Tooth Extraction Requires Attention to Both Physical and Emotional Comfort

It is understandable that patients have emotional factors that dentists have to consider when teeth cannot be saved. Most patients, think that they are embarking on a painful journey when they come in to have a tooth removed. When they need to have multiple teeth extracted, their anxiety grows exponentially.

Prior to the procedure the patient is focused on the process of tooth removal, but today we have very effective ways to anesthetize patients. I very rarely face a situation where a patient feels pain and there is nothing we can do about it, or feels pain after we have administered anesthetics. In fact, most people are pleasantly surprised that we kept them so comfortable during the procedure.

There are also emotional factors to consider when patients are contemplating losing a tooth, because they do not want to lose a body part. As an analogy one might think about a person losing their little toe. Most people understand that they do not really need their little toe, but removing it would be a body disfigurement that leaves the person no longer whole. The prospect of losing a tooth may trigger a similar emotional response which can be very stressful.

Another possible concern a patient may have is worrying about what their significant other will think of them if they are missing teeth. Some people have memories of seeing their grandparents’ dentures or partial dentures, and they are certain it is not an acceptable option for how they want to live. We reassure our patients by explaining that having to take out artificial teeth out at night is only one option; we now have dental implants that remain fixed in the mouth and provide the closest possible substitute for natural teeth.

In my periodontal practice, we take time to help patients understand very quickly that our goal is to alleviate their pain and help them return to having a healthy mouth. We listen to patients’ concerns and pay close attention to making sure they are physically and emotionally comfortable. We like to say that we are concerned about the entire patient, not just their teeth.

Dr. Karl A. Rose
Periodontist
Periodontal & Implant Associates of Greater Washington
Chevy Chase, MD
New Patients Welcome
www.periodontistwashingtondc.com

The Personal Touch of Dr. Karl A. Rose’s Periodontal Office

Many patients are anxious about coming to a periodontist’s office. My team and I purposefully provide a personal touch to help patients feel relaxed and comfortable when they come into the office for a visit. I find that a personal touch can sometimes best be accomplished with a little bit of touching. In our culture we shake hands or perhaps give people a hug.

Historically, shaking hands shows you do not have a weapon in your hand, and in modern times it serves to start breaking down barriers through this simple physical contact. When I am with patients I want to build trust. I offer to shake hands and I encourage them to call me by my first name. I try to break down the barriers that otherwise prevent them from being comfortable.

I also like to use humor with patients. This approach works most of the time, but some people do not think that the dental office is an appropriate place for humor. They are very serious when they get here, and they are very anxious, so there is a risk that my humor may backfire—but I find that a touch of humor goes a long way to help relax people.

Another consideration is that the doctor and all the staff must appear to be confident and know what they are doing. Patients notice this demeanor and they feel that they are in good hands.

Observing a well-run periodontal practice is much like watching a well-choreographed dance. Our office routines are smooth; all members of the team move in harmony achieved by years of working together. Patients get comfortable with the competence of our staff and systems. They know they are safe and being treated by true professionals when they come to our office.

Dr. Karl A. Rose
Periodontist
Periodontal & Implant Associates of Greater Washington
Chevy Chase, MD
New Patients Welcome
www.periodontistwashingtondc.com

Establishing Good Dental Health as a Foundation for Dental Implants

I am a firm believer in therapeutic efforts that help patients. We help patients become free of pain and comfortable with their dentition so they can function properly. We are dedicated to comprehensive dental care and the good health that goes along with accomplishing long-term dental stability. To that end, in my practice I focus on helping the patient attain good periodontal health before we replace missing teeth with dental implants.

A good clinician knows how to sequence treatment to get the best result. If a patient has current problems that keep them from being totally functional or free of pain, then we need to take care of those problems first. The next immediate course of care is to eliminate disease before we proceed to reconstructive treatments.

This way of thinking is very similar to how a plastic surgeon would approach treating a burn patient. The first step is to help the patient’s tissue to heal in preparation for the reconstructive phases of treatment. Similarly, when tissue in the mouth is recovering from gum disease, we wait for the tissue to heal before starting dental reconstructive treatments.

This methodology is also used when it comes to dental implant treatment. When a patient has periodontal disease, we work with them to help get them healthy again. This treatment might also include growing bone in the jaw that has experienced bone loss while teeth have been missing, or a series of specialized cleanings or gum grafting procedures. We want to develop a stable bone and gum structure as a foundation for the implants.

We talk with the patient about their timeline and needs for dental procedures and create a treatment plan that is comfortable for them. We achieve great results with dental implants and other procedures for patients by focusing on healing first.

Dr. Karl A. Rose
Periodontist
Periodontal & Implant Associates of Greater Washington
Chevy Chase, MD
New Patients Welcome
www.periodontistwashingtondc.com

Dr. Karl Rose Explains the Advantages of a Periodontal Specialty Practice

There is a distinct benefit to being referred by a general dentist to an office dedicated to periodontal treatment instead of staying at that general dental office and being seen by a periodontist who practices there only one day a week. A referral based specialty practice, such as Periodontal & Implant Associates of Greater Washington, offers more treatment options and more numerous successes.

To specialize in periodontics or any field of specialty requires a combination of specialized systems and features that make that business run well. For example, if you are a specialist in repairing Lamborghinis or Volkswagens, you are going to have specialized parts. You will be required to have special tools that work with parts designed specifically for those Volkswagens and Lamborghinis.

As a function of staying on the cutting edge and being in the loop of information as a specialist, you will constantly receive business updates from the Lamborghini or Volkswagen manufacturers. You will hear about design flaws that they have discovered over time concerning your product line, how to resolve those problem, and how replacement parts work.

