Palm Beach Smiles - Cosmetic Dentistry & 6 Month Braces

Palm Beach Smiles is mobile!

2012-01-15T07:00:00.000-08:00

No, we haven't rented an RV and taken our dental act on the road. We have a new website designed specifically for mobile (smart phone) users. It's easy to use, and it's fast!

You can visit by clicking Palm Beach Smiles mobile website.

Or if you have a QR code reader app on your smart phone, you can scan the code right here from your computer screen. Very cool! Try it!

Smile Makeover Video Testimonial

2011-04-27T06:08:00.001-07:00

Check out this patient testimonial. Carol had been unhappy with her smile for many years. Be sure to see the before & after photos at the end of the video!

Don't Get Dental X-ray Advice from Dr. Oz!

2011-01-03T10:43:00.000-08:00

Dr. Oz is at it again. He must be running low on ideas for his TV show. You'd think there is PLENTY of material out there in the medical world to fill his shows into perpetuity. But, noooooo.... He's spouting off nonsensically again about dentistry - a field in which he has ZERO training. He's as qualified to talk about dentistry as I am about his specialty - heart surgery.

This time Dr. Oz is telling people they should avoid dental x-rays. His reason is a piece of "research" that purportedly links increased thyroid cancers to dental x-rays. There's a reason I put the word, research, in quotes. Here's an excerpt from the article he apparently referenced (but failed to include in his show):

The researchers studied 313 thyroid cancer patients in Kuwait where dental treatment is free and where the incidence of thyroid cancer is relatively high compared to Britain. They said the results of their study, although the largest case-control study on the subject, should be treated with caution because the data were necessarily based on self-reporting by the participants. Comprehensive historical dental x-ray records were not available from the clinics.

Pay particular attention to what is bolded in the excerpt above. 313 patients is a VERY small study. The data is based on SELF-REPORTING. That's not science, folks. And, the real kicker that is quite stunning to me... they are saying the cancer is related to dental x-rays, BUT they don't have ANY records of what kind, how many, if any, x-rays taken on each patient. WHAAAAAAAAT?

There's an adage in science: "Correlation does not equal causation." To illustrate what that means, I submit the following analogy:

I did a study of 313 rabbits from Arkansas. They ate a lot of carrots. And, they all died. I can't tell you how many carrots they ate, or how often. I didn't keep any records. But, the rabbits really seemed to like carrots. So, I think they ate a lot, especially since they didn't have to pay for the carrots. But, eventually, all the rabbits in the study died.

My "obvious" scientific (not!) conclusion is that carrots are LETHAL. Don't eat carrots. And, if a restaurant tries to force them on you in a salad, you should tell them that a famous TV hair stylist said you shouldn't eat carrots. Carrots KILL!

Of course, we would be hard-pressed to logically conclude that carrots are dangerous. But, if a famous TV celebrity doctor blessed by Oprah says, "A study showed that carrots can kill you," you can bet people will watch. And, you can bet the celebrity doc won't give any details about a flawed "study."

Dental x-rays are a necessary part of a complete dental examination. X-rays reveal decay that we cannot see with our eyes. X-rays reveal bone loss from periodontal disease. X-rays reveal abscessed teeth. X-rays also reveal cysts, tumors, and even cancers. If any of those conditions go undetected, they will invariably get worse and more difficult to treat.

Dental x-rays are the "standard of care." That means any dentist who treats patients with out the proper examination, including x-rays, is practicing below what is accepted as a bare minimum of competency.

So, you see... we dentists must practice within at least the parameters of what is considered the standard of care. An Oprah-endorsed TV personality (even a heart surgeon) is NOT the arbiter of how dentistry is practiced. While he is a popular celebrity, Dr. Oz is NOT an expert on dentistry. However, your dentist IS. Some may argue that the dentist has a vested (financial) interest in doing x-rays. But, I will counter that argument that it is minuscule compared to Dr. Oz's financial interest in gaining viewers by offering provocative topics to discuss on his TV show. The more viewers he gets, the more he makes on advertising during his show. We're talking MILLIONS of dollars, folks. Rest assured that your dentist isn't "making his / her money" by over-prescribing x-rays.

If you're interested in some real numbers, refer to the table below** (You can view the table as a larger image by clicking on it.) I've highlighted in green, the typical exposure level from annual dental x-rays: 0.008 millisieverts. Now look at the first source listed in the table, "Natural Background." The figure is 2.4 millisieverts. So, you get 300 times MORE radiation from just being alive and walking around than you do from dental x-rays in any given year.

It sure makes for sensational TV when a famous Oprah-fied doctor says, "going to your dentist is dangerous." But, it's a tremendous disservice to the public and outright misinformation. But, that's television, facts be damned.

Your dentist should be happy to discuss the reasons for prescribing dental x-rays. Don't be afraid to ask. But, if you insist on no x-rays, in most cases, you can expect your dentist to decline seeing you as a patient. That's the simple truth, and that's reality. To provide dental care without x-rays is simply wrong, and it puts the dentist in a seriously liable and indefensible position.

