Speed Dentistry or Quality Dentistry?


Over the past 5-10 years or so, a trend in dentistry has become alarmingly fashionable.  We at Plaza Health Dentistry have even coined a term to describe it … Speed Dentistry.  This racier style of dental drilling we feel is likely a direct result of the proliferation of HMO style Dental Plans; the types of plans that have a restrictive list of dentists, who looking for more “business”, sign up for discounted fee structures, which are designed by insurance companies and then packaged and sold at a discounted rate to employers.  

So what’s not to like about lower dental fees?  Not one thing, that is, unless quality is sacrificed in the process, which is exactly the case with speed dentistry.  To illustrate, here’s an example.  Imagine, don’t actually do this (we care not to be held liable for injury), trying to completely peel an apple with a paring knife in 10 seconds.  You could probably do it … but how would the apple look when you’re finished?  

Now, reach for another and spend a minute or so carefully peeling it.  It’s obvious which apple would look better upon completion.  It’s interesting (and noteworthy) to then visualize exactly how much extra good apple (beneath the skin) was lost, needlessly, during the “speed” cut.  Now, imagine replacing the paring knife with a dental drill (at 40k RPM) and the target switching from a red delicious to your permanent molar.  Ouch.  

Carrying on … Let’s examine again last week’s Blog issue of a Crown vs an Onlay.  Trust us (we’re in the field) a tooth can very easily be cut down for a Crown with a rapidly spinning, sharp diamond bur.  In fact, would you believe there are “profitability advisors” for dentists that are recommending that dentists whittle teeth down for crowns in 5 mins or less!  

An Onlay, on the other hand, is more slowly and meticulously prepared, resulting in much more of your natural tooth to be spared in the process.  Ensuing problems after a Crown are far more numerous than after the more minimally invasive Onlay.  One common problem as a result of the trauma associated with a Crown preparation is a dead tooth (maybe months/years down the road), which then becomes infected.  This leads to more time in the dentist’s chair to have a root canal performed; and even more money spent.  Again, ouch (referring to the money – the root canals are usually not painful these days).  

Other problems with Speed Dentistry are visible in the pictures below.  These patients came to Plaza Health Dentistry concerning problems with their Crowns.  The lack of care (speed?) which created these problems in another office has now led to even more problems, more chair time and, of course, even more money!  

Speed Dentist vs Quality Dentist

Is Speed Dentistry really much cheaper?


Bottom line, be an informed dental health care consumer.  Think twice about a Crown and discuss this matter with your dentist.  Let s/he know that you are aware of treatment options (like an Onlay) and of quality differences in dentistry.  Choose the option that makes the most sense to you.  Don’t be afraid to, early and often, ask questions.  Ask to see a post-treatment x-ray (with a lay description) and a prognosis when treatment is complete.  

Next week we’ll look at very new trend in dentistry, and Plaza Health Dentistry’s answer to control costs, namely the efficient use of ultra-modern, high technology.  

Visit our website at http://www.stlouis-cosmeticimplantdentist.com/ or give us a call at (314) 843-0500. 

Posted in Cosmetic Dentistry, Dentistry, Dentists | Tagged , , , , , , , | 2 Comments



See what the National Experts have to say…

A Dental Crown is a (nearly) 200 year old technology that carries with it benefits, of course.  However, the problems associated with Crowns are numerous and worthy of discussion, especially since a much newer, better and less invasive technology (called a BONDED ONLAY) is available today.

Briefly … A Dental Crown involves the removal with a drill of ALL of a tooth’s enamel — all the way down to the gumline.  Then, an impression of the cut tooth is made.  Later …  a Crown (or “Cap”) is glued/cemented to the tooth. 

Problems with Dental Crowns are…

  • Crowns involve more tooth removal — causing more internal tooth trauma which can lead to a future root canal problem.
  • Crowns involve cutting into the tooth aggressively near the “neck” of the tooth which is closer to the interior Root Canal System … thus, more trauma is imparted to the NERVE of the tooth.  Again, the result is a higher likelihood of necessitating a Root Canal in the future.
  • A Crown’s Margin (perimeter) is right at the gum-line.  This is a natural food collection zone (almost like a gutter).  When food sits right next to the margin of a Crown it is much more likely that the Crown will DECAY at this margin — likely, then, the Crown will need to be re-made.  This, of course, leads to more tooth reduction, more trauma, etc.  which promotes even more dentistry and costs (root canals).
  • Because a Crown’s margin is at the “neck” of the tooth it actually can WEAKEN the tooth.  This is especially disconcerting considering that a Crown is ostensibly being placed to strengthen the tooth.
  • A Crown typically (not always) will have a metal understructure to it to give it strength.  This metal will usually show up as a “black line” right at the gum line where it results in very unpleasing cosmetics.  Many patients become frustrated with this “black line” showing at the gum-line because they do all they can do to keep the area clean and it still looks “dirty”.

