What are the most affordable and hassle free dental plans?

Most people find choosing the right dental insurance to be a complex problem that is both confusing and exhausting. There are various types of dental insurance plans including: Indemnity Insurance Plans, HMO Network Dental Insurance, PPO Dental Insurance and Discount Dental Plans. We want to highlight the two most common types of insurance coverage plans, HMO

(heath maintenance organization) and PPO (preferred provider organization) and show you their pros and cons. An HMO insurance plan refers to a network of individuals who belong to a specific

comprehensive dental care plan which partners with a designated dentist or dental clinic. With HMO plans, a patient must visit their primary care dentist first before they can go to any other specialist or another provider within the network. Although HMO plans tend to be more affordable compared to a PPO, you are restricted to seeing only the dentist you are assigned too. Also, not all procedures are covered under an HMO plan. For instance, most HMO plans only allow patients to get amalgam (silver) fillings, so if you want a white filling you are responsible for paying for the whole procedure.

A PPO is a managed care organization of doctors who have contracted with an insurer to provide dental care at reduced rates to the insurers or patients. For a patient, that means you can choose any doctor in your network and you do not need a referral from a primary care dentist before you see a specialist. Patients who are covered by these plans must use the professionals that are part of the network in order to get full benefits, or else they may end up paying the difference between the networks fee schedule and the doctor’s office fee schedule. A PPO tends to be more convenient because it allows you the flexibility to see any dentist you choose.

Let’s break down!

Do I need to have a primary care physician (PCP)?

HMO: YES

PPO: NO, you can receive care from any doctor in your PPO network. FYI: You will pay a little more if you choose a doctor not in your “preferred” network!

What if I need to see a specialist?

HMO: You need a referral from your PCP.

PPO: You do not need a referral. Find a doctor in your preferred network!

How do I pay for services when going within my network?

HMO: The only charge you are responsible for are in-network copayments. You will not be covered if you decide to go out of your network. You are also limited to the procedures that are covered under your insurance plan.

PPO: You are responsible for your copayments but have the option to go outside of your network if you so desire. Some PPO’s do have an annual deductible that you pay once a year before you start any major procedure. They also have an annual maximum of money that you can use per year.

Dr. Kederian’s dental office is in network with most PPO dental insurances. We are dedicated to providing the best services to our patients and feel that PPO insurances allow us to provide the best quality care. PPO insurances allow us to use the most modern and updated procedures while allowing patients to maximize their insurance coverage.

The best advice we can give is to do your research and seek out a plan that allows you to utilize the largest network of providers, with the lowest co-pays and highest coverage you can afford. I hope this helps to clarify some of those pressing dental insurance questions and concerns that can leave you feeling paralyzed!

If you have any additional questions about dental insurances, please feel free to call our office at (424) 901-0701 so that we can assist you in choosing the right plan for your needs.

Remember, all great things start with a smile!!

If you’ve been following our blog for the past two entries, you’ve probably noticed a trend… we’ve been focusing on gums. That’s because your gums are a direct path your blood stream. Having healthy gums is important to having strong and healthy teeth as well as keeping yourself healthy. Inadequate oral hygiene can lead to medical problems; regular dental cleanings are important.

Cleaning procedures are designed to cleanse and polish the tooth surface and under the immediate gumline. Much like washing a car, removing dirt from the road gives the paint that ‘new car’ glow. The same concept applies to your mouth. Excess food, tartar, and calcium build and grow on your teeth and around the gumline. This excess has to be removed to keep your teeth and gums healthy and feeling fresh.

So let’s break down the steps of a cleaning and examination. If it’s the first time you have had a cleaning done by your doctor, or the first time in over a year, x-rays are a must. The x-rays give your doctor a behind-the-scenes look at what’s going on under your gums, to the roots of your teeth and the bone structure of your jaw. Once your doctor has seen your x-rays and examined your teeth, he or she can determine the best cleaning procedures.

