Monday, December 10, 2012

Parents – How to make sure your kids are taking care of their braces

Parents – How to make sure your kids are taking care of their braces
More and more teens are getting braces than ever before. Braces are more than a means to a pretty smile. They set the stage for healthy teeth and gums for years to come. The thought of a healthy mouth makes it worth the cost of the braces. For the teen, however a healthy mouth many years down the road has little value when compared to the here and now. It is a parent’s responsibility to educate their teen on the proper care and maintenance of braces. While the braces are on, they do require special care. If the brackets are broken off due to negligence, you will be charged a fee to replace them. In addition, if your teen does not implement a teeth and gum cleaning regimen, then they will experience problems down the road.

If you are a teen who has braces, you know by now how important it is to take care of your braces, teeth and gums. It may seem like a never-ending ritual that takes way too much time, but in reality, it is a simple routine that is easy to implement.

Stepped up Brushing and Flossing Regimen - Orthodontic brushing and flossing is by far the important factor in caring for your mouth. Where you once brushed and flossed three times per day, you now need to brush after every meal and before going to bed. The metal brackets and wires are easy places for bacteria and plaque to hide and fester. The food particles eventually turn into cavities. Your orthodontist may recommend a 4% fluoride toothpaste instead of the regular toothpaste found at the grocery store. The additional fluoride assists in strengthening your teeth and avoiding cavities.

Increased Flossing
- Flossing is mandatory with teen braces. The only way to floss around the brackets is with floss threaders. They allow you to get the floss under the wires. Flossing needs to be done on a daily basis, no exceptions.

Foods to Avoid
– Teen braces are strong, but not unbreakable. They are designed to break off under certain conditions to protect the teeth. Because of this, certain foods need to be avoided when wearing braces. You don’t want to eat anything too sticky, such as taffy, or too crunchy, such a CornNuts. If you eat apples or carrots, cut them up into bite size pieces. Finally, chewing hard candy and gum is not allowed. If you are a teen who smokes, you will need to stop. Firstly because of the obvious health benefits of doing so and, secondly, because smoking discolors the teeth, but not the place where the bracket is. When the braces are removed, you could see little white squares on your teeth where the brackets were and yellowing where the brackets were not.

A little care will go a long way in keeping your teeth healthy.
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Thursday, November 1, 2012

Smoking and Your Teeth and Gums

Mothers have a hard enough time keeping a child’s hands clean, let alone caring for the little one’s teeth! It is difficult to know when is the right time to begin brushing your child’s teeth or even schedule the first visit with the dentist. Many parents make the mistake of thinking that their child is too young to see a dentist. Some children do not see a dentist until they enter school.

The fact is that you can begin training your children to become comfortable with brushing their teeth as early as a few months old. Infants should have their gums cleaned once per day either with a clean washcloth on the end of your finger or by using a gum cleaner specially made for infants. The baby will welcome the cleaning as it massages their tender gums and alleviates some of the pain associated with teething.

Brushing your child’s teeth on a regular basis lays the foundation for a lifelong routine of oral care. Just as it takes time to train a child to use the potty or wash their hands before eating, it takes time to instill healthy oral hygiene.

Most people think that gum disease only affects the elderly or people who do not brush their teeth. This is not accurate. Teens are at the same risk for gum disease as adults. In addition, brushing and flossing alone does not guarantee that you will not get gum disease. It is estimated that more than 75% of people have some form of gum disease and out of those, 90% have no symptoms to alert them that they have a problem.

Simply stated, gum disease, also known as periodontal disease, is an infection of the gums. The infection is specifically located in the small space between the tooth and gums. The disease attacks the area of the gum that attaches to your teeth and causes the gum line to break down. As the tissue breaks down, a pocket is formed. The worse the disease is, the deeper the pocket becomes. 

There are two stages of gum disease, gingivitis, and periodontitis. Gingivitis is a mild and reversible form of the disease. Gingivitis only affects the gums. Periodontitis is the advanced form of the disease that affects the gums, teeth, and bone. If left untreated, gum disease will cause the teeth to shift, and they may be need to be extracted. Serious cases of periodontital disease have been known to cause teeth to simply fall out!

A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of gum disease. Periodontists spend an additional three years studying the disease beyond what is required in dental school. 

The American Academy of Periodontology educates the public on the dangers of tobacco use and its effect on the gums. Along with the American Medical Association and the American heart Association, the American Academy of Periodontology has been educating people for years about the risks associated with tobacco use. Those risks include cancer, heart and lung disease, and low birth weight babies. Despite the risks that we all are aware of, people continue to smoke. There is another very good reason to quit smoking and that is your oral health. Smoking increases your risk for periodontal disease. 

