J. Peter St. Clair, DMD Blog

I have focused the majority of my career on family preventive and general dentistry. While I enjoy most aspects of what I do, I firmly believe that a good percentage of dental problems are avoidable, which means that dentists shouldn’t be as busy as we are with routine fillings, removal of teeth, and many other procedures. While there are other factors at play, such as genetics, personal responsibility is often at the head of the pack.   

Prevention often takes a back seat to fixing problems.  Decayed, broken and worn teeth all had nothing wrong with them at some point. Granted, you have to fix what is already broken, but “How could it have been prevented?” has always been the question I ask myself, and try to make my patients understand.

What are the factors at play for the 6 new cavities? What could have been done to avoid the wearing-down of all the teeth? Could anything have been done during growth to alter how the airway develops? What factors are causing the chemical erosion of the teeth? These are important questions to be considered.

Much of what is being marketed to dentists today is technology; 20 years ago, it was cosmetics. The technology available today in dentistry is really cool, just like the technology available in most other areas of our lives. There are some things I would not want to live without since adding them to our office; digital x-rays, digital scanning instead of messy impressions, computer-generated restorations, telemedicine, etc. However, how much technology do we really need if we avoid the problems in the first place?

Let me give an example. If I had to pick the single most important “technology” that has impacted dentistry in the last 30 years, it would be dental implants. Grafting of bone and dental implants have changed the lives of many people, who would otherwise have been forced to wear something removable in their mouth to replace teeth.  And, while this is a great service to patients, I’m still always thinking, “What are the lessons I have learned to help my next patient avoid needing all this dentistry?”

More dentists are being trained to place dental implants, not only to replace one missing tooth, but to replace ALL the teeth. You may have seen the commercials from a large dental franchise with stories from “real” patients who have had dental implants change their lives. What they don’t tell you is that they remove all the teeth, even ones that can be saved, remove a ton of bone to be able to place 4-6 dental implants, to then have a piece of plastic with plastic teeth screwed to it. They claim – “You can put an end to dealing with missing teeth or repetitive dental work with dental implants.”

You have to go in for the consultation to find out that upper and lower “All-on-4” dentures attached to implants will run you $60K+. They also fail to mention in any of the advertising that there is maintenance that can be costly. And, they don’t really feel like teeth. While this treatment may be acceptable for some patients, the clear choice is to avoid it.

Keeping your natural teeth makes much more sense. Improving and maintaining any part of our health requires time, commitment and resources. There are many great dentists out there to help you maintain your teeth for a lifetime.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have, please email them to him at jpstclair@stclairdmd.com

I think it is safe to say that our healthcare system has some flaws. Wouldn’t it be nice to have a healthcare system that realized that everything in the body is connected? Unfortunately, there are no reasonable solutions for this in the near future. Therefore, it is important for you to take your health into your own hands and plan appropriately.

Patients will sometimes balk at treatment not covered by their dental insurance. Dentists will often hear, “Just do what my insurance covers. I don’t want anything extra.” In fact, a recent ADA poll showed that a lack of dental insurance was the #1 reason most patients gave for not visiting a dentist. Here are some frequent questions patients often ask about dental insurance.

Why doesn’t my insurance cover all of the costs for my dental treatment?

Dental insurance isn’t really insurance (defined as a payment to cover the cost of a loss) at all. It is a monetary benefit, typically provided by an employer, to help their employees pay for routine dental treatment. “Dental Insurance” is only designed to cover a portion of the total cost.

But my plan says that my exams and other procedures are covered at 100%.

That 100 percent is usually what the insurance carrier allows as payment towards a procedure, not what your dentist may actually charge. Dentist’s fees are usually a reflection of the level and quality of care in a particular office. Some cost more, some cost less, depending on the costs of running their office, how much they pay their staff, the materials they use, etc. An employer usually selects a plan with a list of payments that corresponds to its desired premium cost per month. Therefore, there usually will be a portion not covered by your benefit plan.

If I always have to pay out-of-pocket, what good is my insurance?

Look at medical insurance. Many people have been forced into high deductible plans ($2000 or more). Most dental plan deductibles are $50. While dental insurance is far from ideal, any amount that reduces your out-of-pocket expense helps.

Why is there an annual maximum on what my plan will pay?

Although most maximum amounts have not changed in 30+ years, a maximum limit is your insurance carrier’s way of controlling payments. Dental plans are different from medical plans, in that dentistry is needed frequently. Medical emergencies are rare. It is your dentist’s responsibility to recommend treatment based on diagnosis and treatment planning of what is appropriate for your dental health, not necessarily what your dental plan covers.

If my insurance won’t pay for this treatment, why should I have it done?

