There is an old adage that a smart person is not someone who knows everything but a person who knows he doesn't know everything. I truly believe this is the truth with being a dentist. A good dentist is not one that thinks he/she knows it all but a dentist that knows he/she doesn't know it all.
Now there comes a time with most dental patients that a dentist will refer the patient to a specialist. Usually, the patient's first question is, "Why?"
Before I explain why I think I should clarify the different dental specialties. The following are the nationally recognized specialties. I would also like to emphasize the ones that are NOT recognized as true dental specialties. All dental specialists attend certification programs that range in duration from 2 years to 7 years and must pass a state or regional licensing exam to be considered true specialists.
1) Periodontist: These are the "gum specialists." They concentrate on treating the structures that keep your teeth stable and healthy. These are the gums, periodontal ligament (ligament that holds your tooth to the jaw bone), and the bone surrounding each tooth. They are also fast becomming the specialist of choice for dental implant placement because the most important aspect of implant success is their ability to be stable in the jaw bone.
2) Prosthodontist: These are the "denture specialist." Although they are very knowledgable about dentures they also specialize in tough crown and bridge cases and full mouth reconstructions for those patients that have gone without teeth for a number of years.
3) Endodontist: These are the "root canal specialist." Endodontist specialize in performing root canal therapy for a tooth where the nerve has died and formed an abcess. Their specialized training allows for a better long term prognosis for root canals they perform compared to a general dentist. Although a general dentist can have great success on a straight forward root canal treatment, endodontist have much higher success with the tough ones.
4) Orthodontist: These are the "braces specialist." They have specialized training on straightening your teeth with braces and/or other appliances. Most general dentist can "move" teeth with braces, but orthodontists are the true specialist in "straightening" your teeth and giving you a healthy bite (the way your teeth come together when you close your jaw).
5) Oral Surgeon: These are the "wisdom teeth specialists." Oral surgeons have completed the four years of dental school and continued on to graduate from either 4 or 7 years of medical school. They are truly M.D.s as well as D.D.S.s. Although dentist usually refer to OS for tough wisdom teeth extractions, oral surgeons also specialize in any surgeries of the head and neck including cancer treatment and TMJ evaluation and treatment.
Next, I would like to expand on some titles for dentist that are NOT true dental specialties. To be continued...
The field of dentistry has benefitted greatly from the advancements in materials and technologies to help promote good oral health. Yet as a dentist myself, I've seen that my profession has embraced these new technologies at the risk of spending less time promoting "prevention through education." The truth is the healthiest mouths are not the mouths of the wealthiest people, but rather the mouths of educated people. This blog is my effort to educate the public and promote good oral health.
Wednesday, July 23, 2008
Friday, July 11, 2008
What's in a checkup?
Many patients in the past have asked me, "So what's in a checkup?" I assume they mean what am I and my dental team looking at and looking for in a typical dental exam. I'll take this opportunity to let you know exactly what comprises one of my dental exams.
First, let me clarify that I'll be describing the makings of one of my initial exams. A comprehensive initial exam is given by my dental team when it is the patient's first introduction to our office. After this "initial" exam the patient receives "recall" exams or a condensed version of this initial exam on cleaning appointments.
The first task that is completed by my team is reviewing your medical and dental history. Here, the important point is making sure you are physically healthy and you do not have any contraindications to receiving dental care. Major issues we are looking for is a history of heart problems, high blood pressure, diabetes, siezures, and congenital defects. Although not specific to your mouth, these conditions can affect the timing or type of dental care you receive. An interesting factoid is that most cases of high blood pressure is indirectly or directly diagnosed during a dental check up. So this is a very important step for us and our patients.
At this point, the dental team will proceed to taking dental xrays that are necessary for the initial exam. This is also the time to notify the team if you have an urgency, such as toothache or sensitivity, because certain conditions may require another type of dental xray.
We then proceed to the head and neck exam. During this part of the exam, I am looking for any out of place or noticeable bumps, marks, and swellings. Your TMJ or Temporal Mandibular Joint will also be evaluated at this stage. This also serves as the first part of you oral cancer screening, which is the next step.
During your oral cancer screening, I examine all the tissues in and around your mouth. I'm looking for ulcers, colored marks, bumps, and white patches. Although most of the time these things are not cancerous, they should always be noted, measured, and recorded for specialist referral or future reference.
We then use the xrays and a visual exam to note the existing dental work and conditions of the teeth. Usually, I communicate with my team using dental terminology during this part of the exam, but we always explain our findings to you the patient after the visual exam. We are looking for failing dental work, cavities, loose teeth, staining, missing teeth, and fractured teeth.