Briefly … A Dental Onlay involves only the removal of weak or affected tooth structure, leaving the healthy and strong part of the tooth un-touched.  An impression of the prepared tooth is then made.  Later (maybe even same-day?) a Protective Onlay is Bonded to the Tooth.  This “Bonded” Onlay very closely re-creates and resembles a healthy, natural tooth.

Why Onlays are better…

  • Less Trauma to the Nerve inside the tooth (less chance of a Root Canal being needed on this tooth)
  • Less chance of recurrent decay at the edge of the restoration (called the margin) … since the margin of an Onlay is in a higher, more cleansable area and the margin of a crown is at the gum line.  This leads to longer lasting and healthier restoration.  Crown margins at or below the gum line may often incite gum inflammation, or worse, more severe forms of Gum Disease.
  • Due to the above 2 considerations… a Crown is more likely to have to be re-made than a properly performed Onlay
  • YET…. If another restoration is ever needed, there is more tooth structure to still work with under an Onlay as opposed to under a Crown.
  • Onlay is a better looking restoration than a Porcelain fused to Metal Crown — No Black line showing at the gum line.  Many times with an Onlay we don’t have to cut down the visible side of the tooth and, thus, the Onlay blends in with a nearly “chameleon” type effect.  A typical Crown often looks too opaque and fake.

It’s not over for Crowns quite yet, however, the fat lady is clearing her throat.  Crowns are still the restoration of choice in these instances..

  • When a Full Crown already exists and it must be replaced
  • When a tooth is so badly broken down or bothersome that an Onlay will not work.  This is really quite a rare occurrence.

 National Experts have, for many years, been guiding/teaching Dentists to place more conservative, minimally-invasive Onlays instead of Crowns!


So then … Why are dentists still doing crowns?  

Habits…Older dentists prefer crowns since they know them best.  They are very comfortable practicing their usual ‘drill-em and fill-em’ or (better yet), ‘crown-em’ dentistry. 
Less experienced types have learned a similar conventional, yet older, mind-set from well-aged dental school instructors who, likely, are light-years away from state-of –the-art dentistry circa 2010.

Degree of Difficulty… Onlays are technically more demanding and difficult to perform than Crowns.   They are harder for the operator to prepare and much more difficult to bond in to place.  Therefore, there is a steep learning curve required.

Onlay treatment performed with lesser skills leads to colossal frustration for all involved. 
Further, the lab work is much more challenging.  Only higher-quality labs will even offer Onlays since they are so much more difficult to make.

Expense… Due to their technical demands, Onlays are more expensive (for the DDS) to perform, especially when they are just starting to learn how to place them. However, for an experienced provider of Onlays the difference is insignificant.
Further, the Lab Fees, as described above, are higher for Onlays.  Therefore, it makes sense for an operator to provide the better treatment of Onlays for patients only if skills and experience warrant it.

What Have the National Experts Been Saying?

Dr. Gordon Christensen of Provo, Utah is, almost without question for the past 20 years, the most recognizable and trusted worldwide dental authority on restorative dentistry techniques and materials.  He travels and lectures virtually everywhere to share his vision and he continues to “practice what he preaches” as he still sees patients for exceptional treatment.  His research (Clinical Research Associates) is virtually unchallenged as guiding DDS types into doing the right thing for their patients.  He travels across the globe sharing and teaching wet-fingered dentists the best procedures that we should be provding for our patients.

Dr. Christensen’s view on the subject of Crowns vs Onlays is very clear.  He is not a fan of cutting a tooth down for a Crown, just because it is the easier treatment, one that practicing dentists have been providing for patients for scores of years.  He has even gone so far as referring to Crowns as “Tooth Coffins” (meaning Crowns can lead to the death of the inside, root canal- nerve part of the tooth) in a clinical essay trying to prod dentists to do the right thing and cut-back on all that cutting!

Instead, Dr. Chrisensen and almost every other reputable national “guru” or expert on the subject preaches (and has been preaching for quite awhile) that general restorative dentists should be preparing weak or fractured teeth more minimally and then bonding an ONLAY on top of the tooth.  Yes, it takes more time… but it is most definitely worth it for optimal oral health.

Visit our website at http://www.stlouis-cosmeticimplantdentist.com/ or give us a call at (314) 843-0500.

Posted in Cosmetic Dentistry, Dentistry, Dentists | Tagged , , , , , , , , , , , , , , , , | 1 Comment

NO Mercury!

Away with the 100 year old Silver-Mercury Filling Material …

Here are Some Facts to Consider…

  • Mercury is considered a hazardous material
  • NO amount of mercury is considered to be a safe ingestion amount
  • Yet… Mercury leaches out of all silver fillings during the chewing process

Almost incredibly … the American Dental Association’s position on Mercury-Silver fillings in a “Cliffs-Notes” style synopsis is this… 

NO Mercury Fillings, Plaza Health Dentistry, St. Louis Cosmetic, Minimally Invasive Dentist

Because no study has been performed to show the harmful effects of mercury released from silver-mercury fillings …. therefore, this material should be considered “safe”.

