Shopping for Dental Insurance?

Has a change in plans found you shopping for dental insurance? If you are shopping for a dental plan, here are a few things we suggest you consider:

  • Networks. Will the plan allow you to see an in-network or out-of-network provider? Is there any difference in the coverage for visits at an in- or out-of-network provider?
  • Maximum Annual Benefit. How much will the plan pay per year? Is it based on a calendar year (January through December) or benefit year (July through June or ???)
  • Deductibles & Co-Pays. Most plans will require you to pay a deductible for certain categories of treatment before the plan’s benefit applies. Does that deductible apply to preventative and diagnostic services (checkups and cleanings?)
  • Waiting periods or other exclusions. Some plans require you be covered for a period of six to twelve months before basic and/or major restorative treatments are covered. Some plans may waive part or all of the waiting period if you are moving from another plan within a certain period of time. Similarly, some services may not be covered at all – such as implants or bonegrafts. Most plans have frequency limitations on nearly all services.
  • “Cleanings”. If you have a history of periodontal disease and need “periodontal maintenance” (vs “regular / prophy”) cleanings, make sure you understand whether the periodontal maintenance will be covered and, if so, whether it is covered as “preventative” or another category which may require a deductible and/or copay.
  • Where to look. Our office is “in network” with Delta Dental as Premier and PPO providers.
    – Moda/ODS
    ⋅ Several Delta Dental individual plans with different network / deductible / copay options
    ⋅ Waiting periods may be waived
    ⋅ Does not cover implant services
    ⋅ Go to https://www.modahealth.com/plans/individual/dental.shtml
    – AARP
    ⋅ Members may be eligible to enroll in an AARP plan through Delta Dental.
    ⋅ Several plans with different network / deductible / copay options
    ⋅ Implants are covered with certain limitations and exceptions
    ⋅ Go to www.aarpdental.com/coverage
     – Oregon Health Plan
    ⋅ Screening questions to see if you qualify
    ⋅ Apply online or download and print the application
    ⋅ Find community partners who can help you apply
    ⋅ Go to www.oregon.gov/oha/HSD/OHP/Pages/Apply.aspx
  • No Insurance? No problem!
    – We accept Visa, MasterCard, Discover, AmericanExpress, and CareCredit
    – 10% senior discount on all services for patients ages 63+ who do not have insurance.
    – 7% cash discount for non-insured patients when services total $250 or more and are paid in full with cash or check at the time of service.

If you have additional questions, our friendly Front Office staff is happy to help!

Toothpaste: What’s on YOUR brush?

mcrobeadsYou may have seen news reports lately about micro beads, and how they may be harmful to our environment.

Micro beads are tiny bits of polyethylene plastic now used in all kinds of personal products – including facial cleaners and toothpaste. The marketing message is that these beads act as “scrubbers” to better exfoliate your skin or whiten your teeth.

They may work well in skin products. In tooth paste, the jury is still out on what the benefits might be – and there have been a few reports about micro beads getting stuck in the crevices between the teeth and gums.

The environmental problems with micro beads are:

1.)  They don’t break down or dissolve.
2.)  They tend to soak up toxins like a sponge.
3.)  They are, well, micro. After washing down the drain, the little plastic bits are so small they tend to slip through most water treatment plants and end up in our waterways.

Once in the water, they look a lot like fish food. An increasing body of scientific evidence suggests that fish are eating them, which can pass the toxins on to humans and wildlife.

We don’t need little bits of plastic in our toothpaste. Check out the label – ingredients called “poly-“ anything are likely plastic-related.

Is toothpaste even necessary?

It’s actually the mechanical action of brushing that does all the work of cleaning teeth. And baking soda is a perfectly good – and cheap – alternative to toothpaste. But it doesn’t taste good, and it isn’t fun to use.

Some toothpaste additives are environmentally safe and can be helpful, including some that:

  • Contain fluoride to help prevent cavities
  • Help counter sensitivity
  • Work to help reduce plaque build up
  • Whiten teeth
  • Freshen breath

Your dentist can answer your questions and make a recommend about what might be beneficial for you. One of the biggest benefits of toothpaste is that it helps get people to brush their teeth. And that is a very good thing.

 

 

 

Baby Boomers: Get your dental care now!

kayakerJan

My aunt doesn’t mind being a baby boomer at all. What she does mind are the increasing references (nearly everywhere) to aging baby boomers.