The next step is to evaluate your periodontal health, which means the health of your gums and the bone underneath that hold your teeth in place. We do this by taking measurements of the gums itself and noting areas of inflammation and spontaneous bleeding. This is the step where it is determined what type of dental cleaning you will need.
Finally the last and most important step of the initial exam is presenting you our patient with our findings and reccomendations for treatment or maintenance (also known as the treatment plan). Our dental team makes a special effort to educate during this step and feel the exam is complete only when you are comfortable with all the aspects of your personal treatment plan.
First, let me clarify that I'll be describing the makings of one of my initial exams. A comprehensive initial exam is given by my dental team when it is the patient's first introduction to our office. After this "initial" exam the patient receives "recall" exams or a condensed version of this initial exam on cleaning appointments.
The first task that is completed by my team is reviewing your medical and dental history. Here, the important point is making sure you are physically healthy and you do not have any contraindications to receiving dental care. Major issues we are looking for is a history of heart problems, high blood pressure, diabetes, siezures, and congenital defects. Although not specific to your mouth, these conditions can affect the timing or type of dental care you receive. An interesting factoid is that most cases of high blood pressure is indirectly or directly diagnosed during a dental check up. So this is a very important step for us and our patients.
At this point, the dental team will proceed to taking dental xrays that are necessary for the initial exam. This is also the time to notify the team if you have an urgency, such as toothache or sensitivity, because certain conditions may require another type of dental xray.
We then proceed to the head and neck exam. During this part of the exam, I am looking for any out of place or noticeable bumps, marks, and swellings. Your TMJ or Temporal Mandibular Joint will also be evaluated at this stage. This also serves as the first part of you oral cancer screening, which is the next step.
During your oral cancer screening, I examine all the tissues in and around your mouth. I'm looking for ulcers, colored marks, bumps, and white patches. Although most of the time these things are not cancerous, they should always be noted, measured, and recorded for specialist referral or future reference.
We then use the xrays and a visual exam to note the existing dental work and conditions of the teeth. Usually, I communicate with my team using dental terminology during this part of the exam, but we always explain our findings to you the patient after the visual exam. We are looking for failing dental work, cavities, loose teeth, staining, missing teeth, and fractured teeth.
The next step is to evaluate your periodontal health, which means the health of your gums and the bone underneath that hold your teeth in place. We do this by taking measurements of the gums itself and noting areas of inflammation and spontaneous bleeding. This is the step where it is determined what type of dental cleaning you will need.
Finally the last and most important step of the initial exam is presenting you our patient with our findings and reccomendations for treatment or maintenance (also known as the treatment plan). Our dental team makes a special effort to educate during this step and feel the exam is complete only when you are comfortable with all the aspects of your personal treatment plan.
Thursday, July 3, 2008
What's a cavity?
I think most adults and probably a lot of kids only kind of know what a dental cavity is, and I think many dentists assume everyone does. Unfortunately, when I made a casual survey of my friends and family I got a whole array of responses, some pretty accurate and some fairly funny. Although dental cavities are not the most common of diseases in the human mouth they're the most obvious to us all.
So what do most people think of as a cavity? I imagine pictures and impressions of black spots, teeth "rotten away", and pain come to mind. As humans, we usually visualize terms or ideas as still-framed snapshots instead of processes that occur over time. For example when asked to create a mental image of age, we usually picture either a baby or an old man. We rarely picture the baby aging into the old man. Most people's mental picture of cavities are the same, but cavities are really a process that occurs over time.
First let me digress and give a little history lesson. Many people may have wondered, "Tooth brushes and tooth paste are relatively new inventions, so how did the cavemen care for their teeth or prevent from getting cavities?" In fact, we tend to imagine cavemen as having ugly, rotten teeth, but the archaeological evidence states otherwise. Most skeletons of ancient human beings have impeccable teeth without cavities. So what did they brush their teeth with and why don't we just do the same, right? The answer is not necessarily in how they cared for their teeth but rather a much broader aspect of ancient life. Lets fast forward to late 19th century London. Although, as Americans, we stereotype Merry ol' England as a nation of bad teeth, England has the oldest and most in depth surveys concerning their teeth than any other nation. And when this mountain of data was examined to see how rampant cavities are and were, some interesting facts appeared. Interestingly, their was a gigantic increase in the incidence of cavities in the city of London during the late 19th century. Oddly, this coincided with the increased use of the modern toothbrush. Now the common mistake would be to blame the toothbrush for cavities, but it makes more sense to say the use of toothbrushes were in response to the increase in cavities. So anthropologists and dentists looked at other possible reasons for the increase, and one historical event stood out by mirroring the increase in cavities. This event was the Industrial Revolution that occurred at the same time in London.
