For Your Comfort

What can we do to make you most comfortable?

We ask this question on our intake form. The most common response is: EXPLAIN WHAT YOU ARE GOING TO DO. When I look for a person to help me with any aspect of my life I want them to listen to me and then based on my needs and wants help me find a solution to my issue. My practice philosophy evolved out of what I want for myself in my relationships. I want to feel listened to and understood and I want to understand the reasons why a recommendation is being made. In every interaction with our patients, that is our goal. When examination or treatment is being done we want to tailor it to each individual person. We welcome feedback. If we can do something to make you more comfortable please ask. We will take the time to help you understand what is ideal and optimal for your dental condition and if you want other alternatives to explain them to you.

Be well,
Richard Stickney DDS PS

Don't Do It!

Good afternoon!

Here's a little bit of advice, in case this ever happens. If you have a painful tooth or swollen gum don't ever do this:

Do not put heat on the outside of the face. Do not use a heating pad of hot towel. It might feel comforting but it can draw infection out of the tooth or gum and cause a severe wound on the outside of the face or neck. Any time you have pain or swelling in the mouth it is best to have it evaluated by a dentist. Sometimes the problem is minor and easily remedied and other times having it looked at early can save you a lot of time and money as well as preserve more of your tooth or gum tissue. If you cannot get in to the dental office right away, warm salt rinsing is a safe bet. Use one teaspoon of salt to 8 ounces of warm water. Then see your dentist as soon as you can. The old adage "better safe than sorry" applies to pain or swelling in the mouth.

Be well!

Richard Stickney DDS PS

Sterilization

Hello,

Today we wanted to discuss a topic that may be on the minds of some people. Recently, articles have been published about an oral surgeon in Oklahoma who has not been following state regulation on sterilization and anesthesia. This put thousands of patients at risk for contracting Hepatitis B and C, as well as HIV, the virus that causes AIDS. Upon inspection of his two practices, they've discovered that he was using rusty instruments, reusing needles, and potentially contaminated drug vials. Beyond that, they were not properly using the machine used to sterilize instruments, and it hadn't been tested in over 6 years. His practice is currently under investigation.

But we are not here to scare you, rather, we wish to put your mind at ease. In my practice, we take sterilization very seriously. We even have one employee whose specific job is to sterilize and clean all of our instruments and make sure they are all in good condition, although each of us knows how to do it. Ashley cleans all the rooms after each patient and makes sure each step in the sterilization process is done correctly, from using our ultrasonic (which uses sonic energy, as well as a cleaning solution to break up any debris left on instruments) to the autoclave (which is a steam powered sterilization machine, that kills any remaining bacteria and viruses). Each week we have our autoclave tested to make sure it is doing it's job properly. We also use a cold sterilization process which uses a chemical "bath" to soak certain instruments that cannot go into the autoclave and we leave them in for 12 hours for proper sterilization. Disposable needles are the only kind of needles for anesthesia we have in the office, and when the needle has been used on a patient, we have a sharps container that we put them in so they can never be reused. In addition, at the end of every week we run cleaning solutions through our suction lines and water lines and leave them over the weekend to ensure a proper and clean environment. We have 3 filters in the office that are there to kill airborne bacteria and viruses as well to protect you and us. In 2003 the CDC established infection control regulations for dental practices which covers rules about hand washing, proper glove changing, and sterilization of instruments, but inspections are left up to each individual state. We are sure to follow these rules and regulations.

In every way we are trying to protect our patients. As well, each employee in the office has had OSHA training to ensure that we also know how to protect ourselves. This requires us to wear proper PPE (personal protective equipment), which includes a lab coat, gloves, mask, and protective eye-wear. All licensed individuals (dentists, hygienists, dental assistants) must take an 8 hour course on HIV/AIDS as well to become licensed through the state of Washington. In addition, every year we review proper handling of instruments, needles, inspection of all equipment, and we go over proper procedure when exposure has occurred.

To your health,
Richard Stickney DDS PS

Composites: A Technique Sensitive Procedure

Hello!

My team and I went to a dental seminar this past Friday and I wanted to share a few of the things we learned with all of you!

One of the interesting things we heard was that people are living longer. In the early 1900s men were only living an average of 45-50 years, and women 50-55 years. Back then, it didn't matter as much that dental restorations lasted only a short time. Now, a hundred years later in the 2000s, men and women are living well into their 80s and 90s, so our approach to dentistry has changed dramatically and we want our restorations to be lasting a long time.

There is only so many times you can drill on a tooth before the tooth is compromised. With that statement in mind, we want to be as minimally invasive as possible to preserve as much natural tooth structure so that the tooth will last a long time. Interestingly though, on average, composite restorations only last about 5 years, and bridges only 8 years! There is something very wrong with those numbers. Lets say at 25 you get a 2-3 surface filling and by 30, that filling has failed and you are now treatment planned for a 3-4 surface onlay. Now lets say that onlay lasts about 15 years and you are now 45, but the onlay needs to be replaced by a build up and a crown. On average crowns can last 15-20 years so at best that crown lasts until you are 65. But now what? Did that tooth reach its 85th birthday? Doesn't look like it.

