As Covid cases climb, testing options grow. Here’s a look at what’s new.

If you are exposed to someone with Covid-19 and want to know if you caught it, your choices are much better than just a few months ago. You can go to urgent cares, retail pharmacies, doctors’ offices and private laboratories for a variety of tests and rapid results – a critical expansion of choices at a time when new cases are spiking in Florida and the U.S.

The state has ditched the slow-processing labs, secured quicker tests and cut wait times from the early months of the pandemic. Floridians will now find a range of choices on places to go, types of tests, and turnaround speed.

Earlier this week, Alex Morton found out at 5 p.m. his roommate had tested positive for the virus, and wanted to know if he could go to work the next day. Morton rushed to a nearby Fort Lauderdale urgent clinic open until 9 p.m., took a coronavirus test and learned he was negative the next morning. “It was a relief,” he said.

No appointment required

Many urgent care centers in South Florida offer evening hours for testing. Holy Cross Hospital operates urgent care centers in Fort Lauderdale and Coral Springs and says patients can get results with 8 to 10 hours.

If you’d rather test yourself at home, Quest Diagnostics and Labcorp, two of the nation’s biggest laboratories, will deliver collection kits to take a sample and send it back for processing. Quest charges $119 for the test.

Costco offers its members do-it-yourself Covid-19 tests that involve spitting into a small tube and sending it to a lab. For $129.99, you’ll get results 24-72 hours after the lab gets the test. For $10 more, you can get results 24-48 hours after the test arrives at the lab.

If you prefer drive-thru testing, Walmart, Walgreens and CVS, have it available at certain South Florida locations.

CVS Minute Clinics have begun to offer rapid tests with 30-minute results, but so far the nine Florida locations are in the central area of the state and the pharmacy hasn’t announced when they will be available in South Florida.

The state continues to run numerous walk-up and drive-thru testing sites in Palm Beach, Broward and Miami-Dade. Many are open seven days a week, but all close by 6 p.m. and some much earlier. Appointments are not required but some locations make them available.

Currently, the Hard Rock Stadium in North Miami-Dade County is the busiest, but not nearly as bad as the early days. “Anyone who wants a test can get one. We are not seeing the challenges of when we first started,” said Mike Jachle, chair of the Florida Association of Public Information Officers, which supports the state at the test sites.

Some cities like Miramar also have opened their own free test sites. Miramar’s self-administered saliva test given at Miramar Regional Park has a 48 hour turnaround time.

Anyone can get tested, for free

In most cases, you do not have to pay for a

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What’s It Like To Visit the Dentist During the Pandemic?

Health

I never feared going to have my teeth cleaned. Then the pandemic hit.


dentist chair

Photo via Getty Images

Way back when, during the simpler days of December, I made a routine appointment for a teeth cleaning. It was the sort of thing I didn’t think twice about at the time, but as the months raced by it began to take on the outsize importance of an existential question: Was I willing to risk getting COVID-19, or giving it to those around me, in the name of improving my gum health? I was caught between two poles: the knowledge that Massachusetts had one of the lowest transmission rates in the country, and my sheer horror—after months holed up at home without going anywhere unless my mouth remained duly covered—of sitting in an enclosed space with a stranger while my jaws hung open for 20 minutes straight.

As the date rapidly approached in mid-August, I leaned toward canceling. It just didn’t seem worth it, but then my dentist’s office called and walked me through the prescreening protocol. It was the same list of hygiene-theater questions we’ve all heard—Had I been running a fever? Had I been around anyone who’d tested positive?—and so forth, as though there is anyone in America this net would catch. Either you’re asymptomatic and have no idea you’re infected, or you’re a buffoon or someone who doesn’t care about other people’s safety, in which case the screening probably won’t be enough to stop you. At the end of the call, though, the scheduler caught me off-guard with six little words: “So, are you going to come?” I was still unsure: Six months into this pandemic, I remained utterly incapable of assessing risk meaningfully. Was a dentist’s office safe? As much as I fear the consequences of not getting my teeth cleaned, maybe it really wasn’t that important. Or maybe it was just important enough.

