Advanced Family Dental

Mom's kiss can spread cavities to baby

2011-01-30T14:38:00.000-08:00

A kiss on the mouth or sharing utensils can transmit bacteria

When Rachel Sarah took her daughter in for her first dental checkup a few years ago, she got a surprise. Not only did her 24-month-old have two cavities in her baby teeth, the pediatric dentist suggested she might have “caught” them from her mom.

“The dentist handed me this piece of paper that talked about saliva transfer,” said Sarah, a 37-year-old writer from San Francisco. “It said not to share cups or utensils or food and said, ‘No kissing your kid on the lips.’ I was shocked; I’d been taking a bite of food and then giving her a bite since she started eating. I told the dentist I’d never heard of this and he said these were new findings.”

As it turns out, studies about the transmission of cavity-causing bacteria from mom to baby have been published for 30 years. The primary culprit is Streptococcus mutans, a bacteria that can pass from person to person through the transfer of saliva, such as sharing utensils, blowing on food, and yes, even kissing that sweet little bundle of joy on the mouth.

According to a 2008 study in Pediatric Dentistry, “strong evidence demonstrated that mothers are a primary source of MS [mutans streptococci] colonization of their children; a few investigations showed other potential sources … notably fathers.”

“There have been many, many studies,” said Dr. Jane Soxman, a pediatric dentist from Allison Park, Pa. “It’s well-documented. You can’t blame it all on kissing a child on the lips — that’s one of several different factors that would have to be working together. But the main thing to know is that tooth decay is a bacterial infection and you can spread it from one person to another during the window of infectivity, which is during infancy and especially during the time of tooth eruption. That’s when the teeth are most vulnerable. It’s as if you had a bad cold and were kissing your child, you would spread the cold virus.”

Only parents (or caregivers) with active tooth decay can spread the Streptococcus mutans bacteria through the transfer of saliva. And Soxman stressed that the transmission of bacteria-laden saliva is just one piece of the puzzle. Tooth decay is caused by a combination of factors, including the transfer of infectious saliva, genetics, oral hygiene, and feeding practices, such as letting your baby constantly suck on a sippy cup full of juice or milk or other sugar-laden liquid. (Bacteria uses the sugar to produce acid, which breaks down enamel.) Baby teeth are particularly vulnerable to decay.

“When teeth first come into the mouth, when they first erupt, the enamel is very soft,” said Soxman. “They’re brand new virgin surfaces and are very susceptible.”

But the decay won’t just impact baby teeth. If the bacteria are allowed to thrive, Soxman said, they will colonize and stick around for years, attacking the permanent teeth when they come in.

The American Academy of Pediatric Dentistry recommends that parents have their child evaluated by a dentist when the first tooth erupts, or no later than their first birthday.

Chew Xylitol gum
Luckily, there are preventative measures that can help kick the bacteria to the curb. A January 2010 study in the Journal of Dental Research found that the children of moms who chewed Xylitol gum (starting in the sixth month of pregnancy) “were significantly less likely to show MS colonization.”

“If a woman is decay-active, she should be chewing Xylitol in the third trimester so when the baby’s born, the chance of transmission of decay-causing bacteria will be reduced,” said Soxman. “She should also have her teeth cleaned thoroughly during the second and third trimester.”

Cutting back on saliva-transferring behaviors — such as utensil-sharing, toothbrush sharing, blowing on baby’s food, pre-chewing baby’s food and cleaning off the pacifier with your own mouth — will also help.

But some say that’s easier said than done.

“It’s one thing to tell parents who have active decay to be extra cautious, and it’s something to be aware of for the rest of us, but I don’t think I’d be able to completely eliminate those behaviors,” said Marcy Hogan, a 29-year-old stay-at-home mom from San Jose, Calif. “They’re very natural behaviors and actions. I don’t want to avoid kissing my son and I don’t know how I’d get around blowing on his food. Sometimes it’s too hot and kids are not very patient.”

Dr. Stephanie Su, a pediatric dentist and mother of two from Redmond, Wash., said she tries to stress preventative measures as much as possible since saliva transfer between parent and child is almost “unavoidable.”

“When you look at a lab test, yes, there’s transfer of bacteria, but in real life, you’re not going to be able prevent that. You can’t live in a bubble,” she said. “But you can maintain good hygiene practices and a good diet, and the parents can take care of their own oral health and focus on preventative care like flossing and dental checkups and chewing Xylitol gum if they’re at high risk for decay.”

Both dentists also point to a surefire workaround.

“You could do just about everything as long as you wipe that baby’s mouth out repeatedly with a clean wet cloth,” said Soxman. “I tell parents to wipe the baby’s mouth out as often as they change the diaper. Wipe the tongue, the teeth, and the cheeks from infancy on. Then the colonies of bacteria won’t be established.”

Tooth Decay to Be a Thing of the Past?

2011-01-22T10:31:00.000-08:00

Tooth Decay to Be a Thing of the Past? Enzyme Responsible for Dental Plaque Sticking to Teeth Deciphered

ScienceDaily (Dec. 4, 2010) — The Groningen professors Bauke Dijkstra and Lubbert Dijkhuizen have deciphered the structure and functional mechanism of the glucansucrase enzyme that is responsible for dental plaque sticking to teeth. This knowledge will stimulate the identification of substances that inhibit the enzyme. Just add that substance to toothpaste, or even sweets, and caries will be a thing of the past.

The results of the research have been published in the journal Proceedings of the National Academy of Sciences (PNAS). The University of Groningen researchers analysed glucansucrase from the lactic acid bacterium Lactobacillus reuteri, which is present in the human mouth and digestive tract. The bacteria use the glucansucrase enzyme to convert sugar from food into long, sticky sugar chains. They use this glue to attach themselves to tooth enamel. The main cause of tooth decay, the bacterium Streptococcus mutans, also uses this enzyme. Once attached to tooth enamel, these bacteria ferment sugars releasing acids that dissolve the calcium in teeth. This is how caries develops.

Three dimensional structure

Using protein crystallography, the researchers were able to elucidate the three dimensional (3D) structure of the enzyme. The Groningen researchers are the first to succeed in crystallizing glucansucrase. The crystal structure has revealed that the folding mechanism of the protein is unique. The various domains of the enzyme are not formed from a single, linear amino acid chain but from two parts that assemble via a U-shaped structure of the chain; this is the first report on such a folding mechanism in the literature.

Functional mechanism

The unravelling of the 3D structure provided the researchers with detailed insight into the functional mechanism of the enzyme. The enzyme splits sucrose into fructose and glucose and then adds the glucose molecule to a growing sugar chain. Thus far the scientific community assumed that both processes were performed by different parts of the enzyme. However, the model created by the Groningen researchers has revealed that both activities occur in the same active site of the enzyme.

Inhibitors

Dijkhuizen expects that specific inhibitors for the glucansucrase enzyme may help to prevent attachment of the bacteria to the tooth enamel. Information about the structure and functional mechanism of the enzyme is crucial for developing such inhibitors. Thus far, such research has not been successful, states Dijkhuizen: 'The various inhibitors studied not only blocked the glucansucrase, but also the digestive enzyme amylase in our saliva, which is needed to degrade starch.'

Evolution

The crystal structure also provides an explanation for this double inhibition. The data published by the Groningen scientists shows that glucansucrase proteins most likely evolved from amylase enzymes that degrade starch. 'We already knew that the two enzymes were similar', says Dijkhuizen, 'but the crystal structure revealed that the active sites are virtually identical. Future inhibitors thus need to be directed towards very specific targets because both enzymes are evolutionary closely related.'

Toothpaste and sweets

Dijkhuizen points out that in future glucansucrase inhibitors may be added to toothpaste and mouthwash. 'But it may even be possible to add them to sweets', he suggests. 'An inhibitor might prevent that sugars released in the mouth cause damage.' However, Dijkhuizen doesn't expect that toothbrushes have had their day: 'it will always be necessary to clean your teeth.'

