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This is Carin, Signing off

on February 12, 2014

I have been working at Stephens Dentistry for the past seven years. Through these years I have made wonderful friendships and have learned so much. Leaving Stephens is bittersweet. I will miss my wonderful bosses, co-workers, and patients, but I am looking forward to my future endeavors.

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SDManageThis is Carin, Signing off

Soft vs. Medium bristled toothbrush

on February 5, 2014

With all of the different toothbrushes on the market, you may wonder which one to choose. We are here to help you choose which manual toothbrush is the best for you.

Purpose of Toothbrush

Your toothbrush is the number one way to remove bacteria and plaque from your teeth and gums. The mechanical motion of brushing your teeth is the main mode of removal. Removing the plaque and bacteria helps protect your teeth against tooth decay and periodontal disease. To that end, choosing a toothbrush that maximizes the plaque removal is ideal.

Bristle Strength

There are several different strengths of toothbrush bristles, the most widely used are extra soft, soft, and medium. In a study from Franciscan University Center in Santa Maria, Brazil, researchers found that medium bristled toothbrushes remove more plaque than soft bristled brushes. However, they also found that medium bristled brushes do more damage to your gums. In order to achieve whole mouth wellness, our Evanston dentists recommend using extra soft or soft bristles.

Add-ons

Some toothbrushes have added features such as floss action or rubber cups. Although these features may increase the effectiveness of your brushing, they do not replace the action of flossing as they cannot reach between your teeth. The rubber bits work well to remove additional staining from your tooth. If you are someone who eats and drinks a larger amount of staining foods – blueberries, coffee, red wine – these toothbrushes may help you keep your teeth whiter when used in conjunction with other whitening products.

Ideal Choice

The ideal choice for a toothbrush will be different for everyone. Choosing a brush with soft or extra soft bristles is a good starting point. After that consideration, choose a brush that is comfortable for you to use. It is important to choose a toothbrush that you feel comfortable using to ensure that you brush your teeth twice a day. If you find electric toothbrushes too complex, feel free to use a manual toothbrush with a toothbrush timer. Always aim for two minutes of brush time.

Choosing a toothbrush can be a personal decision, but no matter which brush shape and add-ons you choose, choose a soft or extra soft bristled brush to keep your gums healthy.

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SDManageSoft vs. Medium bristled toothbrush

Looking for Dental Insurance?

on January 29, 2014

Several patients have been looking for dental insurance for the new year; so we thought it was time to write another blog about dental insurance.

Where to Look

The first place to look for dental coverage is through your employer. Often companies can get better rates for dental insurance for their employees because they contract for a large group of people.

If your employer does not offer dental insurance, or you are self-employed, you will have to search to find either a medical plan that includes dental, or a stand-alone dental plan. In years past, stand-alone dental insurance was difficult to find for individuals. These days, an internet search for dental insurance will bring up several different places you can shop online for dental insurance, such as eHealthinsurance.com. Additionally, with the implementation of the Affordable Care Act, you can enroll in stand-alone dental insurance through healthcare.gov.

What to Look For

With these and other similar websites, you will be presented with many different options for dental insurance. This may be a bit overwhelming, but our Evanston dentist office is here to help!

There are three types of dental insurance: HMO (sometimes DMO), PPO (sometimes DPO), and indemnity.

  • HMO insurance requires you to go to an in-network dentist to get coverage. If you already have a dentist that you enjoy seeing, such as Dr. James or Dr. Robert, then it is best to contact your dentist to find out if they are in-network before purchasing an HMO insurance.
  • PPO insurances allow more flexibility, as you can see any dentist that you would like to see. These insurance plans provide different coverage for visits to in-network and out-of-network providers.
  • Indemnity plans allow for the most flexibility. These plans allow you to see any dentist that you would like to see without any changes in coverage.

