optimal choices to obtain mutual goals for wellness.

We encourage you to request a phone interview before any appointment is scheduled. You might ask who you may speak to within the dental office to answer some general questions about the dentist's beliefs and practices to determine where you may obtain the best possible services you need. The dental office may request that you complete a new patient medical dental chronology questionnaire because the more preliminary information you provide will allow for more personalized answers to your questions during a scheduled interview with the dentist. The following questions are a compilation of questions doctors have recommended:

  1. May I have a phone interview with you to ask a few questions and may I visit your office? My health is my primary concern and I am fully committed to compliance with healthier alternatives. You are demonstrating your commitment and faith in developing a trusting relationship and achieving appropriate care and you are seeking a dentist also dedicated to trusting relationships.  You are better able to make informed decisions when you have the decision-making variables. Do not be surprised if the dental office does not quote exact time and costs since your goal is to find a dentist who does not set time limits or pricing based upon specific services. You want a dentist who will take the time to listen and provide the skill you need to accomplish your expectations for the most optimal outcome and the time and costs will be dependent upon your specific needs. The dentist's office should be able to provide a range of time and cost estimates based on your proposed treatment plan and their specific costs for rendering dental services

This response will tell me if the dentist will take the time to listen to me and consider my individual needs and concerns. I would ask about the dentist's medical/dental history forms to see what types of questions the dentist asks. I want to know if the dentist will listen and respond appropriately to my concerns. An office visit or virtual tour would allow me to see the equipment used and experience the environmental aspects regarding safety, cleanliness and orderliness of the office and the staff's attention to detail; to see if they are friendly, compassionate, and knowledgeable

  1. What may I expect during an initial phone interview and an in-person consultation/exam? During the initial interview, it should be expected that the dentist provides the opportunity and the ability to evaluate specific needs and identify mutually compatible philosophies, and appropriate service options. The radiographic services should be state-of-the-art and have low radiation exposure. The consultation will further provide potential treatment plans, an estimated range of costs, and time frames. After clarification and understanding of the information from the interview, exam, and consultation, I will be able to decide on the treatment plan that suits me best
  2. How many patients do you see a day? This answer reveals insights about the dentist's motivation and dedication to individual patients and/or practice productivity goals since many dentists are trained to believe that one of the signs of a successful practice is the number of patients effectively seen in a day. I want to know that the dentist is paying attention to my mouth more than the clock. I would rather wait for the patient scheduled before me, knowing that I will receive the same level of focus and dedication when it is my turn. It will also indicate the amount of time dedicated to thoroughness, attention to detail and concern for my well-being and time frames
  3. Does the office use digital x-rays only or do they have a state-of-the-art and low radiation exposure 3D and Intraoral X-ray (see attachment)? A dentist that invests in the best and safest equipment such as high-quality X-ray capability will have a greater ability to "see" your condition and provide you with visuals where you may see your own X-rays and Scans as your dental conditions is explained to you and you are better able to make more informed decisions
  4. Do you request a comprehensive medical and dental history?

A comprehensive Medical and Dental History provides a compassionate dentist with insights to possible concerns and is an essential form of communication and an effective way to "listen" to the patient. It is also an effective exercise that helps patients begin to see their own path and the relationship between various medical and dental events. For example, There is growing evidence and concern that patients with a history of the use of bisphosphonates, which are sold as generic versions of brands like Fosamax and Boniva, as well as Novartis's Reclast, may lead to weaker bones in certain women, contributing to "rare but serious adverse events," including unusual femur fractures, esophageal cancer, and osteonecrosis of the jaw, a painful and disfiguring crumbling of the jaw bone.

  1. Is it true that a General Dentist may provide a greater range of services than a specialist? Will I be able to go to one source for all my potential service needs, both now and in the future? What are some other dental services I might consider?

A dedicated and well-educated dentist seeks training, continuing education, and expertise in all dental-related areas in order to meet the many potential changing dental needs and be experienced with most, if not all, aspects of dentistry. Such services might include; Sleep Study, Grind Appliances, TMJ, Head/Neck/Facial Pain, Cosmetic Improvements, Preventative Periodontal, and Restoration Services, as well as Oral Surgery

  1. How much time do you spend with each restoration or any other dental procedure? How many teeth are you able to restore or how much work can be accomplished during my appointment? Is there a particular sequence of removal of restorations that are followed? Sequential removal depends on a number of factors that the dentist will consider and discuss with you and may depend upon galvanic current reading of individual restorations and is a familiar protocol to biological dentists

This answer will tell me if the dentist's focus is on patient care rather than keeping to a rigid standard where one shoe fits all and if the dentist is more concerned with a tight schedule and how much time is committed to a thorough procedure where all potential decay is removed and new restorations would be on a healthy clean foundation. It would also tell me about how careful and gentle the procedure will be, to protect me and not potentially damage any surrounding tissue and teeth also reducing post-procedural bruising, swelling, and discomfort. Consideration would be for the amount of time and work that would be best for my health and time constraints.

