ONLY 6% of dentists in the United States use lasers according to the Academy of Laser Dentistry.

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1 LASER DENTISTRY: REVOLUTIONIZING PATIENT CARE How State of the Art Equipment has Transformed the Dental Experience from Anxiety to Amazement. BY MELISSA MAKOWSKI, DDS- LAKEVIEW DENTISTRY ONLY 6% of dentists in the United States use lasers according to the Academy of Laser Dentistry. Dr. Melissa Makowski is a graduate of the University of Detroit Mercy School of Dentistry. The American Dental Association, Michigan Dental Association and FAMILY AND LASER DENTISTRY Vacationland District Dental Society are among her professional associations. She is also a member of the National Dental Honor Society, Omicron Kappa Upsilon, the Academy of Laser Dentistry, American Academy of Cosmetic Dentistry, Academy of General Dentistry, and is an Associate Fellow in the World Clinical Laser Institute. Daily, one hears about laser eye surgery, permanent laser hair removal, and laser skin treatments. Why have lasers become such an indispensable tool amongst healthcare professionals? Lasers have revolutionized patient care. They are unparalleled in precision and accuracy, allowing the most intricate tasks to be completed in the least invasive manner possible. What does this mean for you and your dental treatments? Heat, vibration and pressure are the primary causes of pain associated with the use of traditional dental drills. Cutting both hard and soft tissues (teeth and gums) with the Waterlase does not generate heat, vibration or pressure, which means that many dental procedures can be performed with fewer shots, less need for anesthesia, less use of the drill and fewer numb lips! A laser uses a focus beam to indicate where the energy will contact the tooth and gums once the laser is fired. The Waterlase dental laser is unique by utilizing water to aid in tissue removal and to cool the tissue surface, thus eliminating much of the pain associated with dental drills. Additionally, the precision of a dental laser allows for removal of microns of diseased hard and soft tissue as opposed to millimeters of diseased AND healthy tissue removed by traditional drills. Why is this important to you? Keeping a cavity preparation as small as possible by precisely removing only diseased tissue allows a person to keep more of their own tooth structure. The use of a dental laser preserves healthy tooth structure. Oral surgery, involving the removal of gum tissues and bone, was only previously possible by cutting with a scalpel blade, and that method results in greater blood loss, requires stitches, and has a prolonged healing time. The precision of a dental laser targets the diseased tissue virtually eliminating the need for local anesthetic and stitches, which means less post-operative discomfort and shorter healing times by reducing inflammation. Laser energy can also help treat painful conditions like cold and canker sores, and muscle soreness by stimulating the body s healing response. The professional focus of Dentistry of Charlevoix is unsurpassed patient care with comprehensive laser treatment. We do this by maintaining a state of the art dental practice. Our office is one of the elite dental practices in the United States that is equipped with both Waterlase and EZlase lasers, Diagnodent laser decay detection, and digital x-rays. Dr. Makowski has committed to being an expert laser technician to benefit her patient s health and comfort. She is an Associate Fellow in the World Clinical Laser Institute, a member of the Academy of Laser Dentistry, and is currently pursuing her Fellowship in the American Academy of Cosmetic Dentistry, and the Academy of General Dentistry. One of her core beliefs is that education is critical to quality patient care. Dr. Makowski states, professionals are obligated to ensure that they are providing optimum care for their patients and emphasizing their well-being through constant learning and improvement of professional skill and knowledge. Treating patients is a privilege, not a right. Dr. Makowski has always been committed to educational excellence and was rewarded with membership in Omicron Kappa Upsilon, the National Dental Honor Society. Meet our team at Dentistry of Charlevoix and experience dentistry like never before. We will be partners on your journey to unsurpassed oral and overall health.

