Category Archives: Patient Education

Choosing the Wrong Doctor was a Painful Mistake

In March 2013, I came down with flu-like symptoms. I was weak, and my stomach was bloated and acidy. I thought it would pass, but instead it worsened. I called a colleague for a physician referral, but was directed to a different physician who, after an exam, said I needed a CAT scan costing several thousand dollars.

I asked, “No simple tests, no antibiotics, just go directly to the CAT scan?” I thoroughly researched symptoms, tests, and potential cures. An expensive CAT scan wasn’t mentioned. When I refused, he prescribed an antacid, but for only half the recommended dose. After I reported no improvement, the doctor once again told me I needed a CAT scan. Instead, I gave up on the physician at Penn Medicine and obtained antibiotics as suggested by the latest research—which worked.

The physician, one of hundreds at Penn Medicine, failed to properly diagnose my condition and caused a great deal of unnecessary suffering. As patient care is more and more driven by profit instead of medical science, finding a good, trustworthy doctor becomes more like winning the lottery. Penn Medicine provides the facilities and a certain reputation—but in the end, it is individual doctors who provide the care.

Does that mean all physicians at branded health centers are bad? Of course not. Penn Medicine and others have many fine clinicians and great facilities. But there are no guarantees. I was lucky. I understood what was going on. But unsuspecting patients are frequently talked into procedures they don’t need, or denied insurance benefits they’re entitled to.

The same things are happening in dentistry. Business minded people are bringing wholesale changes to dental care that aim for profit above all. Dental patients are having a harder time finding trustworthy dentists, while insurance companies invent new ways to deny claims. Both increase profits at the expense of patient care.

I was able to draw my own conclusions and obtain a more effective, much less expensive treatment. However, most people don’t have a background in dentistry. If you’re not a dental professional, you’ll need help to know where to look.

This website is full of information about what to look for—and what to look out for. Once you’ve done some reading, you can search for a dentist in your area who has agreed to our Code of Ethics. One of our most important tenets is that the dentists in our network won’t try to up-sell you. There will be no unnecessary, expensive procedures. A doctor living by the Opt-In Code of Ethics will only recommend services that will actually help you.

Every doctor-patient relationship should be based on mutual trust. Don’t be fooled by big brands and shiny buildings. They provide the facilities, but they don’t provide care. How you are actually cared for is the job of your doctor. Search the internet, talk to friends and relatives, and don’t be shuffled to someone you don’t know. And read our Code of Ethics before selecting a dentist.

Stop Smoking, Lose Pounds, Get Healthy

Many people smoke to keep their weight down without realizing everything else that is happening to them.  We have all heard about how bad smoking can be for our general health. But, many don’t know how bad it can be for oral health. Smoking not only stains teeth brown and yellow, it also increases gum disease, decay, and tooth loss, and even a deadly form of oral cancer. That means smoking can be more expensive than just a pack of cigarettes.

The CDC reported in 2014 that about 20% of the US population smokes tobacco, causing over 480,000 premature deaths, annually, from cancer, diseases of the heart, lungs, and other related diseases. A known fact is many people won’t quit smoking out of fear of gaining weight. Interestingly, Kruger et al reported in 2005 that obesity from poor diets and lack of exercise is the second leading cause of premature death. So, how do we address all the health issues from smoking without adding the problems associated with weight gain?

The Role of Nicotine

In the 1930’s, cigarette companies began promoting smoking as a way to avoid weight gain. According to research conducted by Lycett and others, tobacco industry suggestions were reinforced by the fact that “approximately 10% of smokers who quit smoking gain close to 30 pounds in weight.” As it turns out, there are good reasons why body weight goes up when people quit smoking. Nicotine initiates the release of chemicals in the brain and central nervous system that decreases hunger and increases metabolism rates. When acting like a diet drug, nicotine also initiates the actions of other chemicals that together, destroy fat cells. Hofstetter reported  that “nicotine increases 24-h energy expenditure by ~10%.” Other deleterious effects of nicotine include “insulin resistance” (diabetic complications) and resistance to inflammation (injury and infection control), as reported by Benowitz, and also reported by Miyazaki.

