In the early years of my practice, i worked for an older dentist that people loved. Patients loved him even though their dental work needed to be replaced often. I realized there were serious quality issues and decided my future practice would be different. In 1990, I moved into a new office and developed a dream practice that is committed to excellence.

For the last 17 years we have provided dentistry that rarely needs replacement, is beautiful and done in a comfortable caring way. I am constantly overwhelmed by how much patients appreciate how they are cared for. I am reminded of the saying, “Excellence is a habit, not a single occurrence.”

Kristin Guenther

Many patients come to our office requiring dental gum treatment. To ensure patient comfort and allow me to be thorough, I commonly numb up the area I am working on. Many patients have a fear of the shot because of their previous experiences. They describe a horrible past experience that was very uncomfortable.

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Normally, when I take a phone call from a patient who has a toothache I get as much information as possible. Just recently I took a brief phone call from a patient who was confident that she only needed the doctor’s advice about her situation and declined an emergency appointment. As for most patients who have a toothache, we would have tried to see her that day.

That evening I happened to see her at Meijer. We talked about her toothache and concluded that the Orajel she was about to purchase was not going to help her situation, but an anti-inflammatory she already had at home may be better to help her short term. She was thrilled and excited that I took the time to stop her and get more information. Sure enough, Aleve took care of her situation, temporarily. After the weekend she came to see us promptly as planned. She was happy that she was able to go to Mackinaw for the weekend and enjoy a five course dinner at the Grand Hotel, and still very happy that we going to help her fix her toothache, just in time.

Kara

“Pre-tax” savings accounts have become a powerful employee benefit. However, it is amazing how many people are unaware of this benefit or hesitate because of the paperwork. We have assisted many of our patients wit setting up and utilizing their “Pre-Tax” spending accounts by sharing our knowledge about their employers plan and by helping with the paperwork necessary for reimbursement. Many patients have thanked me and said,” No one ever told me about this!” (Including major executives and Deans). It is worth checking into.

Over the past 15 years, I have watched dental insurance companies pay less and less of the true cost of dental care. Patients are having to assume greater financial responsibility for their care and are planning their treatment more strategically. At D & G, our patients learn about their current, emerging, and optional dental issues. By prioritizing and dividing treatment into phases, I help patients plan their care for the next year so it optimizes their combined insurance and pre-tax plan benefits. This strategic approach to dental care often allows our patients to elect treatment options that are longer lasting and/or more beautiful than the typically lower levels of care encouraged by the insurance companies.

How do we put an implant in? (by Kirk Donaldson, DDS)

There are several approaches. My most common way is to have my patient lightly sedated, so they are relaxed. After thorough numbing, I open the gumline so I can see the bone clearly. This helps me choose the precise orientation and height of my implant. A pilot hole is gently drilled in the bone, double checked and enlarged. The implant is then carefully rotated into place. In complex cases, I will use a CT scan and a digitally designed guide system to aid in precise implant placement.

I have seen too many poor results because implants were not carefully planned and placed. I generally prefer to close the gums completely while the patient’s bone fuses (integrates) to the implant over a period of 2 to 6 months. In the mean time, patients have a temporary tooth or teeth so they always have teeth in aesthetic areas. Back teeth are often left as just the natural gums during the integration period. The advantage to this approach is highest success rates ( high 90’s) and the best gums later.

I do some clever things to make the gums look very natural on most front teeth. This happens when we uncover the implant and make a beautiful temporary that promotes a natural looking gumline. It is one of the “art parts.”

In special carefully selected situations, we may remove a tooth, place the implant and build the temporary tooth all in one step. Placing implants and teeth all at the same time is becoming more common, but some of the precision and success rates can drop. It is a decision that is important to make with plenty of information.

Once the implants have integrated, the patient is ready to have their new teeth made. We are able to replace a single tooth or several; all the way to an entire arch. Many people do single individually flossable teeth. With two implants, we make lower dentures much more secure. With 4 – 8 implants we can make a whole arch of secure teeth that stay in place and are not removable.