  1. Can you establish effective and efficient treatment plans for patients traveling great distances?

A dentist with experience, a well-organized support system, and the ability to truly listen to the needs of the patient, can coordinate the dental needs of patients traveling from anywhere in the World.

  1. How important is the patient's input in a treatment plan?

The dentist that believes in empowering patients with knowledge and confidence comprehends that when people have an active role in their own care, they are more likely to get the results they want. A dental practice that provides compassionate listening and communicates hope through; technical excellence, positive thinking, skill, and judgment; demonstrates a commitment to excellence and accountability. The treatment plan has several factors to take into consideration based on the patient's expressed needs, expectations, limitations, time frame, costs, etc. Effective communications and careful analysis of all factors are vital to developing a comprehensive treatment plan.

  1. What kind of material compatibility testing do you use? Will you provide me with a list of materials so that I may test them for compatibility?

This would be vital if I have chemical sensitivities and allergic reactions such as to latex. The initial goal is to discover materials that are the least reactive. No dental material is "the best" for every person. And the human body is dynamic and subject to change thus any product that is not part of the body is foreign and can feel different and even cause a reaction. Serum compatibility, Meridian Stress Assessment, and Applied Kinesiology are familiar techniques used by patients to select compatible materials. Patients are encouraged to see a healthcare practitioner who provides appropriate support that will help the patient overcome reactions to various materials.

  1. What is your position on the mercury issue? What is your knowledge and experience with mercury? Is this a mercury-free practice and how long has the dentist practiced in a mercury-free environment? Is there a mercury separator on the office plumbing to prevent mercury pollution of water supplies?

This will tell me if the dentist takes the time to understand and is knowledgeable about integrative patient care; recognizing that the teeth are not a separate part of the body. It would also assure me that the dentist has the courage and wisdom to conduct research, develop protocols, treatment plans, and procedures; making mutually agreed upon decisions based on patient care and safety regardless of popular opposing opinions. If a dentist is knowledgeable and understands mercury biochemistry, it is likely they will take the removal process seriously. I would be concerned if I hear, "I don't think the mercury in fillings is a big deal, but I'll take it out if you like". This is probably a dentist that isn't very concerned about removal protocols and I would seek help elsewhere. If the dentist provides the equipment, skill, and techniques to protect his patients, staff, and self, then the same commitment is generally practiced regarding the appropriate disposal of mercury and toxic products into our environment

  1. Do you use a rubber dam when removing amalgam?

A non-latex dental dam is most commonly used. This would also demonstrate commitment to patients as this procedure increases the amount of preparation time and costs for the dentist. The rubber sheet greatly reduces the number of particulates that might go down the throat and potentially be absorbed by the mucus membrane.

  1. What kinds of protective barriers are used in your office during the removal of existing restorations?

Barriers may include eye protection for patients and staff, nasal coverage with alternate air supply for the patient and gas masks for staff, and high volume intra-oral evacuation and mercury vapor and particulate filter.

  1. Is your suction system powerful and efficient?

Utilizing an efficient suction system in the oral cavity with a specialized adaptor or its equivalent is necessary to contain the mercury vapor and amalgam particles.

  1. Do you apply copious amounts of water to the filling upon removal?

Large amounts of water help contain mercury vapor and fine particulate matter, as well as, cool the filling.

  1. Do you use magnification during procedures and if so, to what level of magnification?

I want to know they can see clearly what may not have been evident on x-rays or scans and a 3.5 or greater magnification would be sufficient and increase the ability to see details.

  1. Do you remove the failing metal mercury/amalgam filling in large sections and do you remove failed Root Canals?

By carefully cutting the tooth in sections, using a very thin bur, and reducing the amount of drilling, the amount of mercury and fine particulates is minimized. Experienced dentists understand the amount of time and skill required to safely remove a failing metal filling. Likewise, it is essential that the dentist be thorough and skilled in removing any infection, dead tissue, root tips, ligaments, and objects left in the jaw.

  1. Do you utilize alternative air sources and/or equipment to reduce mercury inhalation?

The dentist should employ one or more methods to prevent the patient from inhaling mercury vapor and fine particulate matter. And additionally, provide protection for all staff members by wearing mercury vapor masks. Biological dentists typically have air filters and ion generators in treatment rooms and throughout the office to help with air purification.

  1. What type of anesthesia do you use and please explain why you prefer one over another?

This would tell me the dentist's knowledge of safer drugs that will contribute to my comfort, safety and recovery.

  1. Do your patients have the option of being sedated during dental procedures?

The dentist should evaluate the best options given the needs and potential anxiety of the patient and provide healthy options. Many patients benefit from what is termed conscious sedation which is a very carefully administered and monitored sedation known for minimal side effects and optimal quick alertness after the procedure. Most patients report feeling rested and refreshed, yet the sedation is such that the patient may be responsive to questions or requests. This would be optimal to help patients relax during restorative and/or surgical procedures.

