Read about Dr. Burchman
in the March 2002 Issue of
Men's Health
www.menshealth.com VOLUME 17, NUMBER 2
Perfect Teeth
Today's tooth doc has high-tech, pain-free ways to make you smile.
BY CHRISTOPHER McDOUGALL
The Drill is Gone
Your dentist doesn't really
want to hurt you. (Honest!) New high-tech tools at his command
promise a perfect smile without the pain.
By Christopher McDougall
Pain, noxious odors, and ugly stains:
An entire multisensory alert system was going off in my mouth,
warning that the situation inside was bad and approaching critical.
Naturally, I took immediate evasive action: I began chewing on
the other side of my mouth and kept my lips clamped tight when
I smiled. As long as it kept the drills and needles at bay, I
was willing to shut my trap and hope for a spontaneous self-cure.
I didn't realize that in the 4 years
since my last checkup, new techniques and high-tech equipment
had revolutionized modern dentistry. Thanks to soft-tissue lasers,
digital and video imaging, high-propulsion jets and mew plastics-compounding
agents, many of the procedures that once left me clawing at the
arms of the dentist's chair are now performed in minutes-with
no drills, no needles, and no pain.
Or so I was promised when I finally
sought help from Mel Burchman, D.D.S., a suburban Philadelphia
dentist who calls himself "Doctor High Tech." Dr. Burchman
is among a growing group nationwide specializing in laser care
and digital diagnostics. He agreed to spelunk between my deteriorating
jaws and do a complete overhaul. Right up front, I had to admit
my apprehension; I've had bones set and once stitch a gash in
my hip without much moaning, but I can't stand that whining dental
drill and those unpredictable flashes of nerve pain.
"Believe me, there are kids I
treat who have no idea that a dentist visit is supposed to be
painful," says Dr. Burchman, a fit 52-year old whose Mario
Brothers' mustache and muscular arms make him look like a trusty
mechanic. "I will have a whole generation of patients who
think going to the dentist is about as scary as getting a haircut."
A NEW WAY TO GET CLEAN
As the exam begins, I try to calm myself
with these assurances. Dr. Burchman steers me toward a small
booth for a panoramic x-ray. Instead of taking multiple conventional
x-rays, a dentist can now use a single panoramic x-ray to quickly
scan the entire jaw. I'm getting one because I haven't had a
checkup in more than 3 years, and I may have bit problems and
bone loss due to periodontal disease. As I stand in the booth,
he fits me with a mouthpiece, then activates scanners that circle
my head like a pair of cafeteria trays. In less than 30 seconds,
he's done a complete mock-up of my teeth and jaw.
Then it's into the treatment room,
where the only standard equipment in view is the classic dental
Barcalounger. Mounted on the ceiling are both a computer monitor
and a TV screen. (Dr. Burchman gives patients control of the
remote but bans Jerry Spring: "Makes patients too jumpy.")
Once I'm seated, Dr. Burchman uses a matchbook-size sensor to
take digital x-rays of my questionable teeth. "The digital
negatives deliver a level of detail that the panoramic x-rays
don't show," he notes. In seconds, the digitized images
are downloaded from the office computer network and flash on
the ceiling-mounted monitor, where they can be magnified and
adjusted for contrast. "And if you ever change dentists,"
adds Dr. Burchman, "I can just e-mail him your entire file."
X-rays completed, I notice that Dr.
Burchman is now holding an odd-looking wand with a fish-eye lens.
"This is an intraoral camera," he says, before carefully
positioning the thing inside my mouth like a tongue depressor.
Instantly, full-color close-ups of my teeth appear on the TV
screen. "A broken tooth, cracked filling, or cavity doesn't
always show on x-rays," says Dr. Burchman. Also, photos
are a far more effective way to convince patients that work needs
to be done: Earlystage gum disease is invisible on x-rays
but dramatic in photos, and hidden cavities can be shown in detail
and from various angles.
He discovers that I have four main
problems: cavities (two), widespread staining (including a grayish
cast from a childhood dose of the antibiotic tetracycline), a
small but serious patch of gum disease, and three misaligned
front teeth. The crooked teeth are more than a cosmetic concern,
Dr. Burchman warns; besides looking a little too Austin Powers,
they mean the impact of my bite isn't being evenly distributed,
which could lead to hairline cracks and eventual jaw problems.
Dr. Burchman first goes after the surface
stains and cement like deposits of tartar. Ordinarily, that would
mean intensive flossing and scraping with a steel scaling tool.
But because my tartar buildup isn't too severe, he'll need to
use only the Prophy-Jet, a bicarbonate spray that acts as a pressure
washer for teeth. The sensation is surprisingly pleasant-it's
cool and abrasively minty, like brushing with baking-soda toothpaste,
and the whooshing jet is much more tolerable than the sound of
a rasping scaler.
The cleaning is done in less than 4
minutes. Dr. Burchman takes new photos with the intraoral camera,
then flashes before-and-after images on the monitor. The difference
is amazing, and embarrassing: Before, my smile was dingy with
stains, and the back of my front teeth were brown and mossy from
coffee and missed food particles, providing ripe material for
bad breath and future decay. Afterward, my teeth are brighter
than I've ever seen them. Besides its speed, comfort, and power,
Dr. Burchman says, the Prophy-Jet is more thorough than a rubber-cupped
polisher and does less damage to tooth enamel than a scaler.
"I'm blasting away more stains, and no metal instrument
is scratching your teeth."
SPRAY AWAY THE DECAY
One week later, I return for the most
serious work: my cavities and infected gums.
For the first cavity, Dr. Burchman
briefly sprays a jet inside my mouth, tests the tooth with a
thin instrument, then asks if I'm ready, "Okay?"