Fluoride Facts from the American Dental Hygienists’ Association

2011-01-06T13:32:00.000-08:00

Fluorine, from which fluoride is derived, is the 13th most abundant element and is released into the environment naturally in both water and air.
Fluoride is naturally present in all water. Community water fluoridation is the addition of fluoride to adjust the natural fluoride concentration of a community's water supply to the level recommended for optimal dental health, approximately 1.0 ppm (parts per million). One ppm is the equivalent of 1 mg/L, or 1 inch in 16 miles.
Community water fluoridation is an effective, safe, and inexpensive way to prevent tooth decay. Fluoridation benefits Americans of all ages and socioeconomic status.
Children and adults who are at low risk of dental decay can stay cavity-free through frequent exposure to small amounts of fluoride. This is best gained by drinking fluoridated water and using a fluoride toothpaste twice daily.
Children and adults at high risk of dental decay may benefit from using additional fluoride products, including dietary supplements (for children who do not have adequate levels of fluoride in their drinking water), mouthrinses, and professionally applied gels and varnishes.
Good scientific evidence supports the use of community water fluoridation and the use of fluoride dental products for preventing tooth decay for both children and adults.
Adjusting the level of fluoride in drinking water first used fluoride as a preventative for tooth decay in Grand Rapids, Michigan. Fluoridation of drinking water has been used successfully in the United States for more than 50 years.
Fluoridation of community water has been credited with reducing tooth decay by 50% - 60% in the United States since World War II. More recent estimates of this effect show decay reduction at 18% - 40%, which reflects that even in communities that are not optimally fluoridated, people are receiving some benefits from other sources (e.g., bottled beverages, toothpaste).
Fluoride's main effect occurs after the tooth has erupted above the gum. This topical effect happens when small amounts of fluoride are maintained in the mouth in saliva and dental plaque.
Fluoride works by stopping or even reversing the tooth decay process. It keeps the tooth enamel strong and solid by preventing the loss of (and enhancing the re-attachment of) important minerals from the tooth enamel.
Of the 50 largest cities in the United States, 43 have community water fluoridation. Fluoridation reaches 62% of the population through public water supplies, more than 144 million people.
Water fluoridation costs, on average, 72 cents per person per year in U.S. communities.
Consumption of fluids--water, soft drinks, and juice--accounts for approximately 75 percent of fluoride intake in the United States.
Children under age six years may develop enamel fluorosis if they ingest more fluoride than needed. Enamel fluorosis is a chalk-like discoloration (white spots) of tooth enamel. A common source of extra fluoride is unsupervised use of toothpaste in very young children.
Fluoride also benefits adults, decreasing the risk of cavities at the root surface as well as the enamel crown. Use of fluoridated water and fluoride dental products will help people maintain oral health and keep more permanent teeth.

Wisdom Teeth and Periodontal Disease

2011-01-06T13:13:00.000-08:00

Retention of visible third molars makes people more susceptible to periodontal disease around the second molar in middle age and later, according to research published in the Journal of Oral and Maxillofacial Surgery. Adults aged 52–74 who had had their “wisdom teeth” removed were one-and-a-half times less likely to have periodontal disease at that site.

The study subjects were 6,793 people from Maryland, North Carolina, and Minnesota who were already participating in a dental substudy of an atherosclerosis risk investigation. Researchers from the University of North Carolina at Chapel Hill probed subjects’ third molars (if present) and/or adjacent second molars. A probing depth greater than 5 mm and attachment loss of 2 mm or more on the distal of the second molar or around the third molar was considered disease. Gingival bleeding on the adjacent second molar was noted as well.

Probing depths of 5 mm and greater were 1.5 times more frequent in those who had retained their third molars. Gingival bleeding was 1.3 times more frequent in that group. The researchers encourage further investigations to support the negative effects of retaining third molars.

How to Choose the Right Toothpaste

2011-01-06T13:05:00.000-08:00

Just the number of options you have when you buy a tube of toothpaste can be overwhelming. When it comes to choosing the best toothpaste for you, it's important to think about your unique oral health needs.

The basics

Common toothpaste ingredients include:

- Abrasive agents- Scratchy materials help remove food, bacteria, and some stains from your teeth.

- Flavoring- Artificial sweeteners are often added to toothpaste to make them taste better.

- Humectants for moisture retention- these substances prevent the toothpaste from drying out.

- Thickeners- Agents that add thickness to the toothpaste help achieve and maintain proper toothpaste texture.

- Detergents- Those suds you see when you brush your teeth are from detergents.

Fluoride toothpaste

The most important ingredient to look for when choosing toothpaste is fluoride.

Fluoride is a naturally occurring mineral. Its use has been instrumental in the dramatic drop in tooth decay and cavity occurrence that has taken place over the past 50 years. Bacteria in your mouth feed on sugars and starches that remain on your teeth after eating. Fluoride helps protect your teeth from the acid that is released when this happens. It does this in two ways. First, fluoride makes your tooth enamel stronger and less likely to suffer acid damage. Second, it can reverse the early stages of acid damage by remineralizing areas that have started to decay.

Using fluoride toothpaste is an important way to ensure that your teeth are reaping the benefits of this dental-friendly mineral. Don't think you can skip fluoride if you live in an area where the water is fluoridated. Studies have shown that using fluoride toothpaste helps increase the concentration of fluoride in the teeth, even in areas with water supplies containing high levels of the mineral.

Tartar-Control Toothpaste

Everyone has a layer of bacteria on their teeth called plaque. If plaque isn't removed promptly with proper oral hygiene, it hardens into tartar. This hard-to-remove deposit can build up on your teeth and under your gums, ultimately leading to gum disease.

There are a variety of ingredients used in toothpaste to help prevent the accumulation of tartar on the teeth. Chemical compounds, including pyrophosphates and zinc citrate, are often added and have been proven effective. Additionally, some tartar control toothpastes contain an antibiotic called triclosan, which kills some of the bacteria in the mouth.

Certain toothpastes containing multiple anti-plaque agents in one formulation have been demonstrated to be even more effective at tartar control than varieties with only one plaque fighter.

Toothpastes for Sensitive Teeth

For people who have teeth that are easily irritated -- for instance, by hot or cold temperatures -- there are toothpastes available that are specially formulated for sensitive teeth. These toothpastes usually contain potassium nitrate or strontium chloride. These chemical compounds, which can take up to four weeks to offer relief, reduce tooth sensitivity by blocking pathways through the teeth that attach to nerves.

Whitening toothpaste

To help people on a quest for pearly whites, many whitening toothpastes are now being marketed for everyday use.

Whitening toothpastes do not typically contain bleaches. Instead, they contain abrasive particles or chemicals that effectively polish the teeth or bind to stains and help pull them off the tooth surface.

Although you might be concerned that the abrasiveness of whitening toothpaste could damage your teeth, studies suggest that whitening toothpastes are no harder on tooth enamel than other types of toothpaste.

Choosing the best toothpaste for you and your family

Here are some tips to help you choose the best toothpaste to meet your family's dental needs:

- Opt for ADA approval. Whatever your toothpaste needs, be sure to select toothpaste that has earned an American Dental Association seal of approval. Toothpastes that have earned this distinction have been evaluated for safety and effectiveness by an independent review board of scientific experts. All toothpastes earning the ADA seal contain fluoride -- the most important ingredient in any toothpaste.

- Be wary of imposters. In 2007, some toothpastes imported from China were found to contain a toxic substance, diethylene glycol. The FDA is currently advising against choosing toothpaste that says it was made in China.

- Consider your needs and the needs of your family members. As long as you select fluoride-containing toothpaste, the best toothpaste is a matter of personal choice and preference. If you're committed to an all-natural lifestyle, you may want to opt for ADA-approved toothpastes that contain only natural ingredients. For people trying to instill good oral hygiene habits in your children, why not choose fruit-flavored toothpastes with sparkles to entice them to brush their teeth? Some people are eager to restore whiteness to their teeth with whitening toothpastes. Others like the feeling of brushing their teeth with toothpaste containing hydrogen peroxide or baking soda.

Bad News for People with Lip Piercings

2011-01-06T12:45:00.000-08:00

Lip piercing can significantly increase the risk of receding gums, researchers at the Ohio State University in Columbus have found. These findings of a study on a form of lip piercing that centers a stud in the lower lip, where it meets the chin, were presented earlier this month at the 83rd General Session of the International Association for Dental Research, in Baltimore.

The study was conducted on 58 participants, half with this specific type of lip piercing. Researchers found that 40 percent of people with the lip piercing had receding gum lines in their bottom front teeth, and 80 percent of the participants who had the piercing for more than 36 months suffered the same affliction. Only 7 percent of the participants who had no form of lip piercing showed signs of recession.

Because the recession of the gum line is due to continual contact with the stud on the inside of the lip, people with this type of piercing will inevitably have problems with receding gums, study author Dr. Dimitris N. Takatis told Reuters Health. Takatis said that recession puts them at risk for tooth sensitivity and susceptibility to cavities. With an uneven gum line, it also becomes more difficult to brush and clean one’s teeth, increasing the chances of plaque build-up, which could lead to long-term problems such as gingivitis.

Removing the piercing is the best solution, as there is no way to prevent gum line recession with an object constantly rubbing against the gums.

Teeth Whitening Sensitivity- Causes and How to Treat It

2011-01-06T12:42:00.000-08:00

A whiter smile is a popular accessory for almost everyone today. From in-office procedures to dentist-prescribed at-home treatments to trademarked boxes of strips, gels and goos at the store or online, if you want a whiter smile, there's a method and a price point for everyone.

