May 26, 2020
link to facebook link to twitter
More Stories
The importance of building meaningful relationships as we age Fifteen-year cancer survivor Moving forward feeling good Five must dos when aging alone Four ways our world is better Be part of the solution, not the problem, with Covid-19 Protect yourself from COVID-19: Stop smoking and vaping now When hard things happen Gum disease and diabetes during the pandemic The spirit of Alzheimer’s learning Part II Two kinds of Coronavirus anxiety Halloween pirate’s gold Fall risks are sometimes simple, yet fatal Is multi-generational living for you? Correcting this faulty belief about COVID-19 will save lives Natural disaster threats call for preparedness plan to protect seniors The spirit of Alzheimer’s learning  Winter sun safety: What to know about protecting yourself during colder months Tending to spiritual distress with aging and illness Blood pressure control a focus of American Heart month Home your own way March is colorectal cancer awareness month Safety at home for seniors Prepareness plan to protect seniors Covid-19 and Mother's Day How to prevent bad breath War on opioids in California Help families make time for seniors during the holiday season Helping seniors with vision and hearing impairments Holiday stress-busters for harried caregivers It’s what’s inside that counts! Dental emergencies Don’t wait until it hurts! Does spring mean allergy season for you? Top 10 products to help seniors stay home How to take Tylenol safely The role companionship plays in aging 7 Tips to reduce the stress of incontinence caregiving Five best pet types for seniors Time for the yearly flu vaccine The state of Alzheimer’s and caregiving in the U.S. Three types of grief a care partner may encounter Improving the state of aging in America Fight flu this season by getting immunized Confirm your preparedness plans for Seniors Did you get your flu shot? If not why not? A message from the heart Using anxiety to your advantage Youth, women and dementia The long-reaching impact of dementia Children’s dental health month Ten tips for healthy aging Planning for aging at home Thirty-four years as a dentist Tooth friendly Easter tips Feeding my hungry heart How to keep older adults cool during the heat of the day Invisible braces work wonders Prosthetic joints and dentistry Avoiding spooky smiles this Halloween How to keep an aging adult’s blood pressure in the green zone Mother's gum disease linked to infant’s death Giving thanks The increasingly important role of caregivers Ten things you can do now to protect your five senses as you age Wonder what it’s like to lose your senses? The difference between seasonal flu and a pandemic respiratory virus Are glasses enough? Spotting common vision problems in older adults Senate passes Alzheimer’s and dementia research funding October’s most celebrated event Our Feelings Come From Our Beliefs Making sense of the season for seniors Cultures differ on what makes a beautiful smile! How to have a better year Falling in love is easy, but staying in love is very special A confession Women in dentistry Plan for where you want to age Three ways a senior can fund a home remodel Cannabis as medicine-Changing the face of aging May is skin cancer awareness month A brain is a reason to join the Alzheimer’s fight Recognizing and reporting elder abuse Dental technology- computers have changed our lives Create your personal Medicare account Understanding the aging brain Two ways to get your Medicare taken care of Are you stressed out? Seven ways seniors can interact with pets The joy of root canal therapy Lung cancer screening helps combat the #1 cancer killer in the nation Simple happiness hacks for caregivers Multiple sclerosis, an autoimmune disease Seniors and Diabetes What you need to know Let’s talk about guilt and the emotional journey of being a caregiver The wonders of a growth mindset Dealing with emotional storms Dealing with disappointment “Do this for me”: How to convince older loved ones to socially distance A new beginning How to know if you are in danger of compression fractures Psychology Today The Art of Resilience: I Have I Am…I Can The advantage of dental implants Too much of a good thing for seniors and the holidays What families’ caregivers need to know about Recommendations for screen time Resolutions for your oral health Super Bowl, Joe Montana and blood pressure Open heart surgery – Thoughts from the other side Chewing gum - Helpful or harmful? Five tips for a healthy smile I will– I should– I can– I’ll try Rightsizing for seniors doesn’t have to be painful The Joy of Sadness Human Touch: The role companionship plays in aging at home Becoming who we really want to be How to fail well Back to school with healthy teeth Five ways to manage caregiver guilt Senior dating – Mom’s new relationship is heating up... Should you be concerned? Aspirin relieves mild pain Fighting osteoporosis and preventing fall-related injuries Pets and seniors make the perfect pair Turn the page Anxiety: The real reason Mom won’t leave the house My prostate and thyroid cancer Oral piercings and your teeth Understanding senior care options Staying well and safe for the holidays Health habits for the new year New Year, new you: Practicing active aging in 2020 Spotting the signs of Alzheimer’s disease Sniffles and sneezes and fevers, oh my... The risk of isolation and loneliness