Dr. Richard S. Tutin's Blog

As many of you know, I am a proponent of custom athletic mouthguard use. For many years, I have offered a benefit to all my patients. I provide mouth guards at a significant discount, charging only what I am charged for fabrication. I recommend mouth guards for all athletes, including those who are only involved in sports recreationally.
Recently, I treated an emergency patient for a broken front tooth. The patient received an elbow to his mouth while playing pickup basketball in his driveway. The large break was repaired with dental bonding. Over the course of a lifetime, this will need to be repaired many times. It could require a root canal, or even possibly, an extraction. A mouth guard would have prevented this.
People who complain about about pain while wearing mouth guards have never worn a custom appliance. A custom mouth guard is far superior in comfort and fit than the over the counter “boil and bite” variety. The two can not be compared.
The process is simple. All it requires is a simple impression of the top and bottom teeth and a fifteen minute appointment to perfect the fit and optimize your comfort.
I urge you to make the small investment and wear a custom appliance for participation in all contact sports.

In my pursuit to learn and implement new and exciting technologies to my practice I’m pleased to announce that I am certified to provide short term orthodontics to my adult patients. Six Month Smiles is the brand name of this type of orthodontics and it joins Clear Correct and Invisalign as options at Framingham Dental Group. Please feel free to ask about these services at your next appointment.

What Is Six Month Smiles?
Six Month Smiles® is a modern twist on tried-and-true orthodontics. There is little debate within the orthodontic community that braces are the most widely used and most effective method to give patients straight, healthy teeth and a beautiful smile. Six Month Smiles has taken the best aspects of braces and modified the treatment and the materials to give adults a common-sense, cosmetic solution that fits your lifestyle. Here is what makes Six Month Smiles so innovative …
Average treatment times of only six months
Six Month Smiles Lucid-Lok™ clear brackets and tooth-colored wires are barely visible
Use of braces has shown to provide the most conservative and predictable final result
Six Month Smiles Patient Tray Kits™ ensure that your appointments are fast and comfortable
Low forces and short overall treatment times increase comfort, safety, and hygiene
Six Month Smiles is typically less expensive than traditional braces, aligner therapy, or veneers
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There are two questions I’m frequently asked regarding sedation dentistry procedures in my office. The first question involves concerns about being completely “knocked out.” The second question seeks information on pain management.

A great strength of oral sedation is the fact that you are never unconscious. You are in a state of relaxation that allows you to be comfortably drowsy. If a problem or concern arises during treatment, you are able to let me know. I am constantly monitoring your breathing, pulse, and blood pressure. This allows me to keep you in a comfortable state throughout the procedure. Sedation medications produce a state of amnesia. You will be awake and comfortable but will, most likely, not remember having the dental work done.

My expectation is for you to experience no pain. When you are relaxed and comfortable local anesthetics are able to be administered with a high level of efficiency. When I combine nitrous oxide with the local anesthetics, I am usually able to use less anesthetics and less injections are necessary. The result is little to no post operative pain regardless of the complexity of the procedures performed.

Sedation is a great alternative for patients who have trouble with conventional forms of treatment and have been procrastinating necessary procedures due to their fears. Or, it may be something you seek just because a more comfortable experience is possible.

I am available by appointment for consultation regarding sedation dentistry. This service is available for my current patients and referrals of their friends and family. Please call my office at 508-872-0041. More information can be found at www.drtutin.com.

