You are cracking me up!

Your teeth have cracks. It’s a fact.  Most cracks are in the enamel only and very rarely cause problems.  These are caused by temperature changes and biting forces in your mouth.  Most of the time you don’t even know they are there unless they are on a front tooth.

However, some cracks go into the inner tooth structure called dentin. Cracks in dentin are potential problems.  Since most of these cracks do not cause any discomfort or pain, it is important to have a dental professional evaluate them.  In our office we classify cracks into the dentin as low, medium and high risk.

Low risk cracks are straight up and down on the tooth, are not stained and follow the grooves of the tooth. These cracks we make note of and may take a picture in order to monitor it, but treatment is usually not needed.

Medium risk cracks often detour from the anatomy of the tooth. They may run diagonal across a tooth.  They can be associated with an older filling.  They are V-shaped and are wider at the top, and may be stained.  Medium risk cracks need to be evaluated individually.  If there is sensitivity or undermining of an existing filling, treatment is needed.  This treatment may be anywhere from a bite adjustment, to a small filling, to a full coverage crown.

High risk cracks often run diagonally across a tooth. They can emanate from a restoration. High risk cracks can have a halo of darkness around them indicating bacterial penetration (top right image).  Multiple cracks are a red flag, especially if they outline a cusp or biting surface of the tooth creating a wedge of unstable tooth (top left image).  High risk cracks need treatment.  These cracks will get larger over time.  As the cracks progress into the tooth, several things can happen.  The most common result of a high risk crack that is not treated is a broken tooth.  Hopefully that break leaves enough tooth to restore.  This almost always involves a full coverage crown.  The biggest risk is that the crack will proceed into the nerve area of the tooth.  This will cause sensitivity and then nerve damage that requires root canal therapy.  If unchecked, a high risk crack can fracture the tooth in half.  If this happens, the tooth is usually lost.

If we find a high risk crack on one of your teeth we will let you know what treatment we recommend. Often patients are reluctant to proceed because they do not have any symptoms or sensitivity.  Our experience with patients over the years is that these teeth will break at some point.    The problem is we don’t know if it will be tomorrow, next week or next year.  We just know it will break.

So if we start talking about a crack in your tooth, sit up and listen. If you don’t, the next time you see us, we could be explaining why that same tooth has to be extracted.

If we have already talked to you about a cracked tooth and you haven’t proceeded with our treatment recommendation, call us today. We are willing to give you a special offer just for reading this blog.

Thanks for reading,

Dr. Bruce

p.s. This dentist has an excellent YouTube video on cracked teeth:


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We have beeen remembering all year!

Our VELscope for Vets campaign has been going strong so far in 2016.  In the first quarter of the year we donated over $600 to the Grand Rapids Home for Veterans.  If you are not aware, our office is donating 20% of our fees for our cancer screening VELscope exams to this veteran’s facility.  We chose to do this to raise awareness of oral cancer and the need for early diagnosis.

There will be over 45,000 Americans diagnosed with some type of oral cancer this year. In that time, over 8500 people will die from oral cancer.  That is roughly one person every hour of every day.  Over 40% of those people who are diagnosed with oral cancer will not survive 5 years.  This mortality rate is higher than cervical cancer, Hodgkin’s lymphoma, laryngeal cancer, cancer of the testes and thyroid cancer.  The reason for this high death rate is because oral cancer is routinely discovered late in its development, often after it has metastasized to another location.

In its early stages, oral cancer may not be noticed by the patient. It frequently prospers without producing pain or recognizable symptoms.  It also develops in areas that are not easily observed like the back of the tongue, floor of the mouth, tonsils and throat.

Dentists and hygienists are trained to look for and detect oral cancers. At our office this exam is done at every hygiene visit.  While the dental profession does a great job of cancer screening, the high mortality rates continue.  Recently there has been an introduction of several cancer screening devices.  Our research found VELscope to be the best device for our office.

