Author: Scott Smith

Let’s Get with the Program!!

Brushing your teeth does not have to be such drudgery! Those couple of minutes in the morning and at night seem to take forever, but with an electric toothbrush, it can be a much easier process. The Philips Sonicare line of toothbrushes, in my opinion, has no equal. It is by far the best brand of electric brush on the market. It really does give a much more thorough than a manual brush. It’s great for a wide range of people including children, orthodontic patients, the elderly, and especially people who have gum disease.

Often overlooked though, are the young adult population and healthy maturing adults. It is my choice for them as well. It will keep your teeth cleaner in between visits and greatly reduce plaque and calculus buildup. You will generally have a cleaner, fresher mouth and less stain buildup. It one of those things that you must experience in order to understand its value. You simply will not want to go back to a manual brush once you have used a Sonicare brush.
Where do I find one of these fancy things?

Sonicare brushes are easily found at local stores and there is probably 15-20 different sizes and styles. They range in price from $40 up to $250. An interesting thing to note, though, is all of their brushes generally work just as good as the next one regardless of price. Most of what Sonicare adds to the more expensive brushes is features. For instance, the Flexcare has a bluetooth app you can download to your phone if you want to monitor how well your kids are brushing instead of standing over them morning and night. The Diamond Clean is sleek and modern-looking with a charger disguised to look like a glass cup. This $200 version is beautiful, yes, but the less expensive models work just as well.

What Benefit do I really Gain?

One of the most valuable things a Sonicare does for you is it takes a lot of the brushing technique out of the equation. It does most of the work for you. You just place the brush where you want the bristles to clean and let it do the work. Some of the models have timers that beep, and some beep if you brush too hard. Probably one of the more useful features would be the different levels of intensity. For those that are tactile sensitive or have sensitive teeth the feature of multiple power levels may be useful. Even for those who are simply new to using an electric toothbrush, it can be helpful to begin with the “gentle” setting before moving up to the “deep clean” setting.  Read up on the model you are looking at to make sure it has what you want.


We are always more than happy to help you find the Sonicare model that is right for you. We receive no compensation from Sonicare, we care about the health of your mouth and the ease of keeping it clean between visits. There are plenty of stores you can visit to find yourself a Sonicare– your local Walmart or shop on Amazon. You can even go to Costco and buy 2 for the price of 1. Happy shopping!

Those Teeth Called Dental Implants!

Dental implants burst onto the scene way back in the 1990’s, and most dentists were skeptical both about their use and their longevity. We simply did not know how well they would function, how they would feel in the mouth, or how long they would last. The research and literature were positive and well-documented, but still, how would they actually work for the everyday patient?

How wrong many of us were. Implants have truly changed the very essence of living for millions of patients worldwide. The surgical placement and the restorative systems of implants were refined throughout the 2000’s and now they have become routine. They can be used to replace one tooth, several teeth, secure a denture, or replace an entire dentition.

In our practice, we perform implant dentistry almost daily. It has been an incredibly rewarding part of our practice, as some of our patients had lost all hope of ever eating normally again prior to the placement of their implant.
Many patients have questions about just how they are placed and how they are restored. Please don’t hesitate to call our office or schedule a free implant consult. I enjoy educating patients about all of their options so that they can make an informed decision concerning their dental care. I gladly do these consults at no charge because it is such an important decision and the information is vital for the patient to understand what is and is not possible.

Photo Courtesy of Peter Kasprzyk


We have been doing implant dentistry since the early nineties and if I have learned one thing, experience counts. Therefore, if you have missing teeth or just want some answers, call us. I can give you an firsthand account of what to expect, since I am getting ready to have my first implant done in my own mouth as I write this.


M. Scott Smith, DMD

Dental Bite Guards for Clenching and Grinding

If you are suffering from headaches, jaw soreness, or tooth pain you may be grinding or clenching at night and not even know it.

Many people grind and /or clench their teeth during the day and at night. This can be just out of habit or possibly from a change in your daily stress level. This problem is widespread and is common in both women and men. I call it the “silent killer” in dentistry because people are generally not aware of the long-term negative consequences from their daily stress.

You may have this problem and it could go undetected or undiagnosed for years. The symptoms vary widely from patient to patient. Many times, it will present as tooth pain from two or three teeth in one area of the mouth. It can range from a vague soreness to a very debilitating severe pain in one tooth. Other generalized symptoms could be frequent or constant headaches, shoulder soreness, and jaw soreness located just under the ear on one or both sides. This condition is sometimes difficult to diagnose because the symptoms may come and go. The symptoms can also widely range from mild to severe.

I usually see multiple patients a month who are grinding or clenching so intensely that they come to the dentist with what they report as a severe toothache. The treatment for these patients is usually easy, and with patience and proper care, their symptoms will resolve. Initially, I will do an examination to determine the underlying cause of the pain. If it is probable that you grind your teeth, I will usually prescribe a bite guard to be worn at night and/or during the day. This is used in conjunction with non-steroidal anti-inflammatory drugs, warm compresses, massage therapy, and most importantly recognizing and minimizing the stress triggers that may be the root cause. A bite guard is an acrylic mouthpiece that is worn much like an orthodontic retainer. This stabilizes your bite and your jaw joint. It allows the teeth to fit together in a more favorable way and places your jaw joint in a more relaxed position.

