2/14 Lecture @ The Gerson Institute

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Update: Zucchini Grown With Fishwater

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Overcoming Dental Anxiety With Dr. Vinograd

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Gutta Percha & The Root Canal Controversy (Podcast 1/2)

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Dentures & Denture Alternatives (Podcast)

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Patient Review After Visiting Dr. Vinograd

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Dental Implants vs Dentures (Podcast)

Hello, this is Dr. Daniel Vinograd, biological dentist in San Diego, California. Today, I’d like to talk a little bit about dentures and denture alternatives.  If you really think about what dentures are, couple of these little plastics, a little bit like castanets, they’re going against each other trying to mash food together.  The concept is a little bit foreign, and it’s a little bit unusual. However, it’s certainly better than not having anything at all.

The truth though is that a lot of people will resign themselves to wearing dentures. At least they have some teeth to show for it, but the mastication is quite reduced, and the quality of life is also not great. There are a lot of issues with sore spots, with bone being reabsorbed, creating dentures to not fit as they should, needing realignments and so forth.  Eventually, with time, the bone will reabsorb to a point where the dentures are hard to really keep in place.

A little history. Dentures go as far back as 700 B.C. were being made with animal and human teeth, and they were put together in some contraption. People would use them to try and show that they had teeth and try to do some chewing. That lasted for quite a while. Even up to the 15th century, you’d still have those dentures that were made out of human teeth and animal teeth.  I can’t even imagine how uncomfortable and unsightly they were. Of course, we don’t believe that they had any kind of extended use. Around the late 1700s, modern dentures came to be with the advent of modern materials, and this is basically what we are today.

Now, a lot of people feel that once they’re in dentures, this is really their destiny. A lot of them have gone through a lot of dental work, and they slowly but surely have lost their teeth.  A lot of our grandparents used to wear them so we became comfortable with the thought that dentures were a normal part of getting old.

The truth though today is that there’s so many alternatives to dentures that can really improve the quality of a person’s life so dramatically, and all of them are really based on the use of implants. Implants, even 20, 30 years ago, were not really considered to be mainstream dentistry. I remember placing one of the first implants, and a lot of my colleagues did not look favorably upon this kind of a procedure. Today, dental implants have progressed to the point that if properly done and properly integrated, the success rate of implants is better than 95%, and implants can actually be used to replace dentures or in conjunction with dentures. So, here’s they work.

There’s actually two ways that you can use implants to improve the quality of life of a denture wearer. First, is you can actually use implants and place an overdenture on them.  What you would do is basically, you would use the denture with a couple of female pieces and attach it to a male piece that would come out of the implant. So, in essence, the dentures are actually buttoned into the area in your mouth where the implants were placed, holding it firmly.

dental implantdental implants w fixed bridge
Dental Implants / Fixed Restorations

The second way that you can actually use implants is by getting rid of dentures altogether, and you can actually place as many implants as there is bone available, and you can actually place individual teeth to replace the teeth that were lost.

Finally, there is another way of doing it which is placing anywhere from four to six implants and then laying an underpiece to the denture, usually made out of fiber, and then, you can actually permanently cement teeth into that fiber underpiece. This would actually be a fixed, not a removable restoration, which acts pretty much like bridges would on regular teeth.

One of the biggest considerations here is the amount of bone that is left on the patient. So, obviously, earlier in the stage of denture wearing, you would probably, in most cases, have more bone than you would have alter in life. So, this procedure would be well-advised for people who are just wearing dentures or haven’t been wearing for a long time.  A lot of patients who have been wearing them for a long time will have conserved enough bone to be able to place some implants, either an overdenture or a fixed prosthesis. So, that is basically the limiting factor.

There are ways to graft bone, and most of the time, it would have to be a bone graft from your own body, usually your hip. You can actually place additional bone there to be able to sustain some implants.

Once you have those implants in place, the difference is just staggering, and I know patients all the time talk about the fact that they could not have imagined how their lives have improved by actually having something fixed and solid again to chew with.

