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DR. RICK MARILL’S SYNOPSIS
I graduated in California State College in 1964 with a degree in Zoology. I was accepted to the University of the Pacific Dental School in San Francisco in 1964 and I graduated in 1968 with honors. I was made a member of the Tau Kappa Omega honor society. This honor was bestowed upon me for my clinical superiority.
I opened a dental practice some time in late 1968 with a class mate mine in Oakland, California. This was a temporary office while we both looked for offices that we wanted to permanently open in other areas of Northern California. I finally found a space in an office building in Alameda, California.
I have been married twice and have two children, Carrie and Jared, from my second wife. I am presently unmarried and living with a real hotty in Alameda.
I lived in Montclair, Oakland for 8 years and moved down to Alameda in the early 70’s. During the 70’s I discovered that the education I had the dental school was far short of the knowledge I needed to have to provide superior dentistry to my patients. For the next 10 years I studied Gnathology, which is the discipline of knowing how the jaw and the teeth interdigitate and function during normal and abnormal conditions. I was the President of the East Bay Gnathological Society during that time, and we had a group study club that met monthly to learn more about dental malocclusion and how to fix it.
Beside the study club, I attended many post graduate courses to fine tune my skills even more. During the late 1980’s dental bonding became the big ticket, and dentists were anxious to learn these new techniques. It was then, that I stopped using silver alloy in my office to fill teeth. Silver fillings have been used for over 200 plus years and millions of people have them in their mouth. There was a discovery made that mercury vapors, which can be toxic to the nervous system, came out of the fillings when people were chewing food. Even though, the ADA and the AMA said that silver fillings are safe and that the release of mercury vapors is negligible during, I felt that because mercury is considered a biohazard to began with, I decided not to place silver filling in patients mouths anymore. Today, with the ever increasing knowledge of composite materials and the techniques to bond them to the teeth, dentistry has an alternative to the use of silver fillings.
During this same time, between 1990 and 2000, I was focused on major cosmetic reconstruction of the teeth using porcelain. I spent many hours in classrooms and labs working on models to learn better ways to restore the teeth with porcelain materials. At the beginning of 2001 I purchased my first Laser to be used in the mouth on hard and soft structures (teeth, bone and gums). It was a Waterlase laser. This laser used the power of the Ng-Yag laser coupled with water to produce the energy needed to cut tissue and teeth without a drill. This represents less pain for the patient and quicker healing of the tissues due to the energy of the laser that stimulates the healing factors. Also during this time the of in office power bleaching made its debut. The process called Zoom (from Discus Dental) utilizes a special light to activate a proprietary gel that is placed on the teeth for a period of time, while the patients sits in the chair watching a movie with TV virtual glasses.
During 2003, I purchased another laser, called a diode. This laser enables me to due bloodless procedures during surgery, helps to coagulate bleeding gums, helps to treat infected gums due to periodontal disease and assists me during preparation of teeth for crowns and other prosthetic procedures.
During early 2008, I purchased a device that delivers anesthetic using a computer that measures the correct amount and places it around the individual teeth with a very small and sharp needle into the ligament that supports the roots of the teeth. This allows me to perform procedure on that tooth without any pain, and the patients are not numb on their face. They leave the office without that feeling of numbness and the felling that their face is swollen.
During my entire carrier as a dentist, my hygiene department has focused on treating periodontal diseases and preventing it from coming back. We have been using special micro sonic instruments to treat periodontal disease that focuses on non-surgical results. The newest attack we used in the mouth along with what we call root planning is the placement of powerful antibiotics into the deep pockets around certain teeth. This drug is called Arestin, and it helps to control the build up of bacteria in the pockets so that the gums can heal and stop bleeding.
Beginning this year, my office has begun implementing a program called the “Heart Healthy Dental Program”. This new treatment protocol focuses on certain tests that we give the patient that will show whether they may have medical conditions that require their personal physicians to look at. One test is for Diabetes, and the test focuses on the A1c reading for blood glucose. The second test is for cholesterol, and the third test is called hs-CRP (high sensitive C-Reactive Protein). This test is another indicator for inflammation. This inflammation could be caused from gum disease, diabetes, heart problems, cancers or any other diseases that might cause inflammation and infection. These tests are given to the patients to take home and perform on themselves. The tests are sent into a lab for them to analyze. The patient and the dentist get a report. The numbers are discussed with the patient and if elevated , the patients are referred to their
physicians for further diagnosis and treatment. If the patient has an active periodontal problem, where there is acute and chronic inflammation, we know that the hs-CRP will be elevated. After we treat the gum problems and feel that the problems with the gums are under control, we test again to check the hs-CRP level. If the hs-CRP level has reached a normal level we can assume that the inflammation that caused a rise in the hs-CRP level was attributed to the periodontal disease. If however, the hs-CRP remains above a normal level, there is probably some other systemic disease or condition that is causing this rise. The patient is advised to seek medical attention from their physicians to see if there are any underlying conditions that need attention.
Also, beginning this year we are looking at how nutrition effects healing and the health of the gum and bone. A company called Pharmaden, has developed a line of Neutraceuticals that aid in supplementing the patients diet to help strengthen the immune system and help build healthy bone a gum tissue. We make these supplements available to each patient who needs them . The success of treatment focused on controlling periodontal disease has four main components. One is the mechanical removal of built up tarter, calculus and plaque around the tooth and on the root surface. Also, the systematic removal of the diseased tissue that forms on the gums that surround the tooth and on the roots of the teeth below the gum line. The second factor in the success of gum treatment, is the patients ability to follow through with adequate home care. The third factor is the nutritional portion of periodontal health. If the patient is not eating the right foods and getting the correct amount of nutrition, the immune system will suffer and the health of the bone and tissues that support the teeth will not heal properly. That is why we make available neuticeuticals from Pharmaden to augment the patient’s diet and help maintain a healthy immune system. The fourth factor that insures continued oral health, is regular maintenance. This requires the patient to be responsible enough to see their dentist on a regular basis to have their teeth cleaned and examined.
In the future, more and more periodontal cases will be treated withlasers and the use of topically placed antibiotics. Dentistry is a very dynamic profession. The scientific community is constantly adding new and more sophisticated instruments to the dentists armamentarium. Some day a patient may be able to get a vaccine that will not only prevent decay but also help to prevent gum disease.
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