"Okay," I respond. "Go
ahead."
"No," Dr. Burchman says,
"I meant, 'Okay, that one's done.'"
It took about 90 seconds. When I though
Dr. Burchman was prepping the tooth, he was actually using an
aluminum-silicate spray, which blasts away decay with a hail
of fine particles. Once the cavity was cleaned out, Dr. Burchman
troweled a tooth-colored bonding adhesive into the gap, instead
of the usual silver amalgamand that was it. Not only is the new
filling tinted to match my teeth, but it's also laced with fluoride
to prevent future cavities.
 Filling
the next cavity goes just as quickly. Dr. Burchman seals both
of them with a Pac-Lite, a blue-light wand that dries and hardens
the adhesive at speeds of about 10 seconds each. The entire procedure
for both teeth, including before-and-after photos, takes about
5 minutes. It involves no Novocain, no drilling, and no swelling.
"This way, you can have a cavity filled on your lunch break
and still have lunch," Dr. Burchman says. And the only drawback
really isn't one: Compound fillings hold up for only 3 to 5 years-compared
with 30-plus for silver fillings-but the ease of replacing them
makes that a negligible concern.
"You can have a cavity filled
on your lunch break and still have lunch."
On to my gums, a trickier proposition
than the cavities. Because I'm a crummy flosser, bits of food
lodged under my gums are being eaten by bacteria and excreted
as flesh-corroding acid. Most dentists have to cut away the infected
areas with a scalpel, requiring several painful Novocain shots
directly into the sensitive hard palate. Afterward, the gum remains
swollen and acutely tender for weeks.
A laser, however, is more gentler and
requires far less anesthetic. "Patients used to schedule
3 days off from work for gum surgery, and would have to come
back four times if they needed treatment on all four sides,"
says Dr. Burchman. "This way, I can do a side in an hour,
and you'll be eating dinner tonight." There's also no need
for antibiotics or gauze packing, since the laser's high heat
sterilizes the cut and instantly coagulates the blood.
Dr. Burchman gives me two shots of
Novocain, both in the outer gum instead of in the more sensitive
palate. With the area properly numbed, he sets to work. Occasionally,
I feel a tiny pricking sensation, like being scratched by a pin,
but mostly I'm watching CNN on the ceiling-mounted TV. Within
40 minutes, Dr. Burchman has cut away all of the infected flesh.
He then uses the laser to recontour my gum so that it fits flush
against the teeth, making it less likely to act as a storm gutter
for food scraps.
I'm out of his office by 7 that evening.
By 8, the Novocain has faded and I'm feeling a little sore, as
if I'd been elbowed in a basketball game. By 9, however, I'm
eating Chinese food and feeling only a little tenderness. When
I wake up the next morning, it takes me a minute to remember
I've just had surgery.
NOW LET'S GET THIS STRAIGHT
 Dr.
Burchman's next challenge is to straighten my crooked front teeth.
The best and most permanent solution, stresses, would be braces.
There are a number of jazzy new options, including transparent
ceramic models and the invisible lingual type, which are positioned
on the back of your teeth. But they all have the same downsides:
They need frequent adjustment during the first few months, they
require 2 to 3 years to "take," and a tooth or two
may have to be extracted for optimal straightening.
In my case, because the alterations
are small and I don't want a multiyear investment, Dr. Burchman
recommends veneers-super hard plastic shields that are glued
over teeth to help compensate for their misalignment. (Think
of them as siding for your teeth.) Veneers require no anesthetic,
and you can be chomping away as soon as you leave the chair.
The catch? Some teeth (like mine) need to have protruding sections
ground down with a high-speed, diamond-tipped burr before they
can be fitted.
Dr. Burchman goes to work on my crooked
canines. In a few minutes, he has ground the edges and given
each misaligned tooth a nice, smooth shape. He evens them until
they form a symmetrical row with the rest of my front teeth.
I keep expecting pain, but I don't feel the slightest twinge
because he's not hitting any nerves.
I can't believe the result.
My wolfman cuspids are gone.
Satisfied with the basic tooth shape,
Dr. Burchman applies a bonding adhesive. Next, he searches through
a selection of veneers until he finds one that exactly matches
my tooth color. After custom-shaping the veneers, he presses
them onto the adhesive, dries it with a zap from the Pac-Lite,
and then buzzes the plastic with a diamond polishing paste. Elapsed
time: 1 hour.
I can't believe the result-it's like
looking into someone else's mouth. My wolfman cuspids are gone,
and that one jagged chopper is smoothed into conformity with
the rest of the crew. For the first time in my life, my entire
mouth looks clean, bright and uniform.
Dr. Burchman's one remaining task is
a full-scale whitening. The most advanced option is laser whitening,
in which the teeth are first pretreated with an acid gel so that
a peroxide solution can penetrate the enamel. A laser is then
used to activate the bleaching action. It can take multiple visits,
however, and even then, knockout pearlies aren't guaranteed.
In my case, though, Dr. Burchman doesn't
recommend it. Tetracycline staining is among the most stubborn
of tooth discolorations, and he believes that no current technology
will yield satisfactory results. In fact, he gives a discounted
rate to tetracycline patients who insist on laser whitening,
as a way of buffering their disappointment in advance. I could
try home bleaching, but he doubts that the outcome will be worth
the effort.
I'm a bit let down, but quickly perk
up with my after-office-hours treat. No free toothbrush for me-instead,
Dr. Burchman hands me a nice, frosty can. Toasting my gleaming
new mouth, he says, "Here's another benefit of high-tech
dentistry-you can crack an ice-cold beer a week after gum surgery."
Copyright © 2002 Men's
Health. All Rights Reserved.
www.menshealth.com
Back to Top
of Page
|