So we’ll go lightly here, and simply say:

Dear Auntie,

As you and your friends are approaching the vibrant, meaningful and action-packed years ahead, here’s something to add to your pre-retirement checklist:

Be sure to get your teeth and gums into the best shape possible while you still have dental insurance.

Many people approaching retirement are thinking about their 401Ks and social security. Not as many are thinking about getting that crown they’ve been putting off or doing everything they can to prevent gum disease.

But when Bankrate.com – which reports on investments and financial planning issues – put together its “Five Things to Do Before You Retire” list, #1 on that list was: Get dental care.

That’s because most people lose their dental benefits when they retire, and Medicare doesn’t help when it comes to dental care. I know you and your cohorts are thinking about all this, at least a little. WellPoint did a survey last year that showed that more than 60% of people contemplating retirement are concerned about how their dental coverage will change.

Fortunately, affordable plans are out there for people in their quickly-approaching vibrant, meaningful and action-packed years. AARP has a partnership with Delta Dental to provide reasonable priced dental plan coverage for its members. Before you retire, you should definitely look into what your options might be.

In the meantime, I’d like to encourage you to get all the dental work you need done – including those two crowns you and your dentist have been keeping an eye on. Consider that zirconia crowns last practically forever! I recently made one for my dad, and I imagine it will last his lifetime.

Once you do retire, regular dental visits will be as important as ever. Teeth inevitably wear down over time, which can lead to thin, weak, or compromised tooth structure. For people with strong jaws, worn down teeth can also cause trouble in the jaw joints (TMJs).

Old restorations break down too, and new cavities or other problems are likely to occur if regular professional care isn’t maintained. And receding gums can cause sensitivity and make you more susceptible to cavities below the gum line.

Often times you spend LESS on regular dental visits and cleanings than you might spend if you only go to the dentist for emergency treatment or when a tooth breaks.

So try to identify and address your dental problems early before they become bigger, more involved issues.

For now, keep smiling – and talk to your dentist about how to maintain your beautiful smile for a long, long time.

Love from your niece,
Dr. Megan

What’s so wise about wisdom teeth?

We’ve had several young people in our office this past summer to have their wisdom teeth evaluated and sometimes removed. Wisdom teeth are the third set of molars furthest back in your mouth and are the last teeth to develop and erupt, often around the ages of 18-25. They were given the term “teeth of wisdom” back in the 17th century because these teeth erupted during mid-adulthood, or the “Age of Wisdom.”

wisdom teeth

Our early ancestors used these teeth more often for a few reasons:

1) they often lost adult teeth early due to decay, infection, or fractures, and these extra molars filled in the empty spaces in the back of the mouth and

2) they often had broader jaws, and these “extra” teeth helped them grind down much coarser and tougher foods than we have today.

These days, teenagers and people in their early 20s are rarely called “wise” – but wisdom teeth still come in, whether we have room for them or not!

While nearly 35 percent of the population never develops these teeth, most of us still do – in jaws that are no longer wide enough to accommodate them. Many people need to have their wisdom teeth removed. Here’s why:

  • Wisdom teeth are commonly impacted, meaning they haven’t had room to erupt normally into the mouth and instead grow at an angle under the gums, sometimes staying trapped (impacted) in the jawbone. Some grow sideways in the jaw, crowding and damaging the teeth next to them.
  • Many wisdom teeth grow partway out of the gums, creating hard-to-clean areas that are highly susceptible to bacteria. Increased bacteria in these areas often causes pain, and can lead to a host of more serious problems, including inflammation, infection, tooth decay, and gum disease.
  • Because wisdom teeth are so far back in the mouth, it can be difficult to keep these teeth clean and healthy, even if they have erupted normally and fully into the mouth. If these teeth develop cavities or gum disease, it is often better to remove them before they begin to cause problems for the neighboring molars.

In our practice, we recommend that wisdom teeth be evaluated during the mid-to late teen years. We often take a panoramic x-ray to better visualize these teeth in the jaw. Not all wisdom teeth need to be removed. But if problems are noticed, we often recommend that the teeth are removed before the roots have fully developed for easier extraction.

With wisdom teeth that are fully grown into the mouth, we can often pull them quite simply in our office with minimal cost and minimal difficulty. If a tooth is impacted, we usually refer the patient to be evaluated and treated by an oral surgeon. In some situations, tissue or bone are also removed in order to access and remove the tooth.

