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Nov 8

10 Basic Facts Dr. Frazar Wants You to Know About Bleaching!

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1. Vital tooth bleaching is safe. This service has been performed for over 20 years with vital nightguard

bleaching proving to be safe and effective since the late 80’s.

2. Side effects are minimal. Reports of tooth or tissue injury in the literature have been few, and are

mostly limited to pulpal inflammation due to excess heat from older wands and heat lamps, to reversible

and transient tissue burns with higher concentration in-office products. Modern lights are fabricated to

keep pulp temperature rise at a minimum, and properly placed gingival barriers reduce transient tissue

burns. Tooth sensitivity is common, transient, and discussed later.

3. Bleaching is NOT a surface phenomenon. Bleaching teeth occurs through free radical production

from the dissociation of unstable hydrogen peroxide molecule through contact with moisture and heat. It

is NOT a surface “acid” that “eats off stains,” but rather a radical releasing substance that goes

immediately between enamel prisms and into deep dentin and the pulp within seconds of contact. These

radicals seek stabilization by attacking long chain stain/pigments, breaking them up into less dense, less

organized stain molecules. The longer the contact with the stain molecule, and the more radicals available

to continue breaking it down, the lighter the tooth becomes. This is a time and concentration

phenomenon. Regardless of bleaching modality used.

4. Bleaching can last for years. Studies show that because bleaching changes the internal and external

color of the teeth, results can be stable for up to 2 years or longer. Of course this depends on patients

habits such as consumption of chromagenic substances such as tobacco, colas, tea, coffee, red berries

etc…

5. Not all stains are created equal! Extrinsic stains break down first, deeper intrinsic stains take longer.

Yellow/orange stains break down faster, while gray/brown stains take longer. Nearly all teeth will lighten

over time… but diligence and compliance is required. Remember, differing stains can exist in the same

mouth, and variability does exist in terms of efficacy. Inform your patient of this, and let them know that

if they are unwilling to assume the risk of unresponsive teeth, they must chose more invasive, definitive

treatment alternatives such as veneers or crowns.

6. Bleaching is NOT dangerous to enamel. Bleaching does not significantly alter enamel. Minor

alterations to surface smoothness do occur, but through natural remineralization, these changes are

corrected quickly. Professional applications of fluoride may speed this remineralization process.

7. Is bleaching safe for immature teeth? To my knowledge, there have been no reports to indicate that

bleaching harms developing or newly developing teeth in the literature. However, since this has not been

studied well, caution must be exercised when bleaching immature teeth.

8. Bleaching causes transient sensitivity. Folks, this is a fact of life. Temporary tooth sensitivity is

thought to be caused by several factors, including the transient increase of dissociated oxygen in the pulp

of the tooth, and possibly the transient permeability of enamel and root structure, and the dessication that

occurs by placing an anhdydrous formulation on the teeth for long periods of time. Different techniques

and different formulations of product can limit sensitivity. This is why it is important to offer more than

one regimen of bleaching, and that doctors supervise/monitor bleaching progress. 8 8. “Sick” orpreoperatively hypersensitive teeth are not good candidates for bleaching. This is just common sense.

If the patient complains of hypersensitive teeth, it stands to reason that bleaching may not be their favorite

pastime. Explore and treat the hypersensitivity first, then consider bleaching. If the cause is idiopathic,

possibly consider in-office protocols that minimize bleaching times.

9. Never promise a certain shade result to a patient. Bleaching results are highly subjective. Studies

have proven that accurate determination of bleaching success is highly variable. Establish reasonable

expectations with every patient. What seems “white enough” to you or a staff member may not meet your

patient’s goals.

10. Periodic “Touching-Up” may be required. The concept of recurring maintenance exists in nearly

every other aspect of dental care, so why isn’t it embraced with bleaching?

As published by Dr. Jeff Blank in Dental Economics, November 2003

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Oct 31

Counterfeit Toothpaste Across the US, Canada, Other Areas

Category: Uncategorized

Counterfeit Colgate toothpaste was found earlier this year in many discount stores across New York, New Jersey, Pennsylvania, and Maryland, according to a June press release by the FDA. The imitation product does not contain fluoride, but does contain the unlisted ingredient, diethylene glycol (DEG), a chemical used in antifreeze. The label on the toothpaste states that is is “manufactured in South Africa,” and many of the packages have misspelled words. Compare the packaging on the at the Colgate site.

The Gray Blog reported in June that nearly one million tainted and counterfeit toothpaste packages were recalled in Georgia, Florida, North Carolina, and South Carolina. Other effected locations include Puerto Rico, Panama, Dominican Republic, and Australia. The packages state that the products are made in China, and the FDA says that these counterfeits also contain diethylene glycol. In July, Health Canada reported finding high levels of bacteria in counterfeit toothpaste, as well. No related illnesses or deaths have been reported to date.