VELscope uses ultraviolet light frequencies to make abnormal tissue look darker than normal tissue. This darker tissue is often below the surface and cannot be seen with the naked eye.  This dark tissue can then be examined and follow-up testing can be done if needed.  All of our new patient exams now include a VELscope exam.  Existing patients are offered an optional exam yearly.  The cost is minimal and the peace of mind is enormous.

As adults we all go through routine cancer screening tests like mammograms, pap smears and prostate exams. Please consider having a VELscope exam yearly.  It may save your life!

And, if you start this year, a veteran will benefit.

Thanks for reading,

Dr. Bruce

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Sometimes You Get More Than You Expect!

If you have read my blogs, you know that I take a lot of continuing education classes. I like to stay on top of new products, techniques and ways to make my practice better.  I am required to take an average of 20 hours a year to keep my license.  Since I average 50 hours a year, it is obvious I don’t just do it because I have to.  But even I get tired of it occasionally.

So last year, when the invitation came to attend “The Total Practice Revolution” for two days in Fort Worth, I decided I really didn’t want to go.  I didn’t need the class hours.  I had been to Fort Worth several times.  It would require travel during spring break and I had heard three of the speakers before.

However, the event was being put together by Jameson Management. These people are my coaches and my friends. It was their first effort at an event of this nature.  I started getting pressure to attend.  I finally justified the trip by deciding to go to the seminar and then fly to Florida to see my Dad and my daughter before coming home the next week.

So, a month ago I flew to Fort Worth figuring I would have some social time with my friends and colleagues and maybe pick up a couple new ideas at the seminars. What happened was I had the best two day dental education experience I’ve ever had.

The Total Practice Revolution” was spectacular!  The program was perfectly designed.  Each day included breakfast and lunch which provided time to talk with old friends, meet and talk with other professionals and interact with the speakers and presenters.  We heard four top of the industry speakers.  Chuck Blakeman. Lois Banta, Mark Hyman and Cathy Jameson all had fresh material that was captivating and relevant.  I took more notes for each speaker than I usually do for a whole weekend at other seminars.  Both days included a panel discussion featuring dental experts talking on about a variety of questions we had submitted.  We even had selected vendors available during the breaks to help us in various aspects of our practices.

Throw in a social hour one night and two dinners spent with good friends and it all added up to a perfect weekend. I feel bad for having such low expectations.  I should have known that the Jameson Management Team would present nothing less than a spectacular event.  This team is filled with outstanding individuals who know their stuff.  I am privileged to be able to work with them.  The dozen years I have been coached by them have been the most rewarding of my 32 year career.  They provide guidance, counseling, education leadership and friendship. A great team needs great coaches and I think we have the best there is.

Thanks for an incredible event John and Cathy Jameson, Jess and Carrie Webber, all the presenters, the vendors and everyone on Team Jameson for doing such a fantastic job. A special thank you to my current coaches Beverly Hill, Nancy Miller and Susanne Kimball as well as my former coaches Ryan Webber and Misty Clark.  You have helped me learn and grow beyond my expectations.  Finally, a special shout out to Amy Parrish.  She is the straw that keeps the Jameson drink stirred to perfection!

While I’m at it, I might as well pat myself on the back for attaching myself to such a great group!

Thanks for reading,

Dr. Bruce

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April Fools: Or is it?

My blog this month was going to be an April Fools’ Day scam. I was going to write about all this cool technology that was coming in dentistry that would make dental visits better.  Then I started thinking.  The best stuff I could come up with is technology that has or may become a reality in our lifetimes.

At a recent career day at the Wayland Middle School I told the students that almost everything in dentistry has changed since I went to dental school. Materials are better, stronger and easier to use.  Techniques are faster and more comfortable for the patients.  Computers have revolutionized dentistry.  Everything including scheduling, billing, filing insurance claims, patient records, x-rays, patient communication, transferring of patient information and business accounting all depend on computers.  Even lab work can now be done electronically by scanning teeth and sending the file to the lab where laser and CAD-CAM technology take over fabrication.