Some surgeons offer higher levels of sedation to keep patients comfortable during more complicated procedures. If we recommend that you or your child see an oral surgeon, we’ll help you understand what to expect, and we’re happy to answer any questions you might have prior to your visit to the surgeon.

If you are aware of some pesky wisdom teeth that may need to be removed, give us a call. For your teenagers, it’s not too early to book time for those extractions to be done during a school break like Thanksgiving or Christmas.

Allow for a few days to recover after wisdom teeth are taken out, and pay close attention to the doctor’s orders about post-operative precautions, like what kinds of food to avoid and how to take any recommended medications!

The wisest move is to have these teeth checked before they cause any problems!

 

 

 

 

 

 

 

 

 

 

Does red wine prevent cavities?

Wine glass photoAh, red wine. A glass an hour or more before bedtime can help you sleep. When properly paired with food, it can enhance the flavor of the meal. Along with dark chocolate, it is credited with helping to prevent heart disease.

And now… drum roll… a recent study has suggested that red wine may help prevent cavities.

A widely reported study, published recently in the Journal of Agriculture and Food Chemistry, suggests that red wine inhibits the growth of certain bacteria found in oral biofilm.

The plaque that forms on our teeth is a type of biofilm. It causes tooth decay and periodontal disease – which is why we brush our teeth to remove it. So drinking wine to kill the bacteria in plaque seems like a good idea, right?

Maybe. Chemical research does not easily break down into media snippets. This study looked at chlorhexidine gluconate, Streptococcus mutans, Fusobacterium nucleatum, Streptococcus oralis, Actinomyces oris and Veillonella dispar. I remember some of these from dental school, but I bet in your house they are not common terms.

The results were actually conflicting, but the suggestion that some properties of red wine might be beneficial to oral health was a notion the media could grasp, and eagerly pass on.

Little mention was made of the experimental conditions that would have you holding the wine in your mouth for two minutes every seven hours for seven days. To my way of thinking, that’s not the best way to enjoy a fine glass of wine.

To maintain oral health, Nevills Family Dentistry recommends that you:

  • Brush your teeth at least twice a day
  • Clean between your teeth once a day
  • Eat a healthy diet and limit snacks
  • Visit your dentist regularly

We have recommendations regarding red wine as well. Try having a glass of wine:

  • With a really good meal – steak is my personal favorite
  • At one of the many great wineries in our area
  • A few hours before bedtime, if you think it may help you sleep

And, since red wine can actually stain your teeth, don’t forget to brush before you go to bed!

Zirconia crowns: amazingly durable

diamond NIn Don Quixote, Cervantes claims that “A tooth is more to be prized than a diamond.” If he was writing today, he might add: But when you need a crown on a tooth, consider zirconia.

When it comes to jewelry, cubic zirconia is a durable – and beautiful – substitute for diamonds.

When it comes to creating a crown for your tooth, zirconia is a durable – and beautiful – substitute for just about any other dental material. It’s what we use now for the vast majority of crowns for our patients.

A dental crown is essentially a covering useful for protecting a weak or damaged tooth, supporting a large filling, holding a dental bridge in place or surrounding a dental implant.

No matter what material we use to make a crown, the procedure for installing one is pretty much the same.

First, we reshape the tooth by trimming away part of the tooth structure. We then make a mold with dental putty to guide the construction of the crown, and put on a temporary crown for about 10 days until the permanent one is ready. On the next visit, we place the new crown to make sure it fits, and then cement it to the base tooth structure with dental adhesive.

Crowns can be made out of a variety of materials – from stainless steel to gold. Until recently, most of the crowns we had made in our office were porcelain fused to metal. These are very strong, and the color easily matched the adjacent teeth.

Now, however, almost all of the crowns we have made are zirconia, because they:
• Preserve more of the existing tooth
• Are stronger and more durable
• Fit in place as well or better
• Last longer than most of us will
• Can be made more quickly so the turnaround time is faster

Zirconia crowns also blend in well with the color of other teeth. Dr. Megan made one for Dr. Dave and I’m quite sure you wouldn’t be able to tell the difference. And you can also fuse porcelain onto Zirconia on a front tooth for added cosmetic advantages. (Porcelain reflects the light a little better on front teeth and thus appears more natural.