Most cleaning procedures following the same methods: ultrasonic instruments are used to loosen the tartar and plaque; fine hand tools are used to scrape the loose tartar and bacteria off the teeth and from under the gumline. These tools also allow the doctor to reach and scrape the tooth further up the tooth if needed. Once the plaque and tartar have been removed an electric tooth polisher is used to finish smoothing and shining the surface of your teeth. If your doctor should think it necessary, the final step is a fluoride treatment. The fluoride helps strengthen the enamel of the teeth, further preventing decay and cavities.

There are multiple purposes behind cleanings. During the exam your dentist is looking for cavities and other forms of tooth decay, as well as symptoms of gingivitis (gum disease). They check for signs of oral cancers and infections. There are also aesthetic purposes for a cleaning. The procedure removes stains from regular oral practices, smoking, soda, coffee and tea. Not only will your gums thank you for removing all the plaque and residue, you smile will regain its natural shine.

Cleanings are not only preventive or a way to cure oral ailments; cleanings are proactive. By having regular cleanings you are proactively considering your health as a whole. You are taking the steps to ensure you keep the pathways to your organs clean and healthy.

Recommendation: It is suggested that adults with healthy teeth get cleanings at least 2 times a year, and sometimes up to 4 cleanings per year, if gum disease is present. Dr Kederian works with her patients to design appropriate cleaning schedules based on their individual needs.

For more information, or to schedule a procedure, please contact Dr. Kederian’s office.

Your toothbrush can save your life.

It’s true. Something that costs less than a dollar will help you maintain a healthy heart. Research isn’t definitive, but all signs point to a strong correlation between gum disease and heart disease, specifically cardiovascular disease.

Cardiovascular disease relates to a group of disorders that affect the heart muscle and/or blood vessels (arteries and veins) of the heart.  There are several conditions in this category including, coronary artery disease, stroke, peripheral vascular disease, and high blood pressure. Causes of cardiovascular diseases range from structural defects, to infection, inflammation, environment and genetics. ^[1]

Research done in the early 2000s yielded two theories about oral bacteria and heart disease:
First: Oral bacteria enters the blood stream through saliva, transferring plaque to blood vessels;
Second: Inflammation and bacteria within the gums are transferred and transported into the blood stream.

University of Buffalo researchers found that diseased gums release higher levels of bacteria with endotoxins into the bloodstream. In fact, patients with gum disease have almost four times the amount of bacteria and stand a greater risk of developing cardiovascular disease.

Periodontal (gum) disease is caused when the inner layer of the gum swells and retracts away from the bone forming a pocket around the tooth. These newly created pockets are a breeding ground for bacteria, spreading deep under the gum line.

When it comes down to it, your mouth is a haven for toxic bacteria to easily find its way to the blood stream even through regular oral functions, like chewing and swallowing. Imagine, every time you get a cut in your mouth, it creates a direct path for bacteria to your arteries.

Once bacteria get displaced into your bloodstream, it collects around your artery walls and can hide inside your heart chambers and valves. Although your immune system has the ability to break down bacteria, having high levels of oral bacteria taxes your body’s immune system and can trigger your body to produce toxins that will aid in the development of heart disease.

It’s most important to remember that your mouth is a pathway to your insides, what happens in there will inevitably have an impact on your heart health. The best way to fight it; develop healthy oral hygiene habits and see your dentist for regular cleanings and checkups.

Here are a couple of interesting findings:

• Patients with periodontal disease are twice as likely to develop cardiovascular disease and other heart related conditions,
• Much like cholesterol, bacteria from the mouth can be used as a predictor of heart disease,
• Oral bacterial components that enter the blood stream can trigger the production of C-reactive proteins from the liver, a predictor of heart disease.

For more information, please contact Dr. Lisa Kederian.

Resources Consulted:

• [1] http://www.cvdf.org/
• https://healthimprovement.stanford.edu
• http://microbewiki.kenyon.edu/index.php/Actinobacillus_actinomycetemcomitans
• Offenbacher S, Beck JD, Moss K, Mendoza L.  Results from the Periodontitis and Vascular Events (PAVE) Study: A Pilot multicentered, randomized, controlled trial to study effects of periodontal therapy in a secondary prevention model of cardiovascular disease. J. Periodontol. 80:190-201, 2009.

