TECH WITH BITE: Dr. Catherine Foote treats patients with an array of advanced tools//Photo by Tessa Marie Images.
Dr. Lindsey Marshall’s Ardmore office is beginning to resemble Star Trek’s USS Enterprise. Lasers, scanners and replicators are among the high-tech tools at her disposal. It’s the same at Dr. Mira Della Croce’s Eagle Family Dentistry in Chester Springs. She’s using the latest devices for everything from digital X-rays to root canals. Pediatric dentistry, it seems, is ground zero for advancements.
“This generation of children perceives dentistry differently than their parents,” says Dr. Micaella Schocker, who has a pediatric practice in Bryn Mawr. “Going to the dentist no longer has to be painful and scary. The sooner we show kids that, the more diligent they’ll be about their dental health.”
One of Schocker’s most effective tools is DIAGNOdent, a wand-like laser that detects tooth decay. Using fluorescent light, it penetrates the enamel and dentin layers to find cavities lurking underneath. That’s important because fluoride hardens the surface of teeth, making cavities tough to spot. “Cavities are like icebergs,” says Marshall, who also uses DIAGNOdent. “They’re often smaller on the surface and very large underneath.”
Lasers are used to treat cavities and for the removal of diseased or overgrown gum tissue. Della Croce has an electric drill that works faster and more precisely than older air-driven versions. She also has a new equipment that makes root canal less of an ordeal. “Now, the actual root canal takes between 15 and 20 minutes, and the whole visit is one hour,” she says.
Chairside CAD/CAM technology now makes it possible to manufacture crowns, bridges and other implants right in the office. “We take a digital image, upload it to our computers, design the implant on the computer, then create it in our office using a mill that’s similar to a 3-D printer,” says Dr. Rohini Bhatia of Chester County Prosthodontics in West Chester.
Then there’s bruxism, one of the most common dental problems in our region. Clenching the jaw and grinding the teeth leads to temporomandibular disorders, or TMD—also known as TMJ. While many dentists recommend custom-made night guards for their patients, Marshall takes that to the next level with what she calls “orthotics for the mouth.” Created to look like teeth, the orthotic is worn day and night until the problem is remedied—about six months. Patients then continue to wear it at night.
To customize the orthotic, Marshall uses TENS Unit electrodes to gently relax patients’ jaws. The K7 Evaluation System electronically measures and records what the correct alignment should be. All of that information gets fed into a computer that creates the orthotic, which looks a little like the clear Invisalign aligners used by orthodontists.
As for Invisalign, it’s more than just a cosmetically appealing alternative. It works quite well, making orthodontics a real option for adults who don’t want to deal with braces. And though it’s not the right option for every patient, Invisalign technology is constantly being tweaked and upgraded to make the aligners more effective and comfortable.
At Foote Orthodontics in Wayne and Bryn Mawr, dental scanners are one of the biggest technological improvements. Dr. Catherine Foote uses handheld digital cameras to capture images of patients’ teeth. Those are sent to companies that manufacture retainers and Invisalign. “The more precise the images, the more precise the appliance will be,” says Foote.
Foote also offers AcceleDent, which speeds movement of the teeth when combined with braces or Invisalign. You bite down on the appliance, and it sends low-level micropulses into the gums and bone, increasing cell turnover.
The only hitch: You have to bite down on AcceleDent for 20 minutes at a time. “I was hesitant about offering it,” Foote says. “But I’ve had it for four years, and I’ve seen it work.”
Della Croce and Marshall say that the biggest change in dentistry these days is the dentists themselves. Continuing- education credits are required of every practitioner, but some do only the bare minimum. Others dedicate many hours to staying up-to-date on technology—even doing postgraduate work.
But dentists typically don’t run out and buy every new piece of equipment. They carefully evaluate new technology to determine if it’s indeed better than what they’re already using. “I also know what many of my colleagues have that I don’t, so if my patients really could benefit from, say, a 3-D X-ray, I’ll send them to someone who has that technology,” says Schocker.
How can patients know what technology is truly necessary, and what’s simply adding to their bill? Dentists advise that they ask about cost up front. Although insurance can be a thorny issue, good practitioners will work with their patients on finances.
Della Croce says to ask for short-term and long-term treatment plans. Some problems are urgent; others can wait a few months—or even a year. Most of all, you should go with a dentist who empowers you through education. If a practitioner can’t or won’t explain what they’re doing, find someone else.
Patients should exert the same healthy skepticism most dentists employ. Case in point: IV sedation has been touted as a significant advancement in easing dental anxiety. And yet, none of the dentists we interviewed use it. Sometimes Valium or Xanax is prescribed. But more often, they simply talk to their patients.
“I explain exactly what I’m doing and show it to them on the computer screen,” says Della Croce. “Patients eventually gain confidence in both me and the technology. Going to the dentist stops being a traumatic event for them, which means they seek treatment more often. It’s a win-win.”