On that less than comforting note, I’d like to explain what exactly periodontal disease (periodontitis) actually is. Simply put, periodontitis is gum disease. Bacteria builds up on the surface of a patient’s teeth, due to a lack in preventative oral regiments (i.e. brushing, flossing, and regular check-ups). These microorganisms penetrate the teeth as well as their support structures. With a continued disregard for oral hygiene, the bacterium causes the teeth to erode, and the gums to swell. However, most patients do not experience any signs or symptoms until it’s too late. If left to progress, the ailment can advance to the point were the only feasible course of action is surgery.  What makes periodontitis even more dangerous is the potential to lead to other serious health problems. Unresolved periodontal ailments can lead to erosion of the alveolar process (the structures that hold the teeth in place), loss of teeth, cardiovascular diseases, atherosclerosis, heart attacks, and strokes. All of this is preventable with good oral hygiene habits, and regular visits to the dentist.

Dave wasn’t wrong in jumping into the water. His mistake happened way before that. The big issue was ignoring the gigantic sign that warned of a very serious danger that swims in the water. If Dave had known a shark took up residence where he was fishing, he (most likely) wouldn’t have gone into the water. Periodontal diseases should be dealt with early. Knowing the signs and symptoms is half the battle. If you are experiencing any swelling, redness, tooth or gum sensitivity please consult your dental care provider. It’s easier to deal with a guppy than a blood thirsty shark.

Good afternoon! It feels great to be here today.  Thank you for inviting me, how are you?

I’m doing great! This cold weather made it a bit tough to get out of bed, but now I’m good. What about you?

Oh, you know the usual. Between getting my daughter off to school and my 3 month old son, there’s never a dull moment.

I can imagine. Now, you’ve been working at Advanced DDS for a little over a year. You are in charge of patient finances and insurance, but you haven’t always been a part of this organization. Tell us about the Michele from before.

I originally went to school to be a medical assistant. I always wanted to help people, so I that was a way that I could achieve that particular goal. When I was nineteen, I was looking for a position that was relevant to my training, but all that I could find was an opening in the billing department of a large dental group.  After working my way up to supervisor, I felt that I needed a change, that’s when I found Dr. Raskin and Advanced DDS. The rest is pretty much history…

So is it easier to be a part of a large dental group, or a not-as-large general dentistry practice?

I don’t really think I can answer that, only because the two are so different. For instance, the other group that I worked for was an “in network” provider, meaning that he only saw patients that were a part of the list of insurance companies that he subscribes to. Dr. Raskin, is completely out of network, so the process is a quite different. The type of dentistry varied as well. Even though both practices provide the same basic services, Dr. Raskin places dental implants, bone grafts, hybridge implants, and has an in-house CAT scanner (services that my previous office wouldn’t provide).

Wow, you don’t see that every day in a dental office.

No, not at all! That’s best part about working here, all the cool new stuff that we have. Every so often Dr. Raskin comes in with another new gadget to play with.

Not to change the subject, but, let’s get back to insurance and finances. What is the biggest insurance oversight you see?

It’s not really an oversight as much as it’s common sense. If there’s one thing I can’t stress enough, it’s knowing your coverage. You should know if you have out of network benefits, your yearly maximum, and the individual break down of coverage. Buying insurance is like buying a car; you don’t just go to a dealership and let the salesperson pick the car that you’ll be driving for the years to come, you chose a car that has all the details and amenities that you want. Your dental insurance is no different. Also, people are leaving up to thousands of dollars on their yearly maximums and let them go to waste. Make sure you use up your yearly benefits, they don’t rollover. 

So what’s the best insurance?

For the reasons I just stated, there is no best insurance plan. However, there is one that works best for you. There are a few things that would be better: Out of network benefits and fees that are based on reasonable and customary conditions.

Well, I think we’re running out of time here, so I want to thank you for being here today.

It was my pleasure, Thank you for inviting me.

**If you have any question for our Michele, please e-mail us at frontdesk@a

Position: Dental Hygienist

Time at Advanced DDS: 1.5 years

Education: New York City College of Technology ’07 (Dental Hygiene, RDH). Currently earning a Bachelor’s degree in Dental Hygiene at State University of New York at Farmingdale.

Hobbies: “I just had a baby; Kayla [daughter] is my hobby. I also like to read.”