The American Dental Association estimates that smoking and tobacco use may be responsible for more than 50% of the instances of periodontal disease. A study conducted by the American Academy of Periodontology found that smokers are more than 4 times at risk for periodontal disease than those who have never smoked. After quitting smoking for at least 10 years, former smoker’s chances of developing periodontal disease is about the same as those who have never smoked. Dentists agree that tobacco use is the single greatest preventable risk factor for gum disease. There has also been a direct link established between the number of cigarettes smoked per day and the chances of developing the disease, with those who smoke more than a pack per day at more than 7 times the risk for developing the disease. 

To increase the public’s awareness of the pitfalls associated with smoking, the American Cancer Association holds the Great American Smoke out each year. The goal is for everyone to quit smoking for one full day, and encourage others to do so as well. The hope is that this may be the first step in people quitting forever. 

Smokers are also at greater risk for developing a hard plaque on their teeth called calculus. The calculus can only be removed during a professional cleaning at your dentist’s office. If the calculus is not removed, it will cause your gums to pull away from your teeth. This leads to periodontal disease. 

In addition to smoking, chewing tobacco and cigars also produce the same negative effects on your teeth. If you are a tobacco user, it is important that you schedule regular checkups with your dentist. If you can quit, then that is the best way to save your teeth. 

Gum disease is treatable by either a general dentist or a periodontist. It is recommended that the least invasive method be chosen to treat periodontal disease. The treatment for gingivitis, the least severe form of gum disease, it a non-surgical treatment that includes scaling and cleaning of the teeth and root surfaces. This treatment cleans the tartar from the periodontal pockets. In most cases, this is the only treatment that is necessary, aside from ongoing maintenance to keep the disease from returning. 

If the gingivitis becomes full-blown periodontitis, then surgery is usually the next step. This step is recommended when the tissue around the teeth is not healthy and needs to be surgically corrected. The surgery aims to reduce pockets and lengthen the crown.

New Treatment Options
Periodontists are now using lasers to treat gum disease as a less invasive treatment. The laser result in less bleeding, swelling and a quicker recovery time than the other treatments available. Lasers can also be adjusted to treat both mild and advanced gum disease as well. There is also a treatment method that uses mouth trays, similar to the ones used in home teeth whitening.

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Monday, October 1, 2012

Pull or Save That Tooth?

You have a toothache, but you ignored it because you couldn’t find the money or the time to get it fixed. Before you knew it, your cavity will require some serious drilling. So now you are faced with the decision to pull or repair the tooth. There are several pros and cons associated with each.

Pulling the tooth

Pulling the tooth is the most affordable option. Extracting a tooth costs between $50-$200 to perform. Once it is pulled, problem gone. The problem with pulling the tooth is that it leaves a gap in your bite. Over time, the other teeth may shift and your bite will be affected. The alignment changes can have a substantial impact on your dental health. If the teeth shift substantially, it could also affect the look of your smile as well. Removing a single tooth has the ability to cause problems with chewing, speaking and overall jaw functioning. The gaps are also prone to trap food and grow bacteria that lead to tooth decay and gum disease. You can opt for a dental implant or other dental appliance down the road to replace the extracted tooth and keep the teeth from shifting.

Tooth extraction may be necessary if the tooth is gone beyond repair. If the tooth has an excessive amount of decay, then there may not be enough of it left to repair it after the decay is removed. If the tooth is cracked or broken, extraction may also be the best option.

Teeth with moderate to advanced gum disease usually have a compromised bone support and should be pulled and not repaired. As the gum disease worsens, the tooth will become loose so it makes sense to pull it. Teeth that are nonfunctional, such as wisdom teeth, are many times pulled and not repaired.

How is a tooth pulled?

The dentist numbs the area with a topical anesthetic and Novocaine. Laughing gas is also used to relax the patient. Using dental pliers, the dentist slowly pulls the tooth by rocking it back and forth. Once it is a little loose, he pulls a little harder and then POP! The tooth is out. After the tooth is extracted, the dentist will provide you with aftercare instructions. Usually, the first 24 hours after a tooth extraction you are instructed not to eat any solid food on the side of the mouth where the tooth was pulled. You are also required to gargle with salt water. If the gap begins to bleed, simply bite down on a piece of gauze to control the bleeding. Essentially, pulling a tooth is a routine procedure that usually requires only a day of downtime.

