Is that Before and After Photo REAL?

Stock photography is EVERYWHERE. In photo frames, all over magazine advertisements, websites, brochures, anywhere you can think of. There are many websites, like iStockPhoto.com, that are dedicated to selling thousands of professional pictures taken with models and professional photographers in whatever pose and situation you could ever imagine. Most of the time stock photos are a great thing. A nice looking photo can really add to a piece of advertising, and it's a lot easier and cost effective to go onto a stock photography website and buy a great looking picture for $20 than to hire a photographer and a model and pay a couple hundred dollars for a photo-shoot. 

In dentistry using stock photos can be really useful. A nice picture of a girl smiling or a family brushing their teeth can improve the look of a brochure or a website. However, "Before and After" and "Smile Galleries" aren't the place for stock photography. Before and after photos are meant to be a portfolio of a dentist's work, actual cases of the dentist's capabilities and talents. Dental work, especially cosmetic dental work, is very personal to those who are considering having some completed. Patients and prospective patients look through these before and after photos as true samples of what their smile could be improved to look like from their specific dentist. Before and after stock photography isn't fair to those flipping through an online Smile Gallery who trust that the cases have actually been completed by that dentist. I feel like this is false advertising. 

I like to take before and after pictures for cases that are especially good examples of either common cosmetic dental work, like veneers or dentures, or especially extensive cosmetic dental work, like dental implants. I respectfully never take photos of the patients' faces, only their teeth or smiles. Here are what natural before and after photos look like:

Look through your dentist's Smile Gallery, do the before and after pictures look believable? Do the people in them look real? Do the pictures look set up? After perusing the internet I found a few great examples of Before and After stock pictures: 

This is kind of a silly one for a dental office, obviously a full 

makeover and you can hardly even see her teeth!

Both of these were found on Shutterstock, a stock photography website.

A Family Dental Care Center: Dr. Seth Rosen

www.drsethrosen.com

2030 West Main St.

Norristown, PA 19403

610.631.3400

The Meaning of Pho

When I entered dental school at Temple University, pretty much right off the Connecticut farm, I noticed that Philadelphians stay to their neighborhoods. Here was a beautiful city with so many different cultural areas and nationalities with ill-defined boarders and boundaries that were nary crossed by true Philadelphians. They were born, raised, went to school, returned, and then raised their families in the same neighborhood. This intrigued me, mostly because I knew that there had to be some great food gems that weren’t being utilized. This was well before the dawn of the internet, GPS, and food blogging.

Vietnamese Pho, beef noodle soup.
Courtesy Pho Tai Nam in East Norriton, PA

One day I noticed a group of Vietnamese students coming back from lunch. They all had toothpicks protruding from their lips and had an odd smell about them. I asked what they had for lunch and they said something along the lines of “fuh”. They thought that I wouldn’t like it, but they would take me anyway the next time they went. Two days later they told me that they were going. We drove less than a mile from the school and entered what looked like an empty storefront in a strip mall. It was a huge room with little décor, large rectangular tables, plastic chairs, and people of all ages (all Vietnamese) bent over these tremendous bowls of what looked like noodle soup. I let them order for me, and before I could blink there was a huge steaming bowl of Pho, beef noodle soup put in front of me. This stuff is brought to the table so hot that the raw beef is cooked in the broth as it sits. There was a small dish of condiments including basil, jalapeños, lime, and bean sprouts. You can adjust the flavor of the broth by adding pepper sauce or plum sauce. Then you slurp away. Besides being the most delicious lunch ever it was also the cheapest at $3.95. By going a little bit out of my comfort zone I was able to score a fantastic lunch at a great price.

The same happens in my dental office. We are getting inquiries from as far away as New York because of the internet. Patients are finally realizing that if they travel a little bit further they can get great dentistry at great prices. To put this in perspective: we recently placed a dental implant in a patient who was quoted $6000 by her New York City dentist, we were able to complete the same procedure for $1800. At first she was hesitant because an implant requires at least two visits to complete, which would mean two trips of 100 miles each way. When I figured out that the six hours of her time was worth $4200, or $700 per hour, she jumped at the chance. Locally we get the same scenario, but patients only need to travel minutes, not hours, to get the best dentistry at the best prices. Dental pricing is based on the local market, which varies from town to town. Right up the street we have a higher average income area that forces the prices of dentistry to be 50% -150% higher than our office three miles down the road.

www.drsethrosen.com

A Family Dental Care Center: Dr. Seth Rosen

2030 West Main St. 

Norristown, PA 19403

This Ain't Your Grandfather's Novocaine Anymore

Before the introduction of Novocaine in the very early 1900's, cocaine was the original dental anesthetic. Obviously, cocaine had to be replaced due to its euphoric and addictive qualities and along came novocaine! For years novocaine was the most widely used and popular anesthetic in dentistry and today any local anesthetic injected into you is referred to as "novocaine". But novocaine isn't actually used anymore. 