Composites are technique sensitive, they require a lot more attention to detail and a lot more time than you might imagine. The bonding process is extremely critical, as well as the type of curing light and filling materials used. If a tooth's first dental treatment is a filling, we want that filling to last much more than 5 years. A composite can potentially last a patient 15+ years if it is done right! That's a huge difference.

Every time you get dental work done, the hole gets bigger and bigger and more tooth structure needs to be drilled away. The last steps at saving a tooth include crowns and root canals. Once those have failed, the tooth often needs to be extracted. But with each of these steps from composites all the way to crowns and root canals, you can prolong the life of your restorations by good homecare and regular visits to the dentist. And if the work is done right the first time, you will get the maximum longevity and lifespan out of your dental restorations. Many of our patients have followed this approach and have their teeth well into their 80s and 90s. When patients lose teeth and must go to dentures, they lose about 80% of their ability to chew food, so the quality of life can go down.

Much of the seminar was a refresher for my team and I, as I have been practicing these techniques for some time now. As always though there were a few new things we will be implementing into our composite routine so that our patients are getting a lot of life out of their composites and that their own teeth get to reach their 85th birthdays! And as always, I want to preserve as much natural tooth structure as possible and use a minimally invasive approach to all aspects of dentistry in my practice.

Be well,
Richard Stickney DDS PS

Bana Testing, What Is It?

BANA Testing

Good afternoon all!

This week's blog post is going to be about a new test we are doing in the office that will help us with periodontal cases. It's called a BANA test.

What is a BANA test?

The BANA test is a quick test that helps us determine whether a patient has any or all of the three most common and riskiest pathogenic bacteria called "red complex bacteria", Treponema denticola, Porphyromonas gingivalis and Bacteroides forsythias. These three bacteria are directly associated with periodontal disease in adults. The test is as sensitive as expensive DNA tests, though despite its accuracy it is also amazingly simple to use.

How does it work?

All this test requires is a very small sample of plaque from a pocket. We lightly smear this sample onto a small test strip that has a specific enzyme on it that reacts with red complex bacteria. We then put this test strip into an incubator for 5 minutes (yes only 5 minutes!) and when it comes out, if any of the 3 bacteria are present, the sample will have changed to a blue color. This test is easy, fast and inexpensive to do!

We are always looking for ways to better help and treat our patients. With some of these new tests we are able to better know how to treat periodontal disease and get our patients back to optimal health! If you have any further questions, please feel free to ask!

Be well.
Richard Stickney DDS PS

Romeo et Juliette Ballet

Good afternoon!

A couple weeks ago, the team and I went to see one of our favorite patients perform with the Pacific Northwest Ballet in it's rendition of Romeo and Juliet! What a wonderful time we had and how special it was for each of us to see one of our patients preform so beautifully as the lead, Juliet!

Many of you know the story of Romeo and Juliet, two young people who fall in love, despite the conflicts between their families, the Montague's and the Capulet's. Although a tragic story, it was beautifully portrayed. What made this story different was that the men and women in the ballet did not use words to tell the story, they used dance. The set was simple, yet the costumes elaborate. The emotions were clearly expressed on the faces of the dancers, and you could tell how hard these people worked on making it perfect. Not one move was out of place. 

For much of our staff, this was the first time at the ballet but each of them expressed how much they enjoyed being able to go and how exciting it was so see one of our patients and friends perform so gracefully and beautifully. We look forward to seeing her perform again in the near future, but for now, the PNB is headed to New York City to perform Romeo et Juliette there!

Here's a shot from the night of the staff and my wife and I!

 (From right to left: Kendra, Ashley, Annika, Kristin, Carol, Me and Katlyn)

Well wishes,

Richard Stickney DDS PS

What Holistic Means To Our Practice

What is Holistic?

There is no dental school that teaches “holistic dentistry”. You could substitute the words biological, integrative, natural, whole person, wellness and longevity and they could all fit. To me, holistic means taking a broader perspective, knowing your patient and what they want. It means working with people who share a common mission and purpose. Recognizing that what works with one person might not work for the next. Listening to what they have to say and honoring it. Striving to love people and help them heal via dentistry. Being holistic and natural also involves avoiding drugs and surgery when possible, caring for the teeth and tissue of the mouth as if they were your own. Everything matters in this type of dentistry. The most bio-compatable dental materials, filtered air and water, and most of all a great team of caring people. Everything matters. These principles have taught me to work slower but more effectively, preserving and protecting what nature has given the patient. I do my very best for each person I come in contact with. I strive to do the least invasive, longest acting and least toxic treatments that I possibly can, doing so with love and kindness. To me, this is holistic dentistry.

Wishing all of you well,

Richard Stickney DDS PS