At your next appointment, visit with the dentists and see if Zirconia crowns might be a good treatment option for you.

To floss or not to floss?

C

Actually, the question usually is :  How often do you floss?  And the answer, if we’re honest with ourselves and our dentist, actually is:  Not very often.

Less than half of us floss every day, and around 20 percent of Americans don’t floss at all.  After 30 years in dentistry, I’m starting to wonder:  Is flossing really necessary?

Research on the topic does not support the long-time advice for flossing  twice a day. Authors of an article published in the Journal of Dental Research, for example, did a systematic review of several research studies on the relationship between flossing and the prevention of cavities.

Only one research project – in which children had their teeth flossed by dental professionals every day for nearly two years – showed a dramatic decrease in the risk of cavities.  But no one I know has this done.

“Self-performed” flossing – which is what the rest of us (sometimes) do — has not been proven to reduce the risk of cavities. Does that mean we’re off the hook for doing anything besides brushing our teeth?  Actually, no.  Think about those particles of food that come out when you do floss. Leaving those particles and unseen numberous  bacteria between your teeth and at your gum line is just not a good idea.

But alternatives to flossing are certainly available.  Those tiny brushes that fit between your teeth are available in a variety of brands, and tend to be easier to use than floss, especially if you wear braces!

Devices that spray of stream of water can also work well. Depending on the brand, they are known as waterpiks, water jets or “oral irrigators.”
The point is:  your toothbrush can’t reach everywhere. If you hate to floss, try something else.  And for those 20 percent of you, who do nothing besides brush, please note that using a antimicrobial mouthwash is better than doing nothing!

Oh, and for what it’s worth: You can stop lying at the dentist’s office.  Your hygienist knows if your flossing or not!

Dr. Nevills to Dr. Nevills

Dear Dad,
I can hardly believe it’s been a whole year since I joined you in practice at Nevills Family Dentistry. I feel like I continue to learn every day, and you are my best resource and support.

I’ve learned so much this past year not only about dentistry but also about what it means to be a true Doctor.

Fathers day blog photo

Here are just a few things I’ve learned in our first year together:

  •  What some consider the “gold standard” treatment options (which we tended to learn in dental school) are often the most expensive, aggressive, or time consuming and not always the best options for our patients
  • It’s worth the time and effort it takes to find alternative solutions to meet patients’ needs – ask questions, listen, and be willing to think outside the box
  •   We can be creative and cost-effective and still be clinically excellent
  • We’re in the business of helping people maintain their health and quality of life – and sometimes this has little to do with dentistry and more to do with The Bigger Picture of life
  •  As a doctor, and as a person who truly cares about others, I will always carry the weight of peoples’ health on my shoulders; but it’s a worthy responsibility and an opportunity to serve people to my greatest capacity

I can’t begin to describe how lucky I am to have you as my professional mentor. I benefit everyday from the time you take to discuss things with me, from patient treatments to business decisions to areas of personal growth. I’ve learned to use our materials well, I’ve implemented different ways of problem-solving and treatment-planning, and I’ve appreciated the trust you’ve built with our patients.

They know we’re looking out for their best interest, and I feel very blessed to have the freedom to make decisions I think are best to help people. I know our office is a place where our patients can find relief from dental worries and pain.

You’ve worked hard these past 30 years to grow a wonderful practice, a place where both patients and staff feel cared for. I’ve had the privilege to come in the door and contribute to the “Dr. Nevills Way” – what an awesome legacy!

Thank you for inspiring me to pursue this profession, and for encouraging me along the path I took to get here. When I go to work, I feel greatly supported, and I have all I need to continue to grow and flourish in my career.

I’ve also watched the choices you’ve made in your personal life over the years, and it’s inspired me with mine. I’m getting married soon – as you well know – and I remember how you were there for us as kids and always seemed to choose “family.”

It meant a lot to me that you showed up for (and sometimes coached!) all of my sports games and school events. You were there for Saturday morning grocery shopping and cartoons, took us on special trips to Disneyland, came on school field trips, and—of course – so much more.

You are a wonderful dentist and a terrific father. I’m grateful for your example and I’m inspired to be the best person and the best dentist I can be.

Happy Father’s Day, Dr. Nevills!

Sincerely,

Dr. Nevills

p.s. – Please don’t think about retiring too soon. I hope we’ll be doing this together for a very long time!