Your gums are important, just as important as your teeth if not more-so. They are part of the soft tissue lining in your mouth and hold your teeth in place, providing a seal around the bone. More often than not patients neglect their gums without knowing it. Minimal to no hygienic effort results in the onset of gum disease. Also, some patients have genetics that leave them prone to gum disease.

There are two classifications of gum disease: Gingivitis and Periodontitis. Gingivitis is inflammation of the gums, but it is the predecessor to periodontitis. Periodontal disease (periodontitis) involves tissue and bone loss, as well as loosening of teeth.

DID YOU KNOW?
Gum disease is the leading cause of tooth loss in adults.

Gum disease always starts with an accumulation of plaque. Plaque contains bacteria that causes an inflammation of the gums; this condition is referred to as gingivitis. More often than not, gingivitis is painless. The inflammation causes tenderness and bleeding of the gums during brushing but has no other symptoms. Gingivitis is very common, but it is reversible with proper treatment, hygiene and maintenance. There is no irreversible bone or tissue damage at this stage of gum disease and can be cured with regular cleanings as well as proper home care.

When left untreated gingivitis advances to periodontitis, a more serious form of gum disease. Periodontitis is caused when the inner layer of the gum swells and retracts away from the bone forming a pocket around the tooth. These pockets are filled with bacteria that multiply rapidly, spreading deep under the gum line. Although the body’s immune system fights the bacteria as the plaque spreads, the toxins from your immune system also cause a break down of the bone and tissue holding your teeth in place. As the infection gets worse, the pockets around the tooth get deeper and more tissue and bone are destroyed, eventually loosening the anchorage of your teeth.

Periodontitis is reversible – to an extent.  Once diagnosed a deep cleaning (known as a scaling) is necessary to remove all the hard plaque and tartar from underneath the gum line. After the bacteria have been removed the patient must then establish a solid oral hygiene routine. If all these steps are followed, the infection can be controlled and the pocket around the tooth will shrink back to a healthy level. If left untreated, surgery becomes necessary to access the tartar build up and a reduction of the gum tissue is preformed to recreate a healthy gum line.

The best way to reduce your chances of gum disease is to see your dentist for regular cleanings and exams. Click here for more information, or to make an appointment with Dr. Kederian please contact us.

Everyday more people are becoming concerned with their appearance, including clothing, weight and smile.  Because of these trends more people are turning to cosmetic dentistry to enhance their appearance. As individuals continue to consume products that stain their teeth – many are turning to whitening or bleaching to get that sparkle back. Unlike a decade ago when whitening began to gain popularity, today treatments are available for everybody’s budget and timeframe: from picking up a home whitening kit (about $20), to taking the time and sitting in the dentist chair (about $400); there is a method for everyone.

But as with any cosmetic enhancement, you shouldn’t go in blindly. Before walking down the path of cosmetic procedures, you should take the time to review all of your options.  It is important to know the look you want to achieve and the best process to get those results.

Here are a few questions you should know the answers to before you start any whitening process.

What is whitening (or, bleaching for that matter)?
Whitening teeth simply means: restoring the natural color to teeth by removing stains and dirt. So technically, any product that cleans your teeth is considered a whitener, even toothpaste and floss. The whitening process starts by cleaning the tooth surface and removing daily plaque from your teeth. In order to get that brilliant pearly glow, a bleaching agent is needed. To keep your teeth glowing, regular teeth cleanings are necessary too.

The FDA (Food Drug Administration) defines “bleaching teeth” as whitening teeth beyond their natural color. This is something that can only be accomplished with the use of a bleaching solution (such as hydrogen peroxide or carbamide peroxide). So, whitening and bleaching is essentially the same thing.

How is whitening done?
An in-office whitening is the fastest and most effective method to bring that sparkle back to your smile. It offers the most significant color change in the shortest amount of time.

First, your lips and gums are protected with a barrier.  Your teeth are then coated carefully with high-concentration peroxide gel. The gel remains on your teeth in intervals of eight-to-ten minutes for up to three sessions during the sitting. While the gel is applied to your teeth, a laser light is used to activate the peroxide, thus breaking the stains away from your teeth.  So, within one hour, your teeth will have a high glossy white glow and your teeth will sparkle.