So, I hope this was helpful, and until next time.

To explore your options, visit Brighton Dental Implant Services, or call (619) 640-5100 for a Free consultation with Dr. .
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Toothaches (Podcast)

Hello, this is Dr. Daniel Vinograd in San Diego, California, biological dentist, and I just wanted to touch base on pain, particularly tooth and gum pain. Basically, I wanted to give the listener an idea of what are some of the expectations and a little bit of what dentists like myself would ask in order to assess the type of pain and what it could mean. So, obviously, my disclaimer is that any of this is just to give you ideas so that you know when it is more likely that you need help or not, but, obviously, ultimately you have to have a proper diagnosis by your dentist.

So, pain is, it sounds like pain is pain, but it really, it could be quite nuanced. First of all, we have to try to decide which kind of pain or what flavor of pain, if you will, your experiencing. We could kind of find out what it is that we may be looking for. If you are having pain that is provoked, in other words, touching of tooth the tooth or gum, cold or heat, makes it hurt, but as soon as this provoking agent disappears, the pain goes away, are usually less worrisome that if you would have unprovoked pain which is pain that would come all of a sudden. As a matter of fact, one of the indications for immediate treatment is when you have unprovoked pain of great intensity, the kind that would wake you up at night. That, I would actually seek immediate help for.

Aside from that, we could talk a little bit about the difference between hot and cold. Usually, when you’re having discomfort with cold, you have some sensitivity, and it’s usually not incredibly worrisome. Hot would be a little bit more concerned about. As I said, the most important thing would be if it’s provoked or unprovoked.

Another differentiation that you can make is whether you are having acute sharp pain or if it’s throbbing pain. Sometimes, I’ll describe the differences with pain like you would be hearing a flute or a drum. The throbbing pain is more like a stomachache. The acute pain is more like a headache, and usually the acute headache type-pain, it’s not a headache, it’s in your mouth, it would be more descriptive of toothache or bone ache while throbbing pain is usually an indicator for gum pain. Obviously, in addition to pain, you would look for other symptoms. If you have bleeding or pus coming out, obviously those would be other symptoms, but you would like at them in conjunction to the pain.

Anyway, anytime that you have any concerns, you should call your health professional and just thought I’d give you a little bit of what some of the indicators are for pain. Typically, when patients come to the office and they’re not sure what tooth or what is paining them, I’d likely tap on the teeth to try to really ascertain which tooth it is, and obviously if there is one particular tooth that responds to the tapping, we call it percussion, that will give you a better idea of what tooth you are looking at.

Again, sometimes when it’s diffused, pain can be projecting itself into other areas. We call this referred pain. So, sometimes it is a little bit tricky where the pain will start at some area, but you will feel it radiating into some other area. That’s because we obviously have a network of nerves throughout the mouth that are connected.
So, I hope that this was helpful to you, and I hope that you have a great day.

Feel free to call or e-mail with any questions: (619) 640-5100 / daniel@drvinograd.com

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Dental Implants: The Biological Perspective (podcast)

Good morning.  This is Dr. Daniel Vinograd, a biological dentist in San Diego, California, and today, I’d like to speak a little bit about dental implants.   So, it’s interesting how much implants have actually progressed over the last couple of decades. I remember, maybe over 20 years ago when I first started placing dental implants, I was considered a little bit on the fringe.

Dentists who placed implants were not looked upon very favorably.  In fact, there was a lot of pressure on people who started placing dental implants, and it was considered, pretty much, outside of the realm of dentistry or at least prudent dentistry as some people saw it. There was some truth to that because they’re quite invasive.  There were large blades that were placed on the mandibles just to restore one tooth.

So, fast forward 25 years, and now, we’re really looking at dental implants as the fastest growing area in dentistry in one that has possibly got a 50% success rate to over 99% success rate if done properly.  So, this is probably an important consideration for most patients that are either going to lose a tooth or have lost a tooth that is important for their function.

