Friday, June 12, 2009

Invisalign sets sales quota for dentists!

The following is my opinion based on my observations and hearing from hundreds of dentists:

Align Technologies, the company that created Invisalign (clear braces) has instituted a thinly-veiled sales quota, euphemistically calling it a "Proficiency Requirement." If a dentist does not start a minimum number of cases per year, that dentist will be banned from providing Invisalign, unless he or she retakes the certification course and pays the tuition again.

Align claims this new rule is intended to ensure dentists are "proficient" at using their system. It is MY opinion (and that of most dentists) that this is a financially-motivated decision and attempt at forcing dentists to start more cases than they normally would.

Quite coincidentally, I was going to sign up for the certification course the same week Align made the announcement. But, I decided not to in light of this development. I believe it is the SOLE obligation of the dentist to decide which treatments and services are appropriate for his or her patients on an individual basis. I do not agree with a sales quota being introduced into the equation. I'm afraid this may lead to inappropriate use of this treatment method and creates a bad precedent.

I will ONLY use my professional judgment when treating my patients.


Imagine if a heart surgeon was forced to use a particular brand of replacement valve a certain number of times per year, or he or she could no longer use that brand of valve at all.

Imagine if a physician or dentist did not write a minimum number of prescriptions of a certain drug and got banned from writing them at all. Is this ethical? Could it create an environment where some doctors might skew their recommendations... for the wrong reasons?

The good news is two-fold:

First... Align is not the only company that makes clear orthodontic "aligners." And, there is already a mass exodus of dentists to the other companies (that don't institute sales quotas).

Secondly, based on my observations, tooth-colored
6-Month Braces provides faster and more precise cosmetic results than aligners.

If you have any questions about the best way to straighten your teeth, don't hesitate to contact me or Palm Beach Smiles.

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Friday, January 16, 2009

Teeth Whitening at Mall Kiosks Banned

As I predicted in my August 2008 post on this topic, teeth whitening provided by untrained people at mall kiosks (and other locations) is being banned. Tennessee has just passed a law banning this practice. I expect other states will follow suit. It just makes sense.

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Thursday, December 4, 2008

Palm Beach Smiles Website - Now with Video!

My primary practice website, http://www.palmbeach-smiles.com/, now has video!

On the home page and nine other pages, you can see video of me introducing the page and topic. Here are links to the individual pages:

Palm Beach Smiles - Home Page

Palm Beach Smiles - About Our Office

Palm Beach Smiles - 6 Month Braces

Palm Beach Smiles - Cosmetic Dentistry

Palm Beach Smiles - Smile Makeovers

Palm Beach Smiles - Porcelain Veneers

Palm Beach Smiles - Before & After Gallery

Palm Beach Smiles - General & Family Dentistry

Palm Beach Smiles - Dental Implants

Palm Beach Smiles - Meet Dr. Michael Barr

Saturday, November 22, 2008

6 (Six) Month Braces or Porcelain Veneers?

Veneers vs. Braces?

Dentistry now has more cosmetic options than ever before. People are also more aware that an unattractive smile is not a life sentence. You can change your smile! If you've watched any TV in the past few years, it's likely you've seen some of what dentistry can do for your smile.

The most common complaints about unattractive smiles usually include:
- dark or discolored teeth
- spaces or gaps
- crowding or crooked teeth
- worn down or chipped teeth

Depending on your goals, the answer to your problem can vary. If your only concern is the color of your teeth, simple whitening may be the solution. If your concerns include the spacing, size, shape, or crookedness of your teeth, then either braces or veneers may be the right choice for you. In some cases, it may be a combination of all the above.

Most people are familiar with braces (orthodontics). There is the traditional approach to braces, and today we also have 6 Month Cosmetic Braces. The way they work is very similar. The goals are different.

Traditional braces are intended to not only straighten teeth, but also to correct any bite discrepancies. Because of the goal to correct the bite, the treatment time is longer. Usually it's anywhere from 12 to 24 months, or even longer in some cases.