Whichever option you choose, you will need to find a good dentist. While all dentists are trained how to perform a repair and extraction, each dentist has their own methodology. Some dentists are very sympathetic to patient anxiety and pain management, while others prefer to perform them naturally whenever possible. Make an initial appointment to ask questions about the procedure and to get to know the dentist before having the procedure performed. If you are not comfortable with the dentist, get a second opinion. The decision to pull or save your tooth is very important and a dental professional can walk you through the process.
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Saturday, September 1, 2012

Cosmetic Dentistry Overview

You only have one chance to make a first impression. Since your smile is the first thing people usually notice about you, it can play a large part in your first impression. Unfortunately, for some people, their smile does not make the best first impression. Brushing and flossing does not always guarantee a perfect smile. Genetics, lifestyle habits such as smoking, and accidents can dramatically change the appearance of your teeth for the worse. Cosmetic dentistry can change the appearance of your smile so that you can make a good first impression.

At one time, cosmetic dentistry was not catered towards the average person.  The field of cosmetic dentistry has grown exponentially in recent years and is now attainable for many people.  As a society, we have become focused on our appearance and cosmetic dentistry is like a face-lift for your mouth. Whereas people once accepted the appearance of their teeth, they now feel empowered to change their appearance. No more is a perfect smile reserved for the rich and famous. In recent years, the cost has come down significantly, and more people are seeking out cosmetic services. In reaction to the growing desire for cosmetic dentistry services, there has been an increase in the number of dental practices devoted specifically to cosmetic procedures. While specialists are great, any dentist is qualified to perform the cosmetic dental services on the market today. 

Traditional dentistry is concerned with medically necessary services and focused on preventing tooth disease and decay. Cosmetic dentistry describes dental services that are not medically necessary to keep your teeth healthy. For example, drilling and filing a cavity is not considered cosmetic dentistry. If someone however wants their silver fillings replaced with white ones, then it is considered cosmetic dentistry because it is not a medically necessary service. Cosmetic dentistry improves the appearance of your teeth. People have cosmetic dentistry for varying reasons. Some are unhappy with their old metal fillings and want tooth colored ones. Others do not like their stained teeth or the gaps between them. Tooth whitening is the most common cosmetic dentistry procedures performed today.

Various types of cosmetic dentistry services

Composite Bonding
 - Bonding is typically used for chipped teeth. A material which looks and feels like enamel is used to fill the chip or crack. The composite material is shaped and then a high intensity light hardens the material. The result is a tooth that contains no evidence that a repair was performed.

Teeth whitening
 is the most common cosmetic dentistry service requested today. Teeth whitening removes stains that are a result of smoking, food, tea, and coffee. Stains resulting from poor oral hygiene are also treated with tooth whitening.

are thin, translucent overlays that are affixed to the surface of the tooth. The veneers are made of a composite or porcelain. Veneers cover up gaps between teeth and camouflage worn or damaged teeth.

Many patients opt for a full smile makeover.
 The makeover assesses your entire mouth and creates a plan to improve the overall appearance. Makeovers may involve veneers, teeth whitening and gum treatments.
The cost of cosmetic dentistry varies greatly. Some dentists offer low cost dentistry, while others change a premium based on their experience and expertise in this area. The materials used in the treatment also affect the cost. For example, crowns can be made over silver or gold.

If you are considering cosmetic dentistry, it is important to research the various procedures that are available. For example, you can opt for veneers or crowns on your front teeth. You can do a one step tooth whitening or one that takes a couple of treatments. You should also consider the risks involved with any procedure you are considering. Do your research and develop a short list of questions to ask the dentist and discuss the pros and cons of cosmetic dentistry.

Finally, consider the cost. Can you afford the procedures that you are seeking? Will you pay cash or charge it on a credit card? Almost all dentists offer in house financing which is a better option than using a credit card. Weigh the costs against the long term benefits. 

If you are unhappy with your smile, there is no need to live with it. Cosmetic dentistry has improved the mouths of thousands of patients. Take the first step by making an appointment with your dentist to discuss how you can have the smile of your dreams.

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Wednesday, August 1, 2012

Maintaining healthy teeth and gums is easier than you think

Many people assume that gum disease is reserved for people who do not brush and care for their teeth. This cannot be farther from the truth. Gum disease can be present in a seemingly healthy mouth, and takes millions of American by surprise each year.

While gum disease can occur at any age, by age 34, 6 out of 8 people develop gum disease in one form or another. Most people use pain as an indication of a tooth problem. Gum disease however, is virtually painless. If not treated, gum disease leads to complete tooth loss and irreversible gum and bone loss. Gum disease is characterized into two stages;  gingivitis and periodontitis. 