Controlling Body Weight

When people stop smoking, the effects of nicotine on metabolism (faster) and appetite (decreased), reverses, resulting in weight gain from caloric increase, if there is no balancing increase in exercise. Those seeking support to overcome these problems find only mixed results. McGovern and Benowits reported in 2011, “One group of smokers received standard smoking-cessation counseling, a second group received this counseling plus diet advice to prevent weight gain (that is, weight control), and a third group received the standard smoking-cessation program plus counseling to reduce their concerns about gaining weight.” They found that after 1 year, those who focused on “reducing concerns about weight gain, rather than controlling weight gain itself” had more success with weight control.

Many prefer to take a pill for a quick fix. Unfortunately, as reported by Kenny, “…these medications appear to delay, rather than prevent, post-cessation weight gain.” In fact, their findings indicate that after medications have run their course, weight returns as if no medications had been taken.

Do it Now

As we all know, smoking can lead to a lot of problems, including reports of chronic disease inflammation, constricted arteries, increased blood clotting, cancer, and complications from diabetes. We also know it causes many problems in our mouths that can lead to tooth loss and oral disease. Quitting smoking has always proven difficult. But with the right help, and a personal commitment, our overall health, our oral health, and our general appearance will be improved and extended for many additional years.

Photo from the Quit Smoking Community

Live Longer Through Proper Oral Health Care

Did you know that not cleaning your teeth could lead to death? Italian researchers reported in 2009 that moderately inflamed gums caused narrowing of the carotid artery that leads to the brain. They also found that after teeth cleaning the inflammation disappeared and the carotid artery returned to normal. This is important because, if allowed to continue, narrowing of the carotid artery can lead to devastating cardiovascular disease, such as stroke and even death. The fact is, oral health is related to our broader, general health, and associated with many other diseases.

Connection Between Oral Health and Disease

According to the Mayo Clinic, our oral health can affect, be affected by, or be associated with a variety of diseases, including, heart disease, diabetes, HIV/AIDS, osteoporosis, Alzheimer’s, Sjorgen’s, and even premature and low weight births.

One of the lesser known links is respiratory disease that affects the lungs and other parts that help us breath. These diseases can include a head cold, pneumonia, and COPD (chronic obstructive pulmonary disease), which sometimes lead to death. Pneumonia can be caused by oral fluids infested with bacteria that the body fails to control. According to Weidlich and her team of researchers who studied 19 reports, “…there is fair evidence of an association of pneumonia with oral health…” They went on to report “…that improved oral hygiene and professional oral health care reduces the progression or occurrence of respiratory diseases among high-risk elderly adults. A recent prospective study conducted with 697 elderly individuals observed that the adjusted mortality due to pneumonia was 3.9 times higher in subjects with periodontal (gum) disease.”

Diabetes, a disease of insulin deficiency, is another well known disease with close ties to poor oral hygiene and gum disease. The disease elevates sugar levels in blood and oral secretions. The excess sugar increases bacterial plaque that can lead to gum disease, a problem affecting 75% of adult populations. Diabetes is a disease that makes oral conditions worse, which then makes life for the diabetic patient harder than it needs to be. If allowed to fester, deteriorating gums and a weakened immune system from diabetes will hasten the arrival and danger of other diseases.

Treating and Preventing Periodontal Gum Disease

The good news is gum disease is very treatable and preventable. In the International Journal of Preventive Medicine, September, 2013, Dr. M. Gulati referred to our mouths as “ ‘the gateway of the body,’ periodontal disease – ‘a silent disease’ and periopathogens – ‘termites’.” To stop the disease we need to eliminate the “termites,” the bacteria in our mouths cause all the problems. The best way to accomplish both is to first, understand the proper way to clean and floss our teeth, use the right kind of toothbrush, or even better, an electric toothbrush, and visit the dentist on a regular basis for teeth cleaning. Most importantly, if your dentist finds a gum infection beginning, or an infection that has established itself, take care of it right away. It could add years to your life. If you need help finding a dentist near you, please visit our Find a Dentist page.