But the fact is, with any method, you're applying a bleach formula directly to your teeth and gums; and bleaches are powerful solutions that can cause discomfort if not handled properly.

Dental sensitivity is the most common issue surrounding teeth whitening-and it can happen to anyone, with almost any method.

What Makes Teeth Sensitive?

Inside every tooth are millions of microscopic "dentinal tubules" that extend from the nerve (pulp) inside the tooth to the outside surface of the tooth. There's fluid inside these tiny tubes, and when this fluid moves inside the tubes, it causes sensitivity. Minerals from saliva normally plug up the open outer ends of the tubes, preventing fluid movement and sensitivity. All bleaching gels tend to dissolve these "plugs," allowing the fluid in the tubes to move and cause sensitivity.

Genetics
For some people the reaction is minor, but for others the reaction can be very painful - and that's where the subject of genetics comes into play. It seems that everyone has a different reaction. Fair-haired and fair-skinned folks tend to experience the highest degrees of sensitivity. But people with various dental problems are also at risk (that's why so many dentists recommend a thorough exam and history before moving forward with powerful teeth whitening techniques.) Genetics can play such a major role in dental sensitivity that some people may never be good candidates for teeth whitening although there is significant progress in addressing this problem.

Bleach Stability
Just think about how strong a whitening gel has to be to actually change the color of your teeth. It's no surprise then that manufacturing dental-grade bleach formulas for oral applications is a tricky science. And it's hard to get it right; make them too powerful and they're hard to keep at peak strength throughout the blending, shipping and storage process. Make them too weak and they won't work at all. That's why the people who make whitening formulas aim for something in the middle - literally - the goal of most whitening gel scientists is to create a shelf-stable bleach with a completely neutral acid/alkaline ratio or pH.

It's hard to do though - so frequently bleaching gels are just a bit off "neutral." What this means for the little tubes in your teeth is this-if the bleaching gel is too acidic, it can dissolve the plugs at the end of your tubes even more, leading to more sensitivity.

So, if you're thinking about whitening your teeth with an unknown over-the-counter method or manufacturer, consider how much science really goes into your more beautiful smile. Then reconsider.

Acid Reaction
The overall action of bleach on enamel, dentin, and gums is cause of most sensitive reactions; and the one most people are familiar with. Minor dental problems (chips, cracks, decay) or daily living and consumption of acidic foods and beverages (such as some sodas, sour candies and overabundance of fruit) can weaken tooth enamel (or create small openings in enamel) to make it easier for acids to reach the inside of the tooth and dissolve the little plugs at the end of your tubes. That's why good hygiene and a good diet make a difference in keeping sensitivity at bay. Regular cleaning, flossing (plaque removal) and examination catch small issues as they occur - minimizing the chance for damage to the inside of your teeth.

How to Treat Teeth Whitening Sensitivity

Because sensitivity is such a big issue in the world of teeth whitening, there's a lot of interest in solving the problem-or at least in providing sensible, affordable and reliable ways to eliminate or minimize the discomfort.

Desensitizing agents can be found in the formulas of whitening solutions and are also used as stand-alone medications that dentists apply during a whitening procedure. Popular stand-alone desensitizers include: UltraEZ® Desensitizing Gel Syringe (with Fluoride and Potassium Nitrate) and Orajel Advanced Tooth Desensitizer. Some dentists utilize desensitizing methods after whitening; one system now performs desensitizing techniques beforeand after (KöR Whitening Deep Bleaching^TM).

Fluoride is probably the most commonly used desensitizing agent. It acts on your dentinal tubes to temporarily reduce their size, reducing the fluid movement in the tubes.

Potassium nitrate is another popular agent. It actually works its way into the center of your tooth (the pulp) and has a numbing action that may reduce discomfort. It tends to work better on some than others. However it doesn't do anything to reduce the tooth nerve inflammation caused by fluid movement in the tubes.

There's more and more research into the use of a compound called amorphous calcium phospate (ACP). ACP helps to strengthen the enamel, but seems to do little to plug the open ends of the dentin tubes.

Desensitizers that rapidly build new plugs in the open-ended tubes have shown to be the most successful at stopping fluid movement in the tubes and preventing bleaching sensitivity. These desensitizers are oxalates (minerals) and HEMA (resin) based products.

If desensitizers are not fully successful, over-the-counter anti-inflammatories may be used. If "anti-inflammatories" sounds too medical, just remember ibuprofen or Aleve. These classes of pain relievers work to minimize inflammation of irritated tooth nerves - which, in turn, helps to reduce additional discomfort and sensitivity some people may feel. If you experience inflammation, your dentist may give you something before and/or after your procedure - or recommend that you follow through at home.

Having a whiter smile can create real feelings of confidence and self-esteem for people, but alongside the advantages may come the discomfort of sensitivity. But, with a little education and awareness, you can help to make sure you experience the brighter side of whitening - whether you opt for do-it-yourself techniques or seek the help of your dentist. Keep smiling!

Power Toothbrushes Vs. Manual Toothbrushes

2011-01-06T12:35:00.001-08:00

Wondering if that hi-tech power toothbrush on display at your dentist’s office is really better than the regular ones? What about a power toothbrush that uses AA batteries? What’s the difference between them all?

In addition to things like your brushing technique, how often you brush and the length of time you spend doing it, experts believe that the type of toothbrush you use will directly affect how well you remove plaque.1 In order to decide which type of power toothbrush is right for you, it’s helpful to understand exactly what kinds are available to you and how they differ from one another.

Knowing the Three Types of Power Toothbrushes

The three types of power toothbrushes on the market are rechargeable electric (including sonic), regular manual and battery power.

Rechargeable Electric Toothbrush: A rechargeable electric toothbrush, also known as a “power toothbrush”, is the kind you plug into the wall to recharge, keeping the handle and replacing the brush head every three months. Rechargeable electric toothbrushes differ among the kind of cleaning technology they use, such as oscillating-rotating (3D Cleaning Action) or sonic technology.
Regular Manual Toothbrush: In contrast, regular manual toothbrushes are the basic toothbrushes you’re probably accustomed to with a plastic handle and various nylon bristle designs on the brush head. This is the most common type of toothbrush, and it doesn’t require any power sources.
Battery Power Toothbrush: Those who want a dose of power but are weary of electric toothbrushes may like battery power toothbrushes. Like electric toothbrushes, battery power toothbrushes are sometimes simply called “power toothbrushes” due to their use of an AA battery. While similar in design to regular manual

Assessing Technology and Features

Rechargeable Electric Toothbrush: Generally rich in technology and features, electric toothbrushes provide the many oral health benefits. Some can even enable you to improve your brushing habits. Hi-tech features include:

Numerous brushing modes specialized for sensitive teeth, whitening benefits or gum-massaging action
Pressure sensors to signal when you’re brushing too hard
Timers to help you keep track of how long you’re brushing each quadrant of your mouth
Digital reminders to replace your brush head
Oscillating-rotating or sonic technology
Multiple brush head compatibility so you can choose which kind of bristle design you prefer

Most electric toothbrushes also come with features for added convenience, like a brush head or toothbrush holder, bathroom-counter storage units and travel toothbrush chargers.

Regular Manual Toothbrush: While ordinary toothbrushes don’t nearly provide the benefits and features of rechargeable electric toothbrushes, the technology featured in their brush heads, bristles and handle designs can be quite advanced, for example:

Crisscrossed, extra-long or multi-level bristles
Polished or rounded bristle tips
Textured bristles
Cupped-bristle design for whitening benefits
Ergonomically designed handles with special grips
Tapered or angled brush head
Gum stimulators
Tongue cleaner pads

Battery Power Toothbrush: While similar in features to regular manual toothbrushes, these kinds of toothbrushes also vibrate to provide additional cleaning action. In addition to those of manual toothbrushes, features include:

Built-in AA battery that can be replaced in some models
“On/Off” or “+/-“ button located on the handle
Bristles or split brush heads specially designed to pulsate along with the vibrations

Modifying Brushing Technique

Proper brushing technique varies when using different kinds of toothbrushes. Both regular manual toothbrushes and battery power toothbrushes require you to provide all or most of the brushing action, moving the brush back and forth along all sides of your teeth and gums. In contrast, rechargeable electric toothbrushes provide the cleaning action while you need only guide it along all surfaces. Once they get the hang of it, many people find this method of brushing easier.

