All posts by Dr Harden

Smile for the Camera

January 2005

By: Scott R. Harden

Diana was preparing to celebrate her 25th Silver wedding anniversary. As she sat before the mirror and prepared to put on her makeup, Diana knew in her heart that she had made the right decision. Her strong desire to improve her appearance coupled with her husband’s support, allowed Diana a great sense of satisfaction in the decision that proved to be her best anniversary gift ever.

Several months ago, Diana was having a family portrait made with her sister. “Smile for the Camera” were four little words that would ultimately improve her life tremendously, but not before experiencing some mental anguish. When the photographer presented her with the close-up of her face, she was devastated by her appearance; the crow’s feet on the side of her eyes, wrinkles on her forehead, and thin lips. The crown on her front tooth detracted a lot from her appearance and was very apparent in the photograph. She never liked the crown because it has always been the wrong shade and has always had that dark band along the gum line as well. My teeth have always been yellow, crowded and just not attractive, she thought to herself.

Diana was overcome with emotion and walked out of the studio without uttering a word. Her sister caught up with her and sat down next to her on the bench. After a period of silence, Diana looked at her sister and exclaimed, “I can’t believe I have aged that much. I don’t want to have our picture taken because I don’t like the way I look”.

Diana researched her options, and made the decision to visit a cosmetic dental office that would deliver the new smile she desired to achieve. Upon entering the spa-like facility, she experienced a very serene atmosphere complete with fountains, candles and TV monitors displaying peaceful scenes in every room. The doctor and staff were all very friendly, and had a thorough discussion with Diana identifying her options and her needs. She was presented with before and after photographs from their smile portfolio to clearly demonstrate esthetic procedures currently available.

An initial treatment plan was developed that sounded very attractive to her, and encompassed cosmetic care that included bleaching, porcelain veneers, all-porcelain cosmetic crowns, and esthetic recontouring of several of her teeth. With Diana’s approval, the cosmetic assistant took impressions of her teeth. At her next visit, Diana was amazed at the level of information that was presented to her. A full display of her photographs were present, along with a “patient treatment plan video” that completely summarized all the photographs of her teeth, her diagnosis, and proposed treatment – with narration. A copy of the DVD was given to her to take home.

Moreover, two sets of study models were present in her consultation; a before and after smile. By working on the model, the doctor was able to demonstrate the exact steps he would perform on Diana’s teeth, which he had recorded into her chart. The model was then waxed up to simulate actual crowns and veneers. Diana was able to become an involved participant in the process and actually critique details of her treatment in advance. She then was asked to review color options and select the color right for her. This permitted her to achieve exactly the smile she desired.

The office manager was very professional about discussing the cost of treatment and financing, which made the dental care affordable to Diana – a sigh of relief. A coordinated referral to a plastic surgeon further assisted Diana in achieving exactly the look she was hoping for and this complimented her new smile perfectly. The office manager then helped coordinate all Diana’s appointments and made her dream a reality.

Diana’s decision for a new beautiful aesthetic smile made her look and feel many years younger. Diana was tremendously elated by her new vitalized self-esteem.

I feel like a million dollars, she thought to herself, and tonight I am ready to celebrate my anniversary. As the waiter poured the wine, and candles glimmered, Diana flashed a gleaming smile at her husband with the most beautiful anniversary gift that she has ever received.

To stay forever young is perhaps the dream of every person. Most of us wish we could visit the Fountain of Youth, and continue to look young and vital throughout our lives. A visit to Fountain View Family Dentistry & Cosmetic Center will provide you the stunning smile you deserve and help you achieve the satisfaction of looking your absolute very best.

Dr. Scott Harden is a cosmetic dentist at Fountain View Family Dentistry & Cosmetic Center. He can be reached at (770) 926-0000.

Gummy Bear

November 2004

By: Dr. Scott R. Harden

As the authorities arrived on the scene, pandemonium was in full swing as onlookers from the crowd gazed down at the perpetrator in disbelief. The alleged assailant fled from the crime scene only moments ago without any insight as to the chain of events about to unfold. As he rounded the large pillar, and swayed to miss the elderly woman polishing her glasses in the middle of the aisle, he twisted to his left and fell to his knees.

The actor had no sooner heard the director yell “cut”, when out of nowhere the large German Shepard attacked and sprang upon him with a momentous force. His fierce eyes and bone-chilling ominous growl lead innocent bystanders on the set to fear for this man’s life. The large dog engulfed the man’s leg with a deliberate wrenching force that extracted a gasp from several people who were frozen in fright.