I won't pretend to give you advice on heart surgery. I wish Dr. Oz would stop giving unqualified dental advice.

**Source: Radiologic and Nuclear Medicine Studies in the United States and Worldwide: Frequency, Radiation Dose, and Comparison with Other Radiation Sources—1950–2007
November 2009 Radiology, 253, 520-531

Dental Amalgam Dangerous? (Silver Fillings)

2010-12-14T06:17:00.000-08:00

Once again, dental amalgam (silver filling) is in the news. Last week on NBC's Evening News with Brian Williams, they ran a story about the FDA's concerns about amalgam fillings and the possible risks of the mercury content.

Personally, I have not used silver amalgam in my practice since around 1994. I believe it is simply an inferior material to a well-placed bonded composite (white) filling. White fillings are the standard at Palm Beach Smiles (click to learn more). The teeth in the photos below belong to my wife. :-)

Silver amalgam starts off as a fine metal powder composed of silver, copper, and other metals which is mixed with a droplet of mercury. This forms a sort of paste which quickly hardens into a solid amalgam. Once hardened, the components are chemically locked together.

The concern is about the possibility of mercury release from those fillings in your mouth over time. There has been a LOT of controversy about this over literally 150 years. To date, no recognized scientific entity has determined that there are any negative health issues with amalgam fillings. And, I am inclined (so far) to believe that there are no real health issues with the mercury that is locked up in amalgam fillings. However, I am open to REAL scientific evidence to the contrary.

A far bigger source of mercury in our environment is from coal-burning electric plants that put tons of mercury in the atmosphere. That mercury ends up in the ground and water. You've probably heard about mercury concerns when it comes to eating fish.

Oddly enough, the government or regulatory bodies in some parts of the U.S. have deemed scrap amalgam as a hazardous waste. Meanwhile, some other government entities assure us it is safe for use in dentistry. So, it's against the law to put it in the garbage or landfills in some places. But, it's safe to put in your mouth? Things that make you go, "Hmmmmm."

Another thing that will make you go, "Hmmmm" is that the goverment is banning incandescent (traditional) light bulbs in favor of the so-called "green" compact fluorescent bulbs. Those are the "curly-cue" bulbs. And, they contain mercury. Click here to see what the EPA recommends if you drop and break one in your house! This is a clear illustration of the contradictory agendas we see, and it should definitely make you go, "hmmmmm."

Some countries around the world have restricted the use of amalgam. And, every so often, the notion of banning it in the United States comes up. And, so here we are again. I believe it will be banned eventually - possibly for the wrong reasons - But, it will be banned some day.

There are some valid concerns over banning it, however. Amalgam has some advantages over other materials. It's EASY to place. It's cheap. And, it WORKS.

By contrast, bonded composites require painstaking attention to detail to place them correctly. If meticulous technique is not used, they tend to fail catastrophically and quickly. They are more expensive in terms of material costs and time (to be meticulous). Most insurance plans do not pay for composite fillings. So, dentists who have patients depending on insurance will face financial concerns. Banning amalgam will put those people between the proverbial rock and a hard place.

Fortunately, in my practice, I simply haven't had those issues in the 16 years I've been "amalgam-free." I've cultivated a practice based on what I would do for my own family rather than cater to insurance executives' and shareholders' interests.

I do not advocate the wholesale replacement of amalgams in order to prevent or treat any medical condition. And, I won't until credible scientific evidence supports the notion. However, I do understand that some patients do not want them in their mouths for a variety of reasons, including cosmetic concerns. "Silver" fillings are really BLACK fillings. And, who wants that?

Stay tuned, as I believe this will be an ongoing issue. And, please visit us at www.PalmBeach-Smiles.com to keep up with what we're doing at Palm Beach Smiles.

Don't listen to Dr. Oz about teeth whitening!

2010-12-09T13:03:00.000-08:00

Recently, the famous TV doctor, Dr. Oz, blogged about natural dental "remedies." With all due (or not) respect to Dr. Oz, he is no more qualified to give advice on dentistry than I am an expert on cardio-thoracic surgery (his specialty).

The theme of his blog post was natural remedies to whiten teeth.

One of his suggested remedies was to eat raisins. The rationale is that raisins will stimulate salivary flow (true), rinsing away plaque (ummm.... baloney!). Raisins are classified as a "sticky sugar." Combine sticky sugars with plaque, and that's how you get cavities (tooth decay). The notion that saliva will rinse away the sticky bacterial mass that is "plaque" on your teeth is utter nonsense. The only way to remove plaque from your teeth is MECHANICALLY. That means brushing and flossing. Period!

Dr. Oz also suggested that the vitamin C in strawberries would "clear away plaque." Again... simply not true. Brush and floss. And, get a professional cleaning twice a year. There is no magic elixir, rinse, fruit, or berry that will "rinse" or "clear" away plaque.

So, he might as well have suggested eating Tootsie-Pops to "rinse away" your plaque. Tootsie-Pops will also stimulate salivary flow. But, like raisins, candy will cause decay if not eaten in moderation. And, I certainly would not recommend either (or any kind of sticky sugar) to do anything beneficial for your teeth. NOT AT ALL.