Additionally, you should look at the maximum benefits. Unlike medical insurance, where you pay for your portion up to the maximum and then insurance covers everything after; dental insurance covers you at your contracted rate until you reach the maximum benefits, then you are responsible for the costs of any treatment above the maximum. So, a dental plan with a maximum of $500 wouldn’t cover as much as a dental plan with a maximum of $3,000.

Finally, look for an orthodontic option. Some insurance plans include an orthodontic option that you can opt in or opt out. If you are not planning on having orthodontic work – such as braces or Invisalign – you may opt out of this option to save yourself some money. If you are planning on orthodontic work or are unsure, it is best to opt-in. However, make sure it is a benefit and not a discount option. Your dental office may not participate in a discount plan, especially if they are out-of-network.

Things to Watch Out For

There are several different things to watch out for when you are purchasing dental insurance. The first thing to be aware of is a waiting period. Some insurance plans will have a waiting period before they will cover basic or major services. If you are looking for dental insurance because you have treatment you pending, look for a plan that does not have a waiting period.

Secondly, some insurance plans may have a ‘missing-tooth’ clause. This is similar to the ‘pre-existing condition’ clause in medical insurance plans. With a missing-tooth clause, insurance will not cover a replacement for a tooth that was missing prior to you having insurance with them. In some cases, the missing tooth clause is waived after a certain period of time. Check your plan to see if there is a missing tooth clause, and if so, when it may be waived.

Finally, most insurance plans have a ‘replacement’ clause. On average, insurance will cover a replacement for a crown or bridge once every five years. You should peruse your insurance plan and see what the specific limitations are on replacement of restorations. If you are planning on having major restorations replaced – such as a crown, onlay, inlay, or bridge – find out the date when the restoration was originally placed so you are prepared when your insurance requests the information.

 

Purchasing dental insurance can be overwhelming, but it doesn’t have to be. Take the time to learn what you are buying to make sure it works for your needs. If you have more questions about dental insurance, check out our other insurance blog posts. If you are purchasing insurance to use at our office, feel free to call our Evanston dental office with any questions. Our staff would be happy to help answer any of your questions.

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SDManageLooking for Dental Insurance?

Dental Insurance: An Overview

on January 29, 2014

Dental Insurance FormLast week’s blog discussed what to look for when searching for dental insurance. This week we help you understand your dental insurance.

Usual and Customary

When looking at your dental insurance coverage, there is usually a breakdown of coverage into different percentages. The thing to remember is that you are not covered at that percentage of the dentist fees, but instead, you are covered at that percentage of the insurance company’s usual and customary fees. The insurance company uses different surveys to determine their usual and customary fee. These surveys may be of dentists over the whole country or of dentists in your particular area. Depending on what data the insurance company uses for the survey, the fees that they deem ‘usual and customary’ may be either equal to your dentist’s fees, or lower. In some cases, the usual and customary fees are much lower than your dentist’s fees.

Here is an example of what the insurance breakdown would look like if your dentist charges $100 for a prophy and insurance has a usual and customary fee of $90 and coverage of 90%:

Example E.O.B.

Deductibles & Maximums

Deductibles and maximums are defined by your insurance plans. Deductibles may be as low as $25 for dental insurance. Some insurance plans do not apply the deductible to preventative care – such as your routine hygiene appointment. In this case, the deductible is instead applied to any basic or major treatment that you need.

All dental insurance plans have a maximum benefit. This benefit defines the maximum dollar amount that your insurance will pay for your dental care during your coverage year. At the end of your annual coverage year, you lose any remaining benefits and your maximum is reset. Often a coverage year is the same as a calendar year, but not always. It is best to read through your benefits so that you are aware of your maximum and your coverage year. This will allow you to schedule your treatment in order maximize your insurance benefits.