Eyebrows were raised as the man threw his arms around a dog’s neck and began to laugh while the dog gummed his calf muscle. This poor dog has been the victim of periodontal “gum” disease that resulted in all his teeth being removed due to severe infection. The happy owner of this beautiful Shepherd, having adopted him only months before, brought “Gummy Bear” to many of his acting engagements. The two of them seemed to deeply enjoy staging a spontaneous final act for their unassuming audience.

Periodontal disease is a very debilitating disease that afflicts pets and people alike.

Oral Disease is the #1 health problem in both dogs and cats. Approximately 80% of pets older than four years suffer from gum disease. Interestingly enough, approximately 80% of people older than 35 suffer from gum disease.

Many of us possess the sad image of an older dog or cat having great difficulty eating because the pain in their mouth is so great, or an elderly person whose dentures are coming out of their mouth when they are speaking or eating.

Periodontal disease in humans and animals has many similarities in diagnosis and treatment. Visual inspection of the oral tissues, probing around the teeth to measure the gum attachment, and x-rays are common to both.

Preventive care is truly the most important aspect for both you and your pets. As the old saying goes, an ounce of prevention is worth a pound of cure.

Both dentists and veterinarians use the same systematic diagnosis and place their patients into one of three categories: health, gingivitis, or periodontitis. Periodontitis is the most serious and it is subcategorized into early, moderate, or advanced.

Treatment for humans and animals has many similarities. The use of anesthesia makes for a pleasant experience. Ultrasonic instruments vibrate the plaque and tartar off the teeth. Hand instruments are used to scale the teeth to make them smooth and stimulate a healthy response.

One monumental difference between treatment of periodontal disease in humans and animals is the concern of getting verbally reprimanded versus getting bitten.

Facts about Periodontal Disease:

Periodontal Disease affects a staggering 80% of Americans, estimated at 35.7 million people nationwide, 7 million people in Georgia, and 160,000 people in Cherokee County.

Research links periodontal disease to other health problems including: cardiovascular disease, preterm low birth-weight babies, stroke, diabetes, and respiratory illness.

The mass of tissue in the oral cavity is equivalent to the skin on your arm that extends from the wrist to the elbow. If this area were red, swollen, and infected, you would visit the doctor. Gum disease is not a small infection.

Smoking may be responsible for more than half of the cases of periodontal disease among adults in this country.

People with diabetes, leukemia, or AIDS/HIV are at increased risk for developing periodontal disease.

Stress can affect periodontal disease and can make the infection more severe and harder to fight. A recent study found high levels of financial stress and poor coping abilities increase he likelihood of developing periodontal disease by twofold.

Periodontal disease is the major cause of tooth loss in adults.

Research proves that up to 30% of the population may be genetically susceptible to gum disease. Despite aggressive oral care habits, these people may be six times more likely to develop periodontal disease.

The basic problem is that once the gums are inflamed, they become a MAIN SOURCE of bacterial absorption into the blood stream. This bacterial invasion into the blood affects the heart, the liver, the kidneys, the joints, the vascular system, and especially the immune system.

What is Periodontal Disease?

Periodontal disease, also known as gum disease, is a chronic bacterial infection that affects the gums and bone supporting the teeth. There are two main categories: gingivitis and periodontitis.

Periodontal disease can affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed.

Gingivitis is the mildest form of the disease, and causes your gums redden, swell and bleed easily. There is usually little or no discomfort. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.

Periodontitis can result from untreated gingivitis. With time, plaque can spread and grow below the gum line. The gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected.

As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Eventually, your teeth can become loose and possibly have to be removed. This destructive process typically has very mild symptoms, which are often undetectable.

Gum Disease is preventable and treatable. Routine visits to the doctor allow either you or your pet to remain healthy and happy. Routine visits to your dentist twice per year, or veterinarian once per year, is not expensive and provides a quality of life you or your pet deserves.

Dental Neglect, The Root of Most Dental Problems

December 2004

By: Dr. Scott R. Harden

“NEGLECT! What do you mean NEGLECT? You have been my dentist for over a dozen years, so how could I possibly need to have all my teeth extracted?”

Jim was angry with himself. He has not routinely kept his six-month cleaning appointments, has denied treatment and he has not flossed at all in years.