Now how did something like the advent of the assembly line, factories, and the locomotive affect teeth? The answer can be found by simply asking a child today, "What causes cavities?" Sugar. Now we think of sugar today as the little, white crystals we put in our morning coffee, but this kind of sugar, or refined sugar, was not around before the Industrial Revolution. It's called refined because it has been purified and concentrated. Have you ever tried to use that "natural" or "raw" sugar to sweeten your tea before? Notice how it takes a whole lot more of that "raw" sugar to sweeten it the way you like, but only half as much of the white, "regular" sugar will do the trick? Well the "regular" or white sugar has been refined. The modern era not only brought us refined sugar, but also gave us the super-duper sugar we all love, high-fructose corn syrup. To complicate it even more, we need to include items high in starch as sugars as well. Our favorite snacks like potato chips, french fries, and breads are all high in starch. Its worthwhile to note that the process of converting starches into sugars begin in our mouths due to our own saliva. So the Industrial Revolution brought us all the goodies of modern life but also gave us the modern diet which is high in refined sugars and starchy foods, and those lil' bugs in our mouths can't thank us enough for it.
Lil' bugs in our mouth? Distasteful as it sounds, but yes we all have bacteria that live in our mouths no matter how many times we rinse with mouthwash or brush our teeth. Now these bacteria are not bad for us. In fact science has shown many of them are extremely beneficial. But remember the advise our moms gave us growing up about, "everything in moderation?" The same is true for bacteria. Too much of anything is gonna be bad for you. Now these bacteria are able to live in your mouth because like you, they live off the food you're eating. Bet you didn't think you were sharing every meal right?
Well this brings us back to the Industrial Revolution and those refined sugars and starchy foods. Ever had a power bar? Those meal replacement bars supposedly have the nutritional needs of an entire meal in a single bar. Well high-fructose corn syrup is the power bar for the bacteria that live in your mouth. It's like a never ending buffet of energy for them and they begin to multiply faster and grow faster.
So lets make this discussion even more distasteful. Specific bacteria in your mouth cause cavities, and these specific bacteria love sugar. The "how they cause cavities" is the distasteful part. Just like you and me, when bacteria eat more they... well, they create more waste products is the nice way to say it. It's the acidity of these waste products that starts cavities and makes cavities get larger.
To top it all off, sugars are sticky as you probably already know. The inherent "stickiness" of sugars also allow these bacteria that cause cavities to stay on your teeth. Interestingly, your teeth are designed to "wash" themselves with the saliva in your mouth. Your teeth are so smooth that bacteria can't "stick" to them normally. Your saliva normally washes these harmful bacteria away from your teeth through out the day. Remember the question about why cavemen didn't get cavities? Here's the answer. Without sticky, refined sugars, cavemen teeth were washing themselves of harmful bacteria naturally, without the need for a toothbrush.
So the process of a cavity (the accurate dental term is caries or carious lesion) is this...
1) Refined sugar sticks to your teeth and is not brushed off with a toothbrush.
2) Cavity causing bacteria get stuck to the refined sugar on your teeth as well.
3) These bacteria rapidly multiply and grow because they have a high energy food source and a place to live, safe from the self-cleaning action of your saliva.
4) Their waste products accumulate around them on the surfaces of your teeth.
5) The acidity of these waste products weakens your natural tooth structure.
6) The process repeats until a cavity is formed and it grows until the bacteria are removed.
So that's basically what a cavity is. It can be thought of as the process of melting away tooth structure by the acids created by bacteria.
The next step is the treatment of cavities by a dental professional, but that's for next time.
Please feel free to comment and let me know if you found this helpful or if you'd like to know more.
So what do most people think of as a cavity? I imagine pictures and impressions of black spots, teeth "rotten away", and pain come to mind. As humans, we usually visualize terms or ideas as still-framed snapshots instead of processes that occur over time. For example when asked to create a mental image of age, we usually picture either a baby or an old man. We rarely picture the baby aging into the old man. Most people's mental picture of cavities are the same, but cavities are really a process that occurs over time.