While this information is no longer “news,” it does raise concerns regarding consumer safety. Knowledge is power, and you can pay a vital role in keeping your patients forewarned. As a dentist, you may want to warn your patients to:

            Read toothpaste labels and consider misspellings a red flag

            Don’t purchase toothpaste made in China or South Africa

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Oct 4

Can’t find a job? Add a Fabulous Smile to Your Resume

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Results of a study conducted by an independent research firm provide new evidence that a beautiful white smile has a direct effect on successful interpersonal interactions, both socially and professionally.  The study shows that a whiter smile substantially affects how others think of you when you first meet.

 

According to the study, which included simulated job interviews, simulated first dates, and a quantitative online survey, more than half of the study participants were more likely to be hired (58%) and receive larger salary offers (53%) after their teeth had been whitened.  I would assume that the same would apply if they had veneers or Invisalign to straighten the teeth.

 

The study also found that evaluators expressed greater interest in continuing their interaction or “date” with more than half of the study participants (54%) after their teeth had been whitened.  Visible from 200 feet, a white smile is the intense focus of what other people look at and a sign of our warmth, confidence, and health.

 

During simulated job interviews, it was found that a majority of the study participants were viewed to be more professional (65%) and more confident (61%) after their teeth had been whitened.  On their simulated first dates, more than half of the study participants were viewed to be more outgoing (59%) after their teeth had been whitened.

 

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Oct 4

www.DentistsforthePlanet.com

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Dr. Kathy Frazar and Dr. Tom Hedge from Cincinnati, have started a “grassroots” effort to have dentist do their part in saving energy and helping out our planet.  At your next dental hygiene visit, you will receive a Compact Fluorescent Bulb instead of a toothbrush.  Dr’s. Frazar and Hedge are encouraging dentist nationwide to join in the effort.

 

There are 120,000 dentists in the United States.  Each has an average of 800 patients.  That would amount to almost a hundred million bulbs with just one check up.

 

If every patient took it home and replaced an incandescent 60 watt bulb, the energy saved would be enough to power a city of 1.5 million people!

 

This would seed an avalanche of people replacing other bulbs.  Once you replace one and see that it provides the same light and with the education that it will last for ten years and use 75% less electricity, it is a no brainer to go out to the hardware store and replace the rest.  The average home has between 50 and 100 sockets!

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May 9

Virtual Smile Consult

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May 8th, 2007  

We are going to try something new in Houston, utilizing new and commonly owned technologies.  If you have a digital camera, a computer, and an internet connection, you are all set.  You can take a few pictures of your smile and e mail it to Dr. Frazar.  She can then give you an idea of what might be possible. 

Here is what you will need to do.  Get your digital camera and set it in Macro Mode.  This is usually a setting with a flower as a symbol.  You will need a helper to take the pictures. It is too hard to take it on yourself. Have the shooter stand about three feet away and zoom in to the corners of the mouth.  Being three feet away allows the flash to diffuse.  Take a straight on smile and one from each side.   

Wash your hands and use your index and middle fingers on each side of your mouth to retract your lips out of the way.  Take two pictures in this position.  Take the first picture biting together and one slightly open so the bottom teeth show.

E-mail this to Dr. Frazar and she will evaluate the possibilities that cosmetic dentistry can offer and e-mail you back.  Label your e-mails as “Smile Consult” and send to info@drfrazar.com.  Please refer to the pictures below for an example:

IMG_1287_small1.jpg  IMG_1288_small1.jpg  IMG_1289_small1.jpg  IMG_1292_small.jpg

This is what happens when you use a flash:

IMG_1290_small.jpg

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May 3

NEW- No Preparation Veneers

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Many people are reluctant to have traditional veneers done because they do not want their own teeth shaved down.  This always involved shots of anesthetic and drilling.  This new technique allows us to make extremely thin and strong veneers that give the patient white straight teeth with no drilling or shots.  The contact lens-like veneers are bonded directly to the tooth in cases where larger teeth are desired for a more ideal arch form.

DSC before.jpg   DSC after.jpg 

AR before_3.jpg  AR after_2_3.jpg

Dr. Frazar is a graduate of The Las Vegas Institute for Advanced Dental Studies. She was featured in H Magazine’s Top Dentists in 2006. Dr. Frazar was also featured in Texas Monthly as a Top Dentist in Texas.

Please feel free to contact me if you are interested in more information.

Aesthetic Dentistry of Houston, Kathy A. Frazar, DDS, P.A.,

4914 Bissonnet, Suite 200, Bellaire, TX 77401

713-668-7137, www.drfrazar.com

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Apr 23

“The Woman without a Face”

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Carolyn Thomas was covered with a sheet at the scene as evidence was being gathered.  Carolyn refused to die. After reaching out and grabbing an officer’s leg, her three year battle began.  A team of six doctors donated their time and expertise to rebuild Carolyn, the woman without a face.

