Scaredy Cat?

acute dental of fountain hills

Are You A Dental Scaredy Cat?

Visit the office of Dr. John A. Porter, DMD and become a dental HAPPY CAT!
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BEFORE
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AFTER
Special consideration for those patients afraid to go to the dentist. Scaredy Cats don’t need Halcion, Xanax, Prosac, or Lorazepam! What they need is TLC. We are here in this small office to hold your hand.

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Denture Story

acute dental dentures and partial dentures

Denture Story

The Disastrous Beginnings

In the nineteenth century, dentures were  expensive, and could only be afforded by a fortunate few. In 1851, a “Miracle Rubber” was founded, which was of tremendous value to denture makers. The new rubber was called Vulcanite, and it was used to make the moldings for dentures. The discovery of this new material allowed dentists to drop the price of dentures and, finally, the average person was able to afford a pair. However, this would be short-lived.
Processing of vulcanite was still expensive and no one had claimed the processing patent. Almost ten years later, this all changed. In 1868, Josiah Bacon, a businessperson, gained control of this production process, purchasing the patent so he would have sole control over manufacturing and distribution of vulcanite. Bacon demanded fees from individual dental practices, raising the fees based on the size of the practice. To add insult to injury, he charged an extra dollar for each denture replacing up to five teeth, and two dollars for dentures with six or more teeth. 
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To put this in perspective, an extra dollar in the 1850s equals more than $30 today. Plus, average wages were significantly lower in the 19th century. In 1860, laborers  made  about 10 cents an hour! That is a mere $6 a week, and only $300 per year! Carpenter salaries were not much better at 14 cents an hour, which is $8.40 a day or $436 per year! If you were fortunate enough to have a higher paying job, wages were still shockingly low. For example, Union Army Privates earned $11 a week; that is only $572 per year! Firemen made a measly 15 cents an hour, averaging $9.00 a week or $468 per year!
acute dental of fountain hills
 Mr. Bacon decided he had the right to examine each and every dentist’s office and records to ensure his patent was being honored.  He became a tyrant and eventually, the necessity of his product led dentists to resent him.
He only made matters worse by hiring spies to travel the country in search of any dentists who may be violating his rights and ignoring his patent. Mr. Bacon went so far as to advertise in newspapers to intimidate dentist, threatening to sue those who did not honor his monopoly over the vulcanite material. None of this helped his reputation. He was despised by dentists near and far.  
On April 13th, 1879, Josiah Bacon was found shot to death in a San Francisco Hotel. (Surprised?! We did not think so.) During the investigation, officers discovered that all the San Francisco dentists they spoke to held a deep-seeded resentment toward the victim. In fact, witnesses recounted that several dentists had actually threatened Mr. Bacon’s life before his murder. The pool of suspects was enormous. Luckily, authorities caught a break.
Some days later, Dr. Samuel Chalfont, a dentist under the control of Mr. Bacon’s vulcanite monopoly, surrendered to police. Samuel Chalfant was a denture dentist in Delaware who was making vulcanite dentures without a patent and didn’t want to pay the fee, so he fled to St. Louis, then to San Francisco, where Bacon caught up with him and the two men had several confrontations. He claimed that Mr. Bacon had begun legal proceedings to prevent him from making the vulcanite dentures in Wilmington, Delaware.
Bacon’s murder trial was sensational, publicized throughout the country. Dr.  Chafont was convicted of second-degree murder and sentenced to 10 years in San Quentin prison. Remarkably, he escaped prison after 3 years, but authorities eventually recaptured him and he was forced to serve out the rest of his sentence. Finally, in 1881, the patents expired and dentists could finally live in peace, and make dentures as they chose once again.
Who would have thought that dentures had such a sordid, bloody history?

Taylor Loves Her Job

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Taylor Loves Her Job!

Taylor, dental assistant at Dr. Porter's Fountain Hills dental office, talks about how much she loves her job. We pride ourselves on our ability to create a calm, welcoming environment for our patients. That being said, if our staff feels like Taylor does, our patients surely do too! Thanks for the glowing review, Taylor.