Frequency Limitations

Dental insurance plans have frequency limitations for different procedures. Some examples of insurance frequency limitations are: one prophylaxis (dental cleaning) every 6 months, one panoramic x-ray every 3 years, one set of bitewings every 12 months. In the case of prophylaxes, sometimes insurance plans change the frequency limitations and state that a prophylaxis is limited to two during one calendar year. In this case, you may have two cleanings throughout the year, no matter how far apart. It is important to pay attention to frequency limitations, especially when scheduling your hygiene appointments. At our Evanston dentist office, we try to schedule everyone 6 months and one day from their last cleaning to avoid any issues with frequency limitations. If a patient asks to schedule earlier, we will do so, but recommend that they contact their insurance company to make sure they will be covered. Reading through your insurance plan to learn your frequency limitations as well as any treatment limitations will help you avoid losing insurance dollars.

Alternate Benefits

Some insurance plans consider tooth colored restorations on your posterior (back) teeth to be cosmetic. If this is the case, your insurance may choose to cover the treatment at an alternate lower benefit. In some cases your insurance may choose not to cover it at all.

Here is an example of an alternate benefit: you have a porcelain/ceramic crown done on a molar. Your insurance company deems this treatment to be cosmetic and instead pays for the crown as if it was a porcelain over metal crown. The benefits would be determined using the usual and customary fee for the porcelain over metal crown instead of the fee for a porcelain/ceramic crown.

By reading through your insurance benefits and understanding if they have alternate benefits or if the deny coverage for procedures; you will be able to save yourself from having to pay out of pocket for treatment.

Orthodontic Benefits

For most people there are a variety of different orthodontic benefits available through your insurance. In some cases, these benefits are only available for patients under the age of 18. Often adult orthodontic benefits are covered only once in a lifetime. If you are unsure of your orthodontic benefits, the dentists at our Evanston office would be happy to submit a treatment plan to your insurance to find out what your coverage. Alternately, you can contact your insurance company directly to learn more about your benefits.

 

Dental insurance can be confusing, but it doesn’t have to be. Your insurance plan is a contract between you and your insurance company. Read through your benefits to make sure you understand what you are paying for. If you have any questions about your coverage, do not hesitate to bring your questions to our team. As always we are happy to submit any recommended treatment to your insurance for a pre-treatment estimate so that you may understand your coverage before you get started.

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SDManageDental Insurance: An Overview

Veneers – A simple way to a new smile

on January 21, 2014

When you are looking to improve your smile there are many different directions you can take. In today’s post we will be exploring one of the options available at our Evanston dental office to maximize your smile potential. Whether you are looking to correct worn teeth, discolored teeth, or a gap in your teeth, veneers may be the option for you.

A veneer in dentistry is a restoration that covers your original tooth. Unlike crowns, veneers allow you to retain the majority of your original tooth structure. Veneers can be a cosmetic solution, but in some instances veneers can be used in a restorative manner. There are several different options for veneers. At our office we offer one visit veneers using our CEREC milling machine and contact lens thin Lumineers®.

Dr. James Stephens has used Lumineers to restore an older, worn smile to a beautiful white smile:

Before Lumineers After Lumineers

Before                                                   After

 

He has also used Lumineers to correct a gap between front teeth:

  Before Lumineers After Lumineers

Before                                             After

 

In both cases, multiple veneers were used to preserve the color and look of the patient’s smile. Traditionally 6 or 8 veneers are done at the same time depending on how wide your smile is.

If you are interested in finding out if veneers are right for you, contact our office. We even have a special going on at our office right now! (Visit our Facebook page for more details.) Drs. James and Robert Stephens would be happy to sit down and go over your smile options with you.

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SDManageVeneers – A simple way to a new smile

Keeping Your Toothbrush Clean

on January 16, 2014

The short answer to the question, “how should I clean my toothbrush?” is; “don’t.” Using additional cleaning methods to try to clean a toothbrush after you are sick or have dropped, it may actually do more harm than good to your teeth and gums.