“Dental Neglect” occurs when a person has the ability to acquire dental care and decides not to. Avoiding dental care can result in problems ranging from minor to catastrophic in as little as one to two years.

Jim is 52 years old and projects himself with great confidence. He stands 6’ 3” tall, has jet-black hair and a dark complexion reflective of his Italian descent. Jim is very meticulous about his appearance, and has dedicated a lot of time and effort to his health, his personal image and his career. However, he has clearly overlooked the importance of his dental health. What am I going to do without my teeth, he kept repeating over-and-over in his mind? What caused all these problems?

Plaque is the culprit, and is a sticky white film of bacteria that accumulates on your teeth. The bacteria create acid that attacks your teeth 24 hours a day causing tooth decay, tooth abscesses and gum disease infections. Plaque, on average, causes the failure of dental restorations at 10-15 years after placement. The bacteria penetrate under the margins of old fillings and crowns and are channeled directly towards the nerve of the tooth. This can ultimately lead to the need for root canal therapy or even tooth loss.

The combined infection of Jim’s tooth abscesses and gum disease could equate to large bleeding ulcers covering your entire forearm. A condition such as this would instantly bring anyone to the emergency room. So why should oral infections of the same magnitude be ignored just because we cannot see them?

Jim has procrastinated doing his dental treatment for many reasons, none of which seemed important to him at the moment. I remember several old sayings my father told me, he thought to himself.

  • Don’t Put Off Until Tomorrow, What You Can Do Today
  • Cleanliness Is Next To Godliness
  • An Ounce of Prevention is worth a Pound of Cure

These words rang out loudly in his head, as Jim envisioned his appearance with false teeth.

Jim is now confronted with a serious psychological challenge that is comparable to losing any part of your body. Contemplating the loss of his teeth, Jim faced feelings of denial, guilt, anger, and ultimately acceptance. Acceptance is the level where he can claim responsibility for his condition, and can assume steps to achieve results. It is my fault, he calmly reflected on his drive home from the dentist.

At home, Jim discussed his dilemma with his wife, who did not extend much sympathy his way. She reminded him that he had received many phone calls reminding him of his dental appointments that he rescheduled or avoided scheduling. “You brought this on yourself because you were too busy to take time to focus on your dental problems. You should have dealt with your dental needs a long time ago.” This is not what Jim wanted to hear, but his wife was correct.

After a long and arduous debate, Jim and his conscience had to come to terms with the long overdue need of visiting his dentist. Jim realized he had avoided a serious need, and that his wife was correct by saying he should have dealt with his dental problems years ago.

Jim listened carefully as his dentist, Dr. Scott Harden, stressed the importance of his commitment to treatment. “Procrastination in dentistry results in patients limiting their treatment options, and typically adds great expense to their restorative needs.”

Jim had a variety of treatment options years ago. At this point, however, Jim faced one hard fact – all of his teeth had to be removed. His options included conventional dentures, implant supported dentures, or implant supported bridges. The good news is that great strides in dental technology provide Jim viable restorative options to replace his missing teeth. The bad news is that Jim could have prevented making this decision altogether, if he would have only been committed to his oral health. It would be a lot less involved, a lot less expensive, and most notably he would be able to keep all of his teeth.

Jim’s dental neglect clearly resulted in a catastrophic problem for him. This should be a clear reminder, that anyone who ignores their dental care needs, may sooner or later have to face significant dental problems as well – problems that could otherwise be avoided.

One other old saying comes to bare:
Be True To Your Teeth, or They’ll Be False To You

False Emergency

October 2004

By: Dr. Scott R. Harden

On the verge of tears, pacing the floor in writhing pain, Tammy could not postpone making a decision any longer. She was feeling desperate, acting irrational, but knew she had to make the pain stop. The toothache that Tammy Jones was experiencing escalated to an unbearable level and was throbbing so badly she could feel her heartbeat in the tooth. I shouldn’t have waited this long to get something done, she thought.

She felt very despondent about picking up the phone to call yet another dentist regarding her bad teeth. As she dialed the phone number to the dentist, she felt a familiar confinement from anxiety overwhelm her. The phone rang and she pondered, why am I so apprehensive about going to the dentist?

Tammy possesses a classic example of dental phobia, an ailment clearly shared by many Cherokee County residents. Dental phobia can manifest from a mild deterrent to a paralyzing fear of seeking dental care. It is related to many causes ranging from psychological issues to physical issues such as macroglossia, an enlarged tongue that partially blocks the airway and gives the patient a sense of choking.