 - Gingivitis occurs when the gums become inflamed. It is caused primarily by bacteria that develops and festers in the plaque on the teeth. The mouth contains more bacteria than any other part of the body. There are more bacteria in the human mouth than in a dog’s mouth.  While it is the job of the saliva to break down bacteria, the enzymes cannot get rid of all of it. It is the bacteria that forms a film of plaque on the tooth surface.

Regular brushing and flossing removes plaque. Dentists recommend brushing 2-3 times per day and after every meal. Brushing regularly is easy if you keep a toothbrush and toothpaste with you. There are also new disposable tooth cleaning items on the market that make brushing on the go easy. Flossing is also made easy with disposable floss picks that are mint flavored as well!

Smoking cigarettes and chewing tobacco both contain nicotine and will lead to gum disease over time. When you smoke, calculus forms on your teeth that regular brushing and flossing will not remove. Your dentist is the only person that can remove calculus during a professional cleaning. If it is not removed, then it creates a gap between the tooth and the gum, where bacteria forms and gingivitis develops. 

As easy as Gingivitis is to get, it is just as easy to remove. A simple treatment at your dentist’s office combined with regular brushing and flossing at home will eradicate Gingivitis completely. 

 - Periodontitis, simply stated, is the result of untreated gingivitis. While Gingivitis is gum inflammation, Periodontitis is a gum infection. Periodontitis cannot be controlled or eradicated with regular brushing. Periodontitis can only be cured by removing the calculus that has accumulated around the teeth. The cause of the infection is enough to make you feel sick to your stomach. The bacteria in the calculus produce waste matter. This biological waste creates toxins that deteriorate the gum line and form pockets around the teeth, where the infection develops. The infection is painless and continues to progress unnoticed. Periodontal treatment consists of scaling treatments that are performed over several visits. If left untreated, Periodontitis will progress to advanced stages, where the only treatment is a surgical procedure designed to remove the affected gum tissue, and uncover the tooth structure. The dentist will clean the tooth and remove any remaining plaque and calculus. If the disease has affected the bone, the area may require a bone graft and surgical placement of the remaining tissue.

Gum disease usually affects more than one tooth, and sometimes all of them. The scary part about gum disease is that seemingly healthy teeth can be riddled with gum disease. X-rays and a thorough exam will quickly uncover gum disease at even the earliest stages. 

Once your gum disease is removed, regular brushing and flossing will keep it from returning. You dentist may require a few follow up visits to ensure that the gums have return to their normal position and the gaps are gone. 

 The best way to avoid gum disease and to maintain healthy teeth and gums is to see your dentist regularly. The American Dental Association recommends regular checkups twice per year to keep your teeth healthy. The regular checkups allow the dentist to recognize tooth decay, gum disease and other oral issues before they become full-blown cavities or periodontal disease.

Provided by: The Online Practice

Sunday, July 1, 2012

Tooth Replacement Options

At one time in their lives, most people will be in need of a tooth replacement. You may be considering a tooth replacement option due to dental decay, an accident that has broken the tooth, or simply to change the appearance of your smile. Tooth replacement has come a long way in recent years. The technology and materials used offer the patient a variety of options to consider. The three options for tooth replacement are a bridge, a removable appliance, and dental implants. Each option has benefits and considerations.

Bridges – At one time, bridges were the best option for restoring missing teeth. A bridge is created by filing down the two teeth on either side of the missing tooth, and then fabricating a bridge, which consists of three crowns that act as a bridge across the gap. The bridge is made by using a dental impression of the teeth before filing them down. The advantage of bridges are that they are permanent and durable. The feel like your own teeth and completely hide the missing tooth. In most cases, you cannot tell the difference between a bridge and natural teeth. The downside to this method is that it requires that two healthy teeth be filed down to accommodate the bridge. As dentists are in the business of saving teeth, dental implants are preferred by dentists if possible.

The advantages of a bridge are that it is fixed, stable, and feels like your own teeth. In most cases, the bridge looks just like you never had a tooth missing. The disadvantage is that you have to file down the two teeth on either side of the missing tooth. These teeth in most cases need to be perfectly sound with nothing wrong.

Removable Appliance – Removable appliances come in a variety of options. A ‘dental flipper’ is simply a piece of durable plastic attached to a false tooth. A Nesbit is a more substantial, durable acrylic over metal partial denture. Removable appliances are a more cost effective option than a bridge or dental implant, but not as cost effective as not replacing the tooth altogether. Removable appliances can replace one or more teeth. They are not as natural looking as a bridge or dental implant. Removable appliances are not as sturdy as a bridge or implant, and may be uncomfortable. Removable appliances are recommended when the teeth on either side of the missing tooth are not healthy.