Understanding Power Toothbrush Value

Rechargeable electric toothbrushes tend to have a higher price value than battery power and regular manual toothbrushes, but you can find some for as low as $22 MSRP, like Oral-B® Vitality. Keep in mind that they offer more health benefits and features. Regular manual toothbrushes cost the least, and they are often sold in multi-packs as well as individually. Battery power toothbrushes are usually only a few dollars more than ordinary manual toothbrushes. Your dental professional is the best person to ask for a recommendation for what’s right for you.

What Can A New Zealand Reptile Tell Us About False Teeth?

2010-12-30T13:50:00.001-08:00

Using a moving 3D computer model based on the skull and teeth of a

New Zealand

reptile called tuatara, a BBSRC-funded team from the University of Hull, University College London and the Hull York Medical School has revealed how damage to dental implants and jaw joints may be prevented by sophisticated interplay between our jaws, muscles and brain. This research will appear in a future edition of the Journal of Biomechanics.

The tuatara is a lizard-like reptile that has iconic status in its homeland of

New Zealand

because its ancestors were widespread at the time of the dinosaurs. Unlike mammals and crocodiles which have teeth held in sockets by a flexible ligament, tuatara have teeth that are fused to their jaw bone - they have no ligament, much like modern dental implants.

BBSRC postdoctoral fellow Dr Neil Curtis from the University of Hull said "Humans and many other animals prevent damage to their teeth and jaws when eating because the ligament that holds each tooth in place also feeds back to the brain to warn against biting too hard."

Dr Marc Jones from UCL, also a BBSRC postdoctoral fellow, added "In the sugar-rich western world many people end up losing their teeth and have to live with dentures or dental implants instead. They've also lost the periodontal ligament that would attach their teeth so we wanted to know how their brains can tell what's going on when they are eating."

The team has created a 3-D computer model of the skull of the tuatara to investigate the feedback that occurs between the jaw joints and muscles in a creature that lacks periodontal ligaments. "Tuataras live happily for over 60 years in the wild without replacing their teeth because they have the ability to unconsciously measure the forces in their jaw joint and adjust the strength of the jaw muscle contractions accordingly", said Dr Curtis.

Although this explains why tuatara and people with false teeth manage not to break their teeth and don't end up with jaw joint disorders, it is still clear that having a periodontal ligament is very useful, in particular for fine tuning chewing movements. This may explain why it has evolved independently in the ancestors of mammals, crocodiles, dinosaurs, and even some fish.

There is anecdotal evidence to suggest that people with implants and dentures may make food choices related to their lack of periodontal ligament. However, the tuatara pursues a broad diet on the islands where they live including beetles, spiders, snails, frogs and occasionally young seabirds.

Professor Douglas Kell, BBSRC Chief Executive said "To support the extension of health and wellbeing into old age, it is vital that we appreciate how we as human beings have developed our extraordinary ability to adapt to adverse situations. This work allows us to understand some of the complexities of the feedback and responses occurring in healthy human bodies and brains. It is impossible in evolution to predict future innovations such as dental implants and yet this research indicates a level of redundancy in our biology that opens opportunities to support long term health and wellbeing."

Source: Nancy Mendoza- Biotechnology and Biological Sciences Research Council

Who Hasn't Had Dental Cavities?

2010-12-30T13:37:00.000-08:00

A research study has for the first time revealed data about dental cavities, periodontal disease, oral treatment needs, the use of dental prostheses and dental hygiene habits among the adult population in the

Valencia

region. The results show that 90% of people have cavities and 20-35% need prostheses.

"These data will make it possible to draw comparisons with other studies carried out in other autonomous regions and nationwide ones", José Manuel Almerich, co-author of the study and a scientist at the University of Valencia (UV), tells SINC.

The study, published in the journal Medicina Oral, Patología Oral y Cirugía Bucal, for the first time provides data about the situation with regard to cavities, periodontal disease, oral treatment requirements and the use of dental prostheses in two age cohorts (35-44 and 65-74) in the adult population of

Valencia

. The study also includes an analysis of these people's oral hygiene habits.

The prevalence of cavities was above 90% in the two samples studies. Social class and educational levels have an impact on the presence of cavities, with those with lower social and education levels having more cavities. Nationality also has an impact, with foreigners having more untreated cavities.

Among the people aged 65 to 74, 20.7% are 'totally toothless'. "From these data we can deduce that the dental status of the institutionalized geriatric population is significantly worse than that of elderly adults living in their homes", says Almerich.

In terms of periodontal disease, the second most prevalent problem, the most disadvantaged social classes again present the worst health status, while the need for dental prostheses fluctuates between 20-35% for the entire population studied, increasing in the older age group.

Bad habits starting in childhood

The study confirms our poor dental hygiene habits and rare visits to the dentist. "Preventive efforts should be aimed at raising awareness about the need for early diagnosis of problems and the best possible oral hygiene", the Valencian researcher suggests.

The findings of this study underline the need to improve dental care among adults. The authors highlight the need to develop new policies that will improve prevention as well as dental care measures "that will make it possible to improve the bucodental map within a few years".

Source: Plataforma SINC

Want To Be Sexy? Improve Your Oral Hygiene

2010-12-30T13:21:00.001-08:00

If you're thinking about being romantic tonight, you might want to make sure your oral hygiene is in check. Based on a new survey, oral hygiene is significantly preferred over the traditional romantic overtures to set the mood, such as dimming the lights, lighting candles, wearing perfume or playing romantic music.

"The results of this study reinforced some of what we already knew - that most consumers simply don't like to floss with string - but we were surprised at how important oral hygiene was in order to be attractive to your significant other"

The national survey, which was fielded by Kelton Research, examined Americans' views on oral healthcare and revealed that a clean mouth was most important in maintaining a healthy relationship. Close to six in ten, or 59 percent, would be most disturbed by their partner not brushing or flossing his or her teeth for a week, as compared to only 24 percent who would be most perturbed if their significant other passed on wearing deodorant. Far fewer were bothered by their partner skipping shaving, hair combing or trimming toe nails for a week, at nine percent, six percent and two percent, respectively.

The Waterpik® Sexy Smile Survey also found that while they are quick to judge the flossing habits of their significant others, the majority of Americans actually have a lot of ups and downs in their own relationship with floss. Key findings on flossing and oral healthcare include:

- Only When I'm Desperate. Americans are most likely to floss just before visiting the dentist (51 percent), and when they have food stuck in between their teeth or have bad breath (64 percent), which could mean their mouths are not as fresh as they should be most other times!

- Below Grade. Nearly six in ten (58 percent) Americans say they deserve a C or lower for the efforts they make to floss their teeth on a daily basis. In fact, about one in five (18 percent) give themselves a failing grade.

- Unpleasant Act. Among people who floss their teeth, close to six in ten (57 percent) say that floss makes their gums bleed, it gets stuck between their teeth, (52 percent), and it caused little bits of food to fly onto the mirror (42 percent). Yuck!

- We Want an Alternative. In fact, Americans would pay an average of $53 for an alternative to regular string floss (which you can usually get for free from your dentist) if it meant that the process was faster, easier and more effective.

"The results of this study reinforced some of what we already knew - that most consumers simply don't like to floss with string - but we were surprised at how important oral hygiene was in order to be attractive to your significant other," said Jay McCulloch, Vice President of Marketing for Water Pik Oral Health Products.

About The Water Survey

The Waterpik® Sexy Smile Survey was conducted by Kelton Research between September 10 and September 16, 2010 among 1,001 U.S. adults using an email invitation and an online survey. Quotas are set to ensure reliable and accurate representation of the total U.S. population ages 18 and over. Results of any sample are subject to sampling variation. The magnitude of the variation is measurable and is affected by the number of interviews and the level of the percentages expressing the results. In this particular study, the chances are 95 in 100 that a survey result does not vary, plus or minus, by more than 3.1 percentage points from the result that would be obtained if interviews had been conducted with all persons in the universe represented by the sample.

Source: Kelton Research- Water Pik, Inc.

When Stress Takes a Toll on Your Teeth

2010-08-10T09:47:00.000-07:00

With economic pressures affecting millions of Americans, dentists may have noticed a drop in patients opting for a brighter smile, but they are seeing another phenomenon: a rise in the number of teeth grinders.

"I'm seeing a lot more people that are anxious, stressed out and very concerned about their financial futures and they're taking it out on their teeth," said Dr. Steven Butensky, a dentist with a specialty in prosthodontics (aesthetic, implant and reconstructive dentistry) in Manhattan.

One of his patients lost hundreds of thousands of dollars invested with Bernard L. Madoff. Another reported that he had lost a job with a seven-figure salary. A third, a single mother with a floral design business on Long Island, said she was working twice as hard for half as much.

"All three are grinders, directly affected by what's going on out there," Dr. Butensky said, gesturing outside his Midtown office window.