I’ve recently finished one of the most rewarding cases of my dental career. It involved a patient who had a lifetime of disappointing and ineffective treatments which resulted in long term avoidence and fear of the dentist. She became a new patient, referred for sedation dentistry by an existing patient. I’m proud of our sedation dentistry procedures and successes. Everyone knows someone who is afraid of the dentist. I’d like to share our process with you.
The key to the success of a sedation case starts when the patient actually calls my office. The patient’s first impression needs to be positive and she shoudn’t feel judged. The patient’s ambivalence is strong. My staff is trained to help the anxious person feel at ease and begin to guide her through the process. Once the patient takes the initiative to make that first phone call, we are motivated to assist her in any way possible to the next step – the initial visit. We provide detailed, warm, and calm advice with no pressure or judgement.
The first visit is just a consult. I talk to the patient about past dental experiences and review her specific fears of dentistry. We work together to discuss the procedures that I use and to make the patient feel confident that this will be her best dental experience ever. An important part of this visit is the taking of a thorough medical history. I review all medications, both prescription and over the counter, as well as pre-existing conditions. I use specific sedation drugs based on each patient’s history. I choose drugs with the least amount of side effects and best results. The only dental procedure that takes place on this first visit may be a set of radiographs in order to start the treatment planning process.
In my next blog, I’ll detail the actual medications and steps that I use in sedation dentistry so that patients are relaxed and ready for their dental work.

Here is an interesting article I saw on the web about oral cancer. Check it out.. http://www.thebostonchannel.com/news/27311772/detail.html

Framingham Dental Group takes diagnosing oral cancer seriously. The office uses the Velscope oral cancer detection technology to supplement our visual exam. It is non invasive and completely painless. Oral cancer can strike anyone at any age. The following are some high profile people who have been stricken with oral cancer:
Michael Douglas -throat cancer
Roger Ebert -salivary gland tumor
Sigmund Freud – cancer of the soft palate
President Grover Cleveland -cancer growth on roof of his mouth
Jack Klugman -cancer of the larynx
Babe Ruth -nasopharyngeal cancer
George Harrison -malignant lump in throat

Cerec cad-cam technology can restore your teeth with all ceramic crowns or onlays in ONE visit: No more goo in your mouth. No more multiple visits. No more temporary crowns. No more metal lines to potentially show at the gum line.

The first visit is the only visit.

I take computer generated pictures of your teeth and use them to design all white ceramic restorations. The crown is created by the Cerec machine in about ten minutes. Then I just bond it into your mouth.

The Cerec technology makes the process of restoration easier and more convenient but it’s also better than the older method. The Cerec allows me to be more conservative when drilling. Also, there is no risk of anything causing infection while you wait for your crown to be made at the lab. The bottom line is: you get a better crown in less time, with less drilling and it looks great!

I’m excited to share this new technology with you. The Cerec is in the waiting room. I hope you enjoy watching it work. If you have any questions, just ask.

I just read a study published in the Journal of Clinical Orthodontics that I find interesting. It states that tongue studs can cause a gap toothed smile. People, mostly young adults, often push the barbell shaped studs back and forth against their front teeth. This can wedge them apart, opening spaces in their mouths. Add to this, a greater risk of fractured teeth and gum recession – it’s a wonder why anyone would want a tongue stud.

The following suggestions will help eliminate or significantly reduce bad breath.

1. Visit your dentist on a regular basis for a complete examination and cleaning of your teeth and gums
2. Prevent bad breath by brushing your teeth twice a day and flossing, especially after meals that contain food and spices that cause bad breath. Don’t forget to brush your tongue to remove any trapped food or bacteria caught in the hair like fibers on the tongue.
3. Try chewing parsley after a meal. It contains chlorophyll, a known breath freshener.
4. To prevent bad breath from smoking—stop smoking!
5. Avoid foods such as garlic, onions, cabbage, and coffee.
6. Dry mouth or xerostomia is a major cause of bad breath. Sip water throughout the day. Chew sugar free gum to help your body produce more saliva.
7. If you use a breath freshener or candy consider one that contains xylitol, studies have shown that it can reduce cavities.
8. Occasionally use a mouth rinse of 50% hydrogen peroxide and 50% water as a mouth rinse. Hydrogen peroxide will help kill the bacteria that causes bad breath

Dear Friends,

I’m writing to share that Framingham Dental Group has new appointment confirmation software. The new software allows us to remind you of and confirm appointments via email and/or text message. It’s your choice; no more playing phone tag and having to interrupt your day to call us back. The new software is easy to use; all you need to do is click to activate it. Of course, all the information you give us stays with us. The process is under way and everyone will be receiving information soon. Let me know what you think!

Richard Tutin, DMD