Dental Implant – Dental professionals have hailed dental implants as the best treatment option when replacing missing teeth. The procedure is considered both cosmetic dentistry and prosthetic dentistry. As the procedure has gained acceptance within the dental industry, it is covered by most dental insurance plans as a necessity and not an optional treatment. A dental implant is essentially an artificial root that is affixed to the jaw. The tooth is affixed to the implant. Structurally, implants are the closest thing to growing a new tooth.

Dental implants are the most durable and effective option for replacing teeth. The greatest disadvantages to dental implants are the cost and time involved with the procedure. Out of the three options considered, dental implants are the most expensive, with the costs varying depending on where you live and the experience of the dentist. The procedure requires that you work with one dentist who performs the surgery of affixing the root to the jawbone and another who will make the implant and affix it to the root. There is also a healing period required, which lasts about two months between the time the root is established and the new tooth is being affixed.  Since they are permanent and the most durable option available, implants are a great investment, if you can afford it.

Not replacing the tooth- There are many people who opt not to replace the missing tooth. This may be the most affordable option, but it causes the most long-term damage to your mouth. Teeth provide natural spacers in your mouth. When a tooth is missing, the other teeth will eventually shift. The long-term effects can cause your bite to substantially change. If enough teeth move, you may need to correct your bite later on with dentures or braces. Finally, the greatest drawback to not replacing the missing teeth is that the jawbone will eventually shrink and deteriorate in the spot where the tooth is missing. Upon an exam and x-rays, your dentist can determine the best options for your situation. Not everyone is a good candidate for some procedures and only a dental professional can make the determination.

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Monday, June 4, 2012

The ABCs of tooth whitening

Hollywood movie and rock stars always have the whitest teeth around. Their teeth are usually so white that they shimmer. When it was first introduced, teeth whitening was very expensive and available to those with a lot of money to spend. Those of us who could not afford a professional whitening treatment opted for at home whitening kits instead.

As long as you choose the correct whitening method for your individual situation, tooth whitening works. Just about all patients see a moderate to substantial improvement in the color of their teeth. Tooth whitening is not a permanent solution however. With maintenance and touch up sessions, you can keep your smile white and bright for an extended period of time.

What Causes Tooth Stains?

Everyone is susceptible to tooth stains. Some stains are avoidable and others are not. What this means for the average person is that sometimes changes in lifestyle can greatly improve the appearance of your teeth. Before considering a tooth whitening option, the cause of your stains should be examined.

Age – The older your teeth are, the more susceptible your teeth are to stains. First, teeth naturally darken because of every day wear and tear. In addition, stains from everyday occurrences, such as drinking coffee, tend to accumulate. What this means is that children and teenagers will see the least dramatic results from a tooth whitening treatment. During the twenties, the teeth begin to have a yellow tint to them. As the years pass, the teeth become dull, and discolored despite frequent brushings and the elimination of coffee and smoking.

Natural tooth color- We are all born with a unique tooth color. Some people are fortunate enough to be born with the whitest of white teeth, with others falling within a spectrum of yellow and gray.

Translucency and thinness – While all teeth are translucent to some degree, there is a spectrum of translucency. The more translucent your teeth are, the less pigment they have. Those who lack pigment in their teeth will not have a substantial response to whitening treatments. Those with naturally thick and opaque teeth, by design, are brighter and more responsive to bleaching treatments.

The food you eat – It is no secret that the food you eat affects your teeth. Food and drinks with deep color tend to leave stains behind on your teeth. For example, red wine, colas, tea, coffee, and carrots will stain the teeth. Eating highly acidic foods such as citrus fruits will wear down the enamel over time, making teeth more susceptible to stains.

Smoking – This one is a no brainer. Use tobacco products and your teeth will be yellow. Enough said.

Prescription drugs/ Chemicals – It is a little known fact that too much fluoride causes a condition called fluorosis that discolors teeth. Many antibiotics will also adversely affect the color of the teeth as well. Children who are chronically ill and are treated with high amounts of certain antibiotics and medications will experience a noticeable change in their tooth color.

Bleaching or whitening?
There is a difference between teeth whitening and bleaching the teeth. The FDA restricts using the term bleaching to instances when the teeth are being whitened beyond their natural color. Bleaching applies to most products that contain bleach, hydrogen peroxide, or carbamide peroxide.