It’s the sort of constant decision-making paralysis so many of us have suffered during quarantine, and could be the reason why a a recent survey done by the American Dental Association found that less than 36 percent of Massachusetts dentists reported experiencing business as usual in August. But for me, it was combined with my lifelong struggle to make choices with the best possible outcome for the highest number of people. If you read that sentence and thought, “That sounds like it would lead to you never making a decision,” you are correct. It is a horrible way to live, and I don’t recommend it. During the pandemic alone, I have argued with myself over everything from whether shopping online or in person is more ethical to whether I could justify visiting the library. Having lived inside this particular mind for a good long time, though, I have developed an important strategy: I let myself go down whatever feverish neural pathways my brain decides are

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COVID-19 in Illinois updates: Here’s what’s happening Friday

The county warning list, which the state Department of Public Health issues weekly, includes Kane, McHenry and Will counties, which all came under stricter state regulations Friday aimed at slowing the spread of the novel coronavirus.

Officials also reported 82,256 new tests in the last 24 hours. The seven-day statewide positivity rate is 5.6%.

That case count of 4,942 tops the previous record of 4,554 new cases set just six days earlier and came as new restrictions, including a renewed prohibition on indoor dining and bar service, took effect in southern Illinois and a wide swath of suburban Chicago.

In addition, the city will again prohibit indoor service at traditional taverns and brewery taprooms that don’t have food licenses, and asked residents to cap any social gatherings at six people starting Friday.

Here’s what’s happening Friday with COVID-19 in the Chicago area and Illinois:

8:25 p.m.: Illinois hits another sad COVID-19 milestone — 5,000 deaths in long-term care — as cases rise

Illinois long-term care facilities are experiencing their biggest jump in COVID-19 cases in months, as the state passed a tragic milestone: 5,000 deaths among residents.

In the past week, Illinois recorded more than 1,400 new COVID-19 infections among residents in nursing homes, assisted living centers and other large, congregate-care facilities, according to the weekly data released by the state.

That’s the highest one-week tally since early June. The weekly tally was also notably larger than the roughly 1,100 new cases seen the week prior, and the nearly 650 cases in the week before that.

Deaths of residents climbed too: another 131 in the past week. That followed tallies the past two weeks of 96 and 95 deaths, respectively, which already was much higher than the 55 deaths seen three weeks ago.

The latest spike put the death toll in long-term care facilities at 5,019, accounting for more than half of the total statewide toll of 9,418 COVID-19 fatalities, as of Friday.

7:10 p.m.: CPS, teachers union both say other side won’t engage on school reopening plans

The Chicago Teachers Union, which has raised serious concerns about plans to resume in-person classes next quarter, has filed a new unfair labor practice charge, accusing Chicago Public Schools and Mayor Lori Lightfoot of illegally refusing to bargain over reopening and safety protocols.

“Our youngest and most medically vulnerable students deserve safety, yet that is exactly what CPS refuses to take steps to document or guarantee,” said CTU Vice President Stacy Davis Gates on Friday.

District spokeswoman Emily Bolton, however, said CPS is working with the union and will continue to do so “in the hopes they engage as productive partners and help us lift up the students and families who need our collective support.”

“We are disheartened that CTU continues to obstruct and mislead the public about the necessary planning measures needed to prepare for a potential return to safe in-person learning,” Bolton said.

As tension builds over the murky plan for next quarter, the union and the district still seem

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What’s A ‘Holiday Bubble Checklist’? Baylor College Releases COVID-19 Advice For Christmas

Doctors fear that the most wonderful time of the year may become the most dangerous amid the coronavirus pandemic. However, creating a “holiday bubble checklist” may be the answer to saving the 2020 holiday season.

Dr. James McDeavitt, the senior vice president and dean of clinical affairs at the Baylor College of Medicine in Houston, has created a “holiday bubble checklist” that will lower the chance of family gatherings turning into superspreader events, NBC News reports.

For families to have a safe holiday season, experts are advising them to choose a “bubble commissioner” that will responsible for making sure the family members who plan to attend the holiday gathering follow whatever guidelines are put in place.

However, the person must take the role seriously and cannot do it halfway. “There is harm in that. It gives a false sense of security,” McDeavitt explained.

The checklist recommends that each member of the family gets a flu shot as soon as possible. “This will decrease the likelihood of developing a flu-related illness around holiday time, which could disrupt your plans,” he stated.