Novocaine was replaced by safer anesthetics, the most popular of these being lidocaine. The majority of people who go to the dentist to have cavities filled will be injected with lidocaine. Lidocaine is more effective, more hypoallergenic, and can be better controlled to determine how long it lasts and how numb the area is meant to be. 


While there are a countless amount of local anesthetics available on the market, we use five different types of anesthetics in our office. We choose depending on how long we want the patient numb for, how numb we want them, and according to the patient's health and medical history. All types of anesthetics are processed in the body differently, some are processed in the liver whereas others are processed in the bloodstream. 


If you just can't stand waiting for the numbness to pass there is a drug available called OraVerse. After the procedure is completed, OraVerse is injected into the same area and reverses the effects of the anesthetic. All feeling is returned to the previously numbed area pretty much immediately. However, OraVerse has it's side effects which include possible cardiac disturbances, and the good doesn't really outweigh the bad. Why take a drug to speed up regaining feeling in an area that, if left alone, would probably lose the numbness within the hour anyway? 

www.drsethrosen.com

A Family Dental Care Center: Dr. Seth Rosen

2030 West Main St. 

Norristown, PA 19403

610.631.3400

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Bright White Teeth

Home Remedies vs. Over the Counter vs. In-Office Whitening
Trying to get bright white teeth over the summer? With the tons of advertisements out there bombarding you with zillions of different ways to achieve a beautiful white smile it's hard to know what the best is for you. Here are descriptions of the most common teeth whitening options:

In-Office Whitening
If you're really serious about white teeth or if you have seriously stained teeth then you should probably choose in-office power whitening. Zoom is a common power whitening system. These professionally applied bleach whiteners are extremely strong and contain hydrogen peroxide in concentrations ranging from 15 percent to 35 percent and are sometimes used together with a light or laser. Your gums will be sealed with a protective gel or isolated with a dental dam while you sit in the chair for about an hour with the bleach on your teeth. This stuff is strong and you can feel it working. You will only require one procedure which will definitely run you a couple hundred dollars. 


If you're looking for a cheaper option you can purchase Dentist Dispensed/At Home gel whitening from your dentist. Your dentist will take impressions of your teeth then make plastic trays. You will also receive a strong whitening gel to put in the trays. The trays with the gel are to be worn for a few hours during the day or over night every other day over a two to four week period. The only bleach whitening that holds the ADA Seal of Acceptance is Opalescence Whitening Gel 10%. 


Over The Counter
OTC whitening products work by bleaching your teeth with carbamide peroxide. Usually these are gels that you can paint on to your teeth. This is a relatively safe and effective way to whiten as the most common side-effects are gum and tooth sensitivity and they usually subside shortly after treatment. 


Whitening toothpastes are different because they contain polishing or chemical agents to remove surface stains rather than bleaches to actually change the color of your teeth. These are gentler on your teeth and a good place to start whitening since it's so cheap and easy to use a simple whitening toothpaste. You should always choose a whitening toothpaste with the ADA Seal of Acceptance like Crest Pro-Health Whitening or Colgate Total Whitening. 


Home Remedies
If you only want to whiten your teeth slightly then there are plenty of natural foods that you can eat that promote whiter teeth. Strawberries, apples, and raisins are all good for your teeth and work as natural teeth whiteners. Recently Dr. Oz suggested a mix of baking soda and lemon juice as a natural home remedy for whitening teeth. This is only a good idea if you leave the mixture on your teeth for less than a minute and don't brush. The lemon juice is acidic and will erode the enamel of your teeth and baking soda is very abrasive- any damage done to the enamel of your teeth is permanent and will cause tooth decay, cavities, and sensitivity. It's safer to use Arm & Hammer toothpaste if you want the whitening power of baking soda on your side since Arm & Hammer uses a controlled amount of baking soda that will definitely not harm the enamel of your teeth.


Keep in mind that if you have any dental work like tooth-colored fillings, crowns, bonding, dental veneers, or bridges that any whitening product will not whiten these. Take caution whitening your teeth under those conditions as the whitener is only capable of whitening your natural teeth. 

www.drsethrosen.com

A Family Dental Care Center: Dr. Seth Rosen

2030 West Main St. 

Norristown, PA 19403

610.631.3400

The Denture "Bait and Switch"

I’m going to make you a really really cheap denture that doesn’t fit, doesn’t look good, and will probably break a lot. You know you want one. No? How about a sorta cheap denture that sorta fits, looks okay in passing, and will probably break in a few months. No? Okay, okay…how about a custom fit denture, hand set customized teeth that will fit like a fine glove, looks like natural teeth even up close, and is guaranteed against breakage. Yes! That’s the one!