As an example, the equipment in my specialty practice is different. We can afford to have specialized CAT scan equipment here on site because we use it so frequently in the periodontal specialty practice. From a business standpoint, the equipment pays for itself. At a general dentist’s office where periodontics is not being practiced eight hours a day, four or five days a week, such a piece of equipment is not justifiable as a business expense.

It is not possible to be a master of everything. It takes much work to be masterful in a dental specialty, but it is feasible. In my periodontal practice we have specialized equipment and supplies, and our staff is specially trained in the problems that periodontists address.

Dr. Karl A. Rose
Periodontist
Periodontal & Implant Associates of Greater Washington
Chevy Chase, MD
New Patients Welcome
www.periodontistwashingtondc.com

Stop Gum Recession Early – Avoid Geriatric Tooth Decay

A significant portion of our population believes that gum recession is not a serious dental problem as long as their teeth are stable and they do not have sensitivity to ice cream or sweets. This thinking could hardly be farther from the truth. Other than adversely affecting one’s appearance, gum recession can also have a negative effect on a patient’s overall health. Geriatric tooth decay must be avoided, and a good way to do that is to stop gum recession as early as possible.

Gum recession continues as people age and then they are very likely to develop geriatric tooth decay. This type of decay occurs in older people and it is often different than the kind of decay that affects people at a younger age. In fact, the types of bacteria that cause this decay in the elderly are completely different and are often associated with various conditions that are created due to the medications that the elderly take on a regular basis.

Elderly people can get very bad decay on the roots of their teeth. Dentistry as a discipline is not at its best in terms of treating decaying roots—the exposed roots of teeth. The treatment required is not the same as taking care of decay at the top of the tooth, and techniques for root treatment have not been perfected.

For some patients, the lack of definitive treatment for root decay means that they continue to have recurrent decay followed by re-treatment–and the cycle repeats itself. Many of these people eventually lose teeth. If the gum recession had not occurred, or if it had been controlled very soon after it started, many of these geriatric patients would not have these problems later in life. Preventing tooth loss in the elderly is a worthwhile goal, and is very achievable with early diagnosis and gum recession treatment.

Dr. Karl A. Rose
Periodontist
Periodontal & Implant Associates of Greater Washington
Chevy Chase, MD
New Patients Welcome
www.periodontistwashingtondc.com

Dr. Karl A. Rose Reflects on His Pioneering Work in Bone Growth Research

Many patients experience bone loss in the jaw associated with periodontal disease or other factors. In my long career, one of the things I enjoy reflecting on most is being one of the pioneers in bone growth research when the profession was just starting to learn how to replace missing bone.

My involvement in bone growth research was through my association with the University of Pennsylvania, where I taught, and some academicians who came to the University of Pennsylvania from Sweden for scholarly and research purposes. These researchers had begun developing bone growth techniques, and with my dental patients I was performing beta testing on some of their products that were critical to growing bone.

Having worked with the materials for growing bone where teeth were present, I had some ideas about how to grow bone where teeth were missing and where bone loss had begun. I was motivated to find a solution for patients because in some patients there was not enough bone present to place dental implants. For dental implant treatment to succeed, there was often a need to build bone volume. We set up a proper trial with my patients who did not have teeth, and the results were that bone grew where only inadequate bone had previously existed.

That success was the birth of a whole area of dental bone growth research that academic dentistry has been working on and further developing for the past 30 years. It was a very exciting time in my career and in the history of dentistry. We learned how to grow bone predictably, and the techniques we helped develop have contributed to growing bone not only for dental purposes but for other medical purposes as well.

Now, patients all over the world have bone augmentation procedures to make them candidates for dental implants and other purposes. It is very satisfying for me to know that I was on the forefront of those breakthroughs and continuing research.

Dr. Karl A. Rose
Periodontist
Periodontal & Implant Associates of Greater Washington
Chevy Chase, MD
New Patients Welcome
www.periodontistwashingtondc.com

Dr. Karl A. Rose Explains His Goal of Saving Teeth

Dentists have historically served a number of purposes, including pulling a tooth to stop a patient’s pain and treating cavities. Eventually dentists got involved in gum disease treatment as a means of conquering tooth decay, which led to people holding onto their teeth. Some dentists today still have a much more mechanical approach and frequently pull teeth.

An important part of the art of dentistry is knowing when it is best to replace a tooth rather than to work to retain it. In my periodontal practice, I have helped many people save their teeth in situations where other dentists would have pulled the teeth. There is a point where, as a knowledgeable and experienced practitioner, I have to make the decision to work hard to save teeth when extracting teeth would be easier.

There is time when periodontal (gum) disease is not debilitating, but during this time it is deforming the dentition and the long-term result can be unsightly smiles. It takes a long time for periodontal disease to render someone unable to eat, or unable to speak or smile as a result of tooth loosening. When a person seeks treatment, that individual has decided that it is better to face their problems and seek a solution rather than live with periodontal disease, which is progressive.

As a periodontist I set out to focus on and study how to avoid losing teeth due to gum disease, which is a treatable problem that should not lead to tooth loss. My view is that if you treat the disease early enough, the problem stops and there is no need to pull teeth in many cases. Patients have excellent results from periodontal treatment and enjoy years of healthy smiling afterward.

Dr. Karl A. Rose
Periodontist
Periodontal & Implant Associates of Greater Washington
Chevy Chase, MD
New Patients Welcome
www.periodontistwashingtondc.com