2014 Newsletter

The Difference In NightGuards

Commonly Asked Questions

The Infamous Joke Box

Our Patients’ Stories

The Gum Line

From My Heart to Yours

Staff Personals

Chisako’s Corner

What Is The Difference Between A NightGuard From The Store And One We Make In the Dental Office?

By Dr. Presley-Nelson

Why pay for a custom nightguard in our dental office if you can just boil one from the sports store or buy one from the drugstore?  There are several reasons why the nightguard we make for you is better.

•           Ours is made to fit only you, putting pressure only where it is safe and allowing the bite to hit only where no damage will result.

•           There are over-the-counter nightguards that cover only some teeth and this can cause the rest of the teeth to hyper-erupt or grow taller.  This ruins your bite and can open up contacts between the teeth, making food traps that lead to cavities, gum disease, and discomfort while eating.

•           Some over-the-counter nightguards are boiled and bitten into to form them.  If the bite indentations are deep, the opposing teeth can be rocked back and forth, loosened and lost because of grinding action.

•           The boiled kind can be so tight that they pull crowns and bridges off when the nightguard is removed.

•           Over the counter nightguards can be so loose that they fall out while you are sleeping, making them useless.

•           Over the counter nightguards can hold the jaws too far apart and cause damage to the joint.

•           Slick pre-made nightguards can encourage jaw motion at night, as there is no place for the bite “to rest”.

•           We build a ramp to keep forces on strong teeth as motion occurs.  Over-the counter guards do not, so a weak tooth may be loosened.

•           Over the counter nightguards are not very durable and do not last very long, while custom ones will last for years.

•           All of the above points also apply to rubbery, sports guard types of “nightguards” that some dentists make.  This refers to the ones that are not hard plastic and do not have a customized bite surface, that controls where opposing teeth hit.

If you are in pain with TMJ stress or can’t rest with grinding problems, an over-the-counter nightguard is probably better than nothing for a short while.  But not for long!  Let us take impressions of you, mount your models on an articulator (a bite simulator), and make a proper nightguard that is custom made and adjusted to be safe for your own specific needs.

 

This is Why… Or The Answer to Commonly Asked Questions

By Dr. Fung

Why do you ask so many questions about my health?

The mouth, like any other organ, is affected by and works in conjunction with the rest of the body.  This means that medical conditions that affect one area of the body could affect the mouth.  For example, many diseases can manifest as sores in the mouth.  Also, diabetes is linked to periodontal disease, which might require a diabetic to be extra vigilant about oral health.

Medications can also have a dramatic effect on the mouth.  Some medications are linked to nighttime grinding.  Others cause dry mouth, which can lead to a sudden increase in cavities and gum disease. Certain medications cause hyperplastic gingiva (big swollen gums). Also before we administer anesthetics or other drugs we need to know what you have “on board” already.

So, while it may seem like we’re being nosy, information about your general health is utilized to give you the best care possible.

Why are you recommending treatment for something that’s not bothering me?

Some common, non-painful issues that we might encourage patients to seek consultation or treatment for are wisdom tooth removal, gum problems, and root canals.

If we are recommending treatment for something that doesn’t hurt, it’s because we want to make sure it never hurts or causes destruction to neighboring areas.  Just like you wouldn’t wait for your car to have engine failure before you change your oil, we don’t want you to wait until you’re infected and/or in pain or have spread damage to nearby areas before you seek treatment.

As for those common concerns that might not hurt: wisdom teeth are potential problems because they are notoriously difficult to cleanse and are often in problematic positions; gums that have receded or have become infected usually get worse until the condition is treated; and we generally only recommend a root canal on a tooth that doesn’t hurt if there is a dramatic and unhealthy change in the surrounding bone.

While these are some of the most common issues, they are by no means the only issues that could create confusion, so we are always happy to answer questions and discuss any treatment recommendations.

Why should I get treatment that my insurance won’t help pay for?

We do our very best to create a thorough treatment plan that is in the best interest of each patient’s oral health, not his or her insurance plan.