from hearing loss Healthcare - this feeling has to change What the Coronavirus is teaching us COVID-19 update, What we know Covid -19  Walking in the wilderness Un-retiring in a changing economy Coping with the unpredictable life of caregiving Double duty tools: toothbrush and floss Merry Christmas and Happy New Year Tips for living with low vision  Keep your Medicare costs down The freedom and choice to again place at home Put dementia on the agenda for 2019 Free app shows what Medicare covers The reason “Four” is the magic number? Preventing tooth decay in children Laughter is the best medicine Sports mouth guards-keeping teeth safe  Help your senior loved one avoid preventable hospitalizations Tips for keeping calm in the midst of crisis  Five cybersecurity tips for older adults Preparing kids for first dental visits Dental treatment concerns with patients taking blood thinners Home Health Care vs. In-Home Care: What you need to know Three ways to lessen negative thinking Five ways our self-talk may be hurtful Is this Summer or Fall What can you do to help dad control his blood pressure? By this time you have learned... whether you’re 14 or 84… Controlling your holidays Your Medicare costs in 2020 Mind your mind Hints for a better life When we’re haunted by regret, we all have regrets. Some surprising discoveries on being optimistic Valentine’s Day befuddling First dental visit – Make it a good one! Unusual connection between your sense of taste and risk for disease Coronavirus, taking life for granted Tempted to go out? Here’s what family caregivers can do instead 4 ways to help Nurses during the Coronavirus Pandemic Amazing results with Arestin Navigating the aging journey Smoke and stress maintenance and recovery How to lower your surgery costs Know your pharmacist… Know your medicine as drug prices will jump in 2019 Influenza activity is increasing throughout California Show your kids’ teeth some love this Valentine’s Day! New life and stormy weather Your Medicare rights and protections Summer snacking and your child’s teeth Back to basics 10 summertime activities for seniors Three ways to boost your self-esteem Increasing West Nile Virus activity in Ca. Why are seniors targets for scams? Summer’s sun damages the skin Abscess gives warning 8 tips to minimize the behaviors of “Sundowning” Keeping your relationships fresh What are dental sealants? Suicide - Are there answers? Nothing is impossible Becoming optimistic in a chaotic world Entitlements - more money Your best Christmas gift? Suicide a growing epidemic What family caregivers need to know about Medicare changes Should you quit? Steps to help minimize wandering behavioral symptoms The Groundhog’s last plane ride Are you making yourself understood? Five tips to prepare for and reduce risk of illness in older adults Thriving in the new normal The impact of technology on vision loss Healthy eating habits can benefit you and your teeth How does the body heal? Apply or renew Covered Ca. Health insurance by Jan. 15 Guilt from holiday eating Toothbrush tips Three reasons for a root canal Seniors: Say no to “free” genetic tests Yoga for relaxation & healing What causes sensitive teeth to hurt All of us make mistakes  Heat and older adults Five tips to cope with caregiver anger Back to school health Real decisions and moderation Conscious Sedation Dentistry– No fear! Still time to change your Medicare health plan Dental emergencies can happen What Medicare does (and doesn’t) cover Weinstein, Sanders, Trump pleasing people? Rain is expected this week in NorCal, and I love gazing at it No Easter for America? Now We Get to Listen! Three gifts you can give yourself Don’t stress, clench or grind! Gratitude and positivity can inspire caregiver self-care Medicare helps seniors use opioids safely Is it elder abuse or neglect? Dental scanning technology improves dental care Using Medicare when on foreign land I slept in last Saturday! Always being bright may not be so bright Trying to save a knocked out permanent tooth Reduce senior fall risk Are glasses enough? Spotting common vision problems in older adults Kobe - preparing for shocking death Who will decide your death? Fear of losing loved ones may keep families from planning To vape or not to vape? What happens to our teeth and gums as we age? Reduce wear and tear As Autumn begins, a reminder flu season can hit seniors hard Overcoming fears surrounding End-of-Life care Important: women and periodontal health Americans unaware of potentially life-threatening skin cancer Sun protection tips for young children Some good news! Aging gracefully The better angels of our nature today Covid-19: We’ll find a way Cannabis symposium Sept. 19th The importance of immunization Returning home is bittersweet Kids who grind their teeth at night Covid-19 and churches shaking hands? Depression, heart disease, diabetes… Could it be low Vitamin D? Osteoporosis, osteonecrosis and dental health Living with Lupus Erythematosus Still time to change your Medicare health plan Teddies in the window How dentistry handles gastric reflux disease Use it or lose it- Muscle mass as you age  A free cheek swab test The value of calm in the midst of chaos Twice a victim Finding a path forward after an accident Use it or lose it- Muscle mass as you age  Managing your mental health with or without insurance coverage Why gardening is the most recommended exercise for seniors