Air abrasion allows us to fill small cavities without anesthesia or drilling. We even have OraVerse which counteracts the anesthetic allowing that numb feeling to disappear faster.  Intra-oral cameras, ultrasonic scalers, white fillings and decay detecting scanners have made dentistry easier, faster, more comprehensive and more comfortable.  Our VELscope device even allows us to save lives by detecting cancer earlier than ever before.

So what does the future hold? How about vaccines for decay and gum disease?  These are caused by bacteria, and scientists are currently trying to develop the perfect inoculation that could be given to children and eliminate cavities and periodontal disease.  How about growing a new tooth?  Stem cell research has been promising.  Cells can be made to grow tooth structure.  Planting these cells and getting them to grow and erupt as a tooth is something that the future could hold.

Just let your mind run wild. How about a rinse that kills gum disease bacteria while leaving the rest of your oral system in tact?  How about a gel that dissolves decay but leaves healthy tooth structure in place?  How about a material that bonds so strongly to teeth that broken teeth can be repaired without crowns?  How about a substance that dissolves necrotic nerve tissue making root canals faster and far less traumatic?  How about robots that perform your dentistry?

O.K. let’s not go too far!

You can see that dentistry continues to grow and change. The scary appointment you had as a child can now be a comfortable, enjoyable experience.  Years from now, who knows how easy dental treatment will become?  I only know that things will get better and better.  No Fooling!

Email us your ideas for the future of dentistry. We will post the best ones on our Facebook page.

In the meantime, watch out for April Fools’ Day pranks and thanks for reading.


Dr. Bruce

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It’s Dental Assistant Recognitinon Week!

Dental Assistants are the unsung heroes of any successful dental office. In my dental practice I have an amazing team that works hard to keep our busy practice running smoothly. Each person has an integral part in our office dynamic. While each job is vital, this month I am singling out the dental assistants, mostly because March 6-12 is Dental Assistants Recognition Week!

The business team greets you at each visit and assists you as you check out. They are the ones interacting with you on the phone. Chances are the hygienists spend the most time with you. They get to see you for at least 2 hourly sessions each year. However, you will probably don’t interact with the assistants nearly as often as everyone else. They may only cross your path when you are in my chair. This is usually when you need clinical treatment and you may be apprehensive, nervous, or down right scared. This is when most people are least likely to want to have a pleasant chat.

This is where the dental assistant shines! They dive in and make you, as the patient, feel comfortable. They are warm and friendly and enjoy spending time with you. They try to get your mind off what you are most worried about and reassure you that everything will be easier than you anticipate. They will answer your questions. They know everything about the procedures, and they seem to explain it so simply. The dental assistant is there to make sure your dental appointment is the absolute best it can be.

Even before you arrive they are working hard for you. They review each appointment ahead of time. They clarify any questions about the treatment. They then set up the room so that everything is ready and can go as smoothly as possible. As they assist during the procedure, they work quickly, calmly and efficiently. They adapt and alter the treatment sequence when the situation dictates. Afterward, they explain the treatment done that day, give you instructions for post-operative care, enter the treatment into the computer system and escort you to the front while answering all of your new questions. Afterward, they hurry back and clean the room for the next patient.

My dental assistants also triage emergencies, take x-rays, deal with lab cases, take impressions, do intraoral digital scanning, make and seat temporaries, help the hygienists, sterilize instruments, set up trays and do a variety of other things to help the practice and the patients.

I truly appreciate how awesome my dental assistants are. I could not function without them. Nor would I want to. Get to know my marvelous assistants on our web page: and please join me on Facebook this coming week to recognize and thank Mary, Judy, Melissa, Jessica and Lisa for the outstanding job they do for all of us!

Thanks for reading,

Dr. Bruce

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Leap Year!

I’ve always been intrigued by Leap Year. First of all, I am amazed at the science behind our calendar. In high school we took measurements of the moon and the Sun’s position every day and calculated orbits and how they were used to develop our current understanding of days, months and years. But we had text books and a very smart teacher. How did the ancient scientific community figure this out and settle on our current calendar? There was some brilliant, out of the box thinking way back then.

