Boise Dentist Blog

The professional blog of Doctors Dan Bruce, Steve Bruce and Rob Ririe

Did you know our office provides Invisalign?

Dr. Dan Bruce - Thursday, December 27, 2012

For those of you who have heard about Invisalign, but aren't quite sure what it is, this post is for you! Invisalign is a system of clear retainers that move the teeth in small increments. This form of treatment has several advantages vs. conventional treatment. The first is esthetics--the trays are clear and are not as noticeable as brackets. Second, the trays are removable for eating and brushing and flossing, so it is easier to keep your teeth clean during treatment.  

Although Invisalign doesn't work well in all situations, it can be a great option for many patients. Some of the best Invisalign cases involve patients who had orthodontic treatment in the past and have had relapse. If you have questions, give us a call and learn more about treatment. If your situation is not an ideal Invisalign case, we can direct you to a great orthodontist in the area.

Case Study - Functional and Esthetic anterior crowns

Dr. Dan Bruce - Friday, July 20, 2012

Below is another case involving cosmetic porcelain crowns.  Our patient had been dealing with old fillings and discolored teeth for a long time.  He also wanted to correct the discrepancy between the widths of the two central incisors.  


 

Our treatment consisted of minor orthodontics with a retainer to move the lower anterior teeth into position.  We then whitened his teeth and created 4 porcelain crowns.  Our final product is esthetic, as well as functional and should protect the teeth that had large restorations in them for years to come.

Sleep and Memory, postings on Sharecare

Dr. Dan Bruce - Thursday, July 19, 2012

I wanted to use this post to introduce Sharecare, which is an information sharing site.  Users post healthcare questions and experts in that field answer the questions.  Since we treat a significant number of patients with oral appliances, I thought this particular question on memory and sleep was interesting.

http://www.sharecare.com/question/how-important-sleep-good-memory

Getting good quality and quantity of sleep is important for so many functions in our body.  Sleep apnea patients often have decreased REM sleep, which can affect memory. 

Keep checking with Sharecare to learn more about healthcare from expert sources!

Summer 2012 Newsletter

Dr. Dan Bruce - Tuesday, July 17, 2012

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Happy 25th Anniversary Tammy!

We are excited to announce that this month marks the 25th year that Tammy has been working for Dr. Bruce. She is a valuable member of our team, and is much loved by her loyal patients. Tammy started working for Dr. Bruce in 1987 after she graduated from the dental hygiene program at Idaho State University. She said, "I'm very blessed to have such a wonderful place to work. I love and appreciate all my patients. It is very gratifying knowing that we strive to consistently provide the best quality care. That is what keeps me here."

Is It Snoring or Sleep Apnea?

About 80 million people in North America snore, and approximately 12 million Americans have sleep apnea. So what’s the difference, and why does it matter?
 
Snoring is caused by the vibration of the soft palate and uvula, occurring when the airway becomes obstructed during sleep. Several things can obstruct the airway and cause you to snore, including allergies, drinking before bed, being overweight, and having large tonsils or a deviated septum.
 
If you only snore occasionally, you probably have nothing to worry about. But chronic snoring can be a sign of sleep apnea, a more serious sleep disorder. People with sleep apnea stop breathing in their sleep – sometimes up to 100 hundred times an hour. Left untreated, sleep apnea can increase your chances of serious health conditions like high blood pressure, stroke and heart disease. At a minimum, you may feel groggy in the morning, fatigued or unable to concentrate during the day.
 
The good news is sleep apnea is treatable. The two most common ways to treat sleep apnea are continuous positive airway pressure (CPAP) therapy, which is administered by a physician, and oral appliance therapy, which is administered by a dentist. CPAP therapy can be very effective for people with sleep apnea, but some find it difficult to sleep with a mask. More people are increasingly turning to the oral appliances administered by dentists. Oral appliances are small, flexible devices that look like mouthguards. They increase the airway space and reduce air velocity and soft tissue vibration (snoring) by moving the lower jaw into a forward position. Patients who have tried both say that oral appliances are more comfortable to wear, easier to care for and very cost-effective.


If you think you may have sleep apnea, or can't tolerate CPAP, call us to schedule a sleep consultation appointment! We are one of the few offices in the area that is trained in the management of obstructive sleep apnea with oral appliances. We are also able to bill your medical insurance, which makes the appliances much more affordable.


Win an IPad 2!

We appreciate our wonderful patients who continue to refer their co-workers, family, and friends to come see us. To say thank you, we have started a new referral program!

When you refer a family member or friend who comes in for an exam, x-rays, and cleaning, you will be entered in a drawing for an iPad 2 or a $500 offiice credit (your choice). The first drawing is at the end of July, so there is still time to get your
name in!


Have a great summer!

Single tooth anterior implant using a 3d CT scan

Dr. Dan Bruce - Thursday, February 16, 2012

This week I was able to complete a long treatment process that started with a cracked front tooth.  Jeff originally had a root canal on his front tooth 25 years ago after trauma to the tooth.  He then had a crown which matched fairly well, but not perfectly.  Also, notice that the crown is wider than the adjacent central incisor and there are gaps near the gumline.  Finally, he had some recession around the front of the gumline.  Last year, the tooth started to hurt to biting and we noted a periodontal defect on the front of the tooth. After consultation with our endodontist, it was determined that the tooth had a vertical root fracture and was not savable.