  1. Are you knowledgeable about local anesthetics and their safety?

The dentist of my choice would have a thorough knowledge of various local anesthetics and be able to determine what is most compatible for each patient. However, in general, local anesthesia, which is achieved without the use of products containing epinephrine or other additives that act as vasoconstrictors - that diminishes blood flow to the area of anesthesia, to prolong its effect, are best for overall healing. Has the patient been tested for MTHFR? A patient's comfort and safety are primary and there should be the opportunity to communicate any concerns or discomfort with the dentist, I would select, would be sensitive and aware of any and all signs of concern.

  1. I am not happy with my smile. Do you provide cosmetic dentistry?

A compassionate dentist understands the value and importance of a confident and comfortable smile that includes attention to functionality and balance, as well as, appearance. And will make every effort to provide various services related to orthodontics, implants, veneers, and prosthetics such as dentures. Services could include idealizing cosmetic improvements, preventive periodontal and restoration services, or more.

  1. Do you perform root canal therapy?

This answer will tell me of the dentist's commitment to whole body health and understanding the relationship between systemic infections originating from infection in the mouth from a failed or dead tooth which is what often happens after root canal therapy--this is a very emotional topic for some and requires research and an individualized common sense approach. Some individuals do not appear to have any adverse concerns with their root canal therapy. There is a significant scientific rationale to support both opinions however, the question is; does it make sense to allow dead tissue to remain in the body and not expect some type of infection to spread

  1. Do you perform metal implant services or non-metal implants?

This is also a very controversial topic regarding the concerns with any metal in the mouth. Some individuals with robust health do not appear to have any adverse reaction to metal or other toxic substances, yet others can trace a downhill spiral of their health shortly after metal fillings, metal implants, root canal therapy, etc. While many professionals do not see any relationship between oral and whole-body health, most integrative and alternative practitioners recommend healthier choices and prefer non-metal dental work and Zirconia ceramic implants for tooth replacement. It would seem to be another common sense answer that suggests if there is a healthier alternative, it is best to choose a healthier preventative approach.

  1. What is your training and knowledge of nutrition do you understand the uniqueness of each patient and are you open to working with other practitioners who are able to help me with protocols, procedures, and monitoring of progress?

This would tell me of the dentist's knowledge and relationships with other practitioners and of whole body care and commitment to my recovery if I am struggling with my health and/or my desire to provide the best possible foundation for health in the future.

  1. Is there any special rinsing done?

Many Biological Dentists use oral rinses before starting the removal of mercury fillings and provide multiple rinses during and after the removal procedure.

  1. Do you use Minimally Invasive Surgical Techniques, Tennant Biomodulator/Biotransducer, Ozone and Platelet Rich Fibrin (PRF) in your practice to help my healing process?

Minimally Invasive yet Thorough Surgical Techniques, Biomodulator Therapy, Ozone, and PRF are additional modalities and services that require additional skill training, instruments, equipment, and time to provide a level of excellence and significant care for patients. Dentists who are skilled with these techniques are demonstrating a dimension of commitment to patient care that is not required yet, has proven highly effective for increased healing and decreased pain and swelling. Most patients do not need pain medications.

  1. Do you keep in touch with your patients and follow up on their progress?

This would tell me of the dentist's true interest in me personally and in my long-term care and successful results. I want a dentist who demonstrates a true interest in; clinical research, learning more, a connection with other health care practitioners, and in my long-term care.

  1. Do you recommend that I coordinate and follow up with a healthcare practitioner and document my progress and report back to you?

I want to understand what I need to do prior to and after my dental care and understand that those answers need to come from my primary care practitioner.

Most doctors and dentists share the following non-mercury practices: No Fluoride. No Fragrances. No Latex. No Root Canal Treatments. No Metals Used with Restorative Dentistry. No Titanium Implants. No VOC in office paints. Yes to a mercury-safe environment, homeopathy, Yes to Full Spectrum Lighting, and Yes to working with like-minded M.D., ND, Chiropractors for Patient Nutritional Supplementation, Detox, and Appropriate Corrections

Attached is more information regarding the NewTom 3D Cone Beam Scan Information and detailed instructions regarding how to obtain a clear scan.  To find a dentist that has a NewTom 3D cone beam scan, you may search for the NewTom 3D cone beam in your locality.

Not all Cone Beam Scans are alike.  Some have higher resolutions and lower radiation exposure like the NewTom. Also, search for biological dentists in your area that uses ozone and platelet-rich fibrin. There are several websites for organizations such as: http.//www.iabdm.org, http://www.iaomt.org  and https://holisticdental.org where you may look up dentists in your area.  Some of these dentists may have a NewTom 3D or equivalent quality cone beam scan.  http://www.oxygenhealingtherapies.com  This is a website to find professionals using ozone.  http://holisticdental.org/find-a-holistic-dentist