What trends are dentists seeing today in terms of patients who need their restorative services as well as patients who elect to have what is known as cosmetic or aesthetic dentistry?
“The most requested procedure – elective procedure – in this office and in America today would be: ‘I want my teeth whiter,'” said Dr. Mark Evans of Pioneer Valley Dental Arts in Longmeadow.
“It is a very conservative process and it is not destructive and really enhances self- esteem and as patients keep their teeth longer, the teeth tend to get darker. One shade every decade. It erases the age on the tooth. Patients look a little bit younger and they feel better.”
Evans said “the original method was a take-home, night-time vital bleaching and that is still available” for patients.
“We can customize trays for their teeth and they can get a whitening gel and wear it every night or they can wear it 45 minutes every day and after a two-week period they will notice their teeth gradually lightening, or there is a more comprehensive jump-start procedure which we can do in the office,” Evans said.
Evans said he has also seen “a surge in adult orthodontics.”
“My oldest female patient was 80,” Evans said.
“She came in and said I am here because my teeth are crooked and I want to have them straightened. Her other dentist that she left had said you are too old for that and she did not want to hear that. I told her that you can have them straightened at any age, but it is going to take a couple of years and we are going to need to do braces and she said OK, and in two years she had a beautiful smile.”
Evans said younger patients have benefited from the use of dental sealants, a plastic material used on the chewing surface.
“Kids over the past three decades have had the advantage of tooth sealants for the grooves of the back teeth. This has reduced the cavity rate in those pits and fissures and is the advantage for a younger individual being seen on a regular basis,” Evans.
What other trends does he see in dentistry?
“We are seeing a lot of patients come in with wear on their teeth as a result of sleep disorders,” Evans said.
With obstructive sleep apnea, a person’s airway becomes blocked through the relaxation of muscles and position of the jaw during sleep and grinding may be a response to counter that.
He added his practice can make removalable protective guards that fit over teeth to help such patients, depending on the severity of their situation.
“We have a lot of patients who may or may not have been diagnosed with a sleep disorder, but who show the destructive effects of the grinding on their teeth that we make occlusal guards for,” Evans said.
“You can replace plastic on an occlusal guard, but not enamel on their teeth without restoring multiple teeth.”
While head and neck screenings are generally done during well visits with primary care providers, Evans said that some patients are more apt “to see a dentist then they are to see a physician,” and that dentists check for malignancies during dental exams that include an oral cancer screening.
“We specifically look for any discoloration, change in texture in tissue. We can also identify patients who might be in a higher risk category and if we see anything we can refer them to an oral surgeon for a second look and possibly a biopsy of that tissue,” Evans said.
He added, “Historically the oral cancer was in the patient who was a heavy drinker or a heavy smoker or both.”
“But we are seeing patients with no high risk factors at all – non-smoker, moderate drinkers. The oral cancer rate is increasing in males in the U.S. so they are looking at human papillomavirus as possibly significant in the manifestation of this disease. It is very important for these screenings to occur twice a year,” Evans.
“Ten years ago, we picked up three oral cancers in one year in this office. I was really stunned. Two had no risk factors whatsoever. You have to be vigilant.”
He added that he felt “in the past two or three decades the dental IQ of the average American public has increased dramatically.”
“I attribute this to the internet which disseminates information. Some of it might be confusing to patients and that is where we come in to help them delineate what is best for them,” Evans said.
“Some patients need more information and that is why seeing your dental health professional on a regular basis is definitely recommended as part of overall health.”