Dr. Oz's second, and even more frightening suggestion is to use a slurry mix of baking soda and lemon juice on your teeth to whiten them. Put simply... it's crazy! Lemon juice is acidic. And, it's not a little bit acidic. The pH is about 2. The pH scale goes from 0 to 14. The strongest acid is 0, where as the strongest base / alkali (opposite of acid) is a 14. Care to guess what the pH of Coca-cola is? It's about a 2! It's the same.

Now, let's add baking soda... an abrasive material. It's also a mildly basic material, which would cancel out some of the acidity of the lemon juice. That's why you'll see bubbles - a chemical reaction. But, I do not agree with the idea of putting an acid on your teeth in combination with an abrasive. It's a recipe for erosion of your enamel.

While Dr. Oz's blog suggests leaving it on for only 1 minute with the caveat that it's acidic and will dissolve enamel, it doesn't account for most people likely REPEATING this process over and over. And, over time... repeated (although short) applications of acid WILL ERODE THE ENAMEL. 100% certainty!

Please don't do this! Don't put acid on your teeth to whiten them. Don't get dental advice from non-dentists. Not medical doctors. Not podiatrists, optometrists, nurses, or veterinarians. Not even famous TV heart surgeons like Dr. Oz. I'm a doctor, too. But, I wouldn't suggest you ask me for advice about heart surgery.

The very idea that a celebrity heart surgeon like Dr. Oz would suggest a DESTRUCTIVE method to "whiten" your teeth in an effort to save a few hundred dollars (cost of professional and SAFE whitening) is stunningly ignorant and a danger to the public, in my opinion.

If you want to explore options on how to SAFELY and EFFECTIVELY whiten your teeth, click on the link in this sentence or please ask a DENTIST.

Stick to what you KNOW, Dr. Oz! Remember, "First do no harm." And, I promise I won't give out advice on how to save money with do-it-yourself heart surgery.

Was Your Mouth Made in China? Dr. Barr gets interviewed on TV.

2010-03-07T13:15:00.000-08:00

In an earlier blog post, I opined about the outsourcing of dental lab work to China. The local CBS affiliate interviewed me about this issue. Here it is:

Mother's gum disease linked to infant's death???

2010-01-25T12:32:00.000-08:00

More and more, periodontal disease (gum disease) which is a chronic inflammatory condition, is being linked to a variety of systemic health issues. Pre-term birth, diabetes, arthritis, pancreatic cancer, stroke, and heart attack are among them.

Here's a recent report linking periodontal disease to infant death:

http://www.msnbc.msn.com/id/34979552/ns/health-pregnancy/

Dr. Barr is now a Six Month Smiles instructor!

2009-11-15T15:37:00.000-08:00

I just returned from presenting a 2-day course for Six Month Smiles. I spent the weekend teaching dentists about Six Month Smiles. Six Month Smiles is a system of providing short term cosmetic orthodontic treatment for patients who want a smile they can be proud of in a reasonable amount of time.

Most patients can achieve beautiful results without spending 2 years braces. In the time it takes between regular cleanings, Six Month Smiles can close spaces and straighten crooked teeth.

I'm proud to be among only 4 dentists selected to be an instructor and look forward to teaching dentists all over the country.

Gum Disease may lead to heart attacks - more news

2009-08-22T13:29:00.000-07:00

A quick note here.

Recently there was another report on the news about how the inflammation from Gum Disease can lead to heart disease or heart attacks. Also implicated is diabetes and strokes. Watch this special report and interview from ABC News:

For more information on how you get yourself checked click on Gum Disease in Palm Beach County.

Invisalign sets sales quota for dentists!

2009-06-12T07:24:00.000-07:00

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.

Teeth Whitening at Mall Kiosks Banned

2009-01-16T04:02:00.000-08:00

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.

Palm Beach Smiles Website - Now with Video!

2008-12-04T12:27:00.000-08:00

6 (Six) Month Braces or Porcelain Veneers?

2008-11-22T06:30:00.001-08:00

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.

Whoopi Goldberg Talks About Gum Disease

2008-11-10T19:07:00.000-08:00

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.

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

2008-08-19T13:48:00.000-07:00

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.

Smile Makeovers With Porcelain Veneers

2008-07-18T18:10:00.000-07:00

In a previous article, I discussed some of the tangible and intangible benefits of cosmetic dentistry. The smile, being the centerpiece of facial expression, has a high value as it pertains to appearance, self-esteem, and the ability to communicate with confidence. Ultimately, an attractive smile can have life-changing implications. A better job, a promotion, the ideal mate, more sales, or simply the chance to laugh without being self-conscious can be included among the many benefits of a beautiful smile.

Years ago, Hollywood stars were known to have their teeth “capped” for cosmetic enhancement. “Caps,” another name for crowns, are a relatively aggressive procedure. Besides having to substantially reshape the teeth for those Hollywood “caps,” the result was oftentimes not very natural in appearance. Some of the results were quite obviously artificial.

