In Hawaii, most people who are employed have dental insurance. However, as a rule, dental plans are good for maintaining dental health but are not designed to help people catch up when they have more than a couple dental problems. All dental plans have limitations on coverage and how much they will pay for a patient in a given year. Yearly benefits are commonly $600 – $1,000. That’s fine if you just need cleaning, examination, X-rays, and a filling a couple times a year, but it’s a meager amount if you need more than routine maintenance. Therefore, if you haven’t been to the dentist in a while, it is imperative that your dentist helps you carefully prioritize your necessary dental care, offer you practical treatment options, and provide affordable financing. If you have postponed care and are looking for a dentist we offer the following recommendations.

How to find a new dentist:
1. Ask your friends and family if they have a dentist they recommend.
2. Use sources such as Rateadentist.com, Google, and Yelp to learn what other patients think about potential dentists.
3. Browse potential dentists’ websites to learn more. If the dentist doesn’t have a website move on, they are not that interested in you.

Your new dentist should:
1. LISTEN to you and your concerns.
2. Examine you carefully and thoroughly and take a complete set of modern digital X-rays.
3. Sit down with you and patiently describe your current problems in plain language.
4. Provide you with several practical solutions to your problems arranged in an understandable step-by-step “worst first” plan of treatment. If necessary, treatment plans should be broken down into of phases that could span months or years.
5. Help you understand your dental insurance and how you can best take advantage of it.
6. Provide a clear written estimate of your expected cost for treatment.
7. Provide financing options for your estimated cost.
8. Always be available to discuss any concerns you might have.

At Kaneohe Family Dental Care we are committed and eager to help our patients regain their dental health and appearance in a way that they can afford. Call us if you are looking for a new Kaneohe or Kailua dentist, we think we know a couple good ones.

-Bruce Keller, DDS

Over the last decade, scientific research has collected a great deal of new information about the cause of periodontal disease, just recently has the processes that bacteria use to propagate, and eventually cause the gum infection, become clear. The knowledge of how gum disease progresses opens up opportunities to treat gum disease in new and unique ways with antibiotics and laser treatment. However, there is little new that changes how we can prevent the problem of gum disease in the first place. So sorry, you still need to brush and floss every day. However, science has discovered much more about why we need to take our daily care more seriously. The good news is that it doesn’t take a degree in microbiology for anyone to understand.

The analogy that we often use at Kaneohe Family Dental Care to explain the extremely complex bacteriological activity that causes gum disease comes from the 1989 movie, Field of Dreams. The famous line from the movie is, “…build it and he (they) will come.”

New information indicates that at least some of the bacteria we’ve been telling people to brush and floss off our teeth isn’t all that bad after all. That’s contrary to the old notion that the goal of brushing and flossing is to remove all the bacteria from our teeth. Frankly, removing all of the bacteria from our teeth is a futile task anyway. It is impossible to sterilize our teeth that are located in our bacteria laden mouths. In order to prevent gum disease and cavities, we just need to disrupt the bacteria on our teeth about every 12 hours or so to drastically reduce our chances of getting periodontal disease.

In our mouths, there are many kinds of bacteria, not all of them have the ability to adhere directly to our teeth. The new research tells us that after we clean our teeth, the bacteria that stick to our teeth first is harmless and even provides beneficial effects for our health. Unfortunately, when we leave that initial layer of good bacteria alone and undisturbed for more than 12 hours it multiplies to a thickness and pattern, a “matrix”, that allows the nasty bacteria that cause gum disease and cavities to adhere to our teeth and rapidly multiply. Hence, if good bacteria “build their matrix” the bad bacteria “will come”. This backs up what we always taught about prevention of gum disease. Maintenance of a healthy mouth requires only that we mess up those good bacteria’s matrix 2 times a day so they never complete their work. In this way, we allow the good bacteria to hang around and do what is beneficial to us, but we prevent them from making a field suitable for the team of players that cause gum disease to show up and do their thing. This also explains why we generally do not recommend mouthwashes that kill bacteria. Eliminating all the bugs in your mouth is not necessary, and can be counterproductive, because doing so indiscriminately kills both good and bad bacteria. Excellent oral health just requires only that you brush and floss two times daily. Doing so will greatly reduce your chance of having periodontal disease, cavities, and even potential cardiovascular problems.

- Bruce Keller, DDS

Of course everyone knows it is never good to postpone dental treatment. At any age, putting off dental care only leads to bigger problems and bigger bills. However, dental procrastination becomes increasingly significant as we progress into our retirement years. For most, aging comes with a decline in overall health and a reduced income. Also, many seniors rely on others for transportation and find it difficult to get to their appointments. For these reasons, it becomes increasingly difficult for seniors to avail themselves to the kind of dental care that will help them enjoy the benefits of good oral health and function. The unfortunate result of mid life dental procrastination is that many in their retirement years have no alternative but to have teeth extracted and replaced with dentures. Sadly, many of these people could have avoided these decisions had they only taken care of things when they still were working for an income. For this reason Dr. Ichiriu and I encourage our patients to have their teeth and gums in good condition well before they retire, while they are healthy, and not yet living on their retirement income. Patients who prepare their dental health for their golden years are able to enjoy the many benefits of good dental function and appearance. These people are able to spend their retirement time, money, and energy on pursuits that are a reward for a life well spent. We recommend that all of our patients shore up any lingering dental issues by their late 50’s, or no later than 3 years before they plan to retire.

- Bruce Keller, DDS

I wanted to blog about the undeniable importance of excellent oral hygiene. We now know that people who don’t brush and floss well potentially have a 80% or greater chance of heart attack and stroke. I was tossing around some ideas in my head while driving home from work the other day when I saw a bumper sticker that said, “Think education is expensive? Try ignorance.” Immediately, an idea for a new bumper sticker occurred to me. It would read: “Think floss is expensive? Have you priced a heart bypass lately???

Information about the very serious effects of gum disease on your overall health can be found at http://www.perio.org/consumer/mbc.top2.htm

- Bruce Keller, DDS