Tooth whitening is used when the teeth are restored to their natural color by removing stains and debris from the tooth’s surface. This would technically classify brushing your teeth as whitening. It logically follows then that any product that works like toothpaste is a whitener.

Many times the terms whitening and bleaching are used interchangeably, even when describing products that contain bleach. This is probably because bleaching carries a negative connotation, which causes the consumer to believe that the bleaching process is harsh on the teeth. This is not true however. The color of the teeth begins to change most dramatically with bleaching treatments, but the treatments themselves are safe for teeth.

People start out life with shiny bright smiles. The tooth enamel is designed to act as a protective layer against bacteria, decay, and stains. Over time, the enamel is worn down and it becomes less protective and more transparent. It is this transparency that allows the tooth’s yellow core material (dentin) to be visible. Once the enamel is compromised, microscopic cracks allow debris to accumulate, and stains on the teeth are the result. This is why teeth become dull as the years progress. Tooth whitening removes the stains.

Which is better, at home or professional whitening?

The professional treatments are done with a special whitening solution and an ultraviolet light. The cost ranges from between $400-$800, depending on where you have the procedure performed. Recently, mall kiosks have been popping up that offer teeth whitening for $199, with no appointment necessary. We have certainly come a long way!

The at home kits range from the ones you purchase at the local grocery store for $25 to $99 that you can purchase on the internet or from your dentist. Home whitening kits consist of trays with whitening solution that you wear over your teeth each night. The grocery store kits are even more convenient as the whitening agent is on a strip that sticks to your teeth. With those, you can whiten your teeth on the way to work, and then easily discard the strip in a trashcan.

What could be easier?

While the at home and in office procedures are both very effective, they are not for everyone. For example, if you have severely discolored teeth due to years of smoking and coffee stains, then the in office laser-whitening treatment will produce the best results for you. If you have everyday stains on your teeth, the at home kits will work for you.

Unsure which treatment is right for you? Your dentist can tell you which treatment will produce the best results for your teeth. The best time to assess your tooth color is right after a cleaning at your dentist’s office.

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Friday, May 4, 2012

Life Style Diseases & Dental Health

Definition of Lifestyle Disease: A disease associated with the way a person lives. Lifestyle diseases include atherosclerosis, heart disease, and stroke, obesity and type 2 diabetes; and diseases associated with smoking, alcohol and drug abuse. Regular physical activity helps prevent obesity, heart disease, hypertension, diabetes, colon cancer, and premature mortality.

A recent disclosure by the World Health Organization (WHO) stated that 4.4 million people die due to raised cholesterol levels, 7.1 million people die because of hypertension, 4.9 million people die from tobacco use, and 2.6 million people die as a result of being overweight or obese. Lack of sleep leads to an increased production of the hormone ghrelin, which stimulates appetite. A recent study showed that sleep-deprived individuals eat more sweet, salty, and starchy foods.

Dentally speaking the same life style factors that contribute to heart attack, stroke, diabetes, and hypertension also contribute to the two primary dental diseases: caries and periodontitis. Over eating, (frequent snacking), poor choice of foods (sugar, soda pop), lack of exercise (as in oral hygiene exercise), self neglect, smoking, drug abuse, failure to obtain professional care and failure to follow wise council (advice) all contribute to dental disease. Dental disease doesn't start in the mouth. It starts in the mind.

According to a recent joint media briefing sponsored by the American Medical Association and American Dental Association, there is a predominance of epidemiological evidence showing a two way association between oral health and systemic health. The strongest evidence shows people with diabetes have more severe periodontal disease, and once they have periodontal disease, their diabetes gets worse.

Ask your dentist for advice on developing a dentally healthy lifestyle. I'm confident they will promote a smart diet, good oral hygiene, and regular professional care. A positive lifestyle is paramount and will help you to live a longer, healthier, more rewarding life.

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Monday, April 2, 2012

Xylitol Gum for Prevention of Cavities

921 children (aged 3-6 years) attending daycare centers in Finland were randomly assigned to receive xylitol chewing gum (one piece, three times a day, each chewed for 5-10 minutes, for a total of 2.5 g/day of xylitol) or to brush their teeth after lunch. The respective treatments were continued for periods of one to three years, with one to four months off during the summers. At age nine years, the proportion of children who were cavity-free was 57% in the xylitol group, compared with 49% in the brushing group (p < 0.05). No significant difference between groups was seen at ages three or seven years.