Be a hero, know how to save a tooth!

sore toooth artYou don’t have to be a hockey player to lose a tooth while playing sports. Collisions with baseballs, elbows and the ground can knock out a tooth. The best defense, of course, is wearing a mouth guard.

But if one of your teeth is knocked out, there’s a good chance it can be re-implanted if you take quick action and get to a dentist within 60 minutes.

Most dentists have emergency numbers on their recordings if you call outside business hours.

If your tooth does end up on the ground, the first step is: Find the tooth! This might be harder than it sounds, especially if you are a little dazed by what just happened, but have others help you.

If you can, gently place the tooth back in its socket and hold it there until you get to the dentist. Try to place the tooth back in the mouth where it fell out, so it is level with other teeth. This is a little easier with front teeth. Bite down gently on gauze or a wet tea bag to help keep it in place. Be careful not to swallow the tooth.

If this is not possible:

  • Hold the tooth by the crown – not the roots
  • DO NOT rinse the tooth with water (or anything else) because biological agents on the surface of the roots may help them reattach in the mouth
  • Do keep it moist. Your saliva is actually the best wetting agent, so either hold it in your mouth or spit into a container and put the tooth in it
  • If milk happens to be available, it is a good solution for keeping a tooth moist

Anyone can take quick action can action to help save a knocked-out tooth. My first experience with dental emergencies, in fact, came when I was about 10. A neighbor girl crashed her bicycle in front of our house. She hit the ground hard, and when she got up, one of her front teeth was missing. We searched the ground and found it, and she was whisked away to the dentist.

Truth be told, I’d rather make a mouth guard for you than re-implant your tooth. So be careful on your bikes, and when playing sports, remember: keep your eye on the ball!

 

 

How dentists save lives

Regular visits to your dentist are more than just good for your teeth. They just might save your life.

April is Oral Cancer Awareness month – a good time to remind everyone that regular dental checkups are often the first line of defense in catching oral cancer early. That’s because we see what’s going on inside that mouth of yours – and keep an eye out for any suspicious changes.

During your regular dental cleanings and exams, your hygienist and dentist are looking at more than just the teeth – we’re also looking at your lips, cheeks, tongue, tonsils, palate, gums, glands and lymph nodes. There are some areas of the mouth in which cancers are more prevalent, like the sides of the tongue, floor of the mouth, and lower lip.

Oral cancers include cancers of the mouth, tongue, tonsils and throat. While not as common as other types of cancer, the Oral Cancer Foundation estimates that more than 43,000 new cases will be diagnosed this year. 90% of oral cancers are squamous cell carcinomas, and can be treated with great success if caught early.

We all have irritations in our mouths from time to time such as cheek bites, canker sores, or burns from hot foods. But it’s important to call your dentist if any of these symptoms last for more than two weeks:
● A sore or irritation in the mouth
● Red or white patches on your inner cheeks, lips, gums or tongue
● Pain or numbness anywhere in the face
● Lumps in the mouth or neck
● Difficulty or pain with swallowing
● Scabs or blisters on the lips

When we find something suspicious in the mouth during a dental visit, we talk with our patients about what we see. If further evaluation is needed, such as a biopsy or CT scan, we send them to a specialist we trust. We have periodontists, oral surgeons, ENTs and primary care doctors on our healthcare team who carefully and proficiently examine and treat these areas of concern in the mouth.

How can you know if you might be at risk for developing oral cancer? Those at an especially high risk are heavy drinkers and smokers older than 50.

But, attention young people: The fastest growing demographic for oral cancer patients is actually young, healthy nonsmokers. The human papillomavirus (more commonly known as HPV) has been found to cause cancer of the oropharynx, which is the middle part of the throat including the soft palate, the base of the tongue, and the tonsils.

HPV is sexually transmitted and is the same virus that causes cervical cancer. It is transmitted to the mouth through oral sex with an infected partner. Safe sex practices and HPV vaccinations may help prevent HPV infections of the mouth.

Similar to other cancers, oral cancers are treated with great success when caught early. With most oral cancers, patients have an 80 to 90 percent survival rate when the cancer is found in the early stages. Regular dental check-ups will serve you well in identifying any areas of concern early on. A wealth of information about oral cancer is available from The Oral Cancer Foundation.

Dentists for Beaverton, Aloha, Hillsboro and Portland