First let me digress and give a little history lesson. Many people may have wondered, "Tooth brushes and tooth paste are relatively new inventions, so how did the cavemen care for their teeth or prevent from getting cavities?" In fact, we tend to imagine cavemen as having ugly, rotten teeth, but the archaeological evidence states otherwise. Most skeletons of ancient human beings have impeccable teeth without cavities. So what did they brush their teeth with and why don't we just do the same, right? The answer is not necessarily in how they cared for their teeth but rather a much broader aspect of ancient life. Lets fast forward to late 19th century London. Although, as Americans, we stereotype Merry ol' England as a nation of bad teeth, England has the oldest and most in depth surveys concerning their teeth than any other nation. And when this mountain of data was examined to see how rampant cavities are and were, some interesting facts appeared. Interestingly, their was a gigantic increase in the incidence of cavities in the city of London during the late 19th century. Oddly, this coincided with the increased use of the modern toothbrush. Now the common mistake would be to blame the toothbrush for cavities, but it makes more sense to say the use of toothbrushes were in response to the increase in cavities. So anthropologists and dentists looked at other possible reasons for the increase, and one historical event stood out by mirroring the increase in cavities. This event was the Industrial Revolution that occurred at the same time in London.
Now how did something like the advent of the assembly line, factories, and the locomotive affect teeth? The answer can be found by simply asking a child today, "What causes cavities?" Sugar. Now we think of sugar today as the little, white crystals we put in our morning coffee, but this kind of sugar, or refined sugar, was not around before the Industrial Revolution. It's called refined because it has been purified and concentrated. Have you ever tried to use that "natural" or "raw" sugar to sweeten your tea before? Notice how it takes a whole lot more of that "raw" sugar to sweeten it the way you like, but only half as much of the white, "regular" sugar will do the trick? Well the "regular" or white sugar has been refined. The modern era not only brought us refined sugar, but also gave us the super-duper sugar we all love, high-fructose corn syrup. To complicate it even more, we need to include items high in starch as sugars as well. Our favorite snacks like potato chips, french fries, and breads are all high in starch. Its worthwhile to note that the process of converting starches into sugars begin in our mouths due to our own saliva. So the Industrial Revolution brought us all the goodies of modern life but also gave us the modern diet which is high in refined sugars and starchy foods, and those lil' bugs in our mouths can't thank us enough for it.
Lil' bugs in our mouth? Distasteful as it sounds, but yes we all have bacteria that live in our mouths no matter how many times we rinse with mouthwash or brush our teeth. Now these bacteria are not bad for us. In fact science has shown many of them are extremely beneficial. But remember the advise our moms gave us growing up about, "everything in moderation?" The same is true for bacteria. Too much of anything is gonna be bad for you. Now these bacteria are able to live in your mouth because like you, they live off the food you're eating. Bet you didn't think you were sharing every meal right?
Well this brings us back to the Industrial Revolution and those refined sugars and starchy foods. Ever had a power bar? Those meal replacement bars supposedly have the nutritional needs of an entire meal in a single bar. Well high-fructose corn syrup is the power bar for the bacteria that live in your mouth. It's like a never ending buffet of energy for them and they begin to multiply faster and grow faster.
So lets make this discussion even more distasteful. Specific bacteria in your mouth cause cavities, and these specific bacteria love sugar. The "how they cause cavities" is the distasteful part. Just like you and me, when bacteria eat more they... well, they create more waste products is the nice way to say it. It's the acidity of these waste products that starts cavities and makes cavities get larger.
To top it all off, sugars are sticky as you probably already know. The inherent "stickiness" of sugars also allow these bacteria that cause cavities to stay on your teeth. Interestingly, your teeth are designed to "wash" themselves with the saliva in your mouth. Your teeth are so smooth that bacteria can't "stick" to them normally. Your saliva normally washes these harmful bacteria away from your teeth through out the day. Remember the question about why cavemen didn't get cavities? Here's the answer. Without sticky, refined sugars, cavemen teeth were washing themselves of harmful bacteria naturally, without the need for a toothbrush.
So the process of a cavity (the accurate dental term is caries or carious lesion) is this...
1) Refined sugar sticks to your teeth and is not brushed off with a toothbrush.
2) Cavity causing bacteria get stuck to the refined sugar on your teeth as well.
3) These bacteria rapidly multiply and grow because they have a high energy food source and a place to live, safe from the self-cleaning action of your saliva.
4) Their waste products accumulate around them on the surfaces of your teeth.
5) The acidity of these waste products weakens your natural tooth structure.
6) The process repeats until a cavity is formed and it grows until the bacteria are removed.
So that's basically what a cavity is. It can be thought of as the process of melting away tooth structure by the acids created by bacteria.
The next step is the treatment of cavities by a dental professional, but that's for next time.
Please feel free to comment and let me know if you found this helpful or if you'd like to know more.