Comment: These results indicate that regular chewing of xylitol-containing gum is at least as effective as tooth brushing for the prevention of dental caries (or cavities) in children aged 3-6 years. Xylitol is a non-nutritive sweetener that has been demonstrated in several studies to help prevent the development of dental caries. The anti-caries effect of xylitol is presumably related to its capacity to inhibit the growth of Streptococcus mutans, a component of mouth flora that has been implicated in the pathogenesis of caries. The beneficial effect of xylitol chewing gum appears to be most pronounced for teeth that erupt after the commencement of gum chewing, as opposed to teeth that are already present when the child starts using the gum. One study has demonstrated that mothers can prevent the development of dental caries in their children by chewing xylitol gum, beginning three months after the birth of the baby until the child is two years old.

Kovari H, et al. Use of xylitol chewing gum in daycare centers: a follow-up study in Savonlinna, Finland. Acta Odontol Scand 2003;61:367-370.
source: Alan R. Gaby
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Thursday, March 1, 2012

Making the Most of Your Dental Insurance

     Most people take full advantage of their medical and vision insurance. They know the policy’s limits, coverage, and deductibles. Dental insurance is not usually thought about until the person has a toothache or other dental issue. This thinking usually causes people not to fully take advantage of their dental benefits each year. This behavior also causes dental patients to not understand their plan benefits. It is important to know exactly what your dental benefits are. The easiest way to determine coverage and to understand the applicable deductibles is to call the dental insurance company. They will give you a snapshot and summary of the plan benefits.

     As with other forms of insurance, annual deductibles apply to most dental insurance plans. For example, the plan year runs from January 1st, through December 31st. There is a $600 deductible for the plan year. This means that the first $600 is paid by the patient. Once the $600 deductible is met, then the plan benefits apply. If you have met your deductible in July for example, it is wise to get as much dental work as possible completed before December 31st , as there will be a new $600 deductible come January 1st. Many dentists are motivated to begin major dental treatments at the end of the plan year to take advantage of the fact that the full deductible has already been utilized for that plan year. Some dentist offices review each patient’s file at the end of each year to assist the patient in taking full advantage of their plan benefits before they expire.

     Most dental insurance plans have a predetermined number of included services per year. For example, a standard dental plan includes two cleanings per year. If you do not have these cleaning completed by December 31st, you lose them. Other similar services include x-rays and gum treatments. Again, use them or lose them!

     Aside from all the great services that you will be losing out on at the end of each plan year, the best reason to use your dental coverage is that it will keep your teeth and gums healthy. The reasoning behind the insurance company offering these services at no cost is to encourage you to get into your dentist’s office on a regular basis. Doing this ensures that cavities and other problems will be caught quickly and not turn into major dental repairs down the road.

It is recommended that each year you develop a strategy for your dental care. First, become the expert on your dental insurance. You should know your plan’s coverage prior to making an appointment with the dentist. This will ensure that you can resolve any coverage misunderstandings with the dental staff quickly. Your dental coverage also consists of more than seeing a general dentist. Most plans cover a visit to the specialist for oral surgery and various conditions of the mouth. Orthodontic coverage is not limited to teens and children. If you are unhappy with the appearance of your teeth, learn what types of services are covered under your dental plan. You may be surprised at the amount of coverage you have and the innovative options that exist for orthodontic services. Most patients are not aware that many orthodontic services are considered necessary and not cosmetic procedures.

     Second, schedule your routine cleanings and checkups at the beginning of each plan year. Dentists are one of the few professionals that are comfortable scheduling appointments months in advance. Finally, if you believe that you have an issue with your teeth, make an appointment before the issue becomes a full-blown problem. As you are responsible for the deductible, catching problems while they are small will mean less money out of your pocket. Your dentist has a vested interest in your teeth. It is his/her goal to keep your teeth healthy and keep you smiling.