Dr. Robert Rawdin, another Manhattan dentist with a specialty in prosthodontics, said he had seen 20 to 25 percent more patients with teeth grinding symptoms in the last year. And in San Diego, Dr. Gerald McCracken said that over the last 18 months his number of cases had more than doubled. They, along with other dentists interviewed for this article, chalk it up to the economy.

"We're finding in a lot of double-income families, we have the people who have lost jobs and are worried, and then we have the spouse, who still has the job, with the added pressure and uncertainty," Dr. McCracken said. "This can cause some real grinding at night."

With or without economic hardship, 10 to 15 percent of adult Americans moderately to severely grind their teeth, according to Dr. Matthew Messina, a dentist in Cleveland and a consumer adviser for the American Dental Association.

Because it is a subconscious muscle activity, most grinders grind without realizing it, until a symptom such as a fragmented tooth or facial soreness occurs.

While many experts believe that genetics may play a role in bruxism (or teeth grinding), stress has long been known to set off clenching and grinding in some people, Dr. Messina said. "Recession breeds stress and our body responds to stressful events so in times like these, the incidence of bruxism goes up," he said, adding that over the last year or so he had heard from dentists around the country who had seen an uptick in patients with bruxism while also complaining about financial stress. In his own practice, he said he had treated twice as many cases in the last year than in the year before.

"Stress, whether it's real or perceived, causes flight-or-fight hormones to release in the body," he said. "Those released stress hormones mobilize energy, causing isometric activity, which is muscle movement, because that built-up energy has to be released in some way."

The most expensive option for rebuilding teeth damaged by grinding is with veneers, but this year, dentists say that many of their bruxism patients are requesting one of the least costly treatments: a night guard, also known as an occlusal splint. Manufacturers said sales of these devices had gone up. "Our night guard sales have increased 15 percent over the prior year," said Greg Pelissier, a manager at Glidewell Laboratories, a maker of custom restorative, reconstructive and cosmetic dental products based in Newport Beach, Calif.

New drugstore products have also come to market, including a disposable night guard, Grind-No-More (about $30 for 14 guards). Its makers hope it will appeal to on-again-off-again grinders.

Stan Goff, executive editor of Dental Products Report, a monthly publication, wrote in an e-mail message that all this teeth grinding "may be playing a role in the introduction of several new products designed to not only prevent bruxism, but to help fight against tooth sensitivity" and other conditions that are aggravated by grinding.

While experts believe bruxism is not a dental disorder per se, but rather originates in the central nervous system, the condition can greatly affect the teeth and the entire craniofacial structure.

"Normally, we exert about 20 to 30 pounds per square inch on our back molars when we chew," Dr. Rawdin said. "But teeth grinders, especially at night without restraint, can exert up to as much as 200 pounds per square inch on their teeth."

Some nocturnal grinders will grind up to 40 minutes of every hour of sleep. The relentless wear and tear can quickly erode enamel (10 times faster than that of nongrinders), fracture teeth, affect bite and damage the temporomandibular joint at the hinge of the jaw, and the masseter muscle, which controls the jaws. Jaw and face pain, as well as earaches and headaches, may also occur.

"I kind of thought I was going crazy," said Adrienne Lee Kornstein, 48, a patient of Dr. Butensky, whose floral design business in Jericho, N.Y., has suffered because of the economy. "A tooth broke for what seemed like no reason, and by the time I got to Dr. Butensky, I'd been to my physician, other dentists, even a dermatologist to try to get relief from migraines and facial pain I was taking painkillers for. I had no idea I was grinding or that grinding your teeth could even lead to all that."

The most common treatment for the disorder is to wear a night guard, which may not only alleviate grinding but, in some cases, train someone to stop grinding altogether.

Fitted in the dentist's office, a custom guard is usually a clear, hard plastic device that runs over the top or lower teeth from front to back and prevents the top and bottom molars from making contact. Although not cheap (the price can range from $350 to $1,000), most dentists prefer a custom guard to over-the-counter guards, which are usually made of softer material and can encourage chewing and exacerbate masseter muscle activity.

There are also smaller prefabricated splints that a dentist can customize. These are generally cheaper than the fitted full arch guards and require fewer adjustments. But some dentists argue they are not as effective as the full arch guards.

Many teeth grinders interviewed said they would not go to bed without their night guards.

"Sometimes I wake up in the middle of the night and having my guard in makes me more aware if I'm tensing my body or gripping my jaw, and I can just take a moment to relax," said Alisa Fastenberg, 50, a graphic designer in Manhattan.

Other treatments for teeth grinding include acupuncture, medical massage, hypnosis and Botox injections into the masseter muscle to relax the muscle enough to stop it from going into spasms without changing one's chewing function.

"Grinding is like body building," said Dr. Alexander Rivkin, a head and neck surgeon at Westside Aesthetics in Los Angeles, who has also seen an increase in grinding-related cases this past year. "The constant workout of the masseter muscle, the largest in the head, builds up that muscle and that can cause a lot of pain, not to mention make the face appear more square."

He added, "For, I'd say, 85 percent of the people who come to me complaining about headaches, jaw soreness and pain, Botox injections into the masseter muscle on both sides of the face is the answer."

But even something as simple as taking time before bed to de-stress has been known to help.

"Good sleep hygiene goes a long way to keeping the mind relaxed and the jaws from starting to smack together," said Dr. McCracken, who has studied the relation of sleep to teeth grinding. "We know that the stress center of the brain is directly next to the part of the brain that controls teeth grinding. We're not sure how it relates to the disorder, but it's intriguing. Lately, I even tell my patients, before they go to bed, not to watch the news."

By: CAMILLE SWEENEY

Why It's So Hard to Tell Which Tooth Has the Ache

2010-08-10T09:44:00.000-07:00

When it comes to a toothache, the brain doesn't discriminate. A new imaging study shows that to the brain, a painful upper tooth feels a lot like a painful lower tooth. The results, which will be published in the journal Pain, help explain why patients are notoriously bad at pinpointing a toothache.

For the most part, humans are exquisitely tuned to pain. The brain can immediately distinguish between a splinter in the index finger and a paper cut on the thumb, even though the digits are next-door neighbors. But in the mouth this can be more difficult, depending where and how intense the ache is.

"We don't know much about tooth pain," comments dentist and neuroscientist Alexandre DaSilva of the University of Michigan in Ann Arbor, who was not part of the new research. The new study is one of the first to address the puzzle of toothache localization, he says.

In the study, researchers led by Clemens Forster of the University of Erlangen-Nuremberg in Germany analyzed brain activity in healthy - and brave - volunteers as they experienced tooth pain. The researchers delivered short electrical pulses to either the upper left canine tooth (the pointy one) or the lower left canine tooth in the subjects. These bursts of electrical stimulation produced a painful sensation similar to that felt when biting into an ice cube, Forster says, and were tuned such that the subject always rated the pain to be about 60 percent, with 100 percent being the worst pain imaginable.

To see how the brain responds to pain emanating from different teeth, the researchers used fMRI to monitor changes in activity when the upper tooth or the lower tooth was zapped. "At the beginning, we expected a good difference, but that was not the case," Forster says.

Many brain regions responded to top and bottom tooth pain - carried by signals from two distinct branches of a fiber called the trigeminal nerve - in the same way. The V2 branch carries pain signals from the upper jaw, and the V3 branch carries pain signals from the lower jaw.

In particular, the researchers found that regions in the cerebral cortex, including the somatosensory cortex, the insular cortex and the cingulate cortex, all behaved similarly for both toothaches. These brain regions are known to play important roles in the pain projection system, yet none showed major differences between the two toothaches. "The activation was more or less the same," Forster says, although he adds that their experiments might have missed subtle differences that could account for why some tooth pain can be localized.

Because the same regions were active in both toothaches, the brain - and the person - couldn't tell where the pain was coming from. "Dentists should be aware that patients aren't always able to locate the pain," Forster says. "There are physiological and anatomical reasons for that."

DaSilva agrees that the brain's inability to tell top-tooth pain from bottom-tooth pain "pairs really well with what we see in the clinic."

Understanding the pathway from tooth to brain may help researchers devise better treatments for acute tooth pain, such as cavities or infections, and more-chronic conditions, DaSilva says. One such condition is phantom pain that persists in the mouth after a tooth has been removed.

By, Laura Sanders, Science News

Tongue Piercings Associated With Gap Between Teeth

2010-08-04T11:56:00.000-07:00

'Playing' with a pierced tongue stud could lead to a gap between the front teeth - according to a new study. The Research, which was carried out at the University at Buffalo in New York, suggested that tongue piercings could be a major cause of unnecessary orthodontic issues.

The report claimed that those with tongue piercings were likely to push the metal stud up against their teeth and consequently cause gaps and other problems to arise.