At-home bleaching trays are the second most effective method of whitening. Often your dentist will recommend using the trays after you’ve had an in-office session to keep your smile brilliantly white.

When using at-home methods, dental trays are made to fit your teeth. Patients are provided with the whitening solution and directed to fill the molds with the solution and wear the tray for approximately thirty minutes at a time, for several days in a row.

No matter which method you chose, it’s important to discuss expectations with your dentist so you know which procedure is best for you.

Why are teeth sensitive after a whitening, is the solution damaging my enamel?
There is nothing harmful about getting your teeth whitened, although there may be a few side effects you might find bothersome.

Many patients experience sensitivity to extreme hot and cold temperatures initially. This is because when the teeth are whitened the pores of the enamel are opened to remove stains. The discomfort should only last about 24 hours after the whitening process – it takes time for the pores to close.

Research indicates that teeth lose some enamel hardness when using different whitening agents. However, using these agents under the supervision of a dentist should not cause permanent damage. You should be aware that prolonged exposure to these whitening agents could cause tooth color to change to a grayish hue. This only occurs if whitening agents are used too frequently and these effects are usually reversible.

It’s always best to consult your doctor about these concerns, or if you notice any of these symptoms.

Is whitening safe for Bonding, Veneers or Crowns?
Whitening is only truly designed for natural teeth. The whitening agents only lighten the tooth surface, so if you have crowns, bondings or veneers, there is a chance that your natural teeth will lighten and your dental restorations will maintain a darker shade.  For this reason, it is important to discuss whitening options with your dentist before starting whitening your teeth, even if you plan to use over the counter products.

Before placing veneers you should consider whitening your teeth. Doing this will ensure that your new veneer restorations will reflect your natural tooth color. If you choose to lighten your teeth after having veneers placed, you will only be able to lighten the color of your tooth to the shade of the veneer.

How long will the effects of tooth whitening last?
Although the whitening process will bring back the true whiteness of your teeth, the effects are not permanent and the whitening will fade as you consume products that stain (ie: tea, coffee and/or cigarettes). Depending on how you care for your teeth, effects can begin to diminish within months, or can last for years.  By having regular cleanings every six months, most new stains can be removed when the dentist polishes your teeth. Reducing your intake of coffee and tea can also ensure that your pearly white teeth keep their sparkle. If you know that you consume many staining agents, consider having bleaching trays made so that you can touch up every few months on your own, keeping that smile fresh.

If you have any additional question please don’t hesitate to call Dr Kederians office at (424) 901-0701.

Click here to find out more about whitenings by Lisa Kederian, DDS.

When you go to the dentist, chances are you sit in the chair and grin-and-bear-it through whichever procedure you are about to endure. It’s ok – that’s what most patients do, the dentist isn’t the favorite of all doctors out there.  But as with any profession, Dentistry has a history and its history is chock-full of fun facts. Below are some interesting nuggets of information about dentistry proving that not only is dentistry innovative, it’s fun!

