Dr. Ben Kawasaki DDS

07/27/2022

Consider this simulation of a person from childhood into her older aging. Throughout our lives we have bond deposition and bone resorption, more bone deposition than resorption up to our late 20's to mid 30's. Without bone resorption our faces would appear as an enlarged 5 year old. While our bodies continue to deposit bone throughout our lives we gradually lose more bone than is deposited.
We might become osteopenic then osteoporotic. Our jaws are part of our facial skeleton which gradually "shrink"causing our teeth, which don't shrink to be crowded into ever deminishing boney housings hence observed crowding and "gum recession" or attachment losses. Our skin and salivary glands similarly lose their vigor and capacity becoming thinner and losing their qualitative and quantitative outputs increasing our now exposed dental roots to "senile caries".
Our need for increased self care and professional preventive care as we age in time becomes apparent.
Those "bags" under our eyes? Widening of our boney orbit by way of bone resorption...
Control what we can and adapt to what we can not control and hopefully find peace in all of our blessings and cherished friends, family and memories.
Some of my observations re: oral self care.
When I clean peoples teeth I seem to spend 70% of the time on the bottom teeth. Should be brushing more on the bottom? Also I inquire of people who's teeth seem to immaculate during their examinations and cleanings. A common observation is that they change their toothbrush heads way more frequently than Ive ever thought to recommend. These persons replaced their toothbrushes every 2 to 4 weeks! Ive heard comments as "I can feel the difference" or "I am hard on my brushes...". Daily flossing and/or Oral Irrigation devices are other commonalities. The daily 1% self applied Sodium Fluoride I frequently prescribe is another demonstrable aid to impressive self preservation.

02/28/2020

Zirconia and Lithium Disilicate crowns look good on paper.
In practice their executions are highly technique sensitive.
Note the cracks in this newly completed crown.
Their hardness (measured as "flexural strength") results in brittleness as opposed to traditional high noble alloy gold.
Consequently they need to made thicker at the expense of tooth structure. Zirconia is also very inert which is generally a favorable quality of a dental material...except when it comes to adhering it to your tooth! Though computer milled, these crowns first so poorly on their die models requiring literally hours of painstaking adjustments to make them patient ready. That is probably why I am frequently tasked to replace these Zirconia crowns with poor outcomes. On the other hand, alloyed with Yttrium for greater translucency, cosmetic outcomes can be good.

11/24/2019

PREVENTIVE DENTISTRY, Oral Hygiene Favorites

06/30/2019

Some illustrations to remind us that our beautifully designed natural teeth have a service life that can be prolonged with judicious use and care.

04/05/2019

Photo micrographs of osteoporotic and normal trabecular bone. We are especially susceptible to lower bone density with aging and some medications as chronic use of antacids, corticosteroids, immunosuppressive, thyroid hormone replacement, antidepressant medications to mention a few. One of several factors when determining if one might be a candidate for dental implant procedures...

04/27/2018

The distal marginal ridge(back end) of this lower molar has an asymptomatic open vertical fracture, typical with normal wear and midlife. If not intervened with full coverage crown this tooth may be lost due to a vertical root fracture propagating down root's entire length... at that point untreatable.

02/11/2018

This is another interesting example of a tooth at was treated with a Root Canal Treatment (see pink center canal if gutta percha show through) and the auxillary apical accessory canals (black), then crowned to try to control its bite pain symptoms and finally extracted due to the vertical root fracture spanning the entire length of its root. Don't use your teeth as a tool!

01/09/2018

09/14/2016

This graph of the acidity in our mouths over time is a good reason to brush, rinse after consuming sweet, acidic, sour drinks or food...note acidity increase for about 25 minutes under normal salivary flow, and the attenuated levels of acidity bathing our teeth when our mouths are dry or when we might be dehydrated : ( Our poor hydroxyapatite crystalline teeth dissolving in its organic acid stew...
Self applicated Fluoride rinses or gels or topically applied fluoride varnishes help harden our teeth to diminish the undesired effects of "dry mouth dental caries..."

05/05/2016

Photo elastic images of cusp loading with a centrally located restoration and a cusp-covering indirect onlay restoration.
Note high stress foci in the first image versus the lower stress, and distributed stresses in the second image.