Today, the state of the art cosmetic restoration is the Porcelain Veneer. Porcelain veneers have a number of advantages over the old ways of smile enhancement. Porcelain veneers, made with high-tech ceramic materials, can look so natural as to be indistinguishable from natural teeth. Furthermore, they are a much more conservative procedure compared to crowns. Crowns require considerable reduction of natural tooth structure in every dimension. In contrast, porcelain veneers require minimal shaping of the front part of the teeth. Whereas crowns surround a substantially reduced tooth, a veneer is fingernail-like covering bonded to the front of a tooth.

Porcelain veneers may be a solution for a variety of cosmetic dental problems including: gaps, chipped teeth, worn teeth, crooked teeth, crowded teeth, or discolored teeth. In many cases, with two visits, a smile challenged by any combination of the above can be changed to virtual perfection. A talented cosmetic dentist will design your new smile to fit in with your unique facial features. A smile makeover with porcelain veneers will be a customized result, which can be so natural it will defy detection. In choosing a cosmetic dentist, you should always ask to see photos of their porcelain veneer cases.

Here's one of our cases:

There are a few steps involved in porcelain veneer treatment. An initial smile design appointment will include molds for models of your existing teeth along with a series of photographs. The information gleaned from the photographs and models at this appointment will be used to plan the actual treatment.

Once the plan has been agreed upon, the first treatment visit is scheduled. This visit will be a few hours long. It will begin with the conservative reshaping of the teeth in the smile zone to make room for the porcelain veneers. A mold is made of the reshaped teeth, which will be sent to a talented ceramist at a dental lab. Next, temporary veneer restorations are made. These temporaries serve two purposes. They cover and protect the teeth until the final veneers are placed. Secondly, and more importantly, they serve as a preview of the final result. The temporary veneers will be made to create the desired result, with your approval, and then serve as the blueprint for the final veneers.

About two weeks later, at the second treatment visit, the final veneers are placed. After the temporaries are removed, the final veneers are tried in to verify the fit and appearance. After your approval, the porcelain veneers are permanently bonded to the teeth with a special composite resin. Then they are polished creating a naturally attractive smile. Once porcelain veneers are bonded to the teeth, they form a very strong restoration that rivals natural enamel.

Your new smile should last many years with good home care and regular professional maintenance.

For more information click on Porcelain Veneers in Boynton Beach and Palm Beach County.

Are Silver-Mercury Amalgams Dangerous? FDA May Be Changing Its Position.

2008-06-06T14:21:00.000-07:00

Silver-Mercury amalgams (also know as silver fillings) have been controversial ever since their invention about 150 years ago. Amalgam is created by combining a silver alloy (metal) powder with liquid mercury at about a 50/50 ratio. In a few minutes the mixture hardens to a solid mass. While many recognized health organizations have never been able to find a connection between these fillings and any illness or disease, the material has always precipitated heated debate.

Amalgam occupies a prominent place in the history of dentistry. It is a material that is relatively easy to use. It lasts a long time in the mouth. And, it's relatively inexpensive. No doubt, it has kept billions of teeth from being lost to decay / cavities. It simply WORKS.

Over the course of dental history, there have been (and are) alternative materials, each with its own advantages and disadvantages: gold, composite (a tooth-colored plastic), and porcelain, as examples.

Today, the most commonly used alternative to amalgam for fillings is composite. Composite is a high-tech plastic that mimics the color of teeth. It is a far more demanding material in terms of the doctor's technique. Done meticulously, though, it performs very well. And, cosmetically, it looks far better. It's disadvantages include: technically challenging to perform, more expensive, and may not last as long. If composite is not placed with technical perfection, it tends to fail catastrophically.

I have not placed a silver / mercury amalgam in over 12 years. I discontinued amalgam in my office for a number of reasons. However, I've never felt it was a significant health hazard. I simply believe composites are a better service.

The primary reason I switched to composite was conservation of natural tooth structure. Since composite bonds to teeth, we don't have to cut away healthy tooth structure to create mechanical locks, as we do with silver amalgam that does not bond to teeth. Amalgam has to be mechanically locked into the tooth. This is done by making the "hole" bigger at the bottom than at the top. So, when the amalgam hardens, it locks in. This requires possibly removing healthy tooth structure to create this mechanical "retention." Composite requires me to only remove decayed structure - or just the cavity. After that, the composite bonds to the remaining healthy tooth firmly without having to create "mechanical retention."

All that said, it's interesting that in many parts of the U.S. it's illegal to dump silver / mercury amalgam waste into the garbage or down the drain. In many places it has to be collected and disposed of as hazardous waste. Dentists have to pay a special service to haul it away for recycling or refining. So, the same government that has been telling us that amalgam is safe for use in our MOUTHS, also is telling us that it's an environmental hazard. It's OK to put it in your mouth, but don't put it in the garbage! Figure out THAT logic!