Now, in the biological point-of-view, a lot of people ask me what I think about dental implants, what I think about root canals, etc., and my biggest concern is actually from a biological point-of-view is obviously bacterial infection.  When you have a root canal that is the focus of bacterial infection or a tooth that is quite involved periodontally where the gums are inflamed and infected, that, in itself, to me, is a much, much greater challenge to the body than anything else.

So, having said that, when do we decide to place an implant versus, let’s say, a bridge or a root canal?  A lot of those considerations have to do with your general health.  Also, important to look at, for example, if you have two adjacent teeth lost or to be lost that have large restorations, I would probably consider placing a bridge there because, really, there is not going to be a great loss. As a matter of fact, sometimes, it’s an improvement on the adjacent teeth.  However, when you have a couple of virgin teeth on each side, then you really, definitely need to look into an implant.

Now, what are the considerations for a dental implant?  What are the requirements?  Mostly, it’s just about having a healthy bone which 95% of the population has, but also, you need to have enough bone for an implant to be placed.  There are a number of different dental implants in the market, and when the modern generation of implants came out, people were placing implants that were quite, quite big, 18-, 20-millimeter long implants which is really quite a huge implant and quite invasive.

In the last decade or so, dental implants have gotten smaller.  As a matter of fact, there are a lot of research papers that have come out showing that smaller implants integrate better and have equal longevity to longer implants.  So, really, the movement has been towards shorter, better designed implants.

Today, a lot of dental implants are in the 10-15 millimeter range, which is still large and invasive, not compared to where they used to be, but there are other options today which I’d like to talk about.  That’s mini-short implants.  Now, there’s a difference between the mini implants that are placed for dentures, which are very thin, and implants such as Bicon which is the ones that I use.  They’re actually much shorter but very well-designed, and they have a lot of surface that a bone can integrate to.

So, usually, my dental implants are about 6 millimeters long which actually makes a huge difference in my ability to place them without being so invasive, without needing so much bone, and that often translate to not only a less invasive procedure but a shorter recuperation time and often less costly.  That is because often when we don’t have enough bone, we have to actually look at either grafting bone into the area, repositioning nerves, or actually lifting sinuses to create space for the implants.  Those are all invasive procedures, and they are also a bit costly and, obviously, problematic as far as possible complications and bringing new variables into the equation.  So, the ability to place a 6 millimeter implant allows us to have tremendous versatility, lowering costs and allowing us to place in some areas where a regular implant would not be placed.

A lot of people at the beginning were actually doubting how sturdy or how much these dental implants could actually last, and all research has shown that they are equally effective, efficient, and actually a little bit more successful than some of the longer implants.

One of the important aspects on implants from a biocompatible point-of-view is the material that the dental implant is made from.  Most implants, I would say, a great majority of them are made of titanium, which is probably the most biocompatible metal there is.  In Europe, they have been using zirconia implants, and I know a lot of people ask for zirconia implants.  There’s not really a problem with the zirconia itself.  Actually, it’s very biocompatible.

The problem is the zirconia implants are one piece.  They’re very long, very invasive, and by being only one piece while most of the titanium implants are two pieces, you actually have to place this implant in a perfect position to be able to place a crown on them.  That actually translate often into a need for the dentist to re-prepare the top part of the implant where the crown is going to go and create some microfractures.  So, there have been issues with fractures, and there are issues with them being very invasive and really difficult to place, making the outcome less certain.

If you would have tremendous amount of bone and easy line of insertion for the implant, they could work quite well, but in most cases, it is a challenge.  So, for that reason, I have shied away from them.  I understand in Europe they are working on a two piece zirconia implant, and when that takes place, I will revisit that.

Bcion ImplantsIn the meantime, the fact that the Bicon implants are so short and so small, they seem to be so uninvasive that, at this point, I favor those, and that’s definitely what I would place on myself or a family member.  In addition to that, we need to think about the possibility of getting those implants with biocompatible materials that coat them, making them more biocompatible.