I have learned some of the history and science behind dividing the calendar into twelve months, but why did February get short changed when some months get an extra day? My theory on that is that whoever made the decision lived in the snow-belt somewhere and knew that they had to make February as short as possible or we wouldn’t be able to take it.

That brings us to Leap Year. Once they figured out they had to stick an extra day into every fourth year, February was an obvious choice. However, I’m not sure if they considered people being born that day and getting short changed on their birthday parties and celebrations. And let’s face it: no one believes a 30 year old who claims to be only 8!

Our politicians figured things out early on. I am convinced that presidential elections are in leap years to give the candidates one more day in the year to torture us with their campaign speeches, ads and political attacks. Like we don’t get enough of that already!

The summer Olympics are always in leap year. I’m not sure how this is relevant, but it’s something I observed and thought it was worth mentioning.

It’s too bad we don’t have a world-wide holiday every February 29th. It’s an extra day that shouldn’t be lost in the calendar. It is special and unique and we should embrace having one more day during the year to spend with our loved ones and to enjoy life!

So I want to wish everyone a glorious Leap Day on Monday! Pause and enjoy the fact that you only get this opportunity every four years. Why waste it? Do something fun, exciting or spontaneous! Just don’t let it pass you by. It won’t be back until 2020!

Carpe Diem!

Dr. Bruce

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Set a Good Example!

Several years ago there was a commercial on TV depicting a child and his Dad. The cute little boy followed his father around and copied everything the man did. At the end, the Dad lit up a cigarette and the anti-smoking message played. I thought about this commercial after reading an article about things that get children excited about taking care of their teeth.

In a minute, I will share the things the article mentioned, but first let’s address the ONE THING that will get your child interested in oral health care. IT’S YOU! Research shows that habits developed early in life are the ones we are most likely to stick with. Once habits are ingrained, they are exceedingly difficult to change. So, show your children how to brush, floss and take care of their teeth and gums. But more importantly, set a good example. They do what you do! Let your kids see you brush and floss. Talk positively about dental visits. Make it a pleasant, exciting experience for them. Get them started on a path to good oral health as early as possible.

Now, here are a few things to help you get your child interested in brushing. First off, get a great tasting, visually stimulating toothpaste. Sparkly bubble gum tasting tooth paste flat out gets kids to brush. It also gets them to brush longer. If it has the ADA seal of approval on the tube, trust it. It has cavity fighting fluoride in the proper amount and even though it may taste incredibly sweet, it does not have sugar added to it.

Break down and buy your kids an interesting toothbrush. There are a lot of options. Start with a small headed brush. Their mouth is too small for the adult size. Add some fun characters or designs on the handle. Play to their interests. A tooth brush with a timer in it will encourage your child to brush for the recommended 2 minutes. We are all guilty of being in a hurry at times and short changing our brushing time. Mechanical toothbrushes are also a great investment. We recommend the child size Sonicare, but other rotary tooth brushes have been proven very effective in plaque removal and gum care.

Flossing is a habit we wish everyone had. Encourage your child to incorporate flossing in their daily routine. Younger children often don’t have the dexterity to floss effectively. Buy them some floss aides. These are little sections of floss on a plastic handle. These handles come in fun shapes and colors, so again, find something that will get them interested.

Fluoride works. Buy them a kids’ fluoride rinse and have them use it after brushing. These come in pretty colors and tasty flavors with fun characters on the bottle. It is best if they swish and spit, but don’t panic if they swallow some now and again. The fluoride levels are not dangerous.

Finally you need to evaluate the effectiveness of your child’s efforts. Buy disclosing tablets. Visual learning is what we respond to. Your children can chew up one of these cherry flavored tablets and visually see where they need to brush better. The vegetable dye sticks to plaque and turns an invisible enemy into something they can fight against.

February is National Children’s Dental Health Month. Let’s turn it into the month we start getting ourselves and our children interested in life-long oral health care habits.

Thanks for reading,

Dr. Bruce

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