It is a mistake to let your benefits be your sole consideration when you make decisions about dental treatment. People who have lost their teeth often say that they would pay any amount of money to get them back. Your smile, facial attractiveness, ability to chew and enjoy food, and general sense of well-being are dependent on your teeth.

Other than complaining to your dental insurance company or your Employee Benefits Coordinator, your best defense is to budget for dental care. First, find a provider based on a personal fit for you. That is the single most important thing you can do.  If that office can’t work with you financially then I would find another office.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have, please email them to him at jpstclair@stclairdmd.com

There are many people who suffer with pain involving some area of the head. Toothaches can cause pain, but these are mostly avoidable with proper diet, home care and regular visits to your dentist. Teeth can also play an indirect role in facial/head pain.

Orofacial pain includes a number of clinical problems involving the chewing (masticatory) muscles and/or temporomandibular joints (TMJs). Problems can include TMJ discomfort involving muscle spasms in the head, neck, shoulders and/or jaw, migraines or other types of tension headaches, pain with the teeth, face or jaw; and can even play a role in anxiety and/or depression.

You swallow approximately 2,000 times per day, which causes the upper and lower teeth to come together and push against the skull. People who have an unstable bite, missing teeth, or poorly aligned teeth can have trouble because the muscles work harder to bring the teeth together, causing strain. People with seemingly good teeth/bite are also susceptible. Pain can also be caused by clenching or grinding teeth, trauma to the head and neck, or poor ergonomics. Temporomandibular disorders (TMD) affect more than 10 million Americans. Your TMJ’s are located where the skull connects your lower jaw to the muscles on the sides of your head and face controlling the joint’s movements. Women between the ages of 20 and 40 are often more frequent sufferers because of the added estrogen in their bodies.

One in eight Americans suffers from headaches. Experts estimate that 80 percent of all headaches are caused by muscle tension, which may be related to the bite. Clenching the jaw muscles creates tension in the muscles that close the jaw, the main one of which is the temporalis muscle. Signs that may indicate a headache from dental origin include: pain behind the eyes, sore jaw muscles or “tired” muscles upon awaking, teeth grinding, clicking or popping of the jaw joints, head and/or scalp is painful to the touch, earaches or ringing, neck and/or shoulder pain, and dizziness. Keep in mind that in a 24-hour period of time, your teeth should only touch 10 minutes total. If you clench or grind your teeth, your teeth are touching much more than that and I can promise you that something in the masticatory system is being affected.

Sleep disorders can also play a role. I am not just talking about sleep apnea. There are a wide range of sleep disorders and some of them will cause people to clench and/or grind as a defense mechanism of the body to achieve proper air flow.

Dentists have a variety of ways to help relieve orofacial symptoms. One way to treat these problems is called an orthotic, or splint, that is worn over the teeth to help stabilize the bite; kind of like an orthotic some wear in their shoes for alignment and balance when standing. Permanent correction may require equilibration (reshaping teeth), prosthetic dentistry and/ or orthodontics. Many use a splint on a daily basis to avoid having these other treatments done.

Orofacial pain can range from tolerable to debilitating. Maintaining or correcting your bite ensures optimal health, and proper care will help reduce or eliminate orofacial pain or discomfort. If your dentist can not help you, ask for a referral.

Most important lesson of the day: The optimal rest position of the jaw (minus the 10 minutes the teeth touch in 24 hours) is lips together, teeth slightly apart, the tip of the tongue resting just behind your upper front teeth, and you should be breathing through your nose.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have, please email them to him at jpstclair@stclairdmd.com

Besides teeth whitening, the most common forms of cosmetic dentistry are likely porcelain veneers and dental bonding. Each of the two is highly effective at improving the look of smiles! However, the difference between veneers and bonding isn’t always obvious. How do you tell which treatment will benefit you more? As it happens, your local dentist can help you answer that question. Read on to learn three factors you should consider when examining these cosmetic procedures.

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Baseball season is in full “swing” this season with many kids playing throughout the summer. Here’s a lesson about why it’s important to protect your teeth no matter what you are playing.  

In the spring of 1939, in celebration of the 100^th year anniversary of baseball, catcher Joe Sprinz of the Pacific Coast League’s San Francisco Seals announced that he would attempt to establish the world record for catching a baseball dropped from the highest height ever — 800 feet. It would occur during a baseball game before a crowd of 15,000. Coincidently it was Sprinz’s 37th birthday too.

Five balls were to be dropped from the Goodyear blimp hovering overhead. Sprinz missed the first four balls. But on the fifth, the blimp’s captain, A. J. Sewell (an ace bomber pilot during World War I), said he “thought that Sprinz had it.” He added, “From the ship [blimp] it looked as if it hit his glove first. … He walked quite a ways and then sat down. Then some persons crowded around him and we saw him lying down.”