Ultimately, there’s a lot of research.  You can go on the internet and seek a lot of information out.  In my practice, I just really am very observant, and most patients talk to me a lot.  When I see that a procedure is actually being well-received by most people’s bodies, most people’s jaws, that in itself is very reassuring, and what I see in the dental implants I placed is the body really loves them.  They get integrated quite nicely, particularly the design of these Bicon implants.  There are very, very few problems.  Leakage used to be a problem with a lot of them, and the design of these as well as a few others that have improved on their design are really now at a point that if they are well placed, they have over 99% chance of success.

So, I hope that has been helpful.  I have really expanded the place of dental implants in my practice because I feel it’s a very clean, a very successful procedure that has actually been well-received by patients, both in its function and its biocompatibility.

All the best and I hope you all have a great day.

 

If you live in San Diego and would like a Free consultation with Dr. , Call (619) 566-9479.

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11/13 Lecture: Holistic Dental Health (Transcribed) P5

Removable bridge.  For some people, successful.  They have a lot of tolerance.  They put that in, out.  They’re comfortable.  They feel good. From a biocompatible point-of-view, one of the best answers. From a lifestyle point-of-view, one of the worst answers. It’s very, very difficult to have a good quality of life when you have this thing in and out of your mouth.

Fixed bridge.  Now, we can actually do very nice fixed bridges without any metal. Advantage, you replace it.  It’s very biocompatible, but disadvantage is that you have to grind the two adjacent teeth. If you have two adjacent teeth that are broken down, have fillings, then it’s a no-brainer. If you have two very good teeth, nice quality teeth on the two sides of that tooth, I would really think twice before I go ahead and grind those teeth down.

Then, a Maryland Bridge, which is a much more conservative three-unit bridge where you don’t grind the adjacent teeth quite as much is a very nice compromise, but it is a compromise because those bridges tend to get dislodged.

So, again, the magic pill isn’t here, and I’m not here to give you a magic pill. I’m just giving you facts so that you really can make good decisions again. This is a design of a Maryland Bridge.

Now, let’s talk about root canals, biocompatible root canals. I really stopped doing root canals for about 20 years because I just saw what was a root canal and what a really poor job a root canal was doing in really sealing off the canals and preventing biological invasion.

Today, there’s a material called BC Sealer, which is a calcium-based material, which is a very biocompatible, osteogenic, which means it actually helps bone being laid out that is being used in a lot of parts of the body to actually promote bone growth. It’s also hydrophilic.  This is the key.  Hydrophilic means that they like moisture, and what does a material do when it likes moisture? With slight moisture, it tends to absorb a little of moisture, and when you absorb the moisture, it expands.  So, it expands, and it creates a much better seal.

The other advantage of BC Sealer is that it has a pH of 12.4. No living organism survives at 12.4 pH for very long, and this material actually takes 48 hours to set. So, it’s actually actively disinfecting the canal for 48 hours. So, now, I’m doing again biocompatible root canals, and, so far, in seven years, I’ve had zero failures so far.  I mean, I may have had some that I don’t know about, but they’ve been quite.

Now, having said that, if I have a person that has a lot of challenges like cancer, some systemic challenges that are very serious, would I consider extracting a tooth and not doing a root canal? Of course. I may want to do that for a patient that is immune-compromised.  If I have a very healthy patient that is not immune compromised, and this is a particularly important tooth where having that tooth out is going to create a lot of challenges in your lifestyle and your quality of life, I would not hesitate to do a biocompatible root canal.

So, again, you’re going to hear a lot of pros and cons, and you still may disagree strongly with me, but at least now you have some idea of what’s available and what the problems are with root canals. Okay.  Again, you know, it’s your responsibility to take your health into your own hands, and I know I don’t have to tell you this.  You guys are here.  This is the wrong group to be preaching to absolutely.

You guys are the exception. You are the cream of the crop.  You are aware.  So, I don’t have to remind you too much about the fact that in the last decade or so, corporations have basically taken over the decision-making process in this country and in the world where I don’t know if anybody saw this documentary called “Corporation”. Corporations, really their only requirement is to make profits for their shareholders.  There’s really nothing that says there that they have to be moral, that they have a responsibility to the greater good. Nothing.