Our job is to get your mouth as healthy as possible and then help you keep it that way.  We know that times are tough and budgets are tight, so we always look at what treatment is urgent and what might be able to wait.  Unfortunately, the potential for pain or infection doesn’t decrease with decreased insurance coverage.

We have nothing to do with how your insurance plan is structured or what it covers.  We create your treatment plan with your health as the priority.  For example, we recommend nightguards to address tooth or joint pain and/or prevent tooth damage, and we recommend more frequent cleanings when it is necessary for stable oral health.  These are serious concerns that can affect quality of life. The fact that most insurance plans don’t cover these procedures is a mystery to us, unless we surmise that the less they pay out, the more of your premium they can keep.

We know it’s frustrating to have an insurance plan that doesn’t seem very helpful.  The best things you can do are research your plan, talk to your employer (the source of the insurance) about your concerns, and let us know if you have questions about your treatment.  We will do our best to help.

If you have any more questions about these or other topics, please feel free to let us know.  We are always available to answer questions. 

METER MAID MANIA

Those “Parking Police” are on high alert and the tickets are expensive!  Please park on side streets when possible and allow time for the walk!  We will try to feed your meters when necessary, but we can’t insure that you won’t get a ticket!  We cannot be responsible for ticket costs. We’ll do our best to hear your timer, and run out there, but if you can, please use 28th or 27th Avenues.

Thank you so much!  The Dental Management

THE INFAMOUS

JOKE BOX

Thank you jokers for bringing humor to our dental office! We enjoy you!

Thank you wonderful patients for bringing humor into our dental office!  We enjoy you!

OUR WINNER THIS YEAR IS …KEN HJELM!!  A duck goes into a pharmacy and asks for Chapstick.  The pharmacist asks, “How are you going to handle this?”  The duck replies “Put it on my bill!”

FIRST RUNNER UP IS GENE VRANA, “What is the difference between Roast Beef and Pea Soup? Anybody can Roast Beef!”

SECOND RUNNER UP: RICHARD JANN, What car does an eye doctor drive? A ‘Cataract!’

AND  HONORABLE MENTION:

NORMAN GROH Q: Why do dentists make lousy lovers?  A: They always try to make sure you never feel a thing!

BARNEY CROTTY: Only a King and Queen can hail while reigning!

BOB SCHIFF:  Bob: “Did you hear about that actress who stabbed someone?  Reese…aaah…what’s her name?  Reese…?”   Doc: “Witherspoon?”  Bob: “No, with her knife!”

WALT MESERVY: Did you hear about the fire at the Circus? It was INTENSE!

Special thanks to jokers Laura Mezirka for the one about old ladies, Bob Deloria for “wait and see”, Jo Moorhouse for “Ashes”, and Ron Ghilardi for his late night entertainment, and all those listed below:

Danny Yanow, Boudicca Todi, Kathy Trapani, Barry Hanson, Jimmy Johnstone, Skee Tostanoski, Steve Moorhouse, Marilyn Brown, Bianca Hirsch, Michael Novak, the Leikams, Ruth Oats, Fr. Alan Wilson,

Fr. Gerry O’Rourke, and MANY OTHERS!! Please tell us whom we have missed!

 

Babies Born to Our Patient Families in This Last Year

In May of 2013 lovely patients Adam and Liz Zeimann welcomed new daughter Lilly King.  The Stork visited long time patient (since childhood) Andrea Muller Korsunsky and her sweet husband Oleg Korsunsky and brought them baby son Max in March 2013. In January 2013, beautiful baby daughter Anna, became the pride and joy of patients Lisa Silveria, and Dave Herman.  Congratulations and welcome to our extended dental family.

We see children! Start them out at age 2. They love our puppets, rides in the chair and the toy chest!

Our Patient’s Stories

The Broomstick!