One very common and very important subgroup of this condition is patients that grind but have no symptoms. They will usually report no pain, but upon clinical examination it is noticed that they are causing significant damage and excessive wear to their enamel (the first layer of the tooth). These tend to be males and as they grind their teeth over the years, their teeth they become shorter, fractured, and can even expose the nerve once the wear exceeds the thickness of the dentin (the second layer of the tooth). Fortunately, if this condition is diagnosed early, you can wear a bite guard and prevent the damage from occurring. However, if the wear goes unchecked, the treatment can be extensive and expensive and involve placing crowns on some or all of your teeth. If you have porcelain crowns in your mouth, a bite guard can even be used solely as a protective device to prevent fracture of the surface porcelain.

I often receive questions about using over-the-counter bite guards from the drug store. I do not recommend using these, as their consistency is soft, and this seems to stimulate clenching at night. Most of the over-the-counter guards (or “boil and bite” mouth guards) are made this way and seem to worsen the problem.


M. Scott Smith, DMD

Help!! Please Help Me Understand My Insurance! Part II

piggy-bank-2-1241226-1279x1304         With over 25 years as a dental provider, my staff and I have just about seen it all when it comes to dental insurance. We have seen the industry transform itself from a highly regarded employee benefit that your company offers, to plans that many question why they even bother to pay for them. In this second part, I will go into detail and explain what the dental insurance companies are now offering- the good, the bad, and the ugly state of dental insurance.

First, lets just say this up front, dental insurance is not insurance. It was never designed to be insurance, but instead really acts more like a general benefit that you may be given or sold by your employer. It does not “kick in” in catastrophic emergency like medical insurance does.  The benefit plan that you may have is negotiated by your employer to cover as much as they can get, while your insurance company is on the other side trying to sell your company as little as they can, for as much as they can get. That’s the simple truth. And the dentist has nothing to do with either side; however, we are caught in the middle trying to estimate what your benefits are and even if you are covered.

In the current market, the more typical insurance plan we are seeing now is what the industry calls a Preferred Provider Organization or PPO. This is radically different from the plans of past days. The insurance companies have far greater control over the patient’s benefits and the dentist’s fees in these plans. The insurance industry has basically shifted their costs of providing the plan to the patient and the dentist. The PPO plans cost patients more to buy. Premiums have consistently increased over the years while the yearly maximum has been reduced. Twenty years ago a typical plan would pay out a maximum of $2000-$2500 per person per year. Today, your typical PPO plan has a yearly maximum more like $1200-$1500 per person per year. This reduction of benefits has occurred while the cost of the plan, per year, has gone up from $10-$15 per month to $40-$60 per month. The patient is paying much more for far less. Also, if a dentist agrees to become a network provider for these plans, he can only charge the fee set by that individual plan. Since the PPO plans have acquired about 80% of the market, there is huge pressure on dentists to sign up with all these PPO plans. Especially the younger less established dentists who are trying to grow their new business. The insurance companies almost have total control over the benefit package for patients, the type of care they receive, as well as the fee a private dental practitioner may charge. So for the dentist, especially the new graduates, it is extremely difficult to provide high quality care with individualized attention to each patient, because the PPO plans only pay about 60% of the typical fee they normally charge. Most anyone could understand the difficulty if you walked into work one day and your boss said you were only getting paid 60% of what you usually made.

What I would suggest before you agree to buy anything, is to discuss the particulars of the plan with your dentist. We are happy to evaluate this information with you and we are only here to help you make the best decision. We are very experienced at looking at different plans and reviewing the limitations, waiting periods, deductibles, and exclusions that may make the difference between a great option or something that is not worth purchasing. Depending on your dental health or any proposed treatment, your insurance coverage needs may be different from person to person, so what is good for your neighbor might not be your best option for you.

There are also some common misconceptions about PPO’s. If you have a PPO plan, your insurance company will try to persuade you to only see an “ in-network” dentist. Regardless of your particular plan, you may choose to see any dentist and your insurance will pay a benefit. That is the one of the main advantages of a PPO. You get to pick your provider. The older managed-care plans (which are being phased out) did not give you a choice.  Your co-pay may be a little higher if you choose to see a dentist who is not “in-network”,  but depending on the procedure, it may not be that big of a difference– and if you prefer a certain dentist it may be worth it.

Another common situation that occurs with these plans is your insurance company will routinely deny benefits on a procedure or tell you that the procedure is unwarranted. If your dentist does not appeal it, you may never know that it should be a covered procedure. For all our patients and every claim that is filed, our office will specifically know if it should be covered based on your benefit schedule. And we track every single claim with a follow-up if it is not paid within 30 days. This behavior by insurance companies has been around for decades so it is vital that you have a good rapport with your dentist and his or her staff. It is extremely hard for patients to get information from their insurance company, so good communication with your dentist’s office staff is essential.  See #4 in this article posted recently about which insurance is worth your money and which just… isn’t.