6 (Six) Month Braces are intended to correct the alignment of the teeth in the "smile zone." 6 Month Cosmetic Braces straighten only the teeth that show in your smile. They do not usually correct any bite discrepancies. 6 Month Braces are a wonderful solution for adult patients who are not happy with their smiles because of spacing, crowding, or crooked teeth. After straightening your teeth, whitening may be the "cherry on top." The advantage of 6 Month Braces over Porcelain Veneers is that it's more conservative and less expensive. By straightening your teeth with braces, no irreversible changes have been made to the teeth themselves, as occurs with Porcelain Veneers. But, naturally, 6 Month Braces cannot change the shape or size of your teeth.

Porcelain Veneers are the ultimate in cosmetic dental makeover treatment. Porcelain Veneers can also correct crooked teeth (with some limitations), discolorations, close spaces, and rebuild worn or chipped teeth. With Porcelain Veneers, we can create picture-perfect teeth in terms of alignment, color, and shape. Exquisite Porcelain Veneers require some reshaping of the natural teeth to make room for the porcelain restorations. And, if the teeth are very crooked, this reshaping can sometimes be aggressive. That's where 6 Month Braces may be a big help - to reduce or eliminate such aggressive reshaping.

So, think of 6 Month Braces as a possible alternative to Porcelain Veneers if your only concern is the alignment of your teeth. Sometimes a combination of both 6 Month Braces and Porcelain Veneers will be the perfect solution. Ultimately, the best way to find out is to give us a call at Palm Beach Smiles for a free consultation.

Dr. Michael Barr is the founder of Palm Beach Smiles, a general dental practice in Boynton Beach, Florida with a focus on Cosmetic Dentistry.

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Monday, November 10, 2008

Whoopi Goldberg Talks About Gum Disease

A few weeks ago, Whoopi Goldberg returned to her TV show, "The View," after being absent for emergency gum surgery. In this episode, she spent a few minutes discussing her personal experience with gum disease and how she will be losing her teeth. But, more importantly, Whoopi did a tremendous public service by bringing up the serious health consequences of gum disease (periodontal disease) that go well beyond losing teeth. Gum disease can kill you! Yes, you read that correctly! New discoveries are revealing possible connections between gum disease and heart disease, stroke, diabetes, and cancer, for example.

Dentists have known about this for several years. But, it's amazing how the power of Whoopi's celebrity will do more for public awareness of gum disease than the dental profession could dream of doing. Whoopi set aside her pride and laid it all on the line to spread a very important message. Thanks, Whoopi!

The good news is that gum disease can be treated and prevented at our dental office in Boynton Beach.

Check out this short video! Whoopi has her facts right about gum disease.





This video was edited and annotated by Dr. Michael Barr, Boynton Beach dentist and founder of Palm Beach Smiles.

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Tuesday, August 19, 2008

Teeth Whitening at the mall, county fair, and even Costco??? Buyer Beware!

It seems everyone (and anyone) has gotten into the Teeth Whitening business lately. Teeth Whitening kiosks are popping up everywhere. The folks manning the booths are dressed in white coats, but they aren't dentists. They aren't in the dental profession at all. So, how do they get away with it?

They get away with it because they don't touch you. Their clients place the bleaching products in their own mouths. So, it's classified as a "cosmetic" rather than "dental treatment." They've taken advantage of a loophole. I've heard that some states are trying to close that loophole.

While on the surface it may seem that dentists would want to simply protect their "turf," there are serious concerns about non-dentists performing dental procedures... Yes, even though they aren't touching their "clients." Undiagnosed gum problems and cavities, for example can become very sensitive or "flare up" with bleaching gel application. Existing crowns and fillings won't change color. Teeth with thin or worn enamel won't change color, either. And, ultimately the results are quite disappointing. These untrained sales people in "white coats" couldn't possibly determine whether any of this applies to you. They have ZERO dental training.