About 15 years ago Dr. Presley-Nelson took her young sons, Gary Clarke and James, to the reservoir near Stonestown so they could play with their remote-control trucks.  She jogged about for exercise while keeping an eye on the boys.  One of her children ran his truck into an open ended pipe and could not retrieve it.  After trying to poke it through with a short stick, she realized she needed something on the order of a broom handle to push the truck through.  Scanning the neighborhood from on top of the reservoir, she remembered that her dear patients, the Crotty family, Joan, Barney, and their college aged children, Michael and Joanna lived nearby.  With her boys in tow, Dr. Presley-Nelson jogged over to what she hoped was the Crotty home, and rang their doorbell to ask to borrow a broom.  Mother and son, Joan and Michael were out, but from deep within the house Barney’s voice could be heard calling to his daughter, “Joanna! See who is at the door!”  Whew!  Doc was relieved that she had remembered the correct house.

The door was opened by beautiful blonde Joanna, who looked very surprised to see her family dentist in exercise clothes, standing on her doorstep.  Not wanting to ask abruptly to borrow a broom, and feeling rather awkward standing at a patient’s door in jogging clothes, Dr. Presley-Nelson thought she would try to be funny.  She looked Joanna seriously in the eyes and asked her, “Have you brushed and flossed this morning?”  Joanna just stared in disbelief for quite a few moments.  In her lovely head she imagined that Dr. Presley-Nelson had taken to roaming about the streets in sweatpants, knocking on patient’s doors to remind them to keep up with their oral hygiene. Finally, after a long silence, she mustered herself and said, in all sincerity, “You’re really starting to “lose it” aren’t you, Doc

The Gum Line:

MI Paste And Fluoride

By Kathleen O’Connor Hanley R.D.H

     You have learned from Dr. P-N, Dr. Fung and myself that plaque control is the key to good oral health.  There are conditions, however, that may require adjunct therapies along with good hygiene.  Many patients experience tooth sensitivity, gum recession which exposes softer root surface, decalcification of enamel, decay, acid erosion and white spots to name a few of the problems. Our decision to recommend therapies in addition to plaque control, occurs with individual case by case consideration of one’s oral health, is based on pH balance, and replenishing the fluoride, calcium and phosphate ions that are important for remineralizing enamel.

 

Fluoride is the long-standing “go-to” dental therapeutic agent.  We have known for a long time that fluoride has both systemic and topical beneficial effects on teeth.  Fluoride remineralizes tooth enamel and, with daily topical use, changes the hydroxyapatite in enamel to fluorapatite, which makes the enamel more resistant to decay.  Fluoride is also effective for treating tooth sensitivity by plugging exposed dentinal tubules.  Fluoride can be applied in different ways.  We recommend in-office treatments at regular cleaning appointments.  This can be delivered in trays, as a rinse or as a professionally applied varnish.  At home treatments can also be in gel or rinse form.  Fluoride uptake is best immediately after your professional cleaning when the teeth have no debris or even salivary film on them.  However, fluoride is also effective when used on a regular, on-going basis at home.

 

MI paste (stands for minimally invasive) is a topical tooth cream that contains RECALCADENT(CCP-ACP) a special milk- derived protein that releases bio available calcium and phosphate to tooth surfaces.  This helps with sensitivity and is often a better choice for treating decalcification than fluoride because it can harden the subsurface enamel whereas fluoride will only harden the top layer of the enamel.  Often, we put patients on an alternating schedule of fluoride and MI paste so they can take advantage of both the remineralization/anti caries effect and the occlusion of the dentinal tubules on exposed root, to help with sensitivity.

 

From My Heart to Yours

In January I always sit down to write a Dental Office Newsletter to send to all of you.  This time, as I paused to reflect on all the great patient anecdotes, patient stories, jokes that have been told here in the office, and the lists of patients who travel a distance to get here, and all the college kids who visit on their breaks, I felt almost overwhelmed.  Not by the task, but by the feelings that swept over me.  How can I describe the gratefulness that I feel for the trust you all have honored me with by allowing me to care for your dental health?  How can I express the joy and happiness you all bring when you come in with jokes and stories, personal sharings, and sometimes gifts or goodies?  How can I tell how proud it makes me when you refer your family and friends to me to take care of?