Chief Executive of the British Dental Health Foundation, Dr Nigel Carter, said the study highlighted the risks that tongue piercings have on oral health.

Dr Carter said: "It's certainly something to think about before going out to get a tongue piercing. The temptation of playing with the stud in the mouth would be very high and in time this could lead to hundreds of dollars worth of corrective treatment.

"The results of this study stress the risks that are associated with tongue piercings. As well as causing an apparent gap, oral piercings can also lead to chipped teeth and infection.

"In order to avoid such health problems in the future, along with the spiralling costs of any related treatment, I would advise people to stay clear of tongue piercings."

Lead author of the study, Sawsan Tabbaa, said that 'force, over time, moves teeth' and that the results are caused by people playing with their studs crop up in a 'very high percent of the cases'.

A professor of orthodontics at the University at Buffalo School Of Dental Medicine, Tabbaa, explained that tooth damage was common in both past and current case studies.

The current study featured a 26 year-old female patient and showed that a space between the upper front teeth had appeared during a period of seven years, as the metal bar was pushed against and between the teeth.

The patient provided researchers with photographs to show that she had no diastema before having her tongue pierced. It was strongly thought that positioning of the tongue stud between the maxillary central incisors caused the midline space between the front teeth.

The only solution was for the patient to wear braces for an extensive period of time.

The author concluded that tongue piercings could result in serious injuries, not just to teeth but said they have also been associated with hemorrhages, infections, trauma to the gums and, in the worst cases, brain abscesses.

The results of the study were published in the Journal of Clinical Orthodontics.

Source: British Dental Health Foundation

Can Green Tea Strengthen Teeth?

2010-08-03T09:04:00.001-07:00

Researchers suspect antimicrobial molecules contained within green tea helps preserve teeth (as long as you don't add sugar).

People aged 40-64 who drank one cup of green tea a day were less likely to lose teeth.
Drinking unsweetened coffee had no effect on keeping teeth.
Antimicrobial molecules called catechins may account for green tea's benefits.

A cup of green tea a day may keep the dentist away.

That's the finding of new research published in Preventive Medicine. The findings show that drinking at least one cup of green tea a day increases the odds of keeping your teeth as you age.

The researchers suspect that antimicrobial molecules called catechins present in green tea and in lesser amounts in oolong tea provide the benefit. But be careful if you like your tea with sugar: sweetener may negate the effect, the team found.

"Green tea may have bacteriocidal effects, which would affect teeth, but only if you drink it without sugar," said Alfredo Morabia, of Columbia University in New York and editor of Preventive Medicine, who wrote an editorial accompanying the new research.

"They also reported that drinking sweet coffee was actually deleterious," he added. "Coffee alone had no problem, but sweet coffee would actually make you lose your teeth."

Yasushi Koyama of the Tohoku University Graduate School of Medicine and colleagues looked at more than 25,000 Japanese men and women between age 40 and 64 in making the determination.

They found that men who drank at least one cup of tea a day were 19 percent less likely to have fewer than 20 teeth (a full set including wisdom teeth is 32) than those who did not drink green tea. Tea-drinking women had 13 percent lower odds.

One possible explanation for the benefits of tea drinking is that warm drinks wash out your mouth. But coffee, which also provides a mouth rinse, had no benefit, suggesting something else is going on.

Catechins have been shown to kill mouth bacteria associated with tooth decay and gum disease, so the researchers suspect this is what gives green tea its dental benefits.

"Previous research has indicated that regular consumption of green tea may lead to a lower instance of periodontal disease, a leading cause of tooth loss in adults," said Samuel Low of the University of Florida College of Dentistry and President of the American Academy of Periodontology in a statement to Discovery News.

Maintaining healthy teeth and gums is part of maintaining a healthy body, Low said. "That is why it is so important to find simple ways to boost periodontal health, such as regularly drinking green tea -- something already known to possess certain health-related benefits."

Toothaches- causes, home remedies, and treatment

2010-08-02T13:27:00.000-07:00

“Tooth ache” can be generally regarded as pain around a particular tooth, teeth or jaws. Tooth pain can range from mild discomfort or sensitivity to being excruciatingly painful. Some women have even compared toothpain to being as painful as child birth. Of course, these might be exaggerated claims from some desperate women, but it does reflect the intensity of the pain arising from a toothache.

The actual pain we feel is due to the irritation of the nerves which are associated with the tooth/teeth. If you didn’t know, nerves are responsible for carrying sensations like heat, cold, touch and PAIN to the brain. In this case when the nerves inside the tooth are irritated, these carry the pain impulse to the brain.

Causes of toothpain

Most of the causes of tooth pain are limited to oral/dental causes.

The oral causes of toothpain are

Tooth Decay or Cavity (being the most common cause of tooth pain)

The most common cause of tooth pain is Tooth Decay. Tooth decay is the degradation of the tooth due to harmful acids secreted by bacteria in the oral cavity.

Gum Disease

The next important causing agent of tooth pain is gum disease. Poor oral hygiene leads to bacterial plaque accumulation and the toxins release from these bacteria damage the gums. The gums become swollen, red and painful (Gingivitis). If gum disease is not controlled early, you are at a risk of losing your tooth.

Root Sensitivity

Root sensitivity (commonly termed as tooth sensitivity) is when the roots of the teeth become exposed due to recession of the gums. The roots are very sensitive and respond with pain to reasonably hot or cold foods.

Cracked teeth

A painful accidental blow or extreme biting force can cause the tooth fracture which can become a source of intense pain whenever the fractured tooth is even touched.

Temporomandibular joint(TMJ) Disorder

TMJ disorder is an inflammatory reaction at the sight of the lodgment of the lower jaw at the skull. Various factors such as Bruxism (Night grinding or teeth grinding), arthritis can cause TMJ disorders.

Wisdom tooth eruption or impaction

The eruption of a wisdom tooth often causes pain due to its misalignement. It can become impacted (does not erupt) and require surgical extraction.

Fillings:

People who have undergone fillings can get severe toothache suddenly. This might be because of the spread of the decay to the pulp and you will need to undergo root canal treatment for that. It can also occur due to accumulation of fluid with organic debris and bacteria between the filling and your teeth often termed as microleakage in dental jargon.

The non-oral causes include Ear and Sinus infections .

Prevention of toothpain

There is no magic trick to prevent tooth pain from occurring. All you need to do is maintain a good oral hygiene.

Home remedies for toothpain

There isn’t a fixed time for toothpain to occur. You can’t drive to your dentist at 3 am at night. However, you can surf the net looking for home remedies. Although, these should not be substituted for a visit to the dentist, they can provide temporary relief from the agonizing pain.

I have not tried any of them and do not suggest their use either. They are listed here for informational purposes only

1. Sensodyne Therapy: Works for tooth cavities

Rinse your mouth with warm water.
Put max strength sensodyne toothpaste on the cavity.
You can feel the pain relief after few minutes.

The effect will decrease when you drink water or other liquids after putting the sensodyne.

2. The Whiskey BC Mix: Works for nearly all tooth pains and is quite effective. Note that this can be nasty when you try it.

Add teaspoon of baking soda in a shot of Whiskey.
Dissolve a packet of BC pain relief powder in the above mix.
Swish around the affected tooth for two minutes.

Try this if you have unmanageable tooth pain and you cant get health care right away.

3. Nyquil therapy: Lots of people swear by this fast and effective trick. It works very well indeed and I have quite a few people thanking me for this one.

Take half a teaspoon of Nyquil or Kroger Nitetime (cold/flu syrups) and swish around the affected area.

Other

Try sucking at a clove or put clove oil on the affected tooth.

Place a raw piece of onion on the affected tooth.

Treatment for Tooth Pain

The treatments for toothpain vary greatly. They treat the actual cause of your tooth pain. For example

If you have tooth decay, you will have to undergo a filling procedure.

If the tooth decay has reached your pulp, you would have to undergo a root canal procedure.

If you have impacted wisdom teeth, they need to be extracted.

Your dentist will determine the best treatment option for you after examining you.

We subconsciously connect a dull smile with age

2010-07-26T12:32:00.000-07:00

We subconsciously connect a dull smile with age — enamel wears over time, darkening our teeth. A bright smile, on the other hand, gives the impression of good health and youth. One quick anti-aging beauty tip: Cut back on teeth-staining habits such as drinking coffee and red wine and smoking cigarettes.

