Oral Cancer Awareness and Early Detection

April is Oral Cancer Awareness month, and we are offering free VELscope® oral cancer screenings to every patient that gets their teeth cleaned during April. Many patients refuse the additional VELscope® oral cancer screening offered by their hygienist. Most insurance companies do not provide coverage for it and it costs around $50.

A multitude of head and neck cancers begin in the oral cavity, which includes your lips, tongue, gums, lining inside the cheeks and lips, and the bony top of the mouth.  Cancer found in its early stages is the most treatable, thus early diagnosis is important.

Your annual check up includes visually examining your head, neck, face and mouth for any masses, lesions, swelling, or any facial asymmetry. In your mouth, we look for both red and white lesions on the mucous membrane, as well any masses with in the tissues. We examine your tongue for ulcers, swellings or other abnormalities, in addition to examining the inside of the back of your throat with a laryngeal mirror.

The additional oral cancer screening offered is the VELscope® Vx Enhanced Oral Assessment System.  It is a handheld scope that provides a more thorough tissue examination than a visual exam.  It uses natural tissue fluorescence to illuminate dysplastic or keratinized tissue. In other words, it helps visually detect tissue abnormalities or tissue that has changed that may not be noticeable in a visual exam.

The best strategy in the fight against cancer is early detection. The VELscope® Vx is a widely used adjunctive device for the enhanced visualization of oral mucosal abnormalities, such as oral cancer or pre-malignant dysplasia.  It makes abnormalities that might not seen by the naked eye visible, thus it is a helpful tool in early detection.

When we find tissue abnormalities, the patient is immediately referred to a specialist for evaluation. While $50 may seem like an unnecessary out-of-pocket expense for a  VELscope® Vx oral cancer screening, how much is your peace of mind worth?

If you have lifestyle (excessive tobacco and/or alcohol consumption) or genetic contributing factors, HPV (human papillomavirus), or a prior head or neck malignancy that could increase your likelihood of developing oral cancer, you should elect to have an annual VELscope® Vx oral cancer screening. Being proactive is essential to early detection and diagnosis.

Additional information regarding VELscope® Vx Enhanced Oral Assessment System can be found at http://www.velscope.com/.

Prevention: Big Cavities and Bad Reviews


Chandler Cosmetic Dentist, Kelly Jorn Cook, DDS

I recently received a bad review on Yelp.  Two stars.  Yikes.  Essentially my patient felt I was recommending unnecessary preventative treatment.  The assertion bothered me, but forced me to think about how I could have better explained the clinical narrative.  Saying the phrase “early caries detection” to most people translates as babble.  In my discussion of treatment, the patient left thinking “preventative” meant “unnecessary”.  What I said to my mind was, “your enamel is soft on the biting surfaces of these teeth indicating the early stages of decay.”  The patient heard “you do not have a full blown cavity yet, but we recommend a filling anyway.”  Clearly I did not effectively explain my clinical recommendation, because the patient left with the impression that unnecessary treatment was being recommended.

In this day and age, dental diagnostic technology has progressed.  We have tools that allow us to detect the early stages of decay beyond what an x-ray will show or an explorer can find.  We use DIAGNOdent™ laser technology engineered to detect early invasion of decay into tooth enamel. Sub-surface caries lesions can be extremely difficult to detect using an explorer, thus the DIAGNOdent™ is a useful diagnostic dental tool. It is especially useful for pit and fissure areas (the grooves on the biting surfaces of your teeth).  The laser reads the density of the tooth enamel to detect softening. Depending on the number value that the laser reads, we will recommend “watching” a tooth for any progression of the decay or removing the decay to prevent the need for a larger restoration in the future.

The grooves of natural teeth often form small cavities over time, which can be treated conservatively without anesthetic and with very little natural tooth structure removed. The preventative nature of the smaller restoration placed at the early detection of decay diminishes the likelihood of a more invasive treatment in the future.

I appreciated the feedback, even though it was through a negative and public review. I regret that my patient was not provided with thorough explanation regarding early caries detection, but this is how we learn and grow.

We try to provide our patients with a conservative approach and the best service for optimal dental health.  If you happen to be interested, additional information regarding DIAGNOdent™ technology can be found www.kavo.com/us/caries-detection.

Flossing – You Know I Know

If you are my patient, you get asked how much you floss at least twice a year. It’s my job as your dentist to get this information.  And yet, I get lied to roughly fifty percent of the time. The majority of those who tell me they are flossing are not.  You don’t have to lie, your gums are truth telling.  If you are not flossing, or think you can floss right before you see me and pass as a dedicated flosser, the jig is up.

In any event, not many people floss once a day every day. Let’s be real. If you are flossing three times a week, you are in upper echelon of oral hygiene. If you floss less than that, you have to make a habit of it. Flossing is like anything else, the more you do it, the more efficient you become at doing it.

I tell my patients to attach it to something. If you watch Jeopardy or Sports Center, bust out 18 inches of floss when you hear the theme song and get to work. Attach flossing to one of your daily rituals a few times a week it will easily become a habit.  It is a small thing you can do for yourself with great long term results.