If it is not broken, don’t fix it!

By: George Malkemus
August 17, 2018

“If it’s not broken, don’t fix it” is a good rule of thumb to live by; however, what should we do if something is broken? In the past, many dentists would simply fix the problem and go forward. In dentistry today, there is another movement that is gathering momentum around the world: Minimal Intervention.

Minimal Intervention Dental Philosophy

Minimal intervention is a treatment philosophy that promotes, “If it’s not broken, don’t fix it and if it is broken, find out why it is broken.” Then, form a treatment plan that involves the least amount of trauma to the patient and the patient’s healthy oral tissues. Minimal intervention’s basic goal is to conserve healthy tooth structure.

Catching treatment early is the best way to conserve teeth and gums.  Not being able to treat dental issues when they are in the early stages of disease has always bothered me. In the early stage, less treatment is typically necessary, which is better for the patient physically and emotionally, as well as financially. With the rapid advancements in technology, I now have many more methods to identify dental disease and fix it before it gets to the critical surgical stage.

Minimal intervention promotes the patient’s well-being through early identification, early intervention, minimal treatment and prevention.

At one time, dentistry was a “drill and fill” kind of treatment. Those days are gone. Now regular dental maintenance therapy is the goal.  Depending on one’s condition, a patient could have one to four or more check-ups and cleaning each year and take an active role in their own oral health care. Yes, that means those brushing and flossing routines for healthy people, but also an array of techniques and devices for improved home care, such as electric toothbrushes and tongue cleaners. It also means a good balanced diet. The minimal intervention philosophy believes that little changes in your behavior will have a big impact on your total health! 

New technologies

Dentists have many new techniques and equipment in their offices today that were only imagined as few as 10 years ago. These techniques are used to detect dental disease early, before it becomes critical. Today, we have the marvel of digital x-rays, digital photos, intraoral cameras, lasers, electric hand-pieces and fiber optics. Computers have moved from the receptionist’s desk to the exam room (in dentist terms called the “operatory” or “treatment room”). Computer technology is now a premier detection tool when used to show digital x-rays and digital photographs.  Computer software can manipulate the digital image to increase cavity detection. The image can be enlarged and then zoomed onto a specific area of concern. The contrast can be changed to improve cavity detection and the brightness and darkness of an image can be adjusted for better viewing. Dental x-rays also use 90 percent less radiation than traditional x-ray films, along with the added benefit of no need for toxic film development chemicals.

Cavity detection

For decades the primary instrument available to the dentist for detecting decay was the “dental explorer.” The dental explorer was poked into the grooves and pits in teeth, feeling for soft spots. Soft spots, which stick with an explorer, indicated that there was a deep cavity that had broken through the enamel of a tooth. Enamel is the outer hard protective coating around teeth; it is the second hardest substance in nature after diamonds. However, acid dissolves enamel and bacteria produce acid to break down enamel. Once through the enamel, the decaying bacteria penetrate to the live tissue inside the tooth, the dentinal pulp. Eventually if left untreated, the nerve becomes infected, causing pain and need for root canal therapy or an extraction. 

In the past, decay was not removed until it penetrated through the enamel. That is because amalgam fillings [made of half silver and half mercury] would have to have a large hole prepared in the tooth to allow them to lock into place and a substantial thickness to keep them from breaking.  A little cavity would need a large amount of drilling to make a hole big enough for an amalgam-filling placement. Now with the advent of tooth colored bonded fillings, less tooth structure is removed and the treatment is less invasive. Bonding is a way of gluing the filling to the tooth so the only drilling necessary is the decay removal. Therefore, it is better to catch the decay early while still just in the enamel. Unlike the internal dentin of the tooth, enamel has no nerve ending so usually numbing is not necessary for the bonded filling preparation and placement. 

Studies have shown that the sticking of the explorer from one tooth to the next is actually transferring decay and inoculating teeth that did not have decay before the explorer checking process began. Along with digital x-rays, decay in my practice is now detected using visual magnification with a video camera. With the video camera, I am able to inspect all the surfaces of the teeth, looking for darkness in the grooves and pits of the enamel. Thus, I am able to catch decay early and prevent its spread through preventive tooth colored fillings with minimal drilling.  The video camera has the added benefit of allowing patients to see the decay for themselves. 

Cavity detector dye                   

When cleaning out decay in a tooth with an instrument or with a burr in a dental drill, cavity detector dye can be placed on the tooth to identify if there is any remaining decay. The dye, which comes in green or red, sticks to only degraded collagen, which shows if any decay remains.  

In the past, dentists could only use vision to determine if all the decay was removed. However, often the dentine looks dark like decay but is actually only stained healthy dentine from a previous silver/mercury filling. By using cavity detector dye, tooth structure is preserved and the dark area is left alone. Also in the past, decay could be missed and left; whereas with cavity detector dye, the decay will stain, so will be found and then removed.

Preventive dentistry

The minimal invasive movement evaluates the whole person. If an individual has a cavity, it is important to determine why they have a cavity. When the reason for their cavity is identified, preventative measures can be recommended that will extend the life of their teeth.  Minimally invasive procedures help patients feel good about receiving dental treatment and create a new attitude about dental and oral health care.

So take advantage of preventive dentistry and the new non-invasive technologies. Even if you have waited too long, there is still hope! It is never too late to get into great dental health and begin a healthy maintenance program. With the use of modern dental methods, including conscious sedation [often called Sleep dentistry], it can all be done in complete comfort. 


George Malkemus has had a Family and Cosmetic Dental Practice in Rohnert Park at 2 Padre Parkway, Suite 200. Call 585-8595, or email info@  Visit Dr. Malkemus’ Web site at