ToothbrushesKeep it Clean

To keep your toothbrush as clean as possible, store your toothbrush in a dry place. Rinse your toothbrush with water after you use it and let it air dry. Do not store it in an enclosed space as this creates an environment which is more conducive for growing microorganisms. If you store your toothbrush in a cup or a toothbrush holder, make sure it is separate from any other toothbrushes to prevent cross contamination.

Do not share your toothbrush, as this could result in the transfer of bodily fluids and bacteria. This is especially the case if you or the person you are sharing with has periodontal disease or an active caries infection, active tooth decay.

You should also be mindful of the location you are storing your toothbrush. If you store it in a bathroom; keep your toothbrush away from the toilet. It is best to store your toothbrush in a medicine cabinet or in your bedroom.

Replace your toothbrush every three to four months. As you use your toothbrush, the bristles become worn out and bacteria will grow. Replacing your toothbrush every three to four months (or sooner), is the best way to ensure that your teeth are properly maintained.

Sterilizing

Do not try to sterilize a toothbrush in boiling water, your dishwasher, or your microwave. The heat from these will warp your toothbrush bristles making it less efficient at cleaning your teeth. These methods of sterilization will shorten the life of your toothbrush.

The ADA does not recommend any commercial toothbrush sterilizers, as there is no clinical evidence that use of one will help your oral or systemic health. The same is true for using an antibacterial mouth rinse to clean off your toothbrush.

Is There a Need to Sterilize Your Toothbrush?

There is evidence that bacteria will grow on your toothbrush, however “there is insufficient clinical evidence to support that bacterial growth on toothbrushes will lead to specific adverse oral or systemic health effects.” (source) As this is the case, our Evanston dentists advise using a common sense approach to taking care of your toothbrush. If you believe that you are at a higher risk of infection, take preventative steps such as changing your toothbrush more frequently or using disposable toothbrushes.

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SDManageKeeping Your Toothbrush Clean

My Invisalign Experience

on January 16, 2014

This week we are turning the blog over to Carin. She is currently in the middle of her Invisalign case and we have asked her to share her experience.

Carin is wearing InvisalignInvisalign is an amazing experience that can be used to shift your teeth using clear plastic aligners. Invisalign can be used to treat a variety of different dental conditions. Recently I started wearing Invisalign to correct a slight shift in my teeth. Here is my story.

I had braces when I was a kid. I have worn my retainer almost religiously since I got out of braces to keep my teeth from shifting back. Since I had my daughter 2 years ago, I haven’t been as diligent in wearing my retainer and when I tried it on again, I noticed that it didn’t fit any more. My teeth had shifted and my bottom teeth were crowding together again. My husband went through Invisalign a couple of years ago for a similar condition, so I knew it was an option. Recently our office staff went to a continuing education course on Invisalign and I learned about Invisalign 5. This is a quick treatment of only five aligners that can be used to correct small problems – such as the crowding I was beginning to experience. I spoke to Dr. Bob about it and he thought I would be a good candidate for Invisalign 5.

My Invisalign experience started with taking impressions of my teeth. Olga explained everything as she mixed the impression material so I knew what to expect. I had had impressions taken before, so I knew it wasn’t going to be a very pleasant experience. Olga was very attentive though and made it as comfortable as possible. Olga tested the impression trays to see how they would fit and she adjusted them as necessary to ensure that they fit properly. She let me know how long the impression material had to sit and she was conscious about how the impression material was drying. She used the high speed suction to get rid of some of the material that was squishing out to make the experience more comfortable.

A couple of days later, Dr. Bob received my ClinCheck. He reviewed it and went back and forth with Invisalign to make sure that they had my treatment correct. He showed me some of the different movies and it was interesting to see how my teeth would move in just 10 weeks! After Dr. Bob approved my ClinCheck file, my aligners arrived in the office about 2 weeks later.