After seven facial reconstructive surgeries, Dr. Kathy Frazar was faced with restoring Carolyn’s upper left maxilla.  She lost teeth #11-15 after tragically being shot to the face.  Her maxilla was reconstructed with a femur and the skin from her leg.  It was a restorative challenge to custom fabricate impression trays that would actually fit into her reconstructed periorbital tissues.  Her lower lip was slid 1/3 up to make a new upper lip, to lower the oral opening.  The second challenge was gingival collar heights on the implants since the intraoral tissue was not similar to the epithelium once in her mouth.  Dr. Frazar was present in the operating room during the implant placement to assist in angulation of the implants.  All facial and intraoral landmarks were missing or in a new location.  She wore a flipper during the healing phase of six months and the final impressions were taken to restore teeth #9-15.  She will be filled with a permanent removable implant supported structure.  She does not have a vestibule and it is almost impossibly to place screw retained prosthetics due to her restricted oral opening.

Carolyn has told her story of violence all over the country and has been featured on Oprah and The Discovery Health Channel.

          “I just wanted to be able to walk down the street and not have people stare at me.  I am speaking on domestic violence all over the country so this will not happen to other women.”

“It is not everyday I can help change someone’s entire life by giving them a smile!”

-Dr. Kathy Frazar

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Apr 17

Nasal spray anesthetic may alleviate the need for needle anesthetic

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Imagine having a tooth repaired painlessly without shots for anesthesia.  Originally, these types of spray anesthetics are used by ear, nose, and throat physicians when operating on the nose. Researcher’s at the University of Buffalo’s school of dental medicine are conducting studies to see if the upper teeth can be anesthetized using a similar spray anesthetic for dental visits.

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Apr 4

Pancreatic Cancer Connected to Periodontal Disease

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Pancreatic cancer is one of the most deadly cancers.  In fact, it is the fourth leading cause of cancer deaths in the United States.

According to Harvard research findings, gum disease may increase the risk of developing this deadly cancer.

Dr. Dominique S. Michaud of Harvard School of Public Health, Boston and his colleagues had analyzed 16 years of data from nearly 52,000 male doctors in the Health Professionals Follow-up Study.  This team is investigating the relationship between lifestyles and cancer.

A total of 216 men who develped pancreatic cancer were studied.  After clearing out factors like smoking, diabetes, obesity, physical activity, diet etc, men with a history of gum disease were found to have a 63-percent higher risk of developing pancreatic cancer as compared to men without periodontal disease.

Two previous studies have already reported positive associations between periodontitis (inflammation of the gums around the teeth) and other chronic diseases.

Periodontal disease may boost the risk of pancreatic cancer through “plausible mechanisms,” Michaud points out.

This type of gum disease results in chronic inflammation (infection) that leads to tooth loss.

People with gum disease harbor high levels of harmful bacteria in their mouths and guts.  These people also tend to have higher amounts of nitrosamines, which have been proposed to increase pancreatic cancer risk.

Although the risk was not as high as those with existing periodontal infections, people who lost teeth also showed an increased risk for pancreatic cancer.

Men who reported a history of peridontal disease and tooth loss in the last four years showed a more than 2.5 fold increase in the risk of developing pancreatic cancer as compared to those who reported no history of periodontal disease.

Pancreatic cancer is one of the most deadly cancers, largely because it escapes detection until it has spread to other parts.  Only about five percent of pancreatic cancer patients survive the first five years after being disagnosed.

More than 30,000 Americans are expected to die from pancreatic cancer this year.

recess4[1].jpg

Gingivitis. Notice the gums are red and swollen

recess6.jpgModerate periodontal disease: notice the accumulation of calculus around the gumline. The gums are red, swollen and tender.recess5.jpg

After non-surgical periodontal therapy (i.e. scaling). The gums have been restored to health. Notice the gums have receded, exposing the root of the tooth. This is due to the irreversible bone loss as a result of previous periodontal disease. This can lead to tooth sensitivity.

recess3.jpg

Advanced periodontal disease: further progression of periodontitis with major loss of bone support. The teeth may lose so much support that they may be loose

Protecting your periodontal health brings many benefits. You can chew with more comfort. You can smile and speak with greater confidence. You can keep dental costs down by preventing further problems. A commitment to maintenance therapy is a commitment to better health. 

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Mar 28

Dr. Frazar achieves VIP Status with Invisalign

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Dr. Frazar has achieved VIP classification with Invisalign.  That entitles Dr. Frazar to receive a “Clincheck”, 3-D image, of all stages of the patients’ treatment to be reviewed and approved by our patients before any monies are collected.  Our patients love this process and are able to see and get excited about treatment before they even begin.  If you are interested in a Invisalign consultation, please call our office today.  713-668-7137

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