2 MYNORTH MEDICAL GUIDE Laser Dentistry: Preventing Disease and Improving Overall Health promote your health 3 OUT OF 4 Adults suffer from some kind of periodontal disease. Julie Meadows Photography Dr. Melissa Makowski has undergone extensive laser training to provide this exclusive service for her patients, holds a mastership in the World Clinical Laser Institute and is a member of the Academy of Laser FAMILY Dentistry. AND Dr. Makowski LASER is also DENTISTRY a member of the dental honor society Omicron Kappa Upsilon, the Academy of General Dentistry, American Academy of Cosmetic Dentistry, American Dental Association, Michigan Dental Association and the Vacationland District Dental Society. According to the World Health Organization, the number one global cause of death is cardiovascular disease. Did you know that your dentist can identify significant oral conditions that contribute to cardiovascular disease and a visit can reduce your risk or progression of this disease? A person s visit to the dentist in 2011 is vastly different than a dental experience 50 years ago or even 10 years ago. A multitude of advancements in dental treatment options, technologies, preventative therapies and scientific knowledge have been made in just this past decade. Are you benefitting from these advancements? According to the American Academy of Periodontology, 3 out of 4 adults suffer from some kind of periodontal disease. The Centers for Disease Control suggest that this rate has been underestimated by 50%. Research suggests that periodontal disease is connected to cardiovascular disease, diabetes and even rheumatoid arthritis. A simple salivary test by your dentist can determine your genetic susceptibility and the level of bacteria in your mouth that causes periodontal disease, which will provide direction for preventive methods to offset this condition as well as its impact on the body. Are you tired lately and have been told that you snore? Has your dentist suggested a sleep study? Well trained dentists have the ability to see oral signs of sleep apnea. It is estimated that 1 out of every 15 Americans has undiagnosed sleep apnea. This is a frightening statistic, because untreated sleep apnea results in a 4 times greater risk of stroke and people are 3 times more likely to have cardiovascular disease. Adults are not the only ones that suffer. Children can have sleep apnea as well causing symptoms similar to ADHD. Regular dental visits can allow your dentist to identify signs of sleep apnea. If you are diagnosed with a certain type of sleep apnea, a simple dental appliance may help alleviate these symptoms. Do you suffer from pain in your jaw and find it hard to chew or even yawn? Approximately 12% of the population suffers from temporomandibular joint disorder (TMJD). TMJD is considered the second most common musculoskeletal condition resulting in pain. Fortunately, innovative noninvasive treatments like low level laser therapy can alleviate the pain of TMJD. This therapy involves direction of diffuse laser energy to the muscles surrounding your joint, and virtually eliminates the need for more invasive treatments like mouth appliances, steroid injections, and prolonged usage of medications. Does it seem like you have a new cavity each time you go to the dentist and is your saliva to blame? A healthy mouth produces 2 liters of saliva per day. Dry mouth, also known as xerostomia, has multiple causes. It s a side effect of over 700 medications and is caused by conditions like acid reflux disease, Sjogren s syndrome, salivary gland tumors, or the removal of salivary glands, which all impact the quality and quantity of saliva. A simple evaluation can determine if you have enough saliva and if a low ph is causing your enamel to soften. Does your dentist know how much saliva you produce or if you have an acidic environment in your mouth? If so, your dentist may have recommended treatment like xylitol and calcium phosphate to help strengthen your enamel. Knowing about your oral environmental condition is critical for preventing more costly and invasive dental treatment in the long run. Dentistry of Charlevoix provides exceptional care through promoting preventative methods and noninvasive treatment by utilizing the most advanced dental technology for patients. Dentistry of Charlevoix has incorporated these procedures as routine evaluations Has your dentist?

3 Innovations in Dentistry promote your health and well-being. Julie Meadows Photography Dr. Melissa Makowski and her team at Dentistry of Charlevoix are committed to providing exceptional care by utilizing the most advanced dental technology for patients. She has undergone extensive laser training with and holds a mastership in the World Clinical Laser Institute. She is a member of the Academy of Laser Dentistry and has also received training in Botox use specific for dentistry by the American Academy of Facial Esthetics. Dr. Makowski is also a member of the dental honor society Omicron Kappa Upsilon, the Academy of General Dentistry, American Academy of Cosmetic Dentistry, FAMILY American AND Dental LASER Association, DENTISTRY Michigan Dental Association and the Vacationland District Dental Society. Dr. Makowski dedicates herself to continuing education to bring the most advanced dental care to her patients. If you have ever overdone an exercise regimen, you know that overuse of a muscle can cause pain, tenderness and limited range of motion. Unfortunately, the muscles of the jaw never really get the opportunity to rest. Hyperactive jaw muscles can negatively impact a person s quality of life causing headaches, earaches, neck pain, tooth sensitivity, and jaw-joint issues which impact the ability to chew or talk efficiently. If this continues on long enough, people