The advertising, posters, and brochures are quite impressive at these mall kiosks. They "guarantee a 5 (or some other arbitrary number) shade improvement." And, that's just it. How much is a shade? On which scale? It means little to nothing. But, it sure sounds good. They'll also tell you that this is the same process used in dental offices. That's simply not true. (We actually touch you, for starters!) The results immediately after the procedure might impress you. But, it will fade, and it will fade very quickly. Why? The next paragraph will tell you.

First of all... bleach is bleach. The primary difference from one product to another is the concentration of the bleaching material (either carbamide peroxide or hydrogen peroxide). Each company may put in its own version of additional "desensitizing" ingredients. The primary determinants of bleaching effectiveness are CONCENTRATION and TIME. The higher the concentration, the bigger the effect. The same thing goes for time. The longer the bleach is in contact with the teeth, the better. In my own experience, time has been the more important of the two factors. I have found that even a lower concentration of bleach with a longer application time will work more predictably than a high concentration for a short time. And, that's why home whitening with a precision-fitted custom tray has been the most predictable and most effective in my experience.

These kiosk operators claim all you need is 15 - 20 minutes. In my 20 years of experience as a dentist, I cannot see any bleaching treatment for such a short time being effective. The results will be very superficial and short-lived.

Now... Here's the part that will ruffle some feathers - even some dentists. It's about the "special light." You will see these operations using a "special light" that is placed close to the teeth during the bleaching process. They are usually a focused bright blue light. Here's the big secret: THEY DON'T DO ANYTHING!!! The lights are 100% HYPE!! The lights are 100% marketing hype. The truth is that the public likes bright lights and lasers. They look high-tech. But, I must repeat: The lights don't do a thing for whitening the teeth. Not one iota! And, this has been proven time and again by independent scientific studies. The only thing the light accomplishes is dehydration of the teeth that makes them LOOK whiter - temporarily. The light dries out the teeth. Clever, eh? Sure, the bleach will whiten the teeth... but only a tiny amount in the 15 minutes, or so, that you're sitting in the chair at the mall. The light just dehydrates the teeth and makes them look even whiter.... until they RE-hydrate. The whitening effect relapses rather quickly.

Unfortunately, there are dentists who use similar lights in their offices. And, I believe they have bought into the marketing of the companies who sell the lights. I believe those dentists truly believe they are helping. But, science is science. And, the scientist in this particular dentist (me) happens to have a louder voice than the marketer in this dentist. I have to call them as I see them. And, I know that some of my colleagues won't like it. And, it's why I don't have the "special light" in my practice. If it really worked, I'd surely have one in my office.

So, while I am very much in favor of a free market, I cannot endorse or acknowledge the industry of whitening provided by non-dental professionals. I believe many clients will ultimately be disappointed, be lighter in the wallet, and not have any recourse. While I believe in a free market, I also believe in the old adage, "Buyer beware."

It's worth noting that in most (if not all states) it's illegal for a dental assistant or dental hygienist to whiten a patient's teeth without the supervision of a dentist. At least those dental personel have some dental training! But, they cannot legally whiten your teeth without a dentist present. So, how is it that someone can buy a "whitening franchise" on the internet and set up shop in the mall or big-box discount store??

There is no doubt that the best and most predictable way to get your teeth whitened is at a dentist's office. A dentist can let you know if it will be effective for you. Not everyone is a candidate for whitening. Secondly, a dentist can monitor your results and make adjustments as needed. I have found the best, most effective whitening is with home bleaching with professionally made custom-fitted bleaching trays. In-office "power bleaching" helps, but it is best used IN ADDITION to home bleaching with custom trays.

I suspect the mall, county fair, and big-box discount store whitening kiosks may disappear as quickly as they appeared. Either the public will become aware of the poor long-term results, or the state dental boards will shut them down due to possible health risks.

If you're not happy with the appearance of your smile, your best bet isn't with someone who bought a "whitening franchise-in-a-box" on the internet and threw on a white coat and fake eyeglasses to make himself / herself look sophisticated. Your best bet is with a licensed dentist. You only get one set of teeth. Trust them to a professional.

For more information on teeth whitening and photos of actual cases in Boynton Beach click on Palm Beach Smiles.

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