Attendees should also self-quarantine 14 days before the holiday if possible. McDeavitt provided a solid template on what should be included in every holiday bubble checklist. He even added that travelers should wear goggles or face shields in addition to regular masks. 

He suggested that the more detailed a list is, the higher the chance families will feel comfortable “co-mingling, singing songs, laughing — all the things you like to do during the holidays.”

Meanwhile, Dr. Leana Wen, an emergency physician, recommended hosting the holiday gathering outdoors. Wen noted that logical thinking tends to go out the window when it comes to seeing loved ones as threats to another’s health. 

“We know that up to 50 percent of people who are spreading coronavirus may not have symptoms,” she said.

“There is this magical thinking that occurs with our loved ones, but we need to be aware that our family and friends are just as likely to have coronavirus as strangers.”

Christian Gaza resident Hanadi Missak adjusts the ornaments on her Christmas tree at her home in Gaza City, but she could not travel to Bethlehem this year as Israeli authorities did not grant a permit in time Christian Gaza resident Hanadi Missak adjusts the ornaments on her Christmas tree at her home in Gaza City, but she could not travel to Bethlehem this year as Israeli authorities did not grant a permit in time Photo: AFP / MAHMUD HAMS

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The Trump Administration Shut a Vaccine Safety Office Last Year. What’s the Plan Now?

As the first coronavirus vaccines arrive in the coming year, government researchers will face a monumental challenge: monitoring the health of hundreds of millions of Americans to ensure the vaccines don’t cause harm.

Purely by chance, thousands of vaccinated people will have heart attacks, strokes and other illnesses shortly after the injections. Sorting out whether the vaccines had anything to do with their ailments will be a thorny problem, requiring a vast, coordinated effort by state and federal agencies, hospitals, drug makers and insurers to discern patterns in a flood of data. Findings will need to be clearly communicated to a distrustful public swamped with disinformation.

For now, Operation Warp Speed, created by the Trump administration to spearhead development of coronavirus vaccines and treatments, is focused on getting vaccines through clinical trials in record time and manufacturing them quickly.

The next job will be to monitor the safety of vaccines once they’re in widespread use. But the administration last year quietly disbanded the office with the expertise for exactly this job. Its elimination has left that long-term safety effort for coronavirus vaccines fragmented among federal agencies, with no central leadership, experts say.

“We’re behind the eight ball,” said Daniel Salmon, who served as the director of vaccine safety in that office from 2007 to 2012, overseeing coordination during the H1N1 flu pandemic in 2009. ”We don’t even know who’s in charge.”

An H.H.S. spokeswoman declined to answer detailed questions about why the vaccine office, set up in 1987, was closed or how the health agencies were planning to track the safety of vaccines once they are injected into millions of people. In a brief statement, she said that Operation Warp Speed was working closely with the Centers for Disease Control and Prevention “to synchronize the IT systems” involved in monitoring vaccine safety data.

Scientists at the C.D.C. and the Food and Drug Administration have decades of experience tracking the long-term safety of vaccines. They’ve created powerful computer programs that can analyze large databases.

“It’s like satellites looking at the weather,” said Dr. Bruce Gellin, the president of the Sabin Vaccine Institute, who headed the National Vaccine Program Office from 2002 to 2017.

But monitoring hundreds of millions of Americans who may get different coronavirus vaccines from a variety of drug makers by summer is like tracking a major storm beyond anything researchers have dealt with before.

The closest parallel was in the spring of 2009, when a new strain of H1N1 influenza emerged, and researchers raced to make a vaccine. From October 2009 to January 2010, it was administered to over 82 million people in the United States.

As the vaccine was developed, Dr. Gellin and other federal officials and scientists organized a system to monitor the population for severe side effects and to promptly share results with the public. Eleven years later, it looks like the lessons of 2009 are being forgotten, experts say.

“We got all these different agencies together, we created governance around it, we created a

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Obamacare Open Enrollment Starts Nov 1. Here’s What’s Changing This Year : Shots

Open enrollment is about to start for those buying private insurance off state or federal exchanges.

PhotoAlto/Frederic Cirou/Getty Images/PhotoAlto


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Open enrollment is about to start for those buying private insurance off state or federal exchanges.