On Tuesday November 22, 2011, I sat down with one of Advanced DDS’s dental hygienists to get a glimpse at dental hygiene from her perspective.

-Thank you, Wendy, for taking the time out of your busy schedule to answer a few questions for me.

                Wendy:  You’re welcome! I always have time to shed some light on the inner workings of proper dental care. The pleasure is all mine.

-Well, I’m glad to hear that. Let’s get started, Shall we?

                Wendy: Ready when you are.

-When and how did you decide to be a dental hygienist?

                Wendy: Let me start off by getting something off my chest, I was a horrible dental patient. I was so afraid of going to the dentist that when I was there, the staff needed three people just to keep my mouth open. I was a mess when it came to my dental health. However, everything turned around in high school. When I was 17, I got a job as a receptionist in a dental office. After seeing that cleanings weren’t as big of a deal as I thought, I decided to bite the bullet and do what I had to do. It wasn’t until a few years after that, that the office’s hygienist began to encourage me to become an RDH [Registered Dental Hygienist]. And after working a few odd jobs at various dental offices, I found a home here, at Advanced DDS.

-What do you think is the biggest myth in dental health?

                Wendy: People have this idea stuck in their head that if there’s no pain, there’s no problem. This couldn’t be farther from the truth. Just because a patient doesn’t experience any pain, doesn’t ,mean they have good oral health. There are many factors involved in why some people are prone to dental issues. Most of the time, if a person is feeling pain, the problem has already reached its advanced stages. This is why it is important to catch periodontal disease [gum disease] early, because it doesn’t initially present with any oral discomfort.

-What is the ideal daily hygiene regiment?

                Wendy: In a perfect world, everyone should brush and floss after every meal. But what some people don’t know is there is a certain technique that must be used to maximize the level of clean taken from each session. Everyone should brush in small circular motions; cover 2-3 teeth at a time. Do not use a rapid up and down motion with clenched teeth, which will only make matter worse.  ALWAYS REMEMBER TO FLOSS! You could miss approximately 30% of your mouth when you don’t floss. It is important to realize that everybody’s mouth is different, and with that comes varying dental hygiene regiments. What works for you, may not work for your neighbor. Make sure to schedule an appointment to see how effective your daily routine is.

-Is there anything that you notice that people overlook, that could be a potential risk?

                Wendy: Bleeding gums. Simply put, healthy gums shouldn’t bleed. Healthy anything shouldn’t bleed. If you’re washing your hands and they start to bleed, you would go see your doctor to see what’s wrong. The same thing is true for your gums. If you are brushing your teeth and notice that they start to bleed, make an appointment with your dentist, there may be an underlying issue that’s causing this problem.

-Are there any trade secrets that you could let us all in on?

                Wendy: I wish there was, but sadly, there’s no replacement for a proper regiment of brushing and flossing after every meal, and seeing your dentist for an exam and cleaning every six months.

-Where do you see the future of dentistry going?

                Wendy: Dentistry, as in any other field in healthcare, is technologically driven. Technology is evolving every day. With each step into the future, there is an opportunity to convert another dentist fearing patient (just like I used to be).  But to answer your question, I don’t really know where the future of dentistry is going because Dr. Raskin always has the most up to date technology. I feel like every time I see something new to the field, Dr. Raskin already has it. I guess in a way, Advanced DDS is the future of dentistry…available today.

-Wow, that was pretty good! Do you mind if I use that?

                Wendy: Please do, there’s a lot more where that came from [she laughs]

-Well, that’s all the time we have. It looks like your next patient just arrived. Thank you again, and I hope to see you soon.

                Wendy: The pleasure was all mine. It had a great time, and I’ll see you at your next cleaning!

HYBRIDGE® DENTAL IMPLANT TREATMENT

-Brian M. Raskin, D.D.S. Brings Latest Implant Technology to Valley Stream-

Valley Stream, N.Y. – Nassau County residents who suffer from chronic dental problems such as decay and periodontal disease, or who simply want to restore full dental function, comfort and confidence, now have access to the latest developments in implant technology. Dr. Brian Raskin, of Valley Stream, NY, is now using the first-of-its-kind implant technology called HYBRIDGE® in patients who are looking for a permanent and cost effective solution to chronic dental problems.