Published by Dentistry IQ: Survey reveals nearly half of all patients consider visiting their dentist a “necessary evil”

Dentistry IQ Article: February 4, 2016

One out of three Americans admits to being nervous about seeing their dentist, and nearly half consider dental visits a “necessary evil,” according to the results of an online survey conducted by Harris Poll on behalf of OPT-In Dental Advantage released Feb. 3. The survey found that misconceptions about dental visits persist among a significant portion of Americans.

The survey of more than 2,000 adults also revealed that older patients tend to have more negative perceptions of dental visits than their younger counterparts, and nearly one in five of those polled lack certainty about their personal dental health. Only a meager 18% said they actually “look forward” to time in the dental chair.

One out of three Americans admits to being nervous about seeing their dentist, and nearly half consider dental visits a “necessary evil,” according to the results of an online survey conducted by Harris Poll on behalf of OPT-In Dental Advantage released Feb. 3. The survey found that misconceptions about dental visits persist among a significant portion of Americans.

The survey of more than 2,000 adults also revealed that older patients tend to have more negative perceptions of dental visits than their younger counterparts, and nearly one in five of those polled lack certainty about their personal dental health. Only a meager 18% said they actually “look forward” to time in the dental chair.

“Despite considerable advancements in preventive care and technology, making dentistry easier and more comfortable than ever before, dental patients still have real concerns about dental visits,” said Dr. Dean Mersky, OPT-In Dental Advantage founder and president.

How can dentists work to change this misconception, which in turn will help their patients relax, and hopefully encourage them to visit their dentist more often?

“As dentists, we tend to focus on the science, the technical and the art of delivering dental care,” Dr. Mersky explained. “We sometimes forget the human side of what we do, the part that cares for our patients’ emotions. There are generally three emotions driving apprehension—the unknown, past experiences, and the natural tendency to avoid perceived danger near our heads. The best thing we dentists can do to help alleviate these emotions is to take the time to understand which are at play, to what extent, and why.”

To help with this effort, OPT-In is launching a dental education campaign, Speaking The Tooth, focused on dispelling patients’ fears by sharing free and accessible information about everything from the reality of how dental insurance works to what patients should ask their dentist at every check-up. Dentists are encouraged to share this information with their patients, empowering both patients and dentists to communicate more openly and effectively, a primary goal of OPT-In.

“Patients are constantly assessing, trying to determine whether they like us and want to return,” Dr. Mersky said. “If they like us, they might refer others. We need to help our patients notice and understand the positives in our offices. We need to make them feel welcome and comfortable in the office environment. Then we need to provide them with focused, quality time to ask questions without interruption. During those discussions, we can allay misgivings and help them understand the advantages of the care we provide. Taking the time to show real interest in patients is the surest way to bridge gaps and build trust.”

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Which Toothpaste is Safest to Use?

What we don’t know about toothpaste could ruin our teeth. If we want to prevent that, we need to read the labels that describe what is in the toothpaste and understand their meaning.

Toothpaste always seems to make our mouths feel clean and refreshed. That’s because of the mint-like flavoring and the foaming nature of most brands. Unfortunately, while the minty flavor and foaming make us feel better, they have nothing to do with cleaning our teeth. The actual cleaning comes from abrasive particles and/or chemical agents. But, abrasiveness can be bad for our teeth, and not all chemical agents work the same.

How Whitening Toothpastes Work

Whitening toothpastes often rely on whitening chemicals, but can also include abrasive particles to clean our teeth. Research shows that chemicals called enzymes slightly “reduced the naturally occurring stains more efficiently than the abrasive paste …” That’s because the abrasive particles remove plaque that is stained, but they won’t whiten enamel, especially in areas difficult for toothbrush bristles to reach.

According to the same research, some whitening toothpastes that are highly abrasive should not be used for more than 4 weeks. Doing so could scrape enamel and damage your teeth. Those low in abrasiveness that contain sodium bicarbonate will remove “considerably more tooth stain” than regular toothpaste, but only after 4 to 6 weeks.

Whitening toothpastes that rely more on enzymes (such as Papain or Bemoelain), destroy the tooth film where bacteria and stain accumulate. Papain, a papaya extract, is reported to have healing properties that reduce inflammation and is kind to enamel because it is non acidic. These are the best properties for whitening sensitive teeth. Additionally, whitening toothpastes with enzymes are reported to have a longer whitening effect after 2 months than those that rely on abrasives, alone, for whitening.