I think this is the place and the moment to let you all know that because of you, last year was a wonder and I humbly look forward to 2014 in your service.

Have a healthy, prosperous, peaceful, and happy New Year,

Dr. Presley-Nelson

 

The “Comes From Afar Box”

Often, when people move away, they still remain as patients in our practice and travel one or more times a year to receive their care from us. We so appreciate their efforts and their loyalty that we want to thank them here.

 

Darwin Albers from Paradise, CA

Tony Bader from Brooklyn, NY

Rachel Bazner from Arcadia, CA

Bill Bender from Hayward

Jan and Tom Brock who take the Bart and muni for hours from the East Bay. We appreciate you!

Linda Carlson from France

Paul Chamberlain from South Peninsula

The Cohen family from Sunnyvale

Helen and Kevin Driscoll from Marin

Rex Golding from South Peninsula

Nancy Husari from Alameda

Richard Jann from Brentwood, CA

Lily Jefferies from Los Altos, CA

Mary Johns, Allie Yu, & Jenna Johns-Yu from Piedmont

Tanya Kauffman from Alameda

Nancy Krop from South Peninsula

Carole and Gerald Leikam from north of Marin

Claire Manhart from Grass Valley

Nancy McGarry from Fairfax, CA

Diane Mibach from Marin

Steve and Jo Moorhouse from Healdsburg, CA

Elisabeth O’Connell from London

Elena Olsen from Pleasant Hill

Roya and Jared Platsis from Petaluma, CA

Eric Polus from New York City

John Riley from San Carlos

Ann Trinh and Yeppo Cheng from Petaluma, CA

Peter and Faaoso Vrana & family from Pittsburg, CA

Melanie Walas from Lafayette, CA

Nancy Walton from Benicia

Rob Waring from Palo Alto

Brenda Linda Wolfe from New Orleans

Lou Zumpano from South San Jose

WE HONOR EACH AND EVERY ONE OF YOU!

 

Cancellation Policy

Please give us advance notice when rescheduling or canceling appointments. Notifying us less than 48 hours prior to the appointment will incur a charge of $30 per half hour scheduled. This means if your appointment was one hour, there will be a lack of notification charge for $60.  We are not trying to be mean, or non-lenient, but overhead is an on-going issue.

 

OUR AWAY-AT-COLLEGE

PATIENTS

MAKE TIME FOR TEETH!

We enjoy, encourage, and appreciate all you college students who squeeze in a checkup and cleaning while you are home on your summer, spring or winter breaks!  We love to hear your stories and “catch up.” Call ahead and reserve your spot.  This year we enjoyed:

Lara Baez – John Hopkins

Tess Brown- Loyola Marymount

Rachel Cohen – University of Wisconsin

David Cuadro- Hofstra University

Robert Fredenburg – Pasadena City College

Leah Gallagher – NYU/Tisch

Khalid Helmy – College of San Mateo

Malik Helmy – UC Davis

Nadeem Helmy-San Diego State

Mettlin Hunter – Seattle University

Devon Ivie – Southern Oregon University

Amy Lunde – Azusa Pacific University

Melanie Manzana – UC Davis

Aine McGovern- Boston College

Riley Norris- Pratt Institute in Brooklyn, New York

Mari Novak – UC Santa Cruz

James Presley-Nelson – UC Berkeley

Sergio Robleto – Concordia University, Irvine

Kalev Sepp- Gonzaga

Sophia Sepp – Georgetown

And more!  Let us know who we missed!

 

Wedding Bells Ring

for Our Family of Patients

In August of 2013 patient, Caleb Gatlin made his sweetheart Joliene his wife.

Our longtime patient (since childhood) Linden Bader married Bryan Rees on November 9th, 2014.  Congratulations and many wishes to all for a happy future together!

 

Fun Tooth Fact

In Egypt, mummies have been found with fillings comprised of resin and malachite, and gold wire was used to bind together loose teeth.