It has been reliably reported that 50% of the American population does not seek regular dental care. An estimated 9-15% of all Americans fully avoid dental care altogether. This translates to some 30 – 40 million people nationwide including 20,000 people in Cherokee County, that are so afraid of dental care that they avoid it altogether.

In terms of your dental health and overall wellness, this can have serious implications. In addition to chronically infected gums and teeth with abscesses, which can affect your overall medical health, your ability to chew and digest can be seriously compromised. Without healthy gums and teeth, your speech can be affected as well. Your confidence and self-esteem can be compromised if you are insecure about your breath and smile. This can ultimately lead to serious limitations in both your social and business environments.

After delaying treatment for four years, Tammy’s visit to a dentist one month ago left her bewildered and distraught. She reflected how direct the dentist was about “having those bad teeth extracted on the lower left”, and how little explanation he had offered as to why. The dentist referred her to an oral surgeon for the extractions and put forth no effort to reappoint her for follow-up care. She had not formed a good relationship with that dentist or the office staff, and was not confident about their advice. Despite her desire to be free of her pain-ridden teeth, she did not feel strongly compelled about having her teeth extracted.

Tammy read various articles regarding dental restorative treatment and implants written by Dr. Scott R. Harden, a restorative and cosmetic dentist located in the Woodstock area. I want to have options, she thought.

“Fountain View Family Dentistry, this is Leanne, how may I help you?” Tammy was nearly speechless as she held the phone to her ear. She responded after an awkwardly long pause, “I have a very bad toothache and would like to make an appointment”. As Tammy drove into the parking lot, she contemplated not keeping her appointment. Embarrassed about the terrible condition of her teeth and gums, and worried about the financial expense of treatment, her apprehension grew exponentially as she approached the door to the dental office.

The initial visit at Fountain View Family Dentistry, proved to be an entirely different experience from her previous visit one month ago. Tammy felt very at ease and more comfortable than she has ever felt in a dental office. The front office staff provided her a warm welcome and created a very positive dental experience, long awaited by Tammy. The practice manager further discussed the expenses of dental care at the end of her visit and made treatment affordable to her. “I feel so comfortable in your office”, she exclaimed to our practice manager before leaving.

The doctor provided Tammy with several treatment options, and discussed them while images of her teeth were projected onto the overhead monitor utilizing an intra-oral camera. Tammy told an assistant, “the camera allowed me to easily understand my diagnosis and treatment plan.” Option one included extracting three teeth in the lower left and replacing them with a removable partial denture, an option unappealing to her. Another option included extracting the same teeth and placing implants to restore her missing teeth. Option three was the most attractive to Tammy; it was very unique and customized for her specific needs. This option included extracting two teeth that were non-restorable, performing a root canal in one salvageable root of a molar while extracting the other bad root of the same tooth, a procedure referred to as a “hemi-section”. This allowed her to acquire a fixed bridge spanning from the retained root forward to a healthy tooth, which would be permanently attached.

The doctor further explained this treatment plan to Tammy utilizing a patient communication tool he calls the “BBOT or building blocks of treatment”. Stages of treatment are simply broken down to basic steps or building blocks that allows the patient to attain a clear understanding of their overall treatment.

At Tammy’s visit to begin treatment, she felt one last imminent desire to abandon her treatment procedure. Knowing that immediate treatment for pain relief was necessary and that Tammy’s concerns were psychologically founded, Dr. Harden added his tender reassurance and gentle words to help calm Tammy’s mental anguish.

“Tammy, you have been a false emergency long enough in your life, and its time to take positive steps to fix your teeth”, the doctor stated to Tammy as she squirmed nervously in the dental chair. “What is a false emergency”, she inquired? “A false emergency”, he explained, “is a patient that has had a significant problem existing for a long time, often years, and decides by some measure that today is the day they must be seen.

In order to help Tammy refocus her attention, the dental assistant provided her with headphones to play either a CD or DVD movie from their library. These added touches along with the Comfort Control Anesthesia device, a computer controlled device that allows anesthesia to be delivered without any discomfort, helped Tammy move forward with her dental care. “The entire procedure was painless despite a root canal and extractions, and I did not even feel any discomfort the following day”. Tammy achieved a major milestone, and is well on her way to achieving complete dental health … a dream come true. Congratulations Tammy!!!

This is a true human-interest story about a recent patient experience at Fountain View Family Dentistry. The patient’s name has been changed to maintain professional discretion.

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