HYBRIDGE® is based on a proven hybrid bridge system that is the most definitive solution for people with missing or failing teeth.  Brothers, Frank LaMar, D.D.S. and James LaMar, D.M.D., dental restoration specialist and implant surgeon at the nationally renowned Elmwood Dental Restoration and Implant Center in Rochester N.Y., invented the HYBRIDGE® as an alternative to dentures or conventional bridgework.  The HYBRIDGE® looks, feels, and functions just like healthy, natural teeth while lasting a lifetime.

“We’re excited to be the first practice on the south shore of Long Island region to offer this advanced dental implant technology to area residents,” said Brian Raskin D.D.S., who provides dental implant treatment.  “Most people don’t realize how many people in our community and across the country are desperate to correct significant dental handicaps, but cannot due to cost. HYBRIDGE® was developed to significantly reduce the cost of dental implant rehabilitation, and make the process fast and relatively easy to go through compared to conventional approaches.”

This revolutionary dental implant technology impacts the quality of life for the many that are trapped in the endless cycle of root canals, crowns and bridgework.  HYBRIDGE® has been developed for people who have poor functioning dentures, functionality issues that affect their speaking and chewing ability, and undergone extensive dental work. It solves the problem of treating the same teeth over and over again for years. HYBRIDGE® is also used to replace crowns and bridges.

“This process allows us to deliver the definitive HYBRIDGE® in as little as three weeks from implant placement,” added Dr. Raskin. “With proper care, studies document a 98% success rate for HYBRIDGE® implants after ten years. We cannot say that for any other procedure in dentistry.”

HYBRIDGE® is a mix between a conventional fixed bridge and a denture.  Unlike a conventional bridge made of metal and porcelain, HYBRIDGE® is screw-retained and fabricated using resin teeth.  The teeth are processed on a substructure of titanium for durability and strength. HYBRIDGE® replaces the full arch – both the upper and/or lower teeth – that is permanently supported on five or six dental implants. The teeth sit on the implant abutments and not on the gums.

Since the HYBRIDGE® process is based on denture technology; it is less expensive to produce then conventional porcelain-fused metal bridgework.  It eliminates potential for decay, periodontal disease and breakdown of teeth. Most patients find the procedure less painful than a tooth extraction.

Sleep apnea occurs when a person’s breathing is interrupted while they sleep. Simply, a person will stop breathing during the night, only to begin breathing again outside the normal rhythm. The interval between each breath where breathing has stopped is called an apnea. There are three major types of sleep apnea:central sleep apnea, obstructive sleep apnea, and complex sleep apnea. Each specific type of apnea has it’s own form of treatments.

The most common form of sleep apnea is obstructive sleep apnea (OSA). Eighty-four percent of all apnea patients suffer from this classification. The mechanism of this subtype is pretty straight forward. Depending on how a person sleeps, there are structures in their body that can occlude (obstruct) the flow of air down through the trachea and into the lungs for processing. For example, a person (let’s call him Frank) that sleeps on their back has gravity to work against. The soft palate and tongue sink down into the back of the throat, and either partially or completely block off the airway. This is exactly what causes an apnea. Frank either has to move, or wake up to continue breathing again. Since Frank worked so well for the last example, I think we should use him for the next. To put this politely, not to hurt his feelings, Frank is a bit overweight. On this particular night, Frank gets into bed after a long, hard, productive day at the gym. He spent the last hour of his regiment exercising is chest muscles, which made his chest very sore and a little weak afterwards. Since Frank hasn’t realized his apnea issues, he is going to sleep on his back. The weakness in his chest muscles combined with the added weight he’s currently hauling around makes it harder for him to breathe. His brain is still telling his body to breathe, but the physical mechanisms involved are not being performed. This is called central sleep apnea (CSA). The final subdivision is complex sleep apnea, which ironically isn’t as complicated as it sounds. This occurs when there is no definite category that the apnea falls into. It’s usually a combination of OSA and CSA, where there is an occlusion as well as another underlying factor that is disrupting breathing rates. Unresolved apnea issues can lead to long term cardiovascular disease, neurological problems (due to a lack of REM sleep), and high blood pressure.

At Advanced DDS, we are limited to only treating the causes of OSA through the use of an oral appliance. The device, when inserted, manipulates the lower jaw bone, and gently keeps it extended outwards, increasing the volume inside the person’s airway. For those of my readers who are EMS providers, this is how we keep airways patent, when dealing with a suspected c-spine injury. Sometimes these issues have a tendency to correct themselves through the implication of changes in a person’s nightly regiment. Sometimes, sleeping on one side can relieve the pressure on the airway from the tongue and soft palate. If a person uses sleep aid, this causes the throat and its accessory structures to relax and sink into the back of the head.