may develop symptoms of depression and anxiety which further impacts overall quality of life. Bruxism (which literally means to gnash teeth) and clenching are two conditions that can occur individually or concurrently. They may be a sign of other underlying conditions such as obstructive sleep apnea or anxiety disorder, and they are often listed as a potential side effect of certain medications. Because bruxism usually occurs while sleeping, 20 percent of people are totally unaware of their condition. Oftentimes it is by chance that a family member hears the teeth grinding and lets them know. My husband used to have this problem, and I would literally wake him up to stop him from grinding! Dentists who are conscientious and astute can also identify common signs of these conditions during simple routine exams. Wear patterns on teeth, tooth mobility, cracking or chipping, or specific patterns on fillings or crowns are all signs of excessive jaw muscle force. Pocketing in gums, recession of gum tissue, or bone loss around the teeth are other serious consequences of untreated bruxism. Chipped and worn front teeth are usually the problems that patients first notice followed by persistent pain in the head and neck areas. Fortunately there are many different interventions available. The first step and least invasive treatment is usually the fabrication of an application device that is worn during the night to prevent the teeth from contacting. This device is designed specifically for the patient and accounts for the unique patterns of movement in the jaw. This device will protect the teeth and supporting structures from further damage, but the hyperactivity of the muscles will usually continue. Shockingly, muscle activity can be up to nine times more intense during sleep than while awake. Reducing the intensity of the hyperactive muscle contraction is where Botox may help. It is one of the most recent additions for treatment of bruxism. Botox is a highly purified protein that binds to the nerves of muscles, preventing contraction. Botox has been used to treat many different conditions, but the most well-known is the treatment of wrinkles. The ability of Botox to smooth out wrinkles is the result of the muscle under the skin not being able to contract to its strongest intensity. Using this principle, Botox can decrease the intensity of bruxism. A patient specific dose is determined to maximize Botox s ability to reduce jaw contraction intensity, but not alter the ability to chew. Another innovative approach effective in reducing pain and limited motion of hyperactive jaw muscles are lasers. Low level laser therapy, or photobiomodulation, has been used as a physical therapy treatment adjunct since the 1970 s. Low level laser therapy increases circulation in tissue, stimulates enzyme production in cells to breakdown inflammatory byproducts that cause pain and speeds the rate of healing in damaged muscle tissue. This minimally invasive procedure takes minutes and can profoundly improve the range of motion in jaw muscles and decrease pain.

4 What Every Parent Needs to Know: promote your family s health and well-being. Dr. Makowski and her team at Dentistry of Charlevoix are committed to providing exceptional care by utilizing the most advanced dental technology for patients. She has undergone extensive laser training obtaining mastership status with the World Clinical Laser Institute and is a member of the Academy of Laser Dentistry. She has also received training in Botox use specific for dentistry in the treatment of temporal mandibular joint disorder. Dr. Makowski is also a member FAMILY of the AND dental LASER honor society DENTISTRY Omicron Kappa Upsilon, the Academy of General Dentistry, American Academy of Cosmetic Dentistry, American Dental Association, Michigan Dental Association and the Vacationland District Dental Society. Dr. Makowski dedicates herself and her team to continuing education to bring the most advanced dental care to her patients. DENTISTRY OF CHARLEVOIX According to the American Academy of Pediatric Dentistry (AAPD), tooth decay is still the single most common chronic childhood disease 4 times more common than early childhood obesity, 5 times more common than asthma, and 20 times more common than diabetes. This is an unfortunate statistic considering dental decay is completely preventable. Half of all children between the ages of 2 to 5 have never even visited the dentist. Children in this age group who have not visited a dentist within the past 12 months are more likely to have decay in their baby teeth. Dental decay can cause numerous problems such as pain, infection, chewing difficulties, speech impediments, and tooth alignment issues that can impact the child s overall wellbeing even into adulthood. Children should visit a dentist no later than their first birthday because bacteria that cause cavities are shared between family members. So if you have an untreated cavity, then these bacteria could spread through saliva. Sharing spoons, testing food before giving it to baby, and cleaning off a pacifier with your mouth instead of water are common ways in which it can spread. The American Dental Association (ADA) asserts that it should be as soon as their first baby tooth erupts. Children will usually get their first tooth around six months of age, and by the time they are three, they should have a full set of twenty baby teeth. The earlier the visit, the more the opportunity to become accustomed to the sights, sound and smells of a dental office. Parents will also be able to learn about their child s dental development and gather valuable information about diet and care that will aid in the prevention of decay. Begin a mouth cleaning routine early in the child s life. First, an infant