At my first appointment Dr. Bob showed me the new aligners and had me try them in to see how they fit. I had two attachments that he needed to place as anchors for the treatment. Dr. Bob used the template to place the attachments, and then cleaned off the excess resin to make them smooth. It felt weird, but much better than metal brackets from braces. Once I put the aligners on over the attachments, I couldn’t even feel them. On the other hand, I could feel the pressure on my teeth. It was an interesting sensation. I have “power ridges” on my aligners that help torque the roots back on some of my teeth. Dr. Bob used clippers to adjust the aligners around the power ridges to make them more comfortable.

On the second day my teeth were sore, but only when I was chewing. I took an ibuprophen to help, and it worked fine. Over the course of the next couple of days, my aligners got easier to take out as my teeth shifted into place. I never had any pain or soreness other than the second day. Wearing them was easier than I expected. It did take me some time to get used to the aligners. It was weird wearing the plastic over my teeth all the time, but it didn’t take long for me to become comfortable wearing them. I had a little bit of a lisp the first couple of days, but this went away as well as I became more comfortable. I did notice that I stopped snacking while wearing my aligners. The idea of brushing my teeth after every time I snacked wasn’t convenient, so I just avoided the hassle.

By the time I switched to my second set of aligners, I was a pro. The second set gave me the same pressure, but not as much soreness as the first. I didn’t even need any pain medication for that set. I am currently on my third set of aligners and have found that each new set brings the pressure and soreness, but each new set has less than the last one. My teeth fit together better than they did and they are almost straight again. Just two more aligners and I will have my perfect smile.

My correction was such a small one, I was glad that there was Invisalign 5 available to help. Invisalign 5 was an inexpensive way to correct my minor crowding issue. My whole Invisalign experience has been a great one. I would not hesitate to recommend Invisalign to our patients. Most of our patients don’t even know that I have my aligners on until I tell them!

Carin works at the front desk at our Evanston dental office. If you are interested in hearing more about her experience, do not hesitate to call our office and speak to her.

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SDManageMy Invisalign Experience

Changes in our Evanston Dental Office

on January 16, 2014

Our Evanston dental office is going through some changes! Two of our amazing team are moving on to bigger things. We wish them lots of luck in their future endeavors.

Good bye Tanya and Paulina. You will be missed!

While we try to find someone to fill their shoes, our blog will be taking a short hiatus. We will be back in September with new posts. In the meantime, post your comments below and let us know what questions you would like us to answer when we come back.

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SDManageChanges in our Evanston Dental Office

New Year’s Resolutions

on January 16, 2014

Make the most out of your dental home careThe beginning of the year is the best time to begin a new habit or to set out to accomplish a new goal. If you are having trouble coming up with a New Year’s resolution, we suggest that you resolve to smile more. Here are some quick and easy suggestions so you can make this resolution a reality.

Strive for the best oral care

Be honest, is your oral care the best that it can be? If not, take steps to improve this year. The first step is to make sure you brush twice a day for 2 minutes each time; try using a toothbrush timer or a brushing app on your phone. Many electric toothbrushes have timers built into them. If you have an electric toothbrush, check the manufacturer’s website to see if it has a timer and if so, how it works. Use a fluoride toothpaste when you are brushing to help strengthen and remineralize your teeth.

The next step would be to floss daily. If you tend to forget to floss before brushing your teeth, carry floss with you in your pocket or purse to help remind you throughout the day. Some dental work, such as braces, fixed retainers, or bridges, make it more difficult to floss. Don’t be discouraged if this is the case, call our Evanston dental office or speak to your dental hygienist the next time you are at our office. Our staff is happy to offer tools to help making flossing easier. Another option may be a Waterpik. At our Evanston dental office, we recommend the ShowerPik which connects right to your shower head. This is a quick and easy way to floss while you’re in the shower.

If you are more prone to getting cavities, add a fluoride mouthwash to your routine, or schedule an appointment with one of our Evanston dentists to see if prescription strength fluoride toothpaste is right for you.