So, where do we stand? The FDA is reclassifying amalgam. What does that mean? I'm not sure. Click on the link above and see what you think. Not surprisingly, the our illustrious government is rather vague. It may mean that dentists who use it may have to warn their patients about possible hazards. I'm guessing not many will choose it! I suspect this is the first step in banning amalgam.

Do I really believe it's a health hazard? Probably not for most people. No doubt, we get more mercury from our environment than we ever will from dental fillings. The vast majority of electric power comes from coal burning plants in the U.S. And, those plants dump TONS of mercury into our environment every year. Fillings are really insignificant sources of mercury, if any at all.

Do I recommend you have all your silver fillings replaced? No. If an old filling is broken down or has new decay, then yes... go ahead and replace it. However, I have no objection to replacing unsightly silver amalgam fillings with composite or porcelain for cosmetic reasons, as well. But, as it stands now, there is no reason to have all your fillings removed for health reasons. And, you should know that every time we work on a tooth, there are risks, which may include the need for root canal treatment. Larger amalgams may require restoration with a crown.

Stay tuned!

Choosing the Right Dentist

2008-05-31T16:44:00.000-07:00

Nothing Personal Doc, But I Hate Dentists!

What dentist hasn’t heard those words? Many patients may have the thought, even if they don’t actually say the words. Since the dawn of modern time, dentistry has served as a ripe source of frightening imagery for artists and comedic fodder. Despite dramatic changes in dentistry, those images persist in the minds of the public, causing some to delay seeing or completely avoiding the dentist.

Many people are unsure how to choose a dentist or how to make informed decisions regarding their oral health. How do you find Dr. Right? A number of sources exist. You can use the Yellow Pages, a referral service, newspaper or magazine ads, a search of the internet, a referral from a friend or other doctor, or select a name from a dental plan list. Ultimately, it comes down to making sure you are in the right place. Do your homework and follow your instincts. When you call an office for the first time, you might ask for a “get acquainted visit” with the dentist. Can you tour the office and be introduced to the staff?

Your first visit should include a comprehensive examination unless your appointment was to address a specific or urgent concern. You shouldn’t feel rushed and have plenty of time to discuss your questions, treatment options, and financial concerns.

The importance of communicating your fears and any issues of embarrassment and trust is critical in making your dental experience a good one. The following checklist may help you express your concerns with your dentist:

Handle Me With Care

¨ I gag easily.

¨ I feel out of control when I’m lying down in the dental chair.

¨ I have not been to the dentist in a long time, and I feel uncomfortable about what you will say about my teeth and my dental hygiene.

¨ Pain relief is a top priority for me.

¨ I don’t like shots (or I’ve had a bad reaction to shots).

¨ Please tell me what I need to know about my mouth in order to make an informed decision.

¨ My teeth are very sensitive.

¨ I don’t like the sound of that tool that makes the picking and scraping noise. It’s like someone is scratching fingernails on a blackboard.

¨ I don’t like cotton in my mouth.

¨ I hate the noise of the drill.

¨ Please respect my time. I don’t want to be left sitting in the reception area.

¨ I want to know the cost up front. No money surprises please.

¨ I have difficulty listening and remembering what I hear while sitting in the dental chair.

¨ I have health problems and questions that we need to discuss.

Let’s look at making a “Handle Me With Care” pact between you and your dental professionals. This simple statement will make a big difference in how you are treated and how you feel about going to the dentist:

I ask that you honestly inform me about my dental health. I want you to make me aware of the best quality dentistry available today. Then we can discuss how I can make healthy choices that will work within my budget. I also want to know all the pain relief options available to me in your dental office, how each dental procedure will work, and how much of my time will be required.

Taking charge of your dental healthcare is your right. Making the right decisions for yourself doesn’t have to be difficult or confusing. I trust the “Handle Me With Care” checklist and pact can help you in your effort to achieve a healthy and beautiful smile. This article was based on a consumer’s guide to dentistry with the same name as the article (with permission). The book, “Nothing Personal Doc, But I Hate Dentists” written by Dr. Mac Lee has been featured on the Discovery Channel.

Dr. Barr’s practice, Palm Beach Smiles, is located at Boynton Beach Blvd. and I-95. You can contact us by calling 736-2377 or by visiting our website at: http://www.palmbeach-smiles.com/.

Your Own Crown Jewels

2008-05-02T17:45:00.000-07:00

A Dental Crown is something familiar to most people who fit into the baby boomer generation or earlier. Crowns, often referred to as “caps,” have been around almost as long as the modern profession of dentistry itself.

Today, crowns remain a staple in the repertoire of dental services. Crowns effectively restore teeth to virtually new condition in terms of form, function, and appearance. Our teeth perform many very important functions in our daily lives. The obvious task of chewing our food, while taken for granted, is literally a life function. Without good teeth, the first step of digestion is compromised which can negatively affect life-supporting nutrition. As we age, the joy of eating our favorite foods makes a healthy and functional set of teeth of paramount importance. Teeth also play a vital role in communication. The phonetic components of speech are formed by how we shape sound with our tongue and teeth. Furthermore, the non-verbal act of smiling may be the single most communicative expression in human society. Each tooth is indeed a jewel to be treasured, maintained, and if necessary, rejuvenated with a modern crown restoration.

