The following is a personal note from Raj, a patient of mine that illustrates the potential issues when you receive treatment at a location which is not your place of residence. As described in the note, Raj had to get a new bridge when he was traveling in India. For various reasons, he was not satisfied with the treatment - the bridge was coming out when he came in to see me. This is not an attempt to insinuate medical professionals abroad - the fact of the matter is that such treatments require multiple visits and constant monitoring which is better done by a medical professional close to home.

I am glad to know Dr. Meena and would like to share my case. I know Dr. Meena since early 2009 when I first went to her clinic in Worcester for a check-up. The reason for my visit was to take her opinion after being a victim of an improperly fitted bridge for my upper right premolar and canines.I had no problem with my teeth until I ...met with a car accident in 1997 when my right mandible was fractured. Also, I lost my upper two incisors. My mandible was immobilized for 4 weeks (during which I survived on liquid diet) and the fracture was healed. Later, my broken incisors were root canal treated and replaced with a new bridge. During all these years, I got a couple of replacement bridges after the previous ones were worn out.

Meanwhile, my sinusitis problem was complicated, probably by these treatments and ended up in a tooth abscess of one of the neighboring canine tooth. This was diagnosed when I went to India (Hyderabad, my home town) for a visit. Although, they diagnosed the tooth abscess, the dentist I saw in Hyderabad did a sloppy job while taking the measurements for my new bridge, which I needed after extracting the abscessed tooth. As a result the bridge loosened day after day and came out completely by the time I returned back to Worcester. I was so fortunate that I could see Dr. Meena who identified and fixed the problem. Till today, I had no hint of any issues with the bridge. I am very thankful to Dr. Meena and her skillful approach to address my case. My sincere recommendation and reference to all is to go visit Dr. Meena, my favorite dentist, if have any dental problem.

Your smile is the first thing that other people notice about you. Whitening your teeth adds confidence to your smile - as your grand mother used to say, it all starts with the smile. A dazzling smile leaves a great first impression - a confident, bright smile is extremely important for a job interview.

Unfortunately, no one whitening system works equally well for all people. Some folks need the outside and inside (buccal and lingual) parts of their teeth to be whitened. For other people, going to bed with the whitening product inserted in their mouth may be more effective. Some may need only 30 minutes per day for 10 days for their teeth to be pearly white. Disposable take-home trays may be a good choice for such people. These trays are typically preloaded with the whitening product and inserted into the mouth. The thin membrane adheres to your teeth and remains securely in place for the 30-60 minute wear time. The bottom line is that one needs their teeth to be properly evaluated by a good dentist to determine which system would be the best option.

Research has shown that the most effective and long-lasting whitening system is the take-home whitening kit. Over the counter whitening gels may harm the gums, if used incorrectly. In comparison with whitening strips, the take-home trays require far less dexterity. The trays are easy to put in, cover much more of the tooth than whitening strips, and are easy to wear. However, if you have extremely yellow teeth, you're better off going with a professional solution.

Plaque is a sticky colorless deposit of bacteria that is constantly forming on the tooth surface. Saliva, food and fluids combine to produce these deposits. Plaque forms 4-12 hours after brushing which is why it is so important to brush at least twice a day and floss daily. Tartar or calculus is a crusty deposit that can trap stains on teeth and cause discoloration. Calcium and phosphate bind to form crystals on the teeth. These calcium phosphate crystals eventually harden with plaque to form calculus. For many folks, these deposits build up faster as we age. Factors that contribute to periodontal diseases are diabetes, genetic disorders, blood diseases, emotional stress, tobacco use and HIV injection.

OK, what is the treatment? This involves periodontal or deep cleaning. Scaling coupled with root planing is used to remove plaque and tartar beneath the gum lines. A local anesthetic is given to reduce any discomfort. A scaler or an ultrasonic cleaner is used to carefully remove plaque and tartar down to the bottom of each periodontal pocket. Root surfaces are then smoothed or planed. This helps pockets to shrink. This procedure also makes it difficult for plaque to accumulate along the root surfaces. Once treatment is completed, regular dental cleanings are required every three months so that the pockets can be maintained.

