Frequently asked questions.
What do you charge for a crown or a root canal.
Our fees are determined by the fees other dentists charge in the same area. Our accountant surveys dentist's fees, they have over 200 dentists as clients. Our fee is usually at or near the median fee. The median fee means half the dentist's charged more and half less. Like I said most of our fees are at or near the median, Which I think this is a bargain since I don't think we provide "median" care.
I hear that silver fillings are half mercury, doesn't that make them dangerous?
First I want to say that we live in an environment that bombards us with information. The trick is to tell proven science from opinion or pseudoscience. I have a scientific background and it's hard for me to tell what literature is real science. It's easy to read good writing and get emotionally caught up in it. That doesn't mean it's science. A list of hundreds of physicians who support an idea at the end of an article does not make something scientifically supported. To be science one wants to see articles written in peer reviewed scientific journals cited as references. This is the easiest way to tell real science from opinion. In my opinion, patients are relying on me to provide proven, scientifically supported treatment. If I introduce treatment based on ideas alone, I don't believe I would be holding up my end of the agreement.
So, finally, my answer to the question. Amalgam or silver filling material is indeed about half mercury. Elemental mercury, mercury in a pure form, is poisonous. Mercury in silver fillings is combined with other materials. Many people compare silver fillings to table salt. Salt has two basic ingredients, sodium and chloride. Chloride by itself is poison, but combined with sodium it makes table salt. There has never been a scientific study showing that people with silver fillings are any more likely to develop any disease or any other condition. Silver fillings have been around since 1603 and began being regularly used in France in the early 1800's. Newer studies show that silver fillings outlast white colored or composite fillings, sometimes by a large margin. Silver fillings have a bacteriostatic characteristic, meaning that it's not easy for bacteria to grow under them. The American Dental Association has concluded that amalgam and composite materials are safe and effective for tooth restorations. So, I believe silver amalgam filling material is a viable option for dental restorations.
What is the difference between a denture and a bridge?
The basic difference in that one is removable and the other stays in the mouth "permanently". The "bridge" stays in the mouth and the "denture or partial denture" is removable. One common disadvantage of both is that the bone where the teeth are missing will slowly melt away. The jaw bones support facial aesthetics. Plastics surgeons say if there is a single thing one can do to keep looking young, it's to keep your teeth.
Do you take out wisdom teeth?
Yes we do remove wisdom teeth. Our low dose dental CT gives us a 3-D image so we can see exactly how the wisdom teeth are positioned and where your vital structures are. Dr. Miller has extra training in impacted extractions and even did a "mini residency" at UOP dental School.
A new patient asks, "My other dentist never told me I had gum disease. How can I develop it that quickly?
Dental research has uncovered many new facts about gum disease. We now know that there is a connection between heart disease and gum disease. We better understand why gum disease is the leading cause of tooth loss in adults. Other risks to ones overall health, like strokes, appear likely and studies continue to prove these connections. At Caring Dentistry of San Rafael we take these risks seriously and apply proper diagnostic procedures for each patient. I can't speak to how other offices approach the diagnosis and treatment of gum disease.
Do medications for osteoporosis cause oral surgery problems?
It is true that oral surgery introduces some risk for patients who have been taking medications for osteoporosis and osteopenia. The risk is considered low, but the complications can be severe. The scientific data suggests that after taking oral bis-phosphonates for three years or more a risk is introduced. Examples of these medications are Fosomax and Boniva. Bis-phosphonate medications given Intravenously carry higher risks and need to be evaluated differently. There is no test that is considered 100% reliable to predict ones risk. There is, however, a test that gives us some information about ones bone metabolism. CTx stands for Serum C-terminal crosslinked Telopeptide, a marker used to measure bone metabolism. A low value indicates that bone turnover is low and thus less likely to recover from trauma. Some believe this test is predictive, others believe it's better used to evaluate patients recovering from the complications and still others question it's validity. It's an easy blood test, and it does give us information about how ones bone heals, so I like to use the test. For a discussion on this topic go to:
Do you do Root Canals, or do I have to go somewhere else?
In the vast majority of cases we can do your Root Canal right in our office. Dr. Miller has enjoyed doing Root Canals since 1996. Newer technology like electronic apex locator's and digital x-rays make them faster than before. We can usually complete your Root Canal in one visit.
Do you take my insurance?
Some plans insist you see the dentist's on their "list". If your plan let's you pay the difference between our fee and the allotment your plan gives for a certain procedure, then you can use your insurance at our office.
Is Dr. Miller an Oral Surgeon?
Dr. Miller enjoys many surgical aspects of dentistry and has extra training in these areas, but he is a general dentist. He completed an oral surgery "mini residency" at University of the Pacific Dental School, where he performed a variety of oral surgery procedures under Dr. Garibaldi and his team. Dr. Miller has also earned a Mastership in two different Dental Implant Societies, as well as the completion of a series of periodontal surgical training courses at The Perio Institute.