Kirk Donaldson DDS MS

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Enjoy your smile again. Schedule an appointment today. Call us at (734) 971-3450.

A little history:

I (Kirk Donaldson DDS MS) have participated in implant dentistry since the current styles were first introduced to North America in 1982. As a graduate student at the University of Michigan, I listened to the Swiss research team present their material to U of M. They wanted Ann Arbor to become THE implant center in North America. U of M was apprehensive because implants had a bad history. Toronto took up the Swiss on their offer and most of the patient studies came from there for years.

As implants became available to the general public, Brannemark’s system was considered the gold standard. They are now owned by Nobelpharma. For historical reasons many dentists still cling to this “godfather” company. I still use them when patients come to my practice from an oral surgeon that still uses the system. Personally, I prefer and use the Biohorizons Implant system. They have the highest level of bone healing and maintenance around the implants. Plus, I can get consistently nice looking gums around them; it’s a joy to use.

There are many good systems out there. I prefer to use a few systems very well and don’t experiment with every new variation until I see some good research that shows significant improvement.

Dear Cathy,

Thanks for your inquiry about alternatives to root canals. I took the liberty to watch a Mercola video to learn where he was coming from.

Your tooth has a big filling. That means the tooth is weakened a bit because a traditional filling does nothing to reinforce the tooth. Teeth like that often get stress cracks over time because of fatigue. If the crack goes off at an angle, a part of the tooth might break away and is easily repaired. However, if the crack moves vertically up the tooth, it can move into the nerve area or even split the tooth in half.

To strengthen a tooth with a crack, the tooth needs to be held together. The most common way to do that is with a crown. A crown is like a new strong outer shell for the tooth ; binding it together. Often an insulating build up is done to clean up , and strengthen the deeper areas where the old filling and or decay was.

When the nerve of a tooth becomes involved, either from a fracture, decay bacteria, or inflammation from trauma; the tooth can slowly or abruptly die. As Dr Mercola describes, a root canal seals the main micro tubes inside the tooth; usually three on a molar. However, like a river system, there are microscopic tributaries or side canals that the cleaning instruments don’t enter. However, as the tooth canals are cleaned out, the tooth is repeatedly irrigated with a disinfecting bleach solution. That important irrigation cleans the auxiliary canals.

About ten years ago the technology for doing root canals dramatically improved. Post operative discomfort and infections are rare. Millions of people enjoy keeping their teeth, thanks to root canals. Do some fail? Sure, but that is fairly rare these days– IF, the root canal is done well.

Back to the crack. The further a crack goes up a tooth, the poorer the outlook. When you bite, it stresses the tooth. The gross majority are saved without a problem, but depending on the situation, it’s possible to overload anything– even a tooth with no prior treatment.

Alternatives: Dr Mercola says extract all root canal teeth. Or maybe your fracture is far gone. Or the infection has gone on so long that a lot of bone has been destroyed around your tooth. OK, the tooth is lost.

The tooth can be left as a space, replaced with a removable appliance, replaced as a bridge, or done as an implant. For an implant to work, you need enough bone. In most cases these days, it is the preferred way too replace a tooth because it is strong, you can floss it normally and it does not force you to treat the adjacent teeth.

It is a complex subject. A good look at what is happening, and an understanding of your personal preferences should help you solve your problem. The tooth sounds like it is feeding an on going infection. Antibiotics help you short term, but are unable to treat the infection at its source inside the tooth (no longer a blood stream to deliver the drug and the pulp tissue inside and it won’t regenerate or heal).

If you are interested in seeing me for an exam, please set up an appointment. You will probably speak with Ann. 734-971-3450

I hope this was helpful to you — and I learned about Dr Mercola. I do disagree with him fundamentally though. I have seen way too many happy patients who have successful root canals, including myself.

Sincerely,
Kirk D.