But oral health habits are much more than skin-deep. Every day, it seems like another new study links oral health problems to other big health issues such as heart disease, premature birth, and erectile dysfunction. Of course, taking care of your chompers starts with daily brushing and flossing and regular dentist checkups — something we're not all so diligent about. About 17% of adults admit to never flossing, according to one report, and about 25% of adults ages 35 to 59 have untreated tooth decay. But even if you're a dentist's dream patient, there are other surprising habits to start — and to skip — for a prettier, healthier smile. Here, 10 simple steps to try today:

Limit carbs to mealtimes

Even not-so-sweet treats — like a handful of potato chips or a whole wheat roll — can be as damaging to your teeth and gums as a double-fudge brownie, if you're not careful.

That's because all carbohydrates break down into simple sugars, which are ultimately converted by bacteria in the mouth into plaque, a sticky residue that is the primary trigger of gum disease and cavities. Carb-based foods such as breads and crackers tend to have a chewy, adhesive texture, making it easier for them to get caught between teeth or under the gum line, where bacteria can then accumulate, says Christine Gerbstadt, MD, RD, a spokesperson for the American Dietetic Association.

Smile Rx: Have carbs at mealtimes rather than as a snack: When you eat a larger amount of food, you produce more saliva, which helps wash food particles away.

Don't drink and brush

Here's one time when you shouldn't clean your teeth: right after you drink a soda or other acidic beverage, says Mary Hayes, DDS, spokesperson for the Chicago Dental Society: Acid in the drink, combined with the abrasive action of brushing, can erode your tooth enamel.

Smile Rx: To protect your pearly whites against the caustic compounds in soda, sip water or chew gum to activate acid-neutralizing saliva — then brush your teeth. It's also smart to follow the same routine if you have chronic heartburn, which keeps your mouth in an acidic state.

Increase your C intake

Vitamin C is the cement that holds all of your cells together.

"So just as it's vital for your skin, it's important for the health of your gum tissue," says Paula Shannon Jones, DDS, spokesperson for the Academy of General Dentistry. People who consumed less than 60 mg per day of C (8 ounces of orange juice or one orange contains more than 80 mg) were 25% more likely to have gum disease than people who took in 180 mg or more, according to a study of more than 12,000 US adults conducted at the State University of New York University at Buffalo.

Smile Rx: Add a daily glass of OJ to your breakfast routine, and make sure your multi meets the RDA for vitamin C.

Have tea

The antioxidants are good for your gums.

Black and green teas contain polyphenols, antioxidant plant compounds that prevent plaque from adhering to your teeth and help reduce your chances of developing cavities and gum disease. "Tea also has potential for reducing bad breath because it inhibits the growth of the bacteria that cause the odor," explains Christine D. Wu, PhD, professor and director of caries research at the University of Illinois at Chicago College of Dentistry, who has conducted several studies on tea and oral health. Many teas also contain fluoride (from the leaves and the water it's steeped in), which helps protect tooth enamel from decay and promotes healthy teeth.

Smile Rx: Steep a cup every afternoon. Added bonus: a bit of caffeine for a postlunch perk.

Sip with a straw

Soda junkies, listen up! Most sodas, sports drinks, and juices contain acids, such as citric and phosphoric, that can erode dental enamel — even if they're diet or sugar-free versions. Sipping acidic drinks through a straw positioned toward the back of your mouth limits their contact with your teeth and helps preserve the enamel, says a study in the British Dental Journal.

Smile Rx: Stock up on straws in your desk drawer at work and kitchen at home so you always have one handy.

Boost calcium consumption

The same way the mineral makes for strong bones, it's also necessary to protect your pearly whites. People who get at least 800 mg a day are less likely to develop severe gum disease, says a study by the Buffalo researchers. The reason: About 99% of the calcium in your body is in your bones and teeth. Dietary calcium — available in foods like cheese, milk, and yogurt — strengthens the alveolar bone in the jaw, which helps hold your teeth in place.

Eat up! A few simple changes to your diet can help keep your teeth healthy for life.

Smile Rx: The recommended amount is 1,000 mg per day for women younger than 51 and 1,200 mg for those older. A calcium supplement could do the trick, but you should aim to get as much as you can from your diet. You get about 300 mg each from an 8-ounce glass of milk, a 6-ounce yogurt, or a 1.5- to 2-ounce serving of cheese.

Protect your smile when you swim

It sounds surprising, but dental researchers have found that excessively chlorinated pool water can erode and stain tooth enamel.

If you're a frequent swimmer, pack a toothbrush along with your towel when you take your next dip. "More chlorine in a pool may equal more protection against bacteria, but overdoing it lowers the pool's pH level and makes it dangerously acidic," says Matt Messina, DDS, consumer advisor for the American Dental Association.

Smile Rx: Brush your teeth and use a fluoride rinse immediately after spending more than an hour in the pool. "If you're swimming a lot and have any tooth discomfort whatsoever, check with your dentist," adds Messina.

Have an apple a day

Yep, it helps keep the dentist away too.

Crunchy foods, including apples, celery, and carrots, act like little toothbrushes when you chew them, and they actually help scrub away stubborn stains over time. The cleansing effect on your teeth may be noticeable — if ever so slightly — especially if you're a coffee drinker who wasn't eating apples every day to begin with. "The mildly acidic nature and astringent quality of apples, combined with their rough, fiber-rich flesh, makes them the ideal food for cleansing and brightening teeth," explains Jeff Golub-Evans, DDS, founding president of the New York Academy of Cosmetic Dentistry.

Smile Rx: If you start eating an apple a day as a between-meal snack and don't get the chance to brush your teeth afterward, be sure to chase it with a glass of water to rinse away the sugar, acid, and any plaque it may have removed from your enamel.

Smooch your partner

From the who-knew school of thought: Kissing your mate can also help safeguard your grin.

Although you enjoy a kiss for other reasons, it also increases saliva in your mouth, which cleans your teeth of the bacteria that can cause cavities, according to Anne Murray, DDS, a spokesperson for the Academy of General Dentistry,

Smile Rx: Consider this a healthy excuse to pucker up! But don't sweat it if you have no one to kiss. Sugar-free gum with xylitol will also do the trick.

Go for whole grains

Whole grains are like dental insurance, suggests research from McMaster University, Canada.

Add this to the laundry list of their benefits, which include keeping your heart healthy, preventing diabetes, and more: Whole grains keep teeth healthier longer. Among 34,000 men studied for 14 years, those who ate at least three daily whole grain servings were 23% less likely to suffer tooth-loosening gum inflammation (periodontitis) than those averaging fewer than one. Eating more whole grains helps stabilize blood sugar levels, which has been shown to reduce periodontitis in diabetics.

Smile Rx: Swap white rice and regular pasta for brown and whole wheat versions. Check labels to make sure brown rice or whole grains are listed as the first ingredient.

Gum Disease linked with gestational diabetes risk

2010-07-26T12:29:00.001-07:00

Pregnant women with gum disease may be more likely to develop gestational diabetes than those with healthy gums, researchers have found.

Gestational diabetes arises during pregnancy and usually resolves after the baby is born, but it can raise a woman's risk of developing type 2 diabetes later on. It can also contribute to problems during pregnancy and delivery, including maternal high blood pressure and a larger-than-normal baby, which may necessitate a cesarean section.

The new findings, published in the Journal of Dental Research, suggest that gum disease may be a treatable risk factor for gestational diabetes.

Among pregnant women researchers followed, the 8% who developed gestational diabetes had higher levels of gum-disease-causing bacteria and inflammation.

Gum disease can trigger an inflammatory response not only in the gums, but throughout the body. It's possible that such inflammation may exacerbate any pregnancy-related impairment in blood sugar control, contributing to gestational diabetes in some women, the researchers speculate.

Past studies have also linked gum disease to a higher risk of premature birth, with one theory being that systemic inflammation is involved.

Of the 265 women in the study, 83% were Hispanic, a group that is at higher-than-average risk of both gestational diabetes and type 2 diabetes. The women who developed gestational diabetes were also significantly more likely to be heavier before they became pregnant, have had gestational diabetes before, and higher C reactive protein levels, a marker for inflammation and cardiovascular disease.

"In addition to its potential role in preterm delivery, evidence that gum disease may also contribute to gestational diabetes suggests that women should see a dentist if they plan to get pregnant, and after becoming pregnant," Dr. Ananda P. Dasanayake, the lead researcher on the study, said in a statement.

"Treating gum disease during pregnancy has been shown to be safe and effective in improving women's oral health and minimizing potential risks," added Dasanayake, a professor at the New York University College of Dentistry.

Future studies, Dasanayake noted, should investigate the link between gum disease and gestational diabetes in other high-risk groups, such as Asian and Native American women.

Journal of Dental Research

Your Dentist Knows Your Heart

2010-07-08T09:26:00.000-07:00

I've had a number of patients say to me, "Doctor, my dentist says I should get my heart checked out, what does a dentist know about hearts?" Then after some tests, I have to tell my patients, that, yes, their dentist was right, they have a heart problem. There is definitely a gum-heart connection and that connection is inflammation. Untreated chronic inflammation can lead to severe health complications.