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Thursday, February 2, 2012

Oral Cancer and Dentistry

When a patient goes to the dentist for a checkup, the last thing he wants to think about is serious illness. Many people think that worrying about decay and periodontal disease is quite enough.
Nevertheless, the mouth is a complicated place. While there are pathological processes unique to the mouth, many diseases not generally thought of as "oral" may also occur or manifest themselves in this location. One such disease is cancer. There are nearly 30,000 new cases of oral cancer each year in the United States, and eight thousand people die each year (2-3% of cancer deaths). 1-3 For all the advances of modern medicine, five-year survival has changed little in several decades.1-3
The risk factors are well known, and have been for years. Tobacco use, alcohol, and chronic sun exposure are all associated with oral cancer. Most victims are male and over 40 years old.
2-3 People who both use tobacco and drink are at much greater risk than those who have only one of these risk factors.4 It should be noted that smokeless tobacco appears to be no safer to the mouth than smoking. Smokeless tobacco has gotten increasing attention as it has become more popular.5 Chronic irritation from ill-fitting dentures and human papilloma virus have also been implicated.
Since early oral cancers are painless, they may be easily overlooked. According to James Sciubba, professor of Oral and Maxillofacial Pathology, SUNY Stony Brook, "Pre-cancers and early stage oral cancers cannot be adequately identified by visual inspection and may easily be overlooked and neglected even by highly trained professionals with broad experience."
Patients who do not receive regular dental care may never have their mouths examined for signs of cancer, and even those who have regular care may never have an adequate screening. The American Cancer Society observed as long ago as 1967 that:
"the dentist too frequently looks only at the patient's teeth; the otolaryngologist, pediatrician, and general practitioner tend to concentrate on the tonsils; the internist on the tongue; and the general surgeon on the thyroid, lateral part of the neck, and lower lip. The angle of the mandible is the “no man's land” in which all these specialties converge, none as yet having staked out a valid claim. Nor has any specialty laid claim to the extracranial head and neck as a whole."

The US Department of Health and Human Services, in its program Healthy People 2010, has a reduced mortality rate from oropharyngeal cancers as one of its objectives.10 Dentists thus must be professionally responsible for providing a comprehensive oral cancer examination for their patients.11,12 There is evidence that recent dental school graduates are more likely to screen for oral cancer risk factors and are more likely to conduct regular oral cancer examinations.13 Screening for risk factors and preventive measures, such as counseling patients regarding the use of tobacco and alcohol, may be even more important than efforts aimed at early detection.14 This counseling may be difficult for dentists who have historically felt unprepared to provide tobacco or alcohol cessation education.13
In May of this year, Surgeon General David Satcher released Oral Health in America: A Report of the Surgeon General. It is likely these services may be more easily implemented by referral to appropriate health care facilities.
15 The report found a large disparity in awareness of important oral health issues between different racial and socioeconomic groups. Minorities and the poor were found to be more poorly informed regarding oral health and its implications for general health. This had led to a "silent epidemic" of oral disease among the poor. The Surgeon General called for action to promote access to oral health care for all. Satcher's findings are borne out by the significantly higher mortality rates from oral cancer in blacks, when compared with whites.
Increased vigilance of dentists, combined with the acknowledgement of the importance of all aspects of oral care by both health care workers and patients, will go a long way toward decreasing the toll taken by this terrible, largely preventable disease.

1. Greenlee RT, Murray T, Bolden S, Wingo PA. Cancer statistics, 2000. CA Cancer J Clin 2000;50:7-33
2. Silverman S. Oral cancer. 4th ed. American Cancer Society. St. Louis: Mosby-Year Book; 1998:1-6
3. Swango PA Cancers of the oral cavity and pharynx in the United States: an epidemiologic overview. J Public Health Dent 1996;56(6):309-18
4. Mashberg A, Samit A. Early diagnosis of asymptomatic oral and oropharyngeal squamous cancers. CA Cancer J Clin 1995;45(6):328-51
5.ADA news release--Oral Lesions from Smokeless Tobacco Dissipate after Stopping Use of Tobacco Products, Study Concludes: July 1999
6. Maden C, Beckmann AM, Thomas DB, et al. Human papilloma viruses, herpes simplex viruses, and the risk of oral cancer in men. Am. J Epidemiol 1992;135(10):1093-102
7. Fouret P, Monceaux G. Teman S, Lacourreye L, St. Guily JL. Human papillomavirus in head and neck squamous cell carcinomas in nonsmokers. Arch Otolaryngol Head Neck Surg 1997;123(5):513-6
8. ADA news release--New Oral Cancer Scanner May Help Save Lives, Study Says: October 1999 |
9. American Cancer Society: The paradox of oral cancer. Brochure, 1967.
10. U.S. Department of Health and Human Services. Healthy people 2010, conference edition. Washington: U.S. Department of Health and Human Services; 2000:3-16-17
11. Horowitz AM, Goodman HS, Yellowitz JA, Nourjah PA The need for health promotion in oral cancer prevention and early detection. J Public Health Dent 1996;56(6):319-30
12. Meskin LH. Do it or lose it (editorial). JADA 1997;128:1058-60
13. Horowitz, AM, Drury, TF, Goodman, HS, Yellowitz, JA Oral Pharyngeal Cancer Prevention and Early Detection: Dentist' Opinions and Practices, JADA April 2000
source: Mark Bornfeld

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