Regardless of the causes of the apnea, the problem is, Frank’s breathing rate is not regular, and not adequate. Steps need to be taken in order to get this corrected. Like with everything else in life, you have to take baby-steps. You don’t want to jump into surgery when all you have to do is roll onto your other side while you sleep. Whatever your decision may be, please consult your doctor or Dr. Raskin with any concern you may have. The important thing is, you get the eight hours you deserve.

A famous philosopher once said, “The journey begins at the beginning.” The most frequently booked appointment in the office is the semi-annual dental visit. Our hygienist, Roxanna Robinson, is riding the cutting edge in this field. “Hygiene is the back bone of dental care. Without it, a patient’s maximum dental potential cannot be achieved.” Roxanna couldn’t be more correct. Basically, you can have the nicest car in the neighborhood, and if you don’t wash it on a regular basis, it’s going to look no better than the jalopy down the street. Your visit will begin by being escorted by your hygienist to her operatory. Before any work is started, Roxanna begins with the most important part. She assures her patients that they are in a “comfort zone.” Of course, it’s possible, in very few cases, you may experience some mild discomfort depending upon the individual; but, our patients are put into an atmosphere where they can feel at ease with their emotions long enough for Roxanna to do what needs to be done. Your cleaning (prophylaxis) will begin with a visual inspection of the mouth. Keep in mind, Dr. Raskin is not just concerned with your teeth, but with your entire mouth. Once the initial exam is done, the hygienist begins the “prophy” section of the visit. She uses a specific tooth paste that is used to get rid of the tarter build-up that your regular toothpaste leaves behind. When that is finished, Roxanna will floss in between your teeth. Don’t worry she will go over all the proper techniques so you can have that same, straight from the dentist feeling, every time you leave the house. At this point in the visit, panoramic x-rays are taken to make your exam as in depth as possible. After all of this, Dr. Raskin comes in for a more thorough examination. He looks over each individual tooth, search in those “hard to reach” places for cavities or anything out of the ordinary. He then checks under the tongue and the entrance to the throat, and makes any suggestions to the patient for a continued course of treatment. The importance of the semi-annual visit doesn’t lie with a cosmetic result, but rather one concerning your health. Untreated teeth can pose a problem to the human body. Tooth decay that is left to its own devices, can lead to gingivitis, or periodontal disease.

In the event that you do have a cavity (dental caries) Dr. Raskin has a few angles of attack in treating and correcting this minor issue. Let’s begin with the basics, what is a cavity? A cavity occurs when bacteria erode the enamel and dentin layers of the tooth, forming holes in the tooth, and allowing more bacteria to get into the tooth and destroy it from the inside. The two types of bacteria that are normally responsible for tooth decay (streptococcus mutans and lactobacillus) combine with simple and complex sugars such as sucrose, glucose, fructose, and most carbohydrates. The bacteria eat these substances and produce an acid that erodes the tooth or teeth. The beauty about seeing your dentist regularly is, most of the time, cavities are caught early, before they become a problem. Once a cavity is identified and examined, Dr. Raskin, or D’Orlando will begin to remove the decayed portion of the tooth and fill it with a fillings. There are a variety of types of fillings that Advanced DDS uses in these situations. Dr. Raskin chooses the proper material that best fits the patient’s particular mouth. Rest assured, all of our fillings are made from tooth colored materials such as porcelain or resin. This makes it easier to camouflage dental work to unsuspecting party guests. Without a doubt, there are people who are reading this with one thing on their mind, “How much is this going to hurt?” The truth is other than the small pinch associated with the injection of a local anesthetic, the procedures are generally pain free.

If knowledge is power, then hindsight is 20/20. The hype is never as bad as the actual event. Most people who get through their visit end up saying the same thing, “It wasn’t as bad as I thought.” Sometimes we just have to face our fears, bite the bullet, and go for it. We can only find out our potential by bringing ourselves to the end of the envelope, and looking ever so cautiously just to take a quick look at a the greener grass.

March's Kindle winner, Barbara Mahr-Zito, and Dr. Raskin