A University of California mathematician calculated the ball was traveling at 145 miles an hour when Sprinz made his catch. The force of the ball gathered as it descended from the blimp, tearing Sprinz’s hands apart, causing the ball to crash against his face. Sprinz had knocked out eight teeth, fractured his upper jaw, broke his nose, and severely lacerated both lips.

The following day, Sprinz “murmured” through his hospital bandages and a wired jaw reflecting on what happened: “I had the ball judged all the way. The ball hit my glove. … [It] didn’t hit my face. The jar of the ball drove the mitt back against my mouth and caused all the damage.”

“Most of the eight teeth lost were bridgework and can be replaced,” his doctor noted. Sprinz chimed in that he was more hurt and baffled by his failure to hold onto the ball “than he is hurt by his hurts.” He returned the following year in May 1940 as the starting catcher for the Seals, claiming he was “just as good” as he was before the accident.

After his retirement from baseball in 1942, he worked with the Seals back office and later with little leagues and the San Francisco Parks and Recreation Department, developing intercity baseball. Sprinz died in 1977 in San Francisco. He was 91.

Sprinz’s catch was officially recorded in the Guinness Book of World Records as the World’s Highest Catch in 1994.

In 2013, baseball sportswriter Zack Hample decided to break Sprinz’s record. He accomplished the feat in July 2013, catching a baseball dropped from a helicopter at 1,050 feet. Unlike Sprinz — and maybe because of him — Hample wore protective gear, including a catcher’s mask, hard-shell protective headgear, and breast plate. Nobody from the Guiness World Record organization attended, although invited. Hample lost no teeth. Officially, Sprinz still holds the record.

Lesson #1: Don’t’ try to catch a baseball dropped from any flying machine; it’s not worth it.

Lesson #2: Baseball is not considered a contact sport but there are many ways “contact” can be made with the mouth. Despite the fact that mouthguard protection is not the “in” thing to do when plying baseball, I highly recommend it.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have, please email them to him at jpstclair@stclairdmd.com

The key to a child’s good dental health begins before his or her teeth become visible. Here are some answers to some of the most frequently asked dental health questions relating to pregnancy, infants, toddlers and children.

1. Does being pregnant affect my oral health? Yes… hormonal changes exaggerate the way gum tissues react to the irritants in plaque. Thorough brushing and flossing of your teeth twice daily to remove the plaque and eating a balanced diet will help to keep your gums healthy.
2. Should I visit my dentist during my pregnancy? Yes… you should continue regular dental visits. However, it is very important to let your dentist know that you are pregnant. You may be asked to be seen more frequently.
3. Are x-rays safe during pregnancy? Yes… x-rays are safe during pregnancy and are a vital tool used in helping to detect dental and other oral health problems. Only the x-rays that are necessary for treatment will be taken. You will be asked to wear a lead apron for extra protection.
4. 4. When will my infant begin to get teeth? Tooth eruption varies from infant to infant. However, most infants will start to get teeth around six to 12 months of age.
5. When should I begin to brush my infant’s teeth? Starting at birth, clean your infant’s gums with a soft infant toothbrush, cotton gauze, or cloth and cool water. For infants under two years of age, parents should consult their child’s dentist before introducing a fluoride toothpaste.
6. How much fluoridated toothpaste should I use when brushing my child’s teeth? Beginning at 2 years of age, a pea-sized amount of fluoridated toothpaste should be used during brushing. Children should be encouraged to spit, not swallow, toothpaste, and the amount of toothpaste used can be increased after five or six years of age when the child can reliably do this.
7. When should I take my baby in for his/her first dental visit? This varies among practitioners. Consult your family dentist. In the meantime, look into the child’s mouth on a regular basis to make sure you don’t see anything unusual.
8. How can I prevent my infant from getting early decay, know as early childhood caries or baby bottle tooth decay? When placing your infant down to sleep (nap or nighttime), place only water in the bottle. Sugary liquids like formula, breast milk, juice and soda can pool around the infant’s teeth and cause decay. Don’t forget to clean or brush your infant’s gums/teeth twice daily to remove food and plaque.
9. What else can I do to keep my child’s teeth healthy? Children are not born with the bacteria that cause decay. They are exposed to these bacteria from their caregivers, especially their mothers. By keeping your teeth healthy and free from decay, you can help reduce your child’s exposure to these bacteria and reduce the chances of early decay.
10. What can I do to help my baby through teething? Many babies like a teething ring, cool spoon, or cold wet washcloth. Some parents/care providers rub their infant’s gums with a clean finger.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have, please email them to him at