Bicon Patient

acute dental of fountain hills

Bicon Patient

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Contact Information

John A. Porter DMD

Phone: 480.816.3214

Address: 17100 E. Shea Blvd. # 450 

Fountain Hills, AZ 85268

What is Gum Disease?

Dr. Porter Fountain Hills Dentist

Gum disease, or periodontal disease, is a very common malady effecting almost all adults over age 40.  In fact other than the common cold it is the world’s most common affliction.  And the most common cause of tooth loss.  All mouths are “infected” with bacteria, commonly called “plaque”.  To control the growth of plaque is why we brush our teeth.  But no matter how well we brush our teeth plaque will be left behind.  This left behind plaque will harden to become calculus, which can’t be removed by brushing alone. 

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Left behind plaque hardens to become calculus.

 

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Plaque is left behind...
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...and hardens to become calculus(tarter)

What is Gum Disease?

One common place for calculus is behind the lower anterior teeth:

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Continued accumulation of calculus at the gum line and under the gum leads to the formation of “periodontal” pockets.  As these pockets get deeper they become more difficult to clean and lead to progressive loss of tooth attachment. (gum tissue, cementum, and bone) Continued irritation by micro organisms in plaque and calculus lead to the formation of periodontal pockets. In the diagram captioned, ‘Periodontal Pocketing,’ note that not only are the gums inflamed and shrunken, but the bone that holds the tooth in place has been partially lost.  Your dentist or hygienist will check the depth of your pockets to assess the severity of the disease. (periodontitis)

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Periodontal Pocketing
Your dentist or hygienist will check for periodontal disease with a “perio probe”. Pocket depths 3 mm or less are considered normal, while pocket depths 6 mm and over are serious.
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Bone loss from periodontitis.

As periodontal disease continues untreated eventually the pockets reach the end or apex of  the tooth.  Up until this point the disease process has been painless.  But at this point pain will be felt and the only alternative will be extraction.  Teeth can become very mobile in the terminal stages of periodontal disease and can sometimes be pulled out with your fingers.       

   

Dr. Porter Fountain Hills Dentist
Perio Probe
Periodontitis causes inflamed, bleeding, and receding gums. It also causes bone loss.
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How to Avoid Periodontitis?

What you can do to help stop the progress of periodontal disease is to to improve oral hygiene and to make an effort to clean below the gum line.  Vibrating your toothbrush bristles at a 45 degree angle under the gum line, and flossing under the gum line will help.    

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Vibrate Toothbrush at a 45 degree angle.
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Floss under the gum line.

Periodontal disease is treated by scaling and root planing, that is, scraping calculus and debris from under the gum line.  The is done by Dentists, Hygienists, and Periodontists (Dentists that specialize in treating gum disease)  Other treatments include bone and tissue grafting, antibiotics injected under the gum line, and laser cleanings. Consult your Dentist to see what he or she recommends.

Avoid Periodontal Disease!

Regular visits to your dentist will help prevent periodontitis.  Our new patient special, including X-Rays, an exam, and cleaning, is only $65.  During this visit, Dr. Porter checks periodontal pocketing with a perio probe to identify any problem areas. Schedule an appointment with Dr. Porter today! 

Missing Back Teeth

why replace missing back teeth

Why Replace Missing Teeth

No one will see it back there!  So, why should I replace my missing back teeth? 

Well, it turns out your dental health is highly correlated with whether or not you make the decision to replace your missing back teeth. 

When a back tooth is removed it is kind of a “two for one” deal.  Teeth that touch together, when you shut your mouth to chew, are “biting partners.”  Like many partnerships, the loss of one partner affects the other.  With no biting partner, the opposing tooth is not useful and chewing power is diminished.  If the “back tooth” is a first molar, or a tooth ahead of the first molar, it will present as a “black hole” in your smile.  No one wants their appearance to be swallowed by a black hole.

Extracting teeth is a “two for one deal.”

why replace missing back teeth

Teeth erupt until they hit something. Making sure teeth touch is the principle behind “teething” and the reason children’s teeth come in at the same time.