There are a number of reasons dentists recommend crowns for their patients. The most common indications for crowns are to restore teeth that have been significantly broken, cracked, or have large cavities. Teeth that have large fillings, which may be at risk for cracks, are also often suggested to have crowns to prevent them from breaking. Typically, most teeth that have had root canal treatment require a crown for final restoration. Cosmetic improvement remains an indication for crowns, as well. Crowns offer the dentist and patient complete control of the appearance of teeth in terms of shape and color.

Years ago, we had only a couple of choices for crown materials. They included gold or “porcelain fused to metal” (porcelain baked onto a metal substructure). Today, there are dozens of choices, but they can be boiled down to three basic kinds of crowns: gold, porcelain fused to metal, and the state-of-the-art, metal-free, all-porcelain crown. Each has its advantages and ideal indications. Gold is still used, but it is typically reserved for the very back teeth that aren’t seen. Porcelain fused to metal combines the strength of metal with the cosmetic appeal of porcelain. It works very well; however, on front teeth it has the disadvantage of creating what is commonly called “black line syndrome." You may have seen people with crowned teeth that seem to have a dark area at the gum line. Today, we have all-porcelain (also called “all-ceramic”) crowns that are ideal for cosmetically prominent teeth. They offer the beauty of a completely natural appearance and, if done well, are indistinguishable from natural teeth. If a crown is recommended, be sure to ask your dentist which type is best for you.

There are many factors that make for a quality crown. Attention to detail and the dentist’s time spent with you are good indicators. Your crown should look and feel natural. It should fit your bite perfectly and touch the opposing tooth just like your natural teeth come together. It shouldn’t catch or trap food, and should be easy to clean. Floss should go around crowned teeth with a smooth snap and shouldn’t shred on the way in or out. With good home care and regular professional maintenance, your “crown jewels” should last a long time.

For more information and to see before and after photographs of actual cases, visit our website at: http://www.palmbeach-smiles.com/.

Dr. Barr’s practice, Palm Beach Smiles, is located at Boynton Beach Blvd. and I-95. You can contact us at: 561-736-2377.

6 (Six) Month Braces Offered at Palm Beach Smiles!

2008-04-17T13:16:00.000-07:00

I am pleased and excited to announce that we now offer 6 Month Braces for adults.

Are your teeth crooked? Are they crowded? Or do you have spaces? Did you think that the only way to straighten them would be the traditional 2 years of braces? Are you an adult who had braces but didn't wear your retainer?

Now, imagine having your teeth straightened in the time it takes between your cleaning visits! 6 Month Braces may be the answer!

Six Month Braces are exactly as they sound. Braces - done in 6 months. This approach to Cosmetic Braces is designed to improve the alignment of the teeth that show in your smile. This can usually be accomplished in about 6 months.

Here's an example of one of our cases:

6 Month Braces are just like regular braces in that brackets and wires are used. However, it's important to mention that the brackets and wires are white, or tooth-colored. So, they are nearly invisible. Once the braces are put on, you have nothing to do but return for a monthly appointment. SixMonth braces move your teeth quickly and safely. There is typically little to no discomfort. Most patients describe a "tightness" in the beginning.

After your braces are removed, a permanent bonded retainer (on the back of your teeth - totally unseen) will keep them in place. You may want to whiten your teeth at this point to finish off a perfect smile!

And, at Palm Beach Smiles, you won't have to sit next to a bunch of teenagers playing video games while you get your 6 Month Braces. At Palm Beach Smiles, we treat one patient at a time in a spa-like atmosphere. Dr. Michael Barr, founder of Palm Beach Smiles, will make sure your experience is a pleasure. If you have any questions, check out our Six Month Braces FAQ, or give us a call at 561-736-2377.

Fillings: Silver or Plastic – Black or White?

2008-04-16T16:21:00.000-07:00

Most of us have had at least one filling in our life. The majority of readers probably have some silver fillings. Most of them are out of sight and out of mind. But, if we look carefully, we’ll notice that the term, “silver filling” is not descriptive of reality. Those fillings may have looked silver or gray the day they were placed, but they certainly aren’t silver any more. They are usually black!

Silver fillings, also known as “amalgam,” have been a staple of restorative dentistry for over 150 years and have served the public well. Certainly, many teeth would have been lost if we had not had an easy to place, long lasting restorative material like amalgam. But, times have changed and so has dentistry. While there are some groups that believe amalgam, which typically consists of 50% mercury, is a health hazard, there have been no scientific studies supporting those assertions.

Over the years, a number of alternative materials to restore teeth have been developed. Among them are: gold, porcelain, and composite (a high-tech plastic). The most modern material is composite, which is bonded to the tooth. Also known as “adhesive dentistry,” bonding has revolutionized dentistry. Materials like amalgam simply fill a hole in a tooth. After removing decay, dentists have to remove additional healthy tooth structure in order to create mechanical interlocks so the amalgam will stay in the tooth once it has hardened. White composite fillings have a big advantage over silver. It bonds, or sticks, to the tooth very firmly. Accordingly, dentists can be very conservative and limit the “drilling” to only the decay. No additional removal of tooth structure is needed to lock the filling in the cavity. The more of your own natural healthy tooth structure we preserve, the stronger and longer lasting your tooth will be.

