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A Quantitative approach (a game of millimeters)

There is always an art to good treatment of a disease. The skill, experience, and knowledge of the clinician is imperative to a good outcome. There are however objective quantitative measurements which guide proper periodontal therapy. All measurements in the mouth are done in millimeters. The following are a few examples of how dentists use millimeters in their care of the human mouth.

Periodontal pocket depths: Every tooth emerges through the skin of the gum and into the oral cavity in essence breaking the seal of the skin. This breach in the skin in compensated for by a tough ring of collagen and immune cells which surrounds every tooth 360 degrees. This forms a shallow pocket which also goes around every tooth 360 degrees. If the depth of this pocket is maintained shallow, typically less than 3 millimeters, with good daily cleansing, then the tissues remain healthy and the ring of collagen which goes around the teeth is tight and healthy. If however, bacterial colonies settle into the pockets and are not removed the 3 millimeter critical depth increases. Both by virtue of gum swelling, and collagen and bone breakdown. As the pocket depth increases to 4, 5, 6, or more millimeters, the cleaning of the pocket becomes more difficult. This in turn allows the bacterial colony to grow more and even worst select for nastier anaerobic bacteria to thrive. It is a viscous downward spiral of increasing pocket depth and worsening inflammation. Thus it is imperative to keep all pockets of all teeth less than 3 millimeters.

Size of Implants: One of the best ways to replace missing teeth is with the use of dental implants. A dental implant is a small titanium screw which replaces the root of a missing tooth. Once anchored into the jaw bone the implants fuse to the surrounding bone and become very strong roots. (This procedure is so common and minimally invasive that it is performed under local anesthesia in the dental chair, and most patients only take some advil after the procedure to get rid of any discomfort) These implants come in many combinations of sizes to suite the tooth they are replacing. The measurement sizes are in millimeters. A dental implant is described by two separate millimeter dimensions its height and diameter. For example a typical molar root in an adult male would require a 5mm X 11mm dental implant. This means the root is 5 mm in diameter and 11 mm in height. Implants are truly small but mighty, considering that the bite force can be as high as 150 pounds per square inch! Yet implants function great for many years.

Cat Scan resolutions: When planning more complicated dental procedures such as dental implants, bone grafting, sinus surgery, wisdom teeth extractions or orthodontics, often dentists can use the help of CT scans to help them diagnose and treatment plan. The CT scan provides doctors with a three dimensional exact digital model of the patients bones and teeth. The resolution is so high that a CT scan is viewed in millimeter slices. Each “slice” is a millimeter section of the human body.

Root Canals: There are canals inside the tooth. These canals house a small piece of tissue called the pulp. When a “root canal” is done, the doctor cleans out the remnants of the tissues and disinfects the canals. The exact length of the canal is measured with an apex locator down to the half millimeter. This is important because the entire canal system must be disinfected and filled with a sealing material exactly to the end of the tooth.

Amir Ahmadi DDS Diplomae, American Board of Periodontology

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The non surgical approach to periodontal therapy is always the place to start when treating periodontal disease. Periodontal disease is usually caused by the immune systems response to bacterial colonies which have settled on the surface of the teeth. Getting rid of these bacterial colonies, or making them small enough so they do not cause periodontal disease is the focus of periodontal treatment. By scaling off, and flushing out, the bacterial colonies, the immune systems response is reduced. If the immune response, also known as inflammation, is eliminated then so is periodontal disease. This is very important because untreated periodontal disease has two main long term consequences, tooth loss and contribution to atherosclerosis, or artery disease. Non-surgical periodontal treatment involves a clinician, either a dental hygienist or a dentist cleaning the plaque, tartar, and calculus off the enamel and root surfaces of the teeth. This is achieved by the use ultrasonic instruments and very fine hand scaling instruments. Either topical or local anesthesia is used to make the procedure more comfortable for the patient. The other critical part of the non-surgical approach is what the patient does at home. Home care is just as important as what is done in the dental chair. The daily cleaning of the teeth will keep the bacterial colonies from forming on the tooth surface. Brushing, flossing, proxa-brushes, rubber tips, gum stimulators, and topical disinfectant rinses are essential tools for maintaining a healthy mouth.

Amir Ahmadi DDS Diplomae, American Board of Periodontology

"No pain, no gain is the rule when it comes to gaining happiness from increasing our competence at something," said Ryan Howell, assistant professor of psychology at San Francisco State University. "People often give up their goals because they are stressful, but we found that there is benefit at the end of the day from learning to do something well. And what's striking is that you don't have to reach your goal to see the benefits to your happiness and well-being." Contrary to previous research, a study found that people who engage in behaviors that increase competency, for example at work, school or the gym, experience decreased happiness in the moment, lower levels of enjoyment and higher levels of momentary stress. Despite the negative effects felt on an hourly basis, participants reported that these same activities made them feel happy and satisfied when they looked back on their day as a whole. This surprising find suggests that in the process of becoming proficient at something, individuals may need to endure temporary stress to reap the happiness benefits associated with increased competency.

Dental Blog by
Ident Specialists
Oral Surgeon, DMD
Dr. Mark Niznikiewicz

No Pain Only Gain

This is very synonymous at i-Dent. i-dent ! yes your place for all your dental specialty needs. No pain ,pain free , relaxing ,no fear of the unknown Root canal treatment to only gain confidence . This concept was perceived in my mind during dental school and has matured to conceive the art of pain free root canals after 25000 plus procedures performed only to erase your painful memories . Every experience with your dentist has a record in your Brain to popup the next time you are at the dentist. So when we focus on understanding your pre-conceived notion of painful root canals & turn that into a positive experience only to unveil the information of the unknown, and perform step by step painfree rootcanal procedure , you leave our office a changed person with a new outlook on dentistry only to Gain confidence in yourself and the Dentist.

Dental Blog by
Ident Specialists
Endodontist
Dr. Sathya Kallur

I remember when first learning about psychology of space, I was amazed to discover that the space around the body is not symmetrical. Yes, the differences between standing far away versus close by are common sense. At one extreme, the further you stand from people, the less connection you have. At the other extreme, standing very close penetrates the intimate space we keep around ourselves. You can often see that clearly when you approach someone who immediately leans or steps back. If the space does not permit moving away, e.g. the person is sitting in the chair, then he might instead close off his personal space by folding hands and feet. Much more fascinating and surprising to me was the discovery that the space around the body is asymmetrical, and the left space is vastly different from the right space. It's great when these spatial preferences are complementary (e.g. if mine is on the right side, then hers is on the left side). But what if they are not? Then the two people talking will feel subtly uncomfortable and might start to unconsciously outmaneuver each other in circles.

Dental Blog by
Ident Specialists
Oral Surgeon, DMD
Dr. Mark Niznikiewicz

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