 

Staff Personals

Dr. Beverly Presley-Nelson and husband Gary wish you a healthy and prosperous 2014.  Gary is still with Hewlett Packard and enjoys his work.  Gary Clarke is working in a law office downtown and enjoying playing in the Praise Band at church.  James Kent is a senior at UC Berkeley at Haas Business School, and also in the Econ department.

Dr. Presley-Nelson’s professional passion is serving you all in her private practice.  Everyday is a joy with patients and staff, and she maintains the same long hours there that she has for many years.  She has enjoyed adding teaching back into her schedule at the University of the Pacific School of Dentistry.  She teaches at times when Dr. Fung is holding down the fort at the office.  The students and co-instructors keep her ‘on her toes’ and excited about the great profession of dentistry.  The famous Presley-Nelson car trips included one to Lake Chelan Washington and on the road they listened to audio book GONE WITH THE WIND unabridged.  Long trip…long book!  The other memorable road trip was from North Carolina all the way to Key West, in search of the perfect Key Lime Pie.  Yummmm!

 

2013 was full of work and kids for Dr. Wendy Fung and her husband Steve.  Daughter, Nora is now six and in kindergarten at West Portal Lutheran.  Despite being nervous about going to a new school, she’s made friends and is having great fun.  Vivian just turned three and started wearing glasses, which she hasn’t lost or broken yet (fingers crossed!!).  In 2014, Steve and Wendy hope to find more time to spend with the two happy, healthy girls they are so blessed to have.  They hope everyone has a safe and peaceful new year!

 

Another busy year down for Kathleen and her husband Patrick. Their son Ryan (18), graduated from high school and is attending College of San Mateo and hopes to find a way to make a living doing something related to the game of golf. Emily (16) is a junior at Terra Nova High School and working hard on her academics and playing trumpet in the marching band. The Hanleys wish everyone all the best in 2014.

 

Chisako Tanaka welcome’s Joyce as a new team member and is grateful to have her help with the considerable amount of insurance work we do for our patients.  As office manager, Chisako is always grateful for help and good work from the staff she over-sees. She is hoping to escape her long hours at the dental office for a little enjoyment of movies.  She likes westerns, movies with Julia Roberts in them, and hopes to see the Hunger Games films.  Chisako runs things around the dental office with a sweet but firm manner.  She stays on top of scheduling, insurance, data entry, check-up reminders, and many other tasks.  Having her Xray license, and long years of chairside experience, she steps in where needed on busy days.  We just can’t make it with out our Chisako.

 

Joyce Lizardo joined our office this year to help Chisako with insurance processing. She works part time behind-the-scenes and has been a great addition to our team. She has learned a lot and is still learning every day. She reports enjoying working with experts in the dental field. When off duty she likes to spend time with her husband and young son.

 

Daniel Gee, our Head Chairside Assistant has his bachelor’s degree in Cellular and Molecular Biology and is in charge of our sterilization program. He oversees our Junior Staff, does inventory control, office maintenance, and is a vital part of daily patient care, working long hours at chairside. He takes classes in, and understands the parts and mechanics of our different Dental Implant Systems and keeps that stocked and organized.  A man of many talents, he has become proficient in the use of our new intra oral camera, which helps us get a closer view of dental problems to aid in diagnosis and patient communication. Outside of the dental office, he enjoys riding his motorcycle, running, and spending time with his girlfriend. Thank you Daniel!

 

Annie Ma has finally graduated from SFSU in May with a Bachelor of Science in Biology: Concentration in Cell and Molecular Biology and a minor in Chemistry. She is currently applying to dental hygiene schools; hopefully she will be hearing some good news soon. She has been helping us for about three years now. She holds her X-ray license with the State of California and is very valuable in covering late afternoon shifts and sometimes morning shifts. She’s very proficient in assisting many procedures and in sterilization and infection control. She also helps Dan with inventory control and maintenance. Annie is always ready with a great smile when she comes in the office. She looks forward to the New Year and is hoping for some delightful new changes. In her spare time, she enjoys spending quality time with her family and friends.