s gums should be wiped with a clean damp cloth or gauze after each feeding. Make it a calm and pleasant part of their routine. If you are stressed about it they will be stressed about it too. As soon as the first tooth appears, an infant sized brush should be used after each feeding. Consult with your dentist about the need for using toothpaste. If the baby falls asleep while eating, the teeth should be cleaned before putting them to bed. They should never be put to sleep with a bottle of milk, formula, fruit juice, soda pop or water sweetened with sugar or artificial flavoring. As children grow, make brushing a fun time- try reciting nursery rhymes, count or sing. A dentist will advise when flossing is necessary. Parents should be an active participant in brushing at least until age six. Healthy eating and drinking habits need to be established early on. Non-processed foods are the best for your dental and overall health. Unfortunately, children between the ages of 2 and 5 that do not eat breakfast and have less than 5 servings of fruit and vegetables per day have a greater risk for dental decay. Simple carbohydrates such as white breads or crackers are broken down into sugars by the bacteria that live in the mouth and cause dental decay. The AAPD and the ADA recommend that children should never be allowed to sip on soda pop, sports drinks or non-diluted juice as the sugars and acids in these drinks, even the diet ones, will rapidly cause decay. Water, fresh fruits, vegetables, cheese and yogurt are healthy choices. For instance, did you know that cheese stimulates saliva production and helps to keep the ph of the mouth neutral, not acidic? It also contains pyrophosphates which help to keep enamel strong. Laser cavity detection is the most cutting edge adjunct to diagnose dental decay at the earliest stages. If your child does develop a cavity, the dental laser is a wonderful tool for removing the decay because it is a precision instrument only removing unhealthy tooth structure. Further, lasers can be used to remove cavities without using local anesthetic, which means less pain during procedures. This allows the child s visit to be less invasive and reduces anxiety for not only the child, but the parents as well.

5 Early Detection for Tooth Decay promote your health and well-being. Dr. Melissa Makowski and her team at Dentistry of Charlevoix are committed to providing exceptional care by utilizing the most advanced dental technology. She has undergone extensive laser training with and holds a mastership in the World Clinical Laser Institute. She is a member of the Academy of Laser Dentistry and has also received training in Botox use specific for dentistry by the American Academy of Facial Esthetics. Dr. Makowski is also a member of the dental honor society Omicron Kappa Upsilon, the Academy of General Dentistry, American Academy of Cosmetic Dentistry, American Dental FAMILY Association, AND Michigan LASER Dental DENTISTRY Association and the Vacationland District Dental Society. Dr. Makowski dedicates herself to continuing education to bring the most advanced dental care to her patients. DENTISTRY OF CHARLEVOIX At Dentistry of Charlevoix, Dr. Makowski continues to lead the way with innovative dentistry in northern Michigan. Utilizing the most state of the art, non-invasive way to detect early dental decay, she has elected to incorporate the Spectra system by Air Techniques into her practice. Spectra is an FDA approved tool that uses a color visual system and software analysis to provide a picture of the tooth showing where the structure is deteriorating. As early as 1998, research in dental decay detection was recognizing that in the presence of certain light, a chemical that bacteria produce called porphyrin readily fluoresces red whereas sound enamel fluoresces green. The bacteria that are responsible for dental decay, S.mutans, produce porphyrin when they are active. Capturing this fluorescence, the Spectra allows for early detection that goes beyond the dentists visual examination and x-ray capability, to identify what was not easily seen by the naked eye. Historically, an x-ray and a sharp dental tool were the only diagnostic tools a dentist had to detect decay. The tooth may have appeared healthy on the surface, but in reality was diseased. By the time the decay was apparent with either of these modalities, the area of decay was quite large, necessitating a larger restorations. The advanced Spectra system can be used as a baseline which allows patients to be a partner in their dental treatment and better understand the options of treatment or observation. As an image is captured, values are set for specific areas on the teeth and recorded. This allows for comparison as time progresses. At the earliest sign of deterioration, the cavity can be identified and restored. If a cavity is identified and the patient decides not to treat it right away, these previous records can be accessed for comparison. The Spectra shows the patient the presence of harmful bacteria in the mouth, and corresponding oral hygiene status. This can help motivate the patient to carry out a regimen of better dental care both at home and through regular check-ups and cleanings at the office. Dr. Makowski continues to bring innovative technology to her practice because her mission is to educate patients about their oral health, prevent decay by disease, and to conserve as much natural tooth structure as possible. Dr. Makowski elected for the Spectra system because it can be used on all areas of a tooth, even areas next to old fillings. Early disease detection is the key and can make a significant difference between patients needing extensive restoration of a tooth versus a surface filling only requiring minimal treatment.