In conclusion, my staff and I are here to help navigate with you through these confusing shifts in insurance. We deal with these companies on an hourly basis and are very familiar with the tactics they use to confuse both the patient and dental office. We are more than happy to sit down and help you decide which plan to choose, if any plan at all.


M. Scott Smith, DMD

Ok, Will Someone Just Tell Me What My Insurance Will Pay???

FrustratedPhoto credit:


Dental insurance can be incredibly confusing for patients to understand. Our office has been working with many types of insurance carriers for over 25 years and we have watched the industry undergo changes over these years.  More recently, we have seen some very dramatic changes that have caused many patients to question why they are even paying for it in the first place. Let’s first review some of the basics, and then we can discuss in detail some of the things that frustrate patients.

When you become active on a plan you will be given a card or a group number. You will need this information to enable providers (dentist) to relay information to you regarding your benefits. However, you must realize that even though you have a card, a group number and have been paying premiums,  many plans will invoke a waiting period on you. This sometimes means that before you can receive benefits for some types of services, you have to pay premiums for up to a year before your benefits kick in. These “types” of procedures are usually the ones that are more costly and/or immediately necessary, for example: root canals, crowns, or periodontal therapy.

…for some types of services, you have to pay premiums for up to a year before your benefits kick in. These “types” of procedures are usually the ones that are more costly and/or immediately necessary…

All dental procedures are classified according to one of about 10 categories. Your insurance pays benefits on these categories based on a percentage. Sometimes the percentage is 100% and sometimes 50%. For example, if your filling costs $300, your insurance may pay 50% of the fee they determine to be the maximum allowable. So if the insurance company’s max allowable fee is $200, they will pay 50% or $100 and you pay the rest ($200) as a co-payment. This is an example of traditional insurance. A common misunderstanding is, “if my insurance is supposed to pay 100%, why do I have to still pay some on a routine cleaning”? The reason is that the insurance company’s max allowable fee may be $85 for a cleaning, but your dentist’s fee may be $97. So the patient still ends up paying $12 on the procedure. Insurance companies will not disclose their maximum allowable fees. They keep this information proprietary and will not disclose it to the dentists. In this type of plan, the dentist has no connection or binding agreement to the insurance carrier. There can be yearly maximum limits, waiting periods on certain benefits, missing tooth clauses, yearly deductibles and co-payments.

Gone are the good old days of insurance benefits. Today, the consumer faces a much more complex array of factors: huge reductions in benefits, escalating plan costs and the necessity of having someone with inside knowledge to help you determine if your insurance company is actually giving you the correct level of benefits. All of these factors are used to decide if what you are buying is actually worthwhile.

Is the insurance you are paying for actually worthwhile?

Stay tuned for part two of “how insurance works”, as our next entry will discuss some of the new plans and how the industry is dramatically changing for our patients.


M. Scott Smith, DMD


Your First Visit with Your New Dentist

       At our office, if you are not in pain, I would like your first appointment to be a very comprehensive exam. I would like to meet you, get to know your concerns and hear what brought you to us. Next,  I would like to complete a thorough exam. During this time, we will discuss any issues that concern you and obtain any records we may need such as radiographs (x-rays)  or casts (plaster models of your mouth).  This more comprehensive approach will allow me to make a better diagnosis and prevent overlooking any problems.

“This more comprehensive approach will allow me to make a better diagnosis and prevent overlooking any problems.”

      By doing a more complete analysis, we can decide things such as what type of cleaning you will need and where we need to start on your treatment plan. With this gathering of information and your input, I can put together a treatment plan tailored just for your needs. This treatment plan is created only for you. Once you and I have a clear set of goals, we can begin.

“This treatment plan is created only  for you.”

       This treatment planning is sometimes overlooked, but is truly a vital part of providing customized care for each individual. It also represents the blue print for your dental care for a lifetime.


M. Scott Smith, DMD

Wow!!! Buffered Anesthetic Equals LESS PAIN and More Profound Numbness

2099Dental anesthetics are currently stabilized for shipment with hydrochloric acid which, upon injection, can cause a stinging sensation. Before the anesthetic begins working, your body must naturally buffer the solution before it can be absorbed and numb the nerves. This is why, many times, the dentist gives an injection and has to wait 10-30 minutes before you begin to feel the full effect. Some patients have limited or slower ability to buffer. This means they may not ever feel completely numb, if at all.

Some patients have limited or slower ability to buffer. This means they may not ever feel completely numb, if at all.

At our office, we have the ability to buffer the anesthetic dose before the injection. A small amount of sterile sodium bicarbonate is placed into the anesthetic solution prior to giving you the injection. This dramatically increases the effectiveness of the anesthetic and reduces the time it takes to fully feel the effects. It can also reduce or eliminate the stinging sensation usually felt during the injection itself. in the past, I have had patients report not being able to get numb, even after having several injections in the same area. Buffering the anesthetic before the injection dramatically reduces these types of problems.

Buffering the anesthetic before the injection dramatically reduces these types of problems.

At our office, we always strive to make your visit as comfortable as possible, and buffered anesthetic is just another method to provide our patients with the best care possible.


M. Scott Smith, DMD