Does Fluoride Toothpaste Help Sensitivity?

Carbonated drinks and fruit juices are naturally acidic and will make sensitive teeth worse. According to research, rinsing with different kinds of fluoride can reduce tooth erosion from acids and abrasives, and reduce sensitivity. Rinsing with stannous fluoride or titanium fluoride had the best results, while sodium fluoride was far less positive.

The best way to minimize sensitivity is to avoid acids, of which carbonated drinks are high on the list. If you are having acids, make sure you use low abrasive toothpaste and brush not sooner than several hours after having consumed acidic substances. As for which toothpaste works best in reducing sensitivity, one research report indicated Colgate Sensitive Pro-Relief was more effective than Sensodyne Rapid Relief.

Can Fluoride in Toothpaste Prevent Cavities?

Yes, but not the same for everyone, and in every location. Fluoride must accumulate to prevent cavities because its concentration is normally low. That means, for the best results, we need fluoridated drinking water (which varies by location) along with fluoride toothpaste. Those who are cavity prone or have very sensitive teeth might need their dental professional to apply and/or prescribe stronger fluoride gels or rinses.

HELP! I Have a Toothache!

Why do teeth hurt?  

Teeth are alive. They have nerves, blood vessels, and ligaments like other areas of the body. They can become infected, suffer a sprain, fracture or break, and, they can become sensitive to changes in temperature. While some problems need the attention of your dentist, other problems might go away on their own.

Hurts only when I chew

Teeth are suspended in your jaw bone by ligaments. Those ligaments can be accidentally over-stretched and sprained, just like an ankle. When that happens, giving it rest by not chewing on it often makes the pain go away in about a week. But, if it doesn’t go away, it might need to be examined by your dentist, who can determine if there is a fracture or maybe a bite alignment problem.

Tooth hurts all the time

When this happens, you definitely need the professional opinion of your dentist. But don’t automatically think the worst. Sometimes, a sprain can continue until a slight adjustment is made. However, continued pain could be the sign of infection or deep fracture in the tooth that sometimes is not salvageable.

Another source is bacteria caused deep decay or tooth infection. The normal remedy for this can be removing the decay, and the area of infection. If the infection is too deep, it might require cleaning the interior of the tooth, a procedure called root canal therapy.

Painful infection can also be found in the gums surrounding a tooth. This happens when food particles attracting bacteria remain trapped, deep in the gums. The inflammation that follows will cause redness to your gums, and sometimes bleeding in the area. With time, the infection will destroy the bone and could cause tooth loss.

Tooth hurts certain times of day

These problems can be mysteries, because tooth pain is not always a tooth problem. Referred pain occurs when a problem in one part of the body is felt in another part. In the mouth, jaw problems might be felt in your teeth. Also, sinus problems will sometimes feel like a toothache. Your dentist will do an exam, maybe take some x-rays, and be able to tell you what is happening and how to fix it.

My tooth is sensitive to cold, but not really a toothache

Thousands of people have this problem. It happens when the enamel protecting the nerves of the tooth is rubbed too thin, or is partially missing. The uncovered inner tooth exposes raw nerve endings to extreme temperature changes that can make a tooth momentarily sensitive and uncomfortable. Your dentist will check these areas and suggest a solution, which might involve covering the areas or, applying a protective gel. But, it also might include changing to less abrasive toothpaste.

Can I have a bad tooth without pain?

Yes, and this happens often. A tooth can have deep decay, or even a bad infection with no symptoms. These can only be discovered by your dentist during an exam.


Sometimes a painful tooth will get better on its own. Too often, however, an achy tooth will only get worse if not addressed. The best thing to do whenever you have a tooth bothering you is, visit your dentist. They can help eliminate the problem, and make you feel better in the process.

If needed, please use our website to find a dentist near you today!


Which Tooth Brush Should I Us? Does it Matter?