With nothing to touch, a superfluous tooth continues erupting. The resulting contact relationships (or lack thereof) of adjacent teeth allow for the formation of food traps. 

Contact relations change with hyper-eruption. Food becomes impacted.

why replace missing back teeth

The biting movement causes you teeth to move up and down a little bit. This process wears the contacts between them. However, over the course of your lifetime, your teeth stay together (usually). So, how does this happen?

There is a mechanism to move teeth forward (for molars) or backwards (for canines and premolars) to keep the contacts tight. With no tooth ahead of the last molar, it starts to move forward.

With no tooth ahead of it, the last molar drifts forward.

why replace missing back teeth

With the last molar tipped forward it becomes hard to clean the mesial. (the part of the tooth closest to the center of the mouth) Plaque and calculus accumulate at the gum line and cause periodontal pocketing. When this pocketing reaches the end of the root, abscesses (cavities filled with pus) form. This is painful and usually leads to extraction of the infected teeth.

Abscesses form when periodontal pockets reach the apex.

why replace missing back teeth

With the posterior teeth gone the same process starts again on the more anterior teeth, with the premolars drifting distally (toward the back if the mouth).

Loss of teeth continues with drifting, food impaction, and pocket formation.

why replace missing back teeth
In conclusion, failure to replace a single molar tooth may start chain of events: overeruption, tilt, drift, gum pockets, decay, and bone loss. Over the years, this chain of events may lead to loss of all your teeth.

Root Canal!

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Root Canal!

The very word “Root Canal” is enough to strike terror into the heart of an otherwise compliant dental patient. So what are root canals and why are they often feared?  

 

Figure 1 shows the anatomy of a tooth with enamel (the white external part of a tooth) and dentin (the yellow part of the tooth under the enamel) and blood vessels and nerves (pulp) inside the tooth. For a variety of reasons the pulp can become inflamed or necrotic (dead) and have to be removed. The process of removal of the pulp and filling the pulp chamber is called a “root canal”. 

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Figure 1. Tooth Anatomy

The process of doing a root canal is the process of removing the pulp (either alive or necrotic), and filling up the resulting space. Figure 2 shows the pulp being removed with an endodontic hand file. Generally pulp is removed first with hand files and then with rotary Nickel Titanium files.

Figure 2. Pulp is Removed

The process of removing the pulp is frequently the most painful part of the root canal procedure. To be pain free it requires good anesthesia. Neither Nitrous Oxide (laughing gas) or IV Sedation (a needle in the arm) alone will give adequate anesthesia. Good block or Infiltration anesthesia or Intraosseous anesthesia is required for a pain free experience. Intraosseous anesthesia is the injection of local anesthesia directly into the bone surrounding the tooth, and nearly always gives a pain free result. A good question to ask your root canal doctor is whether or not he uses intraosseous anesthesia.

After the pulp is removed the empty space of the root canal system must be filled. The accepted filling material is called “Gutta Percha”. Usually the Gutta Percha filler is coated with a substance call “sealer” to fill in the gap between the GP Point and the canal walls, as illustrated in Figure 3.

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Figure 3. Pulp Chamber is Filled with GP

After completion of the root canal process the tooth is “hollow”, and it is frequently recommended that the tooth have a crown (cap) to strengthen it. Sometimes it is also recommended that the canals be reinforced with metal “posts” to give the restored tooth more strength.

If all this sounds simple it really isnʼt. No discussion of root canals would be complete without mentioning the things that can go wrong. Figure 4 shows what is called an accessory (side) canal. Failure to fill these canals can result in root canal failure. Figure 5 shows a highly curved canal that could not be instrumented. Figure 6 shows a crack in the root of the tooth which frequently leads to root canal failure.

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Figure 4. Accessory Canal
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Figure 5. Highly Curved Canal
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Figure 6. Cracked Root

So, should root canals be done by a specialist (endodontist)? Although the probability of success in root canal treatment is the same (90%), endodontists have tools that most general dentists donʼt have. Such things as CT Scan Machines, Surgical Microscopes, and Gentle Wave cleaning systems. Sometimes these things can make a difference.