Wednesday, July 2, 2008
My Practice in Sugar Land, TX
Ok, I know that my stated focus for this blog is Dental Education. I will strive to keep that its focus, but here in the beginning I must digress. Just this once... Please humor me my moment of parent-like pride in my new practice. (I won't let it happen again... I hope, but ya'll keep me honest ok?)
Hope ya'll liked em. Would appreciate some constructive feedback. Thanks for humoring a lil fatherly pride.
I promise this will be the LAST time I will ever post pictures or mention my practice in this section, but I spent a lot of time, sweat, blood, and tears (well maybe not literal tears) on this lil practice of mine. Please keep all the fawning and wooing to a minimum. ;-)
Basically, I'm a general dentist in the Sugar Land, TX area, which is a major suburb of Houston, TX. Although I do offer services in cosmetic dentistry such as veneers, the focus of my practice is family dentistry and general dentistry. Please visit my website for a list of my services so that in the future you'll be able to reference it to see if I even am qualified to be writing on a certain subject (again, ya'll keep me honest). Oh BTW, my practice name is Avalon Dental Group. I've been asked "why Avalon Dental?" a lot. Maybe I'll add that to the text of this blog sometime in the future to explain "why Avalon Dental"...
Reception Area:
Treatment Suite 1:
Sterilization Center (Where we sterilize our instruments.):
Consult Room:
The Avalon Dental Team:
(Jenny, Lorin, Me, Mike)
Hope ya'll liked em. Would appreciate some constructive feedback. Thanks for humoring a lil fatherly pride.
-Dr. Yu
My Guiding Principles
I dedicated my practice in dentistry to uphold these principles and these principles, in turn, have guided me to provide the best possible dental care to my patients.
-Promote good oral health.
-Prevent disease thru education.
-Relieve anxiety with patience and communication.
-Treat the patient with honesty and compassion.
-Provide the highest level of care.
-Stand behind the quality of our care.
-Treat every patient equally.
-Promote good oral health.
-Prevent disease thru education.
-Relieve anxiety with patience and communication.
-Treat the patient with honesty and compassion.
-Provide the highest level of care.
-Stand behind the quality of our care.
-Treat every patient equally.
My Mission Statement
Allow me to introduce myself and share with you my philosophy of dentistry.
I was raised here in Houston and have seen this great city blossom into the diverse metropolis it is today. After graduating high school, I traveled out-of-state for college and dental school. Yet throughout my many travels, my love for Houston endured and I ultimately realized my career and my family would find its home here again.
It was my personal experiences with my family dentist in Houston that inspired me to pursue a career as a dentist. Unfortunately, I soon realized the landscape of dentistry had changed since I left Houston. Insurance companies, the cost of modern dental treatment and profit oriented dental corporations had squeezed out the neighborhood dentist. It created an environment where quality and care was replaced with quantity and the bottom line.
Yet through my experiences in dentistry, I still believe that patient care and education can co-exist with modern dental treatment. In fact, I believe the recent advances in dentistry put a premium on patient education and follow-up, the guiding principles of “old-fashioned” dentistry.
It was with this goal in mind that I created the Guiding Principles that my practice was founded on. Interestingly by practicing these Principles, I discovered the next generation of dental patients. Patients that value a long-term relationship with their dental team, that value knowledge to help them prevent oral diseases such as cavities, and respect the value of their good oral health. I also discovered these patients have become friends over time and has made dentistry rewarding for me again.
I was raised here in Houston and have seen this great city blossom into the diverse metropolis it is today. After graduating high school, I traveled out-of-state for college and dental school. Yet throughout my many travels, my love for Houston endured and I ultimately realized my career and my family would find its home here again.
It was my personal experiences with my family dentist in Houston that inspired me to pursue a career as a dentist. Unfortunately, I soon realized the landscape of dentistry had changed since I left Houston. Insurance companies, the cost of modern dental treatment and profit oriented dental corporations had squeezed out the neighborhood dentist. It created an environment where quality and care was replaced with quantity and the bottom line.
Yet through my experiences in dentistry, I still believe that patient care and education can co-exist with modern dental treatment. In fact, I believe the recent advances in dentistry put a premium on patient education and follow-up, the guiding principles of “old-fashioned” dentistry.
It was with this goal in mind that I created the Guiding Principles that my practice was founded on. Interestingly by practicing these Principles, I discovered the next generation of dental patients. Patients that value a long-term relationship with their dental team, that value knowledge to help them prevent oral diseases such as cavities, and respect the value of their good oral health. I also discovered these patients have become friends over time and has made dentistry rewarding for me again.
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