To this we say, What!?  We have a proven harmful “heavy-metal” toxin that is considered by virtually any competent, state-of-the-art medical professional to be unsafe if ingested/inhaled at ANY level – and we are voluntarily packing it into patients’ teeth?  Only to watch it to become ingested or inhaled as we chew!  Incredulously, we say — C’Mon Man!

PLAZA HEALTH Dentistry respects the opinion of the ADA, our “guiding light” organization.  Thus, we do not officially recommend the routine removal of silver-mercury fillings.  However, our patient education on the matter will not be deterred … allowing for an Informed Patient Choice .. as is always the case at PHD.

Putting aside, for a moment, the systemic health issues, here are a couple of more reasons why silver-mercury fillings are really a relic of the past (or at least should be).

  • They are metallic, thus they expand and contract significantly with exposure to hot/cold (think coffee/ice cream), which can help to cause tooth fractures. (coefficient of thermal expansion).
  • They are a 100+ year-old technology that relies on cutting undercuts into healthy tooth structure in order to get them to stay in place.  This weakens an already weak tooth.  Tooth fractures leading to more extensive and expensive dental treatment awaits (think root canals &/or crowns).
  • Their substitute material, composite resin, is non-metallic, tooth colored and is bonded to tooth structure, thereby strengthening the cut tooth surface.


Check this link out for the full statement of the ADA on this subject…. http://www.ada.org/1741.aspx

Visit our website at http://www.stlouis-cosmeticimplantdentist.com/ or give us a call at (314) 843-0500.

Posted in Cosmetic Dentistry, Dentistry, Dentists | Tagged , , , , , , , , , , , , , | Leave a comment

Dr. William J. Schlotz — IN THE NEWS!!

Dr. William J. Schlotz has written multiple articles that have been published in a local newspaper.

Here are the first two published articles…ENJOY!

St. Louis Dentist, Dr. William Schlotz, DDS local newspaper articles

Visit our website at http://www.stlouis-cosmeticimplantdentist.com/ or give us a call at (314) 843-0500.

Posted in Cosmetic Dentistry, Dentistry, Dentists | Tagged , , , , , , , , , , , | Leave a comment

Welcome to PHD!!

PLAZA HEALTH Dentistry’s First Post on their Blog!!

Welcome to our St. Louis Dental Office – PLAZA HEALTH Dentistry! We at PHD are on a Mission to provide Conservative Aesthetic & Implant Dentistry with an unusual respect for a *Relaxed Level of Comfort* and Affordability — with singular attention and pampering paid to our valued patients.  Our experienced dental caregivers provide Minimally-Invasive General Dentistry with a Focus on Cosmetic & Implant Treatment delivered with extraordinary attention-to-detail and an enduring commitment to World Class Ultimate-Quality of Care.

 When you visit our State-of-the-Art Dental Office you will all that modern dentistry has to offer.  We have transformed a former Pier-One Building into one of the area’s most high-tech & up-to-date dental offices. At PHD we offer scientifically advanced, laser-based minimally-invasive oral health care in a pristine and esthetic setting. 

Once in one of our spacious treatment rooms you’ll feel the confidence and security uniquely a part of the PHD experience.  During the course of evaluation and treatment planning you’ll undergo a Patient Education experience that is second to none. PHD takes the time to use visual aids (video, digital X-Rays, intra-oral photographs) and hand-held models to help explain all of your treatment options. 

You’ll see, first hand, how PLAZA HEALTH Dentistry is a small dental office designed to provide personalized care in a relaxed, fun-loving environment.  As treatment begins, you’ll quickly see PHD’s belief that your comfort is our first concern.  Whether it be stereo headphones, Cable TV or a DVD movie, something as simple as a pillow and a “snuggie blanket”, or as important as *Relaxation Dentistry* (*Sedation Dentistry* with a small pill), any anxiety seems to just drift away.  Just as essential, after treatment, you’ll notice, and appreciate, PLAZA HEALTH Dentistry’s sincere commitment to Reasonable Fees

Dr. William J. Schlotz, a leading St. Louis Cosmetic & Implant Dentist …. who also provides general dental care for the entire family, is very creative with treatment options — empowering patients to select the level and type of care which make sense for them.  We believe the more you learn…. the more informed your treatment decisions will be.  This is called informed consent and we firmly believe in the process.  First of all, we feel it is most ethically correct.  And secondly, we see everyday how it can eliminate the unnecessary costs that are typically associated with making a wrong treatment choice. 

At PLAZA HEALTH Dentistry — No Lectures…. Only First-Rate Care for Your Dental Needs. 

We don’t pass judgment at PHD, we just try to be as caring and compassionate as we can be.  We give it our all to make sure your dental experience is the the best possible one.  We treat our patients as we would our own family.   We’d love for you to join our Practice!  Hope to see you here soon… Here’s to Your Optimal Oral Health! 

Visit our website at http://www.stlouis-cosmeticimplantdentist.com/ or give us a call at (314) 843-0500.

Posted in Cosmetic Dentistry, Dentistry, Dentists | Tagged , , , , , , , | Leave a comment