As a parent, may I be in the room when my child is being treated?

Generally, yes. We want parents to know what is happening to their child, and we understand that parents want to know this, too. In most cases we find the parent's presence helpful during treatment. In rare cases a child may be distracted from doing what we need of them by the presence of a parent, and in that case we will ask a parent to leave the room. We have a window in the rear wall of our operatories that a parent can then watch through to see what is going on. The rate we ask parents to leave the room is - no exaggeration - about once every 2 or 3 years.

Do you accept Medicaid dental coverage?

Currently, no. The Medicaid program, while well intended, comes nowhere close to covering our costs of providing services, putting it in the category of charitable care. When we provide charitable care to patients in need, we do so directly. In bypassing the State's inefficient Medicaid claims process, we can actually deliver charitable care more efficiently. We do try to connect people trying to use Medicaid coverage with clinics that accept Medicaid.

Do you accept my dental insurance?

Yes, with some exceptions. While we can bill most insurance companies on your behalf, the outcome of those claims will depend on your particular dental insurance program, its limitations and exclusions. We are not set up to bill Apple, Provider One, Molina or Medicaid.

Do you do tooth-colored fillings for back teeth?

Yes we do. Composite resin is the most common filling material used in the United States today, and is a vast improvement in appearance compared to the metal silver amalgam fillings that used to predominate. In the interest of full disclosure, composite fillings cost a bit more than silver amalgam and need to be replaced far more frequently than silver amalgam. They also have a reputation for causing teeth to be more sensitive than silver fillings do.

Do you still do silver metal fillings in back teeth?

Yes we do. There are 4 options for filling materials for back teeth. Most back teeth are filled these days with composite resin. Composite resin fillings are slightly more expensive than silver fillings, do not last nearly as long, and too frequently cause teeth to be sensitive after being filled. Inlays and onlays made of gold alloys or ceramics such as lithium disilicate are excellent options but are vastly more expensive than silver or composite resin fillings; as such, they are generally not covered by dental insurance. Silver fillings are unattractive, but provide the most years of service per dollar spent of any filling material.

Does your office do the new computer-designed, one appointment CEREC crowns?

Computer-aided design and manufacture (CAD/CAM) of dental crowns is an impressive technological advance. Once an image of a prepared, properly shaped tooth is captured with a specialized digital camera called a scanner, a computer guided milling machine can take a block of ceramic material and grind it into the shape needed to form a crown that fits the prepared tooth. Dental CAD/CAM systems can be purchased for in-office use by a dentist so that the crown is made right where the patient is seated, or they can be purchased by commercial dental laboratories, whose many dentist-customers can have CAD/CAM crowns made for their patients, but with a delay in getting the crown to the patient for delivery from the lab. Not surprisingly, CAD/CAM systems are very expensive to purchase. It is well known when a dentist purchases such a system how many crowns he will need to produce each month to pay for the system. This creates potential ethical dilemmas, in our view. The first is the case of a tooth that is borderline as to whether it needs a crown. Will the dentist be more likely to recommend a crown than not if he's making payments on a CAD/CAM system? The second is the removal of treatment options for the patient. If a crown could be made with a different material that would be better for the tooth but it is not a material the CAD/CAM system can mill, will the patient be offered the different material or the CAD/CAM crown? We do not do enough crowns per month in our office to consider purchasing a CAD/CAM system. Our dental laboratory (Chapman Dental Laboratory, University Place, WA) does have a CAD/CAM system, however. Matthew Chapman advises, "What is most important is the amount of data the CAD software is providing the CAM software and the number of axes (Ed.: plural of axis, not a wood chopping implement) the burs can move in and the number of burs used in the milling process. Our Weiland mill and 3Shape scanner and design software is superior to the CEREC (Ed.: the leading in-office system) on many levels" (personal communication, 1/25/2016).

How do acidic foods and drinks damage teeth?

First some background science. The pH scale measures how caustic chemicals are. Measured between the numbers 0 and 14, chemicals rating lower numbers are more strongly acidic; higher numbers reflect the opposite of acid, known as base, or alkaline. Chemicals in the middle, grading at number 7, are neutral, neither acid or alkaline. (Water is close to pH 7.) The scale is logarithmic: each number further away from 7 is 10 times stronger than the number closer to 7. Here's where it applies to teeth. The outer layer of teeth, known as enamel, starts to dissolve away at an acidic pH of 5.5 or lower. The pH of a typical soft drink is about 3.5, or 100 times more acidic than necessary to start to dissolve enamel. Coffee (fortunately) and tea are not highly acidic; sports and energy drinks and (sadly) white wine are. Foods known to be good for you, like some fruits, can be just as acidic as processed foods. Likely the strongest acid teeth encounter is not something eaten, but comes from the other direction - stomach acid. At pH 1, people with acid reflux may have extensive acid erosion of the teeth. Teeth worn by acid often look analogous to an ice cube that has had hot water poured on it.

How does your office stay current with advances in dentistry?

Continuing education classes are the primary way dentists stay current. A minimum number of hours of classes each year are required to maintain dental licensure in Washington state. Dr. Knox is a member of the Academy of General Dentistry, which requires more hours of education per year to hold membership than does the State of Washington. The staff at our office also attend a significant amount of continuing education classes each year. Some dentists will choose to form their own continuing education group, called a study club. Dr. Knox is a member of the Puyallup Valley Dental Study Group (graciously allowed to join even though his office is not in Puyallup!). Reading dental scientific journals is another source for learning, which is how Dr. Knox typically spends his lunch hours.

Frequently Asked Questions (FAQs)

FAQ Copy

When should I take my child to the dentist for the first time?
As a parent, may I be in the room when my child is being treated?
What is the best age for a child to get braces?
If a baby tooth has a cavity, does it have to get a filling?
Do you accept my dental insurance?
Do you accept Medicaid dental coverage?
What does teeth cleaning in the dental office do that brushing and flossing does not?
How often should I get my teeth cleaned at the dentist?
Should sealants be placed on my child's teeth?
How do acidic foods and drinks damage teeth?
Why is it that some people who take good care of their teeth still get a lot of dental problems?
How does your office stay current with advances in dentistry?
Why does your office only see patients four days a week?
Does your office do the new computer-designed, one appointment CEREC crowns?
What can I expect at a new patient examination?
Why are teeth whitening products obtained from the dental office better than those I can buy at the drug store?
What is the difference between a porcelain veneer and a crown?
If I am a new patient and am coming in with a dental emergency, is payment expected at the time of service?
Do you still do silver metal fillings in back teeth?
Do you do tooth-colored fillings for back teeth?

FAQ Categories

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Examinations
Diagnosis and Treatment
Emergencies
Pediatric Treatment
Periodontal Care
Teeth Whitening
Zirconia and Lithium Disilicate Crowns
Porcelain Veneers
Composite Resin Fillings
Silver Amalgam Fillings