Basic dentures, these are advertised
as the "economy" cheapest dentures.

Ever see an add for a really cheap denture? We all have.  Free consultation too. The idea is to get you in the door, then convince you that you would never want anything but the best, and most expensive option. I call it bait and switch. They call it upgrading. The old good, better, best scenario. Dentists are advertising various tiers of dentures as "good" or "economy", "better", and "best" or "premium" quality. I've even seen Neuromuscular/FaceLift Dentures that claim that they can make the wearer look "20 years younger". These are also the most expensive type of dentures available. I'm skeptical of these FaceLift Dentures, and especially skeptical of the different available tiers of dentures that some dentists provide. 

Premium or "best" dentures. These
 are advertised as the more expensive
but better quality dentures.

There is no reason for any patient to ever buy the economy level of dentures. These are allegedly lower quality, look less natural, and fit less comfortably. However, I strongly suspect that these different tiers don't even exist and are only advertised to further glorify the "premium" dentures. My practice has never lowered itself to such tactics and never will. All dentures should be seen as a beautiful custom set that shows off my work. In fact, if we have done our job properly no one should appreciate our work. It should go unnoticed. I only provide custom-made dentures in my office of the highest quality, which tend to be a lot less than the premium denture up sell. Everything is guaranteed and there are no limitations on adjustments or breakage. I believe that I have to stand by my work and so I only make the best dentures possible and never offer a lower quality denture. My practice also offers financing for patients who cannot immediately fit the cost of dentures into their budget.

 www.drsethrosen.com 

A Family Dental Care Center: Dr. Seth Rosen 

2030 West Main St. Norristown, PA 19403 

610.631.3400

Toothbrush Etiquette

You should brush your teeth at least twice a day, and ideally after every meal. This is the easiest way to keep up with your oral health. But what about keeping up with your toothbrush? Colgate claims "Got a cold? Change your toothbrush", and we've all heard that flushing the toilet with the lid open can spray various kinds of bacteria, such as E. Coli, all over your toothbrush. So, can you really get sick from your toothbrush? And how often should you replace it?

The bristles in your toothbrush can house germs and bacteria. Keeping a toothbrush protector over your toothbrush, or storing it in a cabinet, can actually increase bacterial growth. You should always keep your toothbrush out in the open to allow it to dry completely after every use. There are plenty of cleaners available to use to keep your brush clean, these are a good idea but not always necessary. The ADA recommends that you wash your toothbrush occasionally in the top rack of the dishwasher. You can also dip your toothbrush in a small cup of alcohol-containing mouthwash (like Listerine) for about 30 seconds to kill off any germs or bacteria that could make you sick. Toothbrush cups or holders that hold many people's brushes are a terrible idea- this is how germs get spread from one toothbrush to another and ultimately from one person to another. A dirty toothbrush can infect someone with bacterial diseases, such as strep throat, or even blood-borne diseases, such as Hepatitis B or C. So yes, you can get sick from a toothbrush so keep your toothbrush away from others and never share! You should also throw away your toothbrush after a bacterial illness, such a strep throat, but not necessarily from the common cold since colds are viral and you can't re-catch a cold from your toothbrush.

Storing your toothbrush close enough to the toilet so that the spray from the flush will hit it isn't as dangerous as you may think. While this is definitely a disgusting thought, the presence of some fecal coliforms won't necessarily make you sick since the bacteria that comes out of you is often what is already living in your mouth. However, the spray from toilet water can spread noroviruses which cause gastrointestinal illnesses on cruise ships. To be on the safe side, it's still a good idea to close the toilet lid prior to flushing to avoid the transfer of any kind of bacteria.

The ADA also recommends that you should dispose of your toothbrush (or toothbrush head if you use an electric one) and get a new one every 3-4 months. This is because the bristles wear out over time and lose their effectiveness, if you notice the bristles bending then get a new one. For the environmentally conscious, Preserve is a company that will send you a toothbrush made out of recycled material and a mail-back pack so you can return the toothbrush back to the company to be recycled when you're finished with it. They also offer a toothbrush subscription- they send you a new toothbrush every 3 months and take back your old one.

www.drsethrosen.com

A Family Dental Care Center: Dr. Seth Rosen

2030 West Main St. 

Norristown, PA 19403

610.631.3400