“Visiting grandma and grandpa and seeing their teeth in a jar are kind of a way of the past,” says Dr. Angela Lueck of Riverwalk Dentistry in Downtown Milwaukee. “The majority of people today will not lose a tooth.” It’s a sign of dental progress, a testament to better care both at home and in the dental chair. But all is not yet white and sparkly in the realm of teeth.
Nearly half of adult Americans – some 65 million – have periodontal disease, chronic inflammation that affects the gum tissue and teeth-supporting bones, according to the most recent data from the Centers for Disease Control and Prevention. Untreated, it can lead to losing teeth. It’s also linked to cardiovascular disease and diabetes, among other ailments – even dementia.
And so, the dental advice you’ve heard all your life still applies. The best path to a lifetime of healthy teeth and gums is to start proper care early and stay with it. But for those who stray from that path, or simply never get on it, the consequences of years of neglect can be halted, reversed and repaired.
Herein you’ll find listings of more than 200 dental professionals in the Milwaukee area. Lueck is on the list, as are Dr. Michael Grady (Marquette University Dental School Faculty Practice), Dr. Eddie Morales (Premier Periodontics in Greenfield) and Dr. Matthew Smith (Stone Ridge Dental in Waukesha). Combined, the foursome has some six decades of experience in the field.
So we tapped their collective wisdom on a range of topics, asking questions about patient phobias, high-tech advances, even dental insurance. Their answers may surprise you.
What is the biggest misconception about dentistry today?
Grady: I don’t have insurance; I can’t go to the dentist. And, oh, it’s going to hurt. No. Dentistry is affordable, and it can be as comfortable as possible. One thing I stress to patients: If you have a small problem, it is going to require a small solution. But if you postpone treating the problem, it is only going to get bigger, and then it is going to become more involved and more expensive.
Morales: That whatever I do is going to be very painful. And it’s usually not the case. More often than not, patients will come back and say it wasn’t that bad, or the stories they heard were way worse than what was done.
Lueck: People think we are stuffy old men and we don’t have personalities. You get customer service that didn’t exist 25 years ago. Warm towels, ChapSticks, just little things we do to try to make the process more pleasurable, more comfortable.
How important is patient comfort?
Lueck: If they can go to someone who doesn’t hurt them in any way, whether it is a comfortable dental chair or a painless injection or using technology to our advantage, it’s a good thing.
Smith: Patient comfort is first and foremost. We really strive to meet all of those types of concerns, and we always ask, ‘What are your expectations? What can we do to make this a great experience for you?’ Our mission is to treat patients as family and friends, and we really mean that, and they feel that connection and trust. That helps with patients who do have anxiety.
Morales: A lot of it is chairside manner. We want the patient to be in control. They have more autonomy than they used to have, and that makes them more comfortable as well.
Is dental insurance adequate?
Smith: I wouldn’t even call it dental insurance. I would call it a dental benefit. If you have a healthy mouth, sometimes you are better off declining that and just paying it out of pocket. The risk is if you need work. But that may only cover a tooth or two teeth, along with your two cleanings a year.
Lueck: Dental insurance has a long way to go to really be beneficial to the patient. The yearly maximums that existed in the 1960s are the same maximums in effect today, but the crowns then were $250, and now they are $1,500.
How has the profession changed since you got into it?
Grady: You are seeing more patients have their teeth throughout their lives, and that’s part of the preventive dentistry efforts. But when all is said and done, it really is the relationship that exists between the dentist and the patient. It’s not about the whistles and the bells and the fish tank and the espresso and the wine bar and the paraffin treatment. When you can establish that trust, you can have a bare-bones office and do some phenomenal dentistry for patients.
Morales: Technology is one of the biggest things. I have a CT machine in my office, so when I am placing an implant, I can have a patient walk into a room and get a CT. I can look at the critical structures of nerves and tissues, show it to the patient on a 3-D model, and digitally plan the implant. I can show the patient exactly what I am doing and have a guide, so when I go in, we are placing it exactly where I planned it. And that, I think, is pretty revolutionary.
What is the coolest piece of technology in your office, and what does it do for patients?
Morales: It would probably be utilizing stem cells and growth factors to help in bone regeneration around teeth. The body has an amazing healing potential, and the use of these new biologics is a huge benefit for patients.
Smith: We have a 3-D X-ray. It’s called a cone beam CT machine, and we can just image your face, your teeth and your mouth three-dimensionally, and find things that we have not been able to find before. And we have had this laser for a few years for patients who have periodontal disease. It only kills bacteria. We can disinfect that pocket, so you have all the benefits of the laser, and there is no pain, there is no cutting, there is no stitching.
Lueck: We have a digital scanner in our office, and it allows us to design crowns and implants and parts digitally. It eliminates impressions, so patients don’t have all the goop in their mouth.
What is the path to sparkling-white straight teeth?
Grady: It’s not like there’s this special yellow brick road to sparkling-white straight teeth. Certainly, good oral home care is where things start. You need to have healthy teeth, good tissue, good bones. If you can do that, you can reduce cavities and reduce surface stains that might accumulate on the teeth.
Smith: [Regarding teeth-whitening], the biggest difference in over-the-counter versus what can be prescribed professionally is the concentration. Do Crest white strips work? Yes. But where are you starting from? If you are starting with a white smile and want to freshen it up, will it work? Yes. If they’re heavily stained or darker teeth, would it work? Yes. Would it take a long time? Yes. I get upset when they sell it as quick and easy. They have to put ‘whitening’ on anything from toothpaste to mouthwash for it to sell, and the effectiveness is not there.
Lueck: If you are older and have crooked teeth, that is where cosmetic dentistry comes into play. There are restorations that can give you the look of having had braces without moving teeth, by adding to what nature has taken away or removing a tooth structure where it was crooked. But you are never too old to get braces, and it is the best solution to a beautiful, vibrant smile at any age.
Beyond cosmetics, why does dental health matter?
Morales: Patients will see a dental professional much more often than they will see their primary care physician, so we’re oftentimes the ones who will diagnose system diseases before anyone else. Autoimmune diseases will manifest in the gum tissue. We take the blood pressures of all our patients before we administer an anesthetic, so we are one of the first lines of defense in combating hypertension as well.
Lueck: If you don’t have solid, strong teeth to eat with, it can affect your nutrition. It is unfortunate that for people who are elderly or who cannot afford quality dental care, their weight will change. That just makes quality of life less.
Smith: It is more than just dealing with the teeth. I’m not here to diagnose medical conditions, but there are a lot of signs that we can look for that can show signs of other things. We have those conversations with patients.
Write to Milwaukee-area freelance writer Laura Merisalo at letters@milwaukeemag.com.