Which Tooth Brush Should I Use

Plaque around the gums can cause bad breath, infection, and ultimately, lead to tooth loss. However, the precursor of plaque begins to form almost immediately after we brush our teeth. The pre cursor, called, pellicle, is a natural occurring protective layer. But, if allowed to collect debris and bacteria, it will eventually form, plaque, the bad coating we try to remove when we brush and floss our teeth. That’s why most dentists and hygienists recommend brushing for two to three minutes, twice daily.

Manual Toothbrushes

Using a toothbrush the wrong way with the wrong toothpaste can saw your teeth in half and cause gum recession. With enough damage, your teeth can become brittle and break.

Toothbrush bristles can be soft, medium or, stiff, can have rounded or jagged tips, and have straight or irregular bristle rows. Dentists generally agree with research that shows hard bristles are better at removing plaque but sometimes disagree on other factors about stiffness. According to research, anything abrasive to your teeth, like using “gritty” toothpaste, can be damaging. Consequently, it is better to use non abrasive toothpaste. You will also want to ask your dental team the best way to brush without causing damage.

Cheap toothbrushes very often have jagged, blade-like, tips that can cut the gums (Research) and lead to inflammation and infection. You always want to use a toothbrush with rounded tips, like the one in the photo from SuperSmile. Designed by a dentist, Dr. Irwin Smigel, it has medium stiffness and very nicely rounded bristle tips.

Most toothbrushes have straight rows and flat alignment to their bristles. Some have bristles angled in different directions. The tooth brush in the photo has an arc shape to the bristles that when angled 45°, allows only bristle tips to contact the teeth when brushing correctly. The center row of bristles at the peak of the arc can more easily access the hard to reach areas of the gums. But, some toothbrush manufactures have designed their bristles to angle in different directions, promising to be more effective. However, research shows those tested with multi angled bristle rows perform no better than those with straight rows. Make sure to ask your dental team for a toothbrush recommendation. They have seen the results and will know best.


Power Toothbrushes

Most research tells us that power tooth brushes, with hundreds of movements per use, clean our teeth better than manual toothbrushes. That’s important because, the longer plaque stays, the faster it grows. Using a power toothbrush has been shown by research to be much more predictable at removing plaque than is a manual toothbrush.

Many dental professionals recommend power toothbrushes, but which power toothbrush works best? According to at least one report, the oscillating type is better at removing plaque after both 4 and 12 weeks, than a purely sonic type. However, because the findings were only observations, not real research, the authors ultimately reported that both power toothbrushes were superior to manual toothbrushes. It’s best to ask your dentist about their experience and recommendation.



Most importantly, we need to brush twice per day for at least 2 minutes with non abrasive tooth paste. And, if possible, we should try to use a power toothbrush with the same non abrasive toothpaste.

In all cases, it is equally important to floss and brush correctly, techniques your dentist or dental hygienist can show you. A great time to review these techniques is during your teeth cleaning, which for most people, should be twice each year.

When Should I Have My Wisdom Teeth Removed?

Wisdom teeth, or 3rd molars, are the teeth furthest back in the mouth. They typically begin to emerge in early adulthood, between the ages of 17 and 25. These teeth are an evolutionary holdover from a time when humans had larger jaws and needed more molars to efficiently grind plant matter. As human mouths became smaller and dental care improved, wisdom teeth became increasingly problematic. Wisdom tooth removal is a common dental practice to treat or prevent issues from occurring.

If your dentist has recommended that you have your wisdom teeth removed, you might be wondering if it’s really necessary. It is important to understand why your dentist is recommending your wisdom teeth be removed, so you can make the right decision for your oral health.

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How to tell if your dentist is independent or part of a chain

How to tell if your dentist

More and more these days, the dental office you go to may not be independently owned. While that’s not an issue for some, others have expressed concerns that a dentist employed by a corporate chain might be subject to management’s decisions for pricing and procedures.

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How to Find Quality Dental Care After a Move

Moving to a new area is almost always a stressful experience. It’s also an experience filled with a long to-do list: unpacking, redecorating, contacting service providers, and learning all you need to know about your new community.

Included in that list is finding a new dentist. If you’ve had the same trusted dentist for years, the idea of finding a new one may seem daunting.

To make the process a bit simpler, we’ve put together the following list of tips. We hope they’ll be a help as you look for a new dentist you can trust and feel comfortable with.

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