PhotoAlto/Frederic Cirou/Getty Images/PhotoAlto

Facing a pandemic, record unemployment and unknown future costs for COVID-19 treatments, health insurers selling Affordable Care Act plans to individuals reacted by lowering rates in some areas and, overall, issuing only modest premium increases for 2021.

“What’s been fascinating is that carriers in general are not projecting much impact from the pandemic for their 2021 premium rates,” said Sabrina Corlette, a research professor at the Center on Health Insurance Reforms at Georgetown University in Washington, D.C.

Although final rates have yet to be analyzed in all states, those who study the market say the premium increases they have seen to date will be in the low single digits — and decreases are not uncommon.

That’s good news for the more than 10 million Americans who purchase their own ACA health insurance through federal and state marketplaces. The federal market, which serves 36 states, opens for 2021 enrollment Nov. 1, with sign-up season ending Dec. 15. Some of the 14 states and the District of Columbia that operate their own markets have longer enrollment periods.

The flip side of flat or declining premiums is that some consumers who qualify for subsidies to help them purchase coverage may also see a reduction in that aid. Subsidies are determined by a mix of a consumer’s income and the cost of a benchmark plan.

Here are a few things to know about 2021 coverage:

It might cost about the same this year — or even less.

Despite the ongoing debate about the ACA — compounded by a Supreme Court challenge brought by 20 Republican states and supported by the Trump administration — enrollment and premium prices are not forecast to shift much.

“It’s the third year in a row with premiums staying pretty stable,” said Louise Norris, an insurance broker in Colorado who follows rates nationwide and writes about insurance trends. “We’ve seen modest rate changes and influx of new insurers.”

That relative stability followed ups and downs, with the last big increases coming in 2018, partly in response to the Trump administration cutting some payments to insurers.

Those increases priced out some enrollees, particularly people who don’t qualify for subsidies, which are tied both to income and the cost of premiums. ACA enrollment has fallen since its peak in 2016.

Charles Gaba, a web developer who has since late 2013 tracked enrollment data in the ACA on his ACASignups.net website, follows premium changes based on filings with state regulators. Each summer, insurers must file their proposed rates for the following year with states, which have varying oversight powers.

Gaba said the average requested increase next year nationwide is 2.1%. When he looked at 18 states for which regulators have approved insurers’ requested rates, the percentage is lower

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What’s Best for Treating Bipolar Disorder? | Health News

By Alan Mozes
HealthDay Reporter

(HealthDay)

MONDAY, Oct. 19, 2020 (HealthDay News) — Combining medication with group or family-based therapy gives patients struggling with bipolar disorder their best shot at living stable lives, a new review suggests.

“People with bipolar disorder have significant mood swings, from periods of depression to mania,” explained study author David Miklowitz, a professor of psychiatry with UCLA’s David Geffen School of Medicine’s Semel Institute for Neuroscience and Behavior.

“These episodes can last anywhere from a few days to weeks” before patients enter a so-called “recovery period,” Miklowitz explained. That is the point at which “people gradually stabilize in mood and try to return to their day-to-day responsibilities,” he said.

During recovery, some patients simply continue to receive psychiatric monitoring while taking medication, which typically involves mood stabilizers and antipsychotic drugs.

However, recovery can also be the ideal time to begin therapy alongside medications, Miklowitz noted.

And after comparing the effectiveness of medication alone against medication plus therapy, Miklowitz’s review concluded that more is more: Patients fared better at keeping mania and depression at bay through a combination of medication and therapy.

That was particularly true when therapy was conducted in a group setting or with family members.

The finding made sense to Dr.Timothy Sullivan, chair of psychiatry and behavioral sciences at Staten Island University Hospital in New York City. He noted that most other studies “show that combining some form of psycho-therapy treatment with medications results in improved outcomes.” Sullivan wasn’t involved in the new research.

Miklowitz and colleagues reported their findings Oct. 14 in the journal JAMA Psychiatry.

Miklowitz noted that among bipolar patients depressive symptoms include low mood, sadness, inertia, fatigue, loss of interests in things, suicidal thoughts or attempts, and/or insomnia.

On the other hand, when bipolar patients experience mania, that can take the form of intense periods of excitement, euphoria, severe irritability with little need for sleep, increased energy and activity, and/or rapid-fire thinking and speech. It may also involve “grandiose thinking,” such as believing one is famous or endowed with “special powers.”