When my patients do finally make it a habit (trust me, my hygienists and I can tell), they said how easy it is to maintain it. Regular flossing means less time and money spent in my chair, which means you can put your funds towards flossin’ your other grill.

What’s Missing and How to Fix it – Implants and Bridges

Chandler Cosmetic Dentist, Kelly Jorn Cook, DDSAre you missing a tooth? You’re not alone. Replacing a missing tooth is important to improve the function of chewing and to stop teeth from shifting.  The current standard of treatment is placing a dental implant, at the same time slapping you with sticker-shock.

I tell patients the most expensive and lengthy procedure is the most convenient and comfortable in the long run. And the cheapest and easiest treatment option is the most inconvenient in the long run.  You will pay more and the procedure is longer for an implant restoration, but it is much more convenient and comfortable than a fixed bridge or removable partial denture.

An implant requires surgery and subsequent healing time. A bridge only requires the preparation of the existing teeth for the abutment crown restorations, and the time it takes to fabricate the permanent restoration. A removable partial denture simply requires an impression, and the time it takes to fabricate the partial. I don’t think I need explain the inconvenience or undesirable nature of a removable partial denture. However, it is the cheapest and fastest treatment.  Then again, there are those who simply chose to live with missing teeth.

An implant procedure requires surgically replacing the root with an implant system, to which an abutment and crown restoration is attached. The bone anchors the implant, so there has to be enough healthy bone to place an implant. If there isn’t, a bone graft is required. Multiple missing teeth can be treated by multiple implants or an implant-supported bridge.

A bridge, also known as a fixed partial denture, was the standard to replace a missing tooth prior to the implant. The missing tooth is replaced by a false tooth, known as a “pontic.” A bridge requires the adjacent existing teeth be crowned to anchor the false tooth. In the case of one missing tooth, the restoration is three units fused together with the false tooth in the middle. If the adjacent teeth and gums are healthy, an implant is the superior option.

All things considered, the longevity of an implant restoration may be cheapest in the long run. It does not decay and is less likely to develop periodontal disease. Unfortunately, most people have to replace bridge restorations at some point. A bridge restoration has the possibility of recurrent decay or affected nerves requiring root canals. At the end of the day, it comes down to what you are willing to live with and what you are willing to pay. It is up to you to determine the value you place on function and convenience.

Comfortably Numb – Overcoming Dental Fear and Anxiety with Sedation

Sedation Dentistry in Chandler, AZ

Fear and anxiety are common issues associated with dental treatment. A bad experience with a previous dentist can have you avoiding routine dental check-ups.  A fear of needles, or the simple fact the mouth is a very personal area, could be keeping you from receiving necessary dental treatment important to your overall health.


There is no shame in having dental fear or anxiety. You are not alone in your dread.  There are a lot of you!  It is important to talk about and recognize my patients’ fears in a rational and tangible manner. Dentistry has come a long way in a short amount of time. Advances have been made making treatments easier, faster and painless.  But at the end of the day, being asked to sit back and open wide while I poke and prod is awkward and intrusive.  It is key to make this process as painless and comfortable as possible.


I offer oral sedation medication, also know as “conscious” sedation.  Oral sedation provides a more relaxed and anxiety-free dental treatment experience. Patients with dental-phobia can receive the dental care they need while avoiding the fear and anxiety associated with their treatment.  Sedation is utilized to provide a relaxed, easy and calm state.

Some forms of sedation, such as nitrous oxide gas, can help raise your threshold for pain. However, most dental procedures still require local anesthetic to temporarily block pain impulses from affected teeth and gum tissue. However, with oral sedation, the injection is given after you are already sedated and comfortable. Ideally, you will not be bothered by or remember the sensation of the injection.

An additional benefit of sedation dentistry is that patients often feel their dental procedure lasted only a few minutes. When in reality, it has taken far longer to complete treatment. Therefore, complex dental procedures such as smile makeovers and full mouth restorations are more tolerable.


Oral sedation is currently the most common technique used to control patient fear. The medications can create such a comfortable experience that some patients do not remember the visit. However, oral sedation does maintain a level of consciousness in the patient for safety and cooperation.  You will not be physically asleep.

Medications used in conscious sedation include: Halcion, Xanax, Valium, or Ativan. The medication is taken prior to your appointment, and it is important to have a responsible caregiver accompany you to the procedure.  A caregiver is also necessary to drive you home after the procedure is completed, and stay with you for an additional two to four hours.

Most patients only require being sedated for one or two treatment appointments.  After they experience a pain free dental visit or two, that is all they need to get over their fear and anxiety.  Additionally, they no longer have the inconvenience of coordinating with a driver to and from their appointments.

If a previous experience has left you fearful and anxious about completing necessary dental procedures, sedation dentistry can help you overcome your anxiety.  Sedation dentistry addresses some of the fears that keep people from going to the dentist on a regular basis, making patients more likely to receive recommended routine care.  As a result, they are less likely to neglect their oral health or allow problems to worsen to the point of requiring extensive dental treatment.

You do not have to be reluctant to change the appearance of your smile due to dental-phobia.  You can complete treatment without fear, anxiety, or pain.  Come on in, and become comfortably numb!