So, legally, they actually have the responsibility to make money before they have a responsibility to create a good product or a health product. What does that mean?  That we have to really make decisions now for ourselves.  So, there are great number of people out there that are going to help you do this.

There are a lot of very committed people.  I often go to missions, dental and medical missions in Guatemala and Central America. I meet some amazing doctors, amazing dentists with their heart in the right place.  So, people are out there to support you, people that are doing the right things for the right reasons. Your job is to find them, and to make them part of your network.

Again, this is my personal website.  You can get a lot of information there.  Personal website about not just about dentistry but how I grow my own fish and my own vegetables and how I make my own toothpaste, a little bit of a more personal website.  Actually, my son built that website for me, and I told him that’s a great memorial. I can die now and leave something behind.

Then, there’s our office website and personal e-mail if you guys have some questions. Of course, I’d be more than happy to communicate with Gerson with any questions that you might have. You can ask them through the Gerson Institute.

Do you have time for just a few?

Absolutely.  Please. Yeah, speak up because the drill over the ears has actually taken a toll. So, you have a root canal with a tooth broken, and it’s kind of deep. You want to get rid of the tooth and put in a fixed bridge. How long would you wait for that to heal before you would do it?

Well, in our office, what we do is we extract the tooth, we prepare the adjacent teeth for a bridge, and we put a temporary.  Then, we wait from six to eight weeks with the temporary bridge in place for that area to heal.  The reason you want to put a bridge there is because as soon as you extract the tooth, the teeth tend to collapse into this space.

So, you actually want to stabilize that area first, but you don’t want to make that bridge prematurely.

Otherwise, you still will be healing underneath the bridge, and you have a gap in between.

How hard is it to pull the rest of the tooth out?

It just depends how much experience you have.

Yeah.  Thanks, man.

I’m sorry.  Could you raise your hand?  There was another one here some place.

Gold inlay.  What are the complications of that?

Gold, as a material, has been used over many, many years.  It’s a good material.  It’s more biocompatible than many other things, but you have to realize that gold is not pure gold.  If you use pure gold, it would be wonderful from a biocompatible point-of-view, but pure gold is too soft.  So, the gold has to be mixed with copper, with tin, with a few other things. So, it’s still a good option.  I would say that today bruxor inlay would be more biocompatible,  a better solution altogether.  Does it mix well with the bruxor?  Yes because it’s basically not a true metal. It’s just a porcelain piece.  So, yeah, it would.

Can you just repeat what he said?  He was asking if.

He was asking if it would mix with gold or other metals in the mouth.

I have a dentist like what you mentioned at the beginning. He’s into business, big money maker, but I’m looking for a dentist that is more economical so that this can get done.  Does your website mention resources in different cities in this country?

It doesn’t, and I really don’t know enough good dentists everywhere to recommend them.I know a few.  So, you can always e-mail me, and I’ll see if I can help you out with that, but most importantly, ask questions, see how people are doing, look into people’s hearts why they’re doing what they’re doing. Then, take responsibility.  Take this information and make sure they’re applying a lot of these basic concepts in the way they’re taking care of you.

Do you recommend that people go to the IONT as a starting point?

It’s not a bad place.  Most of these places where they list dentists, all you need is to pay your dues and become part of their group. So, unless you’ve done something really wrong, they kick you out. So, it’s not a bad place. It’ll weed a lot of dentists out, at least the dentists that have this kind of vision or are trying to work within the parameters, but that does not guarantee that you’re going to get somebody that’s truly biocompatible.

You could start with a list from that in your area, and then go from there.

Absolutely.  You can go interview the dentist, but I would still interview the dentist.

Regarding the BCC Sealer, or is it just BC?

BC Sealer.

Is it BCC Sealer or just BC Sealer?