Did you know that you could save hundreds of dollars by using your dental benefits before the end of the year? While some dental insurance plans run on a fiscal year, most run on a calendar year. If your dental insurance plan is on a calendar year, these 5 reasons will show you why you should make a dental appointment now.

1. Yearly Maximum
The yearly maximum is the most money that the dental insurance plan will pay for your dental work within one full year. This amount varies by insurance company, but the average is around $1,000 per year, per person. The yearly maximum usually renews every year (on January 1 if your plan is on a calendar year). If you have unused benefits, most plans will not allow rollover.

2. Deductible
The deductible is the amount of money that you must pay to your dentist out of pocket before your insurance company will pay for any services. This fee varies from one plan to another and could be higher if you choose an out-of-network dentist. However, the average deductible for a dental insurance plan is usually around $50 per year. Your deductible also starts again when your plan rolls over for next year.

3. Premiums
If you are paying your dental insurance premiums every month, you should be using your benefits. Even if you don't need any dental treatment, you should always have your regular dental cleanings to help prevent and detect any early signs of cavities, gum disease, oral cancer and other dental problems.

4. Fee Increases
Another reason to use your benefits before the end of the year are possible fee increases. Some dentists raise their rates at the beginning of the year due to the increased cost of living, materials and equipment. A fee increase can also make your copay higher.

5. Dental Problems Can Worsen
By delaying dental treatment, you are risking more extensive and expensive treatment down the road. What may be a simple cavity now, could turn into a root canal later. Call our office and schedule an appointment to use those benefits.

I received a nice testimonial from one of my Invisalign patients, Sarah - she has been on Invisalign for the past 4 months. Her experience is very valuable and provides real insight into what patients can expect when they are on the treatment. Without further ado, here it is:

I always thought I would get my bottom teeth fixed "eventually" but never got around to it. My teeth are very tight and shred through dental floss, even the shred-proof kind. It was an annoyance, but not a big deal because most people don't look at your bottom teeth. However, I was starting to have some other problems, and found out that by straightening my teeth I could clean them more easily and prevent further problems down the road. I work long hours and have a very busy schedule, so the thought of braces just sounded too inconvenient, not to mention painful. Starting Invisalign has allowed me to take care of my health while not interfering with my other responsibilities.
Some tips from me:

- Starting Invisalign: If you can, pick a time when you're less busy to start. It's easier to get used to the aligners if you can relax and take your time. The aligners can cause some soreness, but it isn't too bad and goes away after the first couple of days. Learning to pop the trays in and out is tricky at first, but I got the hang of it quickly. You will feel some tightness when you switch trays, but just for a day or two. I like to switch them at night to sleep through some of this.
- Cleaning: I carry a travel toothbrush and toothpaste with me, and a special opaque water bottle (full of mouthwash) on my desk at work to keep my aligners clean when I'm out and about. I use denture cleaning tablets when I'm at home. Taking out your aligners in public is a personal preference. I still don't like to but will discreetly if I have to. I've talked to others who have no problems with this. You'll find what works for you.
- Keeping track of your aligners: I wear eyeglasses, and think of my aligners in the same way. I always make sure to have them with or near me when I'm not wearing them. It's easy to lose track of the case(s) but I try to keep a backup small ziploc bag in my purse or something with me just in case. You will be warned when you start not to wrap them in a napkin because they are easy to throw away accidentally. I didn't believe this at first, but it's true! When I'm in a pinch and absolutely have to do this, I will wrap them and put them in my pocket or purse which helps.
- Paying for Invisalign: I was able to use a payment plan and my employer's flexible health spending account (FSA) to make paying for Invisalign easier. Check with your health insurance and employer to see what your options are.
- "Good" side effects: Since you can't eat while wearing the aligners, it makes it easier to drink more water and pass up on food you shouldn't be eating anyway. It makes you think about what's worth taking them out for. If you bite your nails, you can't do that when wearing the aligners. It does make it harder if you ever "bite" open a bag of chips etc. but so far it hasn't been a big problem for me.