Because amalgams are typically larger and don’t bond to the tooth, they can act as a wedge, possibly cracking teeth. Composite, being more conservative and bonded to the tooth, may be kinder, in the long run, to your teeth. A unique advantage of composite is that it seals the cavity better than amalgam. A good seal is important in preventing decay from reoccurring.

While amalgam is a simple material to place, composite requires meticulous attention to detail by the dentist. The technique is quite different. While an amalgam basically fills a hole, a properly done composite essentially rebuilds the damaged or missing tooth structure.

The advantage of composite over amalgam most apparent to patients is the color. Put simply, amalgam is black, and composite is white. Composite comes in a variety of shades that can be matched to the tooth being restored. Done well, a composite restoration disappears and is indistinguishable from natural teeth.

Which filling would you prefer to fix your cavities? Black or white? If you have old black fillings that show when you smile or talk, you may consider replacing them with newer more cosmetically pleasing composites.

As could be expected, composite is not the end-all in dentistry. There are times where the damage to a tooth requires more than a filling. Generally, if a cavity occupies than 1/3 the width of a tooth, a crown may be a better and longer lasting restoration. Your dentist can help you choose the best way to restore and keep your teeth healthy and attractive.

For more information and to see before and after photographs of actual cases, visit our website at: http://www.palmbeach-smiles.com/.

Palm Beach Smiles, is located at Boynton Beach Blvd. and I-95. You can contact us at: 561-736-2377.

Where is my crown from? Does my dental crown have lead in it??

2008-04-12T12:21:00.000-07:00

You may have heard recent news reports about lead in dental crowns made in Chinese labs. Who knew? Who would have thought, right? Most Americans have probably never given any thought to where their dental restorations are being made. Most probably assumed they were made here. And, historically that has been true.

The new global economy is changing everything, and that includes the dental profession... or SOME of the dental profession. Cheap overseas labor and shrinking profit margins have forced some dentists to outsource their lab work to foreign labs. These dentists are typically those who participate in low-fee "managed care" insurance programs such as HMOs or DMOs. When dentist signs a contract with these plans, he or she must agree to the insurance company's fee schedule, which is typically 50% or even LESS than their normal fees. Ultimately, to remain in business, corners MUST be cut if you're reducing your fees by 50% or more. One way to lower expenses is by sending lab work to China where the costs are pennies on the dollar compared to American labs.

The potential problem is quality control. At least in the U.S. there is accountability. If a lab used contaminated or poisonous materials, there would be significant liability. If a lab in China does it, what is the American consumer to do? What recourse can we have with a lab 7,000 miles away? Is there some regulatory body in China whose purpose is to protect American consumers? Of course not. In the U.S., the materials used by dental labs in making dental restorations must meet very strict quality standards.

Here's the bottom line: Ask your dentist where your dental restorations are being made. And, remember the saying, “The bitterness of poor quality is remembered long after the sweetness of low price has faded from memory.” And, in the case of lead-contaminated dental crowns, that poor quality may have negative effects on your health. There are certain things for which you shouldn't shop for the lowest price.

At Palm Beach Smiles, our dental crowns are made only in U.S. labs. Only certified, high-quality materials are used. Palm Beach Smiles is located in Boynton Beach, Florida. We can be reached at 561-736-2377, or visit our website at: http://www.palmbeach-smiles.com/.

The Face Value of a Smile

2008-04-11T04:14:00.000-07:00

“A smile costs nothing but gives much. It enriches those who receive without making poorer those who give. It takes but a moment, but the memory of it sometimes lasts forever. None is so rich or mighty that he cannot get along without it and none is so poor that he cannot be made rich by it. Yet a smile cannot be bought, begged, borrowed, or stolen, for it is something that is of no value to anyone until it is given away. Some people are too tired to give you a smile. Give them one of yours, as none needs a smile so much as he who has no more to give.” -- Believed to be based on the writings of Rabbi Samson Raphael Hirsch

According to the American Society for Aesthetic Plastic Surgery, cosmetic surgical and non-surgical procedures have increased 304% in the last five years. The greatest increases were among non-surgical procedures with the most popular being Botox® injections. Advertisements for “Botox Parties” have been appearing in a variety of media. Recently, there was an hour-long primetime TV show about cosmetic surgery. It featured a woman that had spent $100,000 on cosmetic surgeries because she was told Wall Street wouldn’t hire a woman older than forty. She got the job.

What does this have to do with dentistry? Certainly it's an indicator of the value placed on appearance by our American culture. While our looks are obviously important, I believe a person’s smile is the most prominent physical feature. Many social surveys have indicated that “bad teeth” is a top turn-off for those seeking a mate. The act of smiling may be the single most communicative expression humans possess. Try this: When you approach a stranger in a public area and make eye contact, simply smile. Nothing more. Almost invariably, the stranger will smile back. A few might think you’re crazy! A genuine, relaxed smile makes anyone instantly more attractive. A smile can even disarm the most irritated individual. A smile is powerful.