BC.  BC for biocompatible.  It’s actually not biocompatible.  It’s bioceramic, but you can remember it by BC.

I have a question about that.  That’s for root canal, is that something that since it’s new, it’s not as harmful as others.  Is that something they can use on children’s sealants because they’re putting sealants on young kids to keep it from getting cavities on their molars?

No, no.  This is strictly for root canal.  This is really not strong enough to withstand the masticational forces. So, you use it inside the root canal, and it’s very good at sealing the canal, but it’s not something that you can use in children’s sealants.

Is there one that’s better that I can ask for?          

Yup.  See, when it comes to sealants, when they’re not placed properly sometimes sealants are worse than no sealants at all.  I’ve seen often sealants coming undone and a lot of decay getting in between the sealant and the tooth.

So, you have to make sure that they’re placed properly, number one, and number two, all sealants are basically composite resins. So, you have to go back to what we talked about which composite resin you want to put in there, the one that has the BPAs or the one that was small amounts of fluoride.

She promised us this would be really fast.

Actually, do you know any other professional who can answer? I just wanted to know with the ozone machine, can it be used for other purposes other than just the importance of?

Yes, an ozone machine can be used for multiple purposes.  People use them to disinfect rooms, their cars, or whatever. I don’t recommend that you use it for any purposes in which the ozone goes into the air because it tends to create a lot of irritation on your respiratory tract, but once you place it in the water, you could actually use it for multiple things. Any place that you can use that to actually kill anaerobic bacteria, you can use it for, You could actually irrigate a wound with that.

If you already have a root canal with a toxic sealant, can you have it redone using the biocompatible sealant?

Excellent question.  We end up in our office doing a lot of retreatments, but really the key is often when you have had a root canal, often dentists will place a metal post in the canal to rebuild the tooth, and then put a crown on it. We don’t use metal posts, and a lot of dentists have given up metal posts because they found the metal posts actually end up cracking the roots and creating a bigger problem.

So, if you do have a metal post in a root, usually that tooth is not retreatable. If you don’t have a metal post, depending on what materials they used, it can be retreated.  I find other people come to get retreated about 60%, 65% of those teeth can be retreated, and the other 35% are not.  We’d be happy if you want to send an x-ray of your tooth so I can give you some feedback on that.

Well, we can’t keep him here any longer, and he talked a lot about options. I think probably you’re all thinking two options: One, you’re going to stick him in your pocket and take him home with you, and the second one is all of you from out of town are going to move to San Diego so Dr. Vinograd can be your dentist.

Thank you so much, Dr. Vinograd. This was just terrific.

Thank you. I appreciate your time being here, and I commend you all. Thank you to the Gerson Institute.  They’re a magnificent institution.

And he is Dr. Smith’s dentist.  So, you know, she is incredibly picky so.

Thank you very much.

You’re not allowed to leave without turning in your evaluation. So, we are at the end, and I just want to tell you it’s been so wonderful spending the weekend with you guys.  I wanted to leave you with one thought also, and I’m not making this up when I tell you this.  This is absolutely true.

Right now, mental health professionals are actually treating people for a condition that they have created called orthorexia.  Orthorexia, by definition, someone with orthorexia, is an individual with an unhealthy obsession with clean, organic, and healthy food. They are actually prescribing psychotropic drugs to treat this condition.

Again, I am not making this up.  After you leave here this weekend, you may have contracted this disease, this problem with your mental health, but I just want to let you know that I would be thrilled to sit in the loony bin with every one of you, and we will all toast each other with a healthy glass of carrot juice.

Again, thank you very much for giving us these few days out of your life.

Be well. Safe home and stay bold.

 

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Dr. Daniel Vinograd, DDS |
10450 Friars Rd, San Diego, CA 92120 |
Phone: 619-630-7174    •    Dr. Vinograd, DDS, is a Dentist in San Diego, CA, offering services as a periodontist, and providing teeth whitening, dental crowns, invisalign, implants, lumineers, dentures, root canals, holistic, family and cosmetic dentistry.


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