 

Cipriano Gudoy, was with us the first 7 months of 2013 and then he left for Dental School! As one of our pre-dental interns for about 6 years we are glad to see him reach his goal and be accepted into the University of Southern California Ostrow School of Dentistry. Congratulations Cipriano! We miss you.

 

Our college interns keep our late shift young and perking. Usually pre-dental majors, they each may work only a few hours a week, but these college students are bright, easy to train, entertaining, and a delightful addition to our office. Their “Staff Personals” are as follows:

 

Michelle Merino is a Pre-Dental student studying Physiology at San Francisco Sate University. She is Vice President of the pre-dental society on campus, which is where Doc connects with the interns that she has, for so many years, enjoyed mentoring and helping. Michele has completed Doc’s rigorous chairside assisting program and has become very helpful at the office in certain afternoon shifts. In her free time she likes to relax at home with her cat or explore San Francisco with her friends.

 

Olga Byakina is a pre-dental student at San Francisco State University, working toward a Bachelor’s degree in physiology. She has enjoyed the education she has received in her internship with Dr. Presley-Nelson and Dr. Fung since last winter. She is very serious about her role in the dental office and is really pro-active about learning and growing in the field. She is a big help in the late shift on certain afternoons and we value her contribution greatly.  She takes coaching with poise and grace.  We are glad to have her in the office. In her free time Olga enjoys hiking, jogging on the beach, and playing with her dog.

 

Jacob Pese is finishing up his second year at College of San Mateo, still debating on which major he’d like to declare. He is conflicted between chemistry and biology and either would do well for a pre-dental student. Recently he completed an infection control program with other office staff, learning how to keep everything in the office sterile and safe for our patients. In the office, he usually works behind the scenes on our mailer program and with clerical tasks. In his free time he has started swimming again and will probably be competing sometime in the near future. We value his contribution.

 

The ONLY automatic toothbrush we approve is the ROTODENT! It has the right size, shape, and type of bristle and motion! Available in dental offices only with a demonstration in proper, safe usage. Ask us!

 

Do you have dental insurance?

Please remember you, your employer and the insurance company agreed on your insurance coverage. You picked/agreed to your plan and have been paying premiums for what you agreed would be covered. Your booklet describes what is and isn’t covered and how often, and under what circumstances re-imbursement will occur.  We are not in any way connected to your plan. We are happy to send claims to your dental insurance and to help you as best we can.  Ultimately, your dental insurance contract is yours.  As you keep your eye on your benefit statements let us know if we should resubmit unpaid claims.  Most claims have a deadline of a year or less for submission or resolution. Please help us help you with your insurance. Know something about your Insurance.  Let us know before your next appointment when your insurance changes. We can help you check if the insurance is in effect before your visit. Remember we are Participating Providers in (In-Network) Delta Dental Premier Plan. Delta Dental PPO Plans offer similar coverage to the Premier Plan. We also participate in the DeCare Dental Network and CIGNA’s Network Savings Program. We accept most insurance even those out-of-network, and the cost to the patient is often not much different “in” or “out” of network.

 

Why do we refer to Specialists?

Dr. Presley-Nelson and Dr. Fung perform a great variety of general dental procedures. However, there are a few dental needs that are better met by referring our precious patients to a specialist. Oral Surgeons, Periodontists, Endodontists, and Orthodontists often have specific equipment and facilities that would be too expensive for a general dentist to maintain. Specialists have two or more years of extra training in their field and so perform only a narrow range of treatment and therefore become faster and more proficient at those few tasks. We only want what is best for our patients, and so we pick specialists whom we know to be tops in their field. Another parameter in our referral choices is that the specialists communicate well and work well with Dr. Presley-Nelson and Dr. Fung. We are like the orchestra conductor summoning the flutes or the violins and we want those flutes and violins to be the very best players possible and to harmonize with the direction we give them, and ask of them.