Today’s dentistry enables highly trained and progressive dentists to transform smiles challenged with unattractive teeth. In many cases it can take as little as two visits. The most significant developments in Cosmetic Dentistry are Porcelain Veneers and all-ceramic crowns (no metal). The advent of these technologies has enabled dentists to create stunning smiles with more conservative procedures. Furthermore, they can create smiles that look natural. I have often heard patients exclaim their objections to “caps” because they’ve seen some on their friends and they “look terrible!” They assume that these “caps” are the standard. And they know they don’t want that look. I don’t blame them. The hallmark of excellent cosmetic dentistry is results that look as if the patient was born with a gorgeous smile. A cosmetically restored smile should be undetectable. Often, after a smile makeover, patients comment that their friends, coworkers, and family suspect weight loss, a new hairstyle, a tan, and even a face-lift! They simply can’t figure out why these patients look so good!

A smile makeover is the ultimate self-indulgence. At Palm Beach Smiles our greatest joy is providing dentistry people want. Our incredible office was designed specifically to create a relaxing atmosphere and cater to our patients’ needs. To learn more about us, visit our website: http://www.palmbeach-smiles.com/. Check out the “Before & After” photos and imagine having your own “Palm Beach Smile!”

Palm Beach Smiles is located at Boynton Beach Blvd. and I-95. You can contact us at: 561-736-2377.

Cosmetic Dentistry - What Is It, Really?

2008-04-10T17:15:00.000-07:00

Plastic surgery is so well known, it now virtually considered routine. Medicine has evolved to perfect our faces, breasts, butts, legs, eyes, and chins. We agonize over how pants fit our butts, how our noses look in profile, and how our chests fill a sweater. Yet, many social studies have shown that the first thing people notice in another person is his or her smile. The most prominent feature on our face is our smile. While most people are aware of the advances of medicine in the field of plastic surgery, most are not aware of how cosmetic dentistry can dramatically impact facial appearance. In my opinion, a smile makeover can have far more impact than even the most dramatic facelift.

A quick perusal of the “Dentists” section of the Yellow Pages would lead you to believe every dentist is a cosmetic dentist. The common and cavalier use of the term, “cosmetic dentistry” has diminished its definition and uniqueness as a specialized skill among dentists. What is cosmetic dentistry, after all? What’s new in cosmetic dentistry? If it’s so common, is it the same, no matter where I go? How do I know where to go for cosmetic dental treatment? I will try to answer some of these questions in this and future articles.

So, what is cosmetic dentistry? It can include a wide range of procedures designed to make a smile whiter, straighter, and more youthful. Individual patient’s needs can range from simply whitening with bleaching products to a complex full smile reconstruction with veneers, crowns and bridges.

Choosing a dentist for cosmetic treatment can be a daunting task. There isn’t a lot of information for consumers in the public domain. It is important to know the qualifications and experience of a cosmetic dentist. To perform cosmetic dentistry at the highest level requires a thorough knowledge of science and an artistic eye. Cosmetic Dentistry is not a degreed specialty like oral surgery or endodontics. However, there are a few cosmetic training institutes recognized by the profession at large. Among the most prestigious are: Aesthetic Advantage, Las Vegas Institute, Nash Institute, and Hornbrook Group. Ask the dentist about this kind of training. Perhaps the best way to evaluate a dentist’s skills in this challenging discipline is to actually see photographs of actual cases. Ask to see examples of treatment you may be considering. Carefully look at the whole smile. Do the results look attractive and natural?

Perhaps the biggest advance in cosmetic dentistry has been Porcelain Veneers. The development of this treatment was a result of the demand for a conservative way to change the color, shape, size and alignment of teeth. Porcelain veneers are more conservative than crowns and are strong and natural restorations. With porcelain veneers, a smile can typically be transformed in just two visits. If you are concerned about discoloration, gaps, worn and chipped teeth, or crooked and crowded teeth, porcelain veneers may be the solution.

Over the past several years, I have spent hundreds of hours in training with a focus on cosmetic and reconstructive dentistry. Besides constantly training, I have helped teach dentists from around the world the art and science of cosmetic dentistry as a clinical instructor with some of the most prestigious cosmetic training institutes in the country.

To learn more about Cosmetic Dentistry visit my website at http://www.palmbeach-smiles.com/ or call my office for a complimentary cosmetic consult at 561-736-2377. We are conveniently located on Boynton Beach Blvd., one block west of I-95.

Welcome to www.PalmBeachSmiles.com

2008-04-10T16:49:00.001-07:00

Welcome to Palm Beach Smiles. I hope readers will find this blog to be informative. I am a dentist who just loves what he does every day. If I won the lottery, I'd still be doing it!

I'll be adding articles on a regular basis that will provide the latest news and views about today's dentistry.

I hope you'll check in on occasion!