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Have you ever taken your car to the mechanic and were told...


...that you needed a repair that you knew very little about, and you felt like you had no choice but to just trust them?  It's an anxious feeling that most of us have experienced.  You may have noticed that that very same thing happens when you  go to the dentist...and that's not right.  

Often, patients are told that they need something (that costs a lot), but they are not exactly sure WHY they need it (or if they even do need it).  And so,  they feel that they have no choice but to simply trust that the doctor has their best interest at heart.  

At Butterfield Family Dentistry, there is no question that our patients are highly educated when it comes to the health of their teeth.  You get the opportunity to see EXACTLY what is going on in your mouth  (unless you request otherwise), and your options and reasons behind different treatments are carefully laid out for you.  We take the time to do this for several reasons.  Firstly, Dr Butterfield loves the field he works in and truly enjoys sharing with his patients the reasons and science behind various options.  The truth is that dentistry is fascinating and exciting!  Secondly, we do this so that you can make educated decisions for yourself rather than just being told what you need.   Every patient is an entire person with needs. and wants, not just a mouth.   It's not "one size fits all" in our office.  

So, how do our patients become educated?  Largely, it's through the amazing technology of high-definition intraoral cameras coupled with Dr. Butterfield's love of teaching.  He takes his time walking patients through these photos, discussing the pros and cons of various treatment options, and calming fears.  It's true, that even life-long phobias fade away when light is shined on the mystery of the mouth.    New patient exams  include many of these pictures during the initial assessment.  Intraoral pictures are also taken on every filling he does, so that you can see the before and after photos of your teeth, as well as appropriate pictures that are taken part-way through the procedure.  Again, these photos serve as amazing education tools for our patients, but they also become an invaluable record for the future. You will be involved in the process and be able to see what your doctor sees and then choose your course of action rather than be dictated to.  

 It can be overwhelming looking under the hood of your car if you don't know what you're looking for.   But when you know the what, where's and why's , you are much better off.  We present treatment options to informed patients, and then they are in the driver’s seat, every step of the way.  

Kids and Fluoride

What’s the deal with kids and fluoride?  

There are many opinions on the subject of fluoride usage and no lack of misinformation out there.  So what is right for my child? 



Before answering that question, it’s important to know that fluoride is an element found in nature.  It also happens to be an ESSENTIAL ingredient in the proper formation of teeth as well as their daily protection. Without fluoride, a tooth would definitely have some big problems (or not exist at all). 


When we are young and our teeth are actually being formed (below gums and bone), we NEED a proper amount of fluoride to be INGESTED and incorporated into teeth, or else they will be weak and way more prone to decay and wear. On the flip-side, ingesting TOO MUCH fluoride as a child (usually from swallowing toothpaste on a regular basis) will likely result in teeth with a mottled appearance.  Teeth with fluorosis will also have permanent bright white (or brown) spots. These spots were made as part of the tooth formation and cannot be cleaned off.  So, again, children need a proper amount of fluoride in their system. Not too much, not too little.  


Side note: Later in life, (once the teeth are formed) ingestion of fluoride has no real benefit. Still,  the presence of fluoride on the outside of teeth (topically) is very important. There, the fluoride soaks into the outermost layer, and helps restore the crystalline structure of enamel. This enamel breaks down slightly throughout the day due to the various sugary exposures causing the fluoride ions to wash away. This leaves the tooth in a weakened state and effectively is the very beginning of decay. Reintroducing fluoride on the outside of the tooth repairs the damage. Kids ALSO benefit from the use of topical fluoride, just as adults do.  But again, they also need it in their system during actual tooth development. 


So what’s the answer?  How do I know if my child is getting the right amount of fluoride, both on the inside and outside of their teeth?  


Well, let’s start with the OUTSIDE (topically) first. Figuring this amount is actually pretty easy. If they are brushing their teeth twice a day (with a fluoride tooth paste), that is adequate. Every few months there is an advantage, as well, to doing stronger topical treatments (say at the dentist office, or participating in a swish program at school).  These treatments are purposefully scheduled only a few times a year, and they are helpful. 


Now to address the fluoride amounts needed INSIDE a tooth for proper tooth development to occur (this pertains to children between 6 months and 16 years old): 

If you live in an area that has public fluoridated water, all your child needs to do is to brush their teeth twice a day, and frequently drink the city water in order to receive a proper amount of fluoride. If drinking city water is not going to happen, a fluoride rinse at night would be a helpful adjunct to brushing. Those that live in areas that utilize well water should have their water tested in order to discover the concentration of fluoride ion present naturally (and then consult with a dentist to determine if a fluoride dosing schedule is appropriate). 


For most children, swishing with fluoride at home is helpful as long as they are old enough to not ingest any. The same holds true for toothpaste. When we brush our teeth, even when we don’t swallow, a small amount of paste does enter our system (we eat a tiny amount). That small amount is a helpful and appropriate dose to help children grow strong teeth.  Younger children who may be ingesting larger amounts of toothpaste or fluoride rinses need to be monitored closely in order to avoid the unsightly white and brown spots mentioned earlier. 


Bottom line:  If your child drinks city water from the tap, they are  going to be in pretty good shape if you simply make sure they brush twice a day, and (if you want added protection) rinse with a fluoride rinse at night.  The rinse is especially appropriate for those that seem to be more prone to cavities.  Those who have well water can do likewise, but with the added task of testing their water and consulting a dentist.  This is to determine whether their child should be taking a daily fluoride tablet, and what that dosage should be for proper tooth development. 


Here are a few reasons why OTC aligners are a poor idea...


Firstly, cutting out the dental professional who knows your teeth and your needs better than anyone else is a huge mistake.  You would no longer have your dentist making sure that the trays you receive will actually produce the movements that you want.  Your dentist should be there from start to finish, discussing your case with a tech, and making needed changes from those initially suggested.  Even with Invisalign, teeth don't always move as predictably as a digital model suggests.  Without professionally placed attachments, and a quarterback overseeing the process, the likelihood of the over-the-counter product yielding desired results are slim...despite their claims.  

Patients who go this route will also miss out on the check-in appointments meant to address issues that inevitably occur along the way, (instead, they are left to themselves).  Finally,  after going through their entire series of trays, and almost always not having achieved their desired result, these OTC patients have no recourse.  Conversely, an Invisalign patient will have the ability to continue treatment in order to finish their case to their liking for a small increase in cost rather than beginning their case anew.  In fact, with Invisalign, most cases are active for several years.  This means that if your teeth shift (lost my retainer), or you need further treatment years later, your dentist is likely to be able to order more aligners to continue your case for a significantly reduced fee.