The review focused on 36 investigations involving adults and three involving adolescents, with a combined total of nearly 3,900 bipolar patients. Collectively the average age was about 37, with women accounting for roughly 60% of the patients.

Prior to each study launch, participants had already been taking medications for their bipolar disorder. In turn, some were randomly assigned to just stick with their prior care (with psychiatric support and monitoring). Others, however, were randomly assigned to participate in individual therapy, therapy involving family members or group therapy (without the involvement of close family members).

Broadly speaking, the various forms of therapy all aimed to help patients develop skills to manage their disorder, including how to maintain regular sleep patterns and how to stabilize depression or mania when symptoms arose.

All the studies tracked patient histories for a minimum of one year on, making note of all recurrences of mania and depression, alongside therapy drop-out rates.

The upshot:

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What’s the Difference Between a Dentist and an Orthodontist? Part 2

This follows on from a previous article explaining the simple difference between dentists and orthodontists in terms of other subjects like doctors and surgeons and police officers and detectives. This article outlines the types of work that dentists and orthodontists do.

Years ago, hundreds of years ago, dentistry was a fairly unsophisticated subject. It required good physical skill, but the range of treatments available was fairly small – if your tooth was badly hurting, you saw someone to take it out. There weren’t any anaesthetics, so if you were lucky, the dentist took out the tooth quickly, and it didn’t break on the way out, and it didn’t hurt too much, and if you were very lucky he took out the correct tooth first time.

There wasn’t the option of modern fillings or root treatments, or gum treatments. There weren’t even antibiotic medicines to stop infections and abscesses. In fact, dental infections were a significant cause of death in the middle ages. Back then, a lot of dentistry, like a lot of surgery, was carried out by barbers, who had a good collection of blades and steel instruments.

Eventually dentistry moved on. More treatments were developed and some teeth could be saved. Advances in anaesthetics meant that more work could be done on teeth without upsetting the patients. After a while examinations were brought in to make sure that the people carrying out dentistry were fit to do so and this helped protect the public from poor dentists.

Over the years dentistry became even more advanced. Nowadays, a dentist would leave dental school and expect to know about:

  • Fillings
  • Crowns
  • Bridges
  • Veneers
  • Tooth whitening
  • Implants
  • Root treatments
  • Gum diseases
  • Jaw muscle problems
  • Problems involving the lining of the mouth, including the tongue, and including monitoring for mouth cancer
  • Dentures
  • Dental Surgery
  • Children’s dentistry
  • Orthodontics
  • Dental X-Rays
  • Medical problems related to dentistry
  • Dental problems related to medicine
  • Medications needed to treat dental problems

That’s a lot to stay on top of, and it also is a lot of instruments to keep in order to provide all of these treatments, so many dentists tend to concentrate on the areas that interest them most. The area I know best is orthodontics, and here are some of the areas of orthodontics that orthodontists need to think about when planning, organising, and carrying out treatment for a patient:

  • Invisible braces (like INVISALIGN))
  • Tooth coloured braces (like DAMON CLEAR)
  • Metal Fixed Braces (train tracks like DAMON Q or MX)
  • Lingual Braces (Braces on the inside of the teeth)
  • Removable braces
  • Retainer braces
  • Twin block braces
  • Headgear braces
  • Developing teeth
  • Extra teeth (supernumerary teeth)
  • Missing teeth
  • Teeth with abnormal roots
  • Teeth in an abnormal position
  • Abnormal jaw bone
  • Abnormal tooth shape
  • Abnormal jaw sizes
  • Abnormal gums
  • How the growth of the face and jaws will affect the treatment
  • How to tell if a patient’s face is still growing
  • If the patient needs surgery for the teeth
  • If the patient needs surgery for the jaws
  • If the patient
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Direct Primary Care and Concierge Medicine – What’s the Difference?

The Difference Between Concierge Medicine and Direct Primary Care

Direct primary care (DPC) is a term often linked to its companion in health care, ‘concierge medicine.’ Although the two terms are similar and belong to the same family, concierge medicine is a term that fully embraces or ‘includes’ many different health care delivery models, direct primary care being one of them.