Make your smile sparkle

You say your oral care already is impeccable, but your teeth still are yellowing or discolored? Make a resolution to whiten your teeth this year. At our Evanston dental office, we offer Stephens Dentistry’s Whitening Club which includes all the tools you will need not only to whiten your smile, but also maintain your smile throughout the year. With Stephens Dentistry’s Whitening Club, you receive custom whitening trays and whitening gel. Our Evanston dentists recommend using the trays each night for 4 to 7days for 30 minutes or until your teeth are as white as you would like. If your teeth are sensitive, we recommend adjusting the frequency of your whitening.

You may have whitened your teeth in the past, but noticed that after time, they are again stained. With our whitening club, you received complimentary tubes of whitening gel throughout the year to help you keep your teeth white.

Let your smile shine

If none of these are issues for you, but you still don’t feel comfortable showing off your smile, contact our office. Our Evanston dentists are happy to have a smile consult with you to help you with your resolution to smile more. With options such as Invisalign, veneers, one day crowns, and tooth colored restorations there are many options available to allow you to maximize your smile.

Resolve to start smiling more this year and don’t hold back. With our highly trained dentists and staff, we have the knowledge and tools to ensure you keep your resolutions this year.

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SDManageNew Year’s Resolutions

Sterilization at our Evanston Dental Office

on January 8, 2014

With all we know about bacteria, viruses, and how disease is spread; we sometimes forget that dentistry was ever done in any other way. In the past dentists didn’t even wear gloves! Nowadays, these dentists of the past are referred to as “wet-fingered” dentists.  Thankfully, that is just one of the many things that have changed about dental sterilization.

Keeping our operatories disinfected involves several different steps as there are different surfaces that need to be cleaned.

Disinfecting Counters and Surfaces

Counters and surfaces are easier to disinfect, as any bacteria that lands on them is not through direct contact. Preventatively, we place barriers on surfaces that our dental technicians come in contact with – such as the handles on the light, the suction, and the air/water syringe. In our office these barriers are either plastic bags or blue plastic stickies. These keep the bacteria from reaching these surfaces.

In addition to the barriers, we use Cavicide spray and Cavicide wipes to disinfect these surfaces after every patient. Cavicide is a medical grade disinfectant which is effective against Tuberculosis, Hepatitis B, Hepatitis C, hydrophilic and lipophilic viruses, bacteria (including MRSA and VRE) and fungi. Cavicide can be used on a variety of surfaces – from the countertops to the dental chairs.

Autoclave at our Evanston dentist officeSterilizing Instruments

Dental instruments are put through a rigorous sterilization process at our office. First, they are cleaned mechanically in a dishwasher to remove any surface contamination. Then our instruments are run through an autoclave to finish off the sterilization process. The autoclave uses pressure and temperature to sterilize the instruments. Our autoclave is tested weekly via a third party testing company to ensure that it is sterile.

The instruments are sterilized inside pouches, which serve two purposes. The pouches have an indicator on them to ensure that the correct temperature and pressure was reached to achieve sterilization. Additionally, the pouches keep contaminates out until the package is opened at the time of your appointment.

Protective Equipment

The final step protects you as well as protecting our staff. This is personal protective equipment. We use masks and gloves to prevent any transfer of bacteria between you and our staff. Additionally, we offer eye protection to all of our patients to protect your eyes from the light and from any splatter that may occur during your cleaning. The protective barriers we use are one time use, and often multiple gloves and masks are used during your appointment to avoid transferring bacteria between surfaces.

Your health and safety is our highest priority. We take the utmost care to ensure that you receive the best that our Evanston dentist office has to offer. If you ever find yourself waiting in our lobby area, it is because we are making sure the operatory is perfectly cleaned and sanitized for you. If you ever have any questions about our sterilization processes, feel free to ask your technician.

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SDManageSterilization at our Evanston Dental Office