• There is evidence that dentistry has been practiced as far back as 7000B.C.
• Cavities and other forms of tooth decay were said to be caused by a “tooth worm” up until the 18^th century during the European Age of Enlightenment.
• Earliest Known Dental Work: A total of 11 teeth from 9 adults who lived between 7,500 and 9,000 years ago were found containing holes drilled with sharpened flint points. Flint-wielding specialists drilled holes, which were believed to have been filled with some type of material. The teeth came from residents of a prehistoric farming village called Mahrgarh in what is now Pakistan.
• Like finger prints, tooth and tongue prints are different for everyone.
• The second most common disease in the United States is tooth decay. The first is the common cold.
• Dental floss was first commercially manufactured in 1882 with silk.
• The most valuable tooth belonged to Sir Isaac Newton.  In 1816 one of his teeth was sold in London for $3,633.00 or in today’s terms $35,700.00.  The tooth was set in a ring.
• More than 300 types of bacteria make up plaque
• Most people consider the smile the first facial feature they notice.
• Some cheeses like aged-cheddar, Gouda and Muenster – among others, have been found to protect teeth from decay
• The major causes of tooth loss in people under age 35 are sports, accidents and fights.
• Queen Elizabeth I’s teeth were noticeably discolored. A German traveler, Paul Henter, speculated that the discoloration was due to the Queen’s excessive consumption of sugar, making the first recorded association between sugar and tooth decay.
• George Washington’s dentures were made from walrus, hippopotamus, and cows’ teeth, as well as elephant tusks.
• Before toothbrushes were invented people used twigs or their fingers to brush their teeth.(Neem twigs are still used in India as they have high bactericidal property)
• A couple of hundred years ago bad teeth were considered to be a rich man’s disease. It was only the rich people who could afford to eat sweet things
• China sets aside September 20th as a national holiday known as “Love Your Teeth Day.”
• The ancient Chinese wrapped tiny pieces of parchment around painful teeth, all of which contained written prayers and incantations.
• During the Middle Ages in Germany, you would have been advised to kiss a donkey in order to relieve your toothache.
• The ancient Greeks devised pliers for extracting teeth
• Lucy Hobbs was the first woman in the world to earn a D.D.S. degree from a dental school. The year was 1866 and the school was the Ohio College of Dental Surgery in Cincinnati, OH. Up until then only men were allowed to practice dentistry.

With Halloween fast approaching, many parents are experiencing concern over the fate of their children’s teeth. Every child loves Halloween—dressing up, watching spooky movies, and eating lots and lots of candy. So how can you let your kids enjoy candy without worrying about cavities? For that matter, how can you yourself enjoy a few Halloween snacks without undoing all your protective brushing and flossing? Dr. Lisa Kederian has put together a few handy tips for this Halloween season in the hopes that your teeth will stay strong and healthy without you having to forgo a few delicious treats.

In order for a cavity to form, three basic elements are necessary. There must be food, bacteria, and an acidic environment. Without all three components, a cavity will not form. Candy, however, creates the perfect combination of all three of these components: candy is a food that is easily broken down by common bacteria found in your mouth. When bacteria digest sugary candy, they produce lactic acid, creating an acidic environment. Thus, if you eat a sugary food with bacteria present in your mouth, an acidic environment is created, completing the trio.

To avoid cavities, there are simple steps you can take to prevent bacteria from breaking down the sugar. First, try eating all the candy you want in one sitting, rather than snacking throughout the day. When you eat a carbohydrate, there is a 30-60 minute period during which bacteria feed on the sugar and produce acid. If you can limit yourself to eating candy all at one time, your exposure to acidity is greatly decreased. If you eat all your candy and then brush your teeth, you can greatly reduce the chances of getting a cavity.

Stay away from hard candies and stick to chewable ones. Hard candies remain in your mouth for a prolonged period of time, as you do not chew and swallow them like a chocolate or chewy candy. The same goes from extremely sticky candies, like caramels, as the sticky substance can become stuck to your teeth and stay there long after you chew and swallow.

If you have an extreme sweet tooth and need to snack, try chocolate candy or sugar-free chewing gum. Chocolate, especially dark chocolate, has a low concentration of sugar, as the candy is sweetened naturally by cocoa solids, which contain tannin. Tannin is a compound that helps reduce the growth of plaque; it also contains oxalic acid, which reduces acid production. Chewing gum stimulates your salivary glands, helping you to produce more saliva, which creates a neutral environment. Also, chewing gum with Xylitol can even help to prevent cavities.  Xylitol is natural non-fermentable sugar alcohol that starves harmful micro-organisms, allowing enamel crystals to re-mineralize damaged areas of the teeth.

Finally, as always, pay attention to your oral hygiene habits. After consuming candy, make sure to brush and floss your teeth right away—do not wait until bedtime. Also, using a rinse with fluoride can also aid in re-mineralizing broken crystal structures on the surface of the enamel, allowing your teeth to become stronger. Halloween is a time for fun and indulging; do not let a fear of cavities ruin your holiday…but do not let the holiday ruin your smile, either!