Similarities

DPC practices, similar in philosophy to their concierge medicine lineage – bypass insurance and go for a more ‘direct’ financial relationship with patients and also provide comprehensive care and preventive services for an affordable fee. However, DPC is only one branch in the family tree of concierge medicine.

DPC, like concierge health care practices, remove many of the financial barriers to ‘accessing’ care whenever care is needed. There are no insurance co-pays, deductibles or co-insurance fees. DPC practices also do not typically accept insurance payments, thus avoiding the overhead and complexity of maintaining relationships with insurers, which can consume as much as $0.40 of each medical dollar spent (See Sources Below).

Differences

According to sources (see below) DPC is a ‘mass-market variant of concierge medicine, distinguished by its low prices.’ Simply stated, the biggest difference between ‘direct primary care’ and retainer based practices is that DPC takes a low, flat rate fee whereas omodels, (although plans may vary by practice) – usually charge an annual retainer fee and promise more ‘access’ to the doctor.

According to Concierge Medicine Today (MDNewsToday), the first official news outlet for this marketplace, both health care delivery models are providing affordable, cost-effective health care to thousands of patients across the U.S. MDNewsToday is also the only known organization that is officially tracking and collecting data on these practices and the physicians — including the precise number of concierge physicians and practices throughout the U.S.

“This primary care business model [direct primary care] gives these type of providers the time to deliver more personalized care to their patients and pursue a comprehensive medical home approach,” said Norm Wu, CEO of Qliance Medical Management based in Seattle, Washington. “One in which the provider’s incentives are fully aligned with the patient’s incentives.”

References and Sources

“Doc This Way!: Tech-Savvy Patients and Pros Work Up Healthcare 2.0”. New York Post. 4/7/2009.

Who Killed Marcus Welby? from Seattle’s The Stranger, 1/23/2008

“Direct Medical Practice – The Uninsured Solution to the Primary Medical Care Mess” with Dr. Garrison Bliss (Qliance Medical Group of WA).

“Direct Primary Care: A New Brew In Seattle”. Harvard Medical School – WebWeekly. 2008-03-03.

DPCare.org

Qliance.com

ConciergeMedicineToday.com

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What’s the Best Way to Discover a Great Cosmetic Dentist?

It is imperative to choose the right cosmetic dentist to get your desired results. Since cosmetic dentistry is not officially recognized in the field of dentistry, any dentist can consider himself/herself as a cosmetic dentist. In general, all dentists learn how to perform different procedures in the area of cosmetic dentistry, but to be able to accomplish a higher level of expertise, they need to go through years of extensive learning and training.

Ask for Recommendations

Ask friends, family members or coworkers if they can recommend a good cosmetic dentist. When they do refer someone, check the website of the doctor, contact the office or visit for a preliminary consultation. You can also ask for referrals from other dentists you know.

Look at Their Work

Majority of dentists who carry out cosmetic dental procedures take pride in what they do, so they document their work by taking before and after pictures. Usually, these photos can be viewed online or in an album at the dentist’s clinic. As a warning, make sure that the photos being shown are real patients of the dentist being considered, and not pictures that are commercially produced.

Check on Their Credentials

Even though a certain dentist is highly recommended and shows beautiful pictures of his/her work, you still want to ensure that he/she has the qualifications needed. Check the prospective doctor’s website to know the school he/she graduated from, the continuing education courses that were completed, as well as the professional organizations in which he/she is a member. The cosmetic dentists that are highly qualified are part of the American Academy of Cosmetic Dentistry.

Make Your Wish List

It is crucial to decide on the things you want to fix about your smile prior to your initial consultation with a cosmetic dentist. Take a look at yourself, then make a list. This way, once you have chosen your cosmetic dentist, you can present your wish list for comparison with the suggestions of your dentist.

Express Your Desire

When it comes to enhancing a smile, it is important for a person to have his own view of what looks good to achieve satisfying results. The art of “smile enhancement” depends on the ability of a dentist to incorporate a person’s own opinion of what is important with the application of the dentist’s scientific knowledge to smile design. Since your dentist is professionally trained and experienced, he can see dental possibilities better than you do. So, it is his/her duty to teach you so you can come up with your own choices. At the same time, you should be confident that your dentist considers the results you want to achieve.

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