The only choice was to extract the tooth and place a bone graft in the socket and where the portion of bone was due to the fracture of the tooth.  In the meantime, we bonded the original crown with a metal wire we imbedded into the crown.  This way the patient did not have to wear a retainer and the crown was used to adapt the soft tissue to the ideal contours.  When then had Jeff get a CT scan using the Galileos 3D scanner.  This scanner uses minimal radiation and allowed us to create a guide for placing the dental implant exactly where we wanted.  The implant was digitally placed in the best bone, with the best emergence profile.  A guide was made that fit to the patient's teeth and to guide the surgical drill to the precise depth and position we wanted.  
After placing the implant, a temporary abutment was placed with a crown to contour the gingiva.  We also placed small bonded composite fillings in the adjacent teeth to make them proportionally the correct shape.  We waited 5 months while the implant integrated to the bone.  During this time the temporary was completely out of Jeff's bite and we warned him not to eat anything with his front teeth.  Notice how the temporary is shorter than the original to keep it out of harm's way.

Finally, we took an impression and had Jeff go to our lab technician for a customized shade match.  We used a white zirconia abutment to attach the crown to the abutment.  Zirconia is strong and will not show through the tissue like a titanium abutment will.  It is also very biocompatible so we did not get any inflammation near the gingiva.  Below are the 2 pictures of the final crown.  The gums have adapted very well.  The color looks a little bit whiter in the one of the photos, but I believe it is because of the way the light bounces of the porcelain when we take a picture.  The smile photo is very indicative of the true color. Jeff is very happy with the result and given the situation, I think it turned out fantastic!  By the way, those are Jeff's fingers in the photos--We would obviously be wearing gloves.

-Dr. Dan Bruce

Give Kids a Smile, Boise, Idaho

Dr. Dan Bruce - Sunday, February 05, 2012

Friday, February 3rd was the national Give Kids a Smile day.  This is a national program which provides free dental care and education for children that need it.  So far, just under 10,000 dentists and almost 30,000 volunteers participated in the program.  It is estimated that more than 400,000 kids were seen.  Check out the ADA link for the latest information: http://www.ada.org/givekidsasmile.aspx

This is a great way to kick off National Children's Dental Health Month.  Since childhood caries is preventable, this gives us a chance to educate children and parents and treat many of the dental problems that can keep kids out of school and in pain. 

I am very proud that we had many of our office staff members volunteer to take part in this event at our Ustick location.  We have a great team at our office who collectively cares about the community they live in.  Way to go everyone! 

Boise-Dentist.com recent comments

Dr. Dan Bruce - Wednesday, December 21, 2011

Below are three different comments we received over the last month from recent patients at our Bay Pointe office, which is located on the Boise Bench.

"Incredible! I have not been as rested and have not had the resulting energy after a night's sleep until using the Somnomed!  Not even from my CPAP maching--not even close.  Finally!! Great sleep.  Thanks, Dr. Dan!" - Rodney, who recently switched from a different oral appliance to a Somnomed.

"I could tell a difference immediately.  I now dream every night, multiple times.  I feel more rested and my blood pressure has been reduced" - Melissa, treated by Dr. Dan Bruce with a Somnomed oral appliance. 

...and one of my personal favorites, "my teeth feel so clean I think I can talk faster!" - Dennis, after his periodontal maintenance (cleaning) visit.

Thank you to our wonderful patients for the kind words!

A brand new smile!

Dr. Dan Bruce - Tuesday, November 29, 2011

This patient had several problems she wanted to address.  She felt her teeth were too dark, too short and she showed too much gum when she smiled.  She has had dental work as needed over the years and ended up with different materials and colors in her mouth (see upper right photo).  At first, we decided to just restore the upper front teeth and then address some of the other discolored crowns later.   We started with models and creating the new shape of the teeth in wax.  I could also then plan for future work and make sure her bite was idea with this diagnostic work-up.  After some minor gum re-contouring with a laser and 6 porcelain crowns, she is very happy with her new smile!

 

 

 

Healthy mouth = healthy body (The proof)

Dr. Dan Bruce - Wednesday, October 05, 2011

There have been a number of potential links between oral hygiene and general health.  This blog post is a report of a health survey in Scotland that looked at the link between oral hygiene and cardiovascular disease events.  The survey was of 11,869 men and women with an average age of 50.  The survey then measured cardiovascular disease events and the self-reported frequency of tooth brushing. 

The results positively correlated poor oral hygiene with a higher risk for a cardiovascular disease event.  Also, those with poor oral hygiene had increased levels of C reactive protein and fibrinogen, which are both markers of cardiovascular disease risk. 

In short, brushing your teeth daily does decrease the chances a person will have a cardiovascular disease event. 

Here is the link to the published survey: http://www.bmj.com/content/340/bmj.c2451.full

How an Ally Bank commercial applies to dental marketing

Dr. Dan Bruce - Wednesday, July 20, 2011
Out of the corner of my ear I heard an advertisement for Ally Bank.  They use interactions with kids to show how ridiculous some of the marketing tactics used in everyday life are.  I think this is a pretty good illustration for dentistry.
 

There are a lot of free whitening, free exams, and free "whatever" for new patients.  I think it is very important that whatever we offer to new patients is offered to every other patient we see.  Existing patients are extremely important to us. 

So here is our marketing plan:  As an existing patient, refer a patient to our practice who comes in for a comprehensive examination, necessary x-rays and the appropriate cleaning and you will receive a gift card for one of 5 local businesses. 

Thanks to our existing patients!  We appreciate you and the friends and family you refer to our practice!