This is how it happens. When you consume anything, residue collects on your teeth, and this residue forms plaque. Plaque is a sticky deposit of mucus, food particles and bacteria formed at the base of your teeth within hours of eating. If you don't remove the plaque it can cause gingivitis, the collection of plaque in pockets between swollen gums and the base of your teeth.

Gingivitis is also the source of bad breath. Left untreated, gingivitis can lead to periodontal disease; also know as gum disease. Your mouth has the highest concentration of bacteria in your body under normal conditions, but if you have gum disease, the bacteria count gets even higher. Inflamed gums present a good portal for bacteria to enter your bloodstream and move on to your heart. There it can damage your heart walls or values. It might also provoke blood-clotting, leading to stroke or a heart attack.

The Good News is - You Can Stop Gum Disease At Your Bathroom Sink

Gum disease is one of the easiest preventable diseases out there. Yet some 50 percent of the adult population has gum problems. Good dental hygiene can eliminate or slow gum disease and all it takes is making a conscious effort to brushing your teeth after every meal and flossing before you go to bed.

Here are the steps recommended by the American Dental Association

Brushing Your Teeth

Place your toothbrush at a 45-degree angle against the gums.
Move the brush back and forth gently in short (tooth-wide) strokes.
Brush the outer tooth surfaces, the inner tooth surfaces, and the chewing surfaces of teeth.
Use the "toe" of the brush to clean the inside surfaces of the front teeth, using a gentle up-and-down stroke.
Brush your tongue to remove bacteria and freshen your breath.

Flossing Your Teeth

Break off about 18 inches of floss and wind most of it around one of your middle fingers. Wind the remaining floss around the same finger of the opposite hand. This finger will take up the floss as it becomes dirty. Hold the floss tightly between your thumbs and forefingers.
Guide the floss between your teeth using a gentle rubbing motion. Never snap the floss into the gums.
When the floss reaches the gum line, curve it into a C shape against one tooth. Gently slide it into the space between the gum and the tooth.
Hold the floss tightly against the tooth. Gently rub the side of the tooth, moving the floss away from the gum with up and down motions.
Repeat this method on the rest of your teeth. Don't forget the back side of your last tooth.

Nutrients for a Healthy Smile

Nutrition plays an important role in gum health. Crunchy fruit and vegetables can actually clean your teeth as you are eating, and the acid delays the formation of plaque. Vitamins A, C, D, E and K and the B vitamins; folic acid; biotin; choline; calcium; zinc; and magnesium have all been found important for your oral health.

Two dietary supplements, coenzyme Q10 and aloe vera, are helpful to gum health. Coenzyme Q10 (CoQ10) may help with periodontal pocket depth. In early research, Dr. Edward G. Wilkinson, of the U.S. AirForce Medical Center, gave patients 50 mg of CoQ10 a day. His patients experienced reduced periodontal pocket depth. Wilkinson said, "Treatment of periodontitis with coenzyme Q10 should be considered as an adjunctive treatment with current dental practice." Later studies have reconfirmed this. Hanioka, et al., say "These results suggest that the topical application of CoQ10 improves adult periodontitis" (Molecular Aspects of Medicine. 1994. 15 Suppl)

Aloe vera is known to kill bacteria. Dr. Eugene R. Zimmerman and Dr. Ruth A. Sims have (Aloe Vera of America Archives, Stabilized Aloe Vera, Vol. I) noted that aloe does have bactericidal properties. This means it may be useful in periodontal disease, which is a bacterial infection. Simply rub the liquid or gel on the gums.

When you take care of your gums and teeth, you are helping yourself on many levels. Superficially, you will retain your beautiful, white-toothed, smile. Your breath will smell sweet. Moreover, your heart and arteries will have an added protection against the onslaught of bacteria.

Institute For Healthy Aging

Dental Botox gains popularity -- and adversaries

2010-07-08T09:22:00.000-07:00

Dentists aren't just wielding needles filled with Novocain these days. Many are now injecting their patients with Botox to improve appearances and alleviate pain -- while at the same time inciting the ire of dermatologists, plastic surgeons, and some of their colleagues.

As state dental boards around the U.S. struggle with how to regulate such injections, some dentists are forging ahead -- and establishing a lucrative new sideline in the process. "We are creating a new category in dentistry," said Louis Malcmacher, D.D.S., president of the American Academy of Facial Esthetics, who teaches dentists how to use Botox.

“It takes a lot more than teeth to make a great-looking smile.”
— Louis Malcmacher, D.D.S.

Nearly 10% of dentists now use Botox, Dr. Malcmacher said, and demand to learn how to administer it is exploding. Dr. Malcmacher expects to teach about 60 two-day seminars on Botox this year, three times as many as last year. And no wonder. With the recession damaging many dentists' bottom line, it's hard to resist the prospect of earning tens of thousands of dollars each year with a relatively simple addition to the services they offer.

"It's a real no-brainer," said Catherine Maley, an aesthetic industry marketing expert who began selling Botox marketing kits for dentists six months ago. "There's a 50% markup, and it takes a couple of minutes to do." She estimates that the average dentist can earn $148,780 a year doing Botox injections, assuming that 20% of their current dental patients will want to get injections two to three times a year. The cost to remove wrinkles between the eyebrows can range from $300 to $400, and getting rid of vertical pucker lines around the mouth can cost $100 to $200 more. In addition, since Botox effects can fade after a few months, many patients return repeatedly for refresher injections.

Dentists are well-positioned to take advantage of the Botox boom because they see patients several times a year, Maley said. With Botox patients needing regular touch-ups, it's convenient for them to have the treatments added to their routine dental cleanings, she added.

Yet Maley advises dentists not to advertise the services in order to reduce the chances that other professional groups will challenge their ability to do such work. Some dentists simply hang up signs in their offices offering the injections -- and watch demand soar, she said.

A turf war?

As Botox demand continues to surge, turf wars over who should be able to administer the medication show no signs of abating. Plastic surgeons and dermatologists are adamant that dentists should not be giving injections in the face. "I'd be very reluctant to let someone stick a needle in my forehead with no training in that area," said Renato Saltz, M.D., president of the American Society for Aesthetic Plastic Surgery (ASAPS). "Everybody feels qualified to handle this. But it boils down to people's ability to handle complications."

In addition to the aesthetic effects achieved with Botox, some dentists use it to treat bruxism, temporomandibular disorders, and migraine headaches.

But many dentists are equally adamant that Botox offers numerous clinical advantages outside of cosmetics (see sidebar). And some argue that they are more qualified to give Botox injections than even dermatologists and plastic surgeons.

"Dentists give more injections than any other healthcare professional," Dr. Malcmacher said.

In addition, almost all of the dental protocols for Botox were co-developed by a dentist. Howard Katz, D.D.S., a San Diego dentist, said he designed most of the protocols while he was co-developing a drug to reverse the effects of numbing agents (OraVerse, Novalar Pharmaceuticals). Dr Katz’s protocols for Botox use are among those that are taught to dentists and physicians around the world.

He initially went to Allergan, which manufactures Botox, looking for studies that might be relevant to his work. At that time, Botox was cleared by the FDA for only a small number of therapeutic purposes, including treating such conditions as crossed eyes and uncontrollable blinking. Allergan didn't have any studies to help Dr. Katz, so he developed protocols for Botox and patented them. Dr. Katz eventually developed 19 uses for Botox in dentistry.

Qualifications questioned

Clinical applications

In addition to its cosmetic uses, Botox is used to alleviate a variety of dental problems.

Orthodontists may use it to retrain muscles not to work so hard, preventing teeth from shifting back after braces are removed, said Louis Malcmacher, D.D.S., president of the American Academy of Facial Esthetics. Similarly, prosthodontists may inject it to help patients relax their muscles and not spit out new dentures.

Dentists have also used Botox to help patients suffering from bruxism, temporomandibular disorders, and migraine headaches. Many people turn to the medication when they can't get relief from mouthguards, said Howard Katz, D.D.S., describing people who come to his office carrying supermarket bags filled with night guards that didn't work.

"It doesn't make sense that generic splints are still considered the standard of care for bruxism," he said.

Even periodontists can benefit from using Botox, said Dr. Katz, pointing out that one leading cause of losing gum tissue involves muscles pulling too hard on frenums that join lips to gums.

"In just about every aspect of dentistry, there's a necessity to control force without being aggressive," he said.

The majority of Botox injections performed by dentists are in Europe and the U.K., he said. But for dentists in the U.S., he said, "it's taken 10 years to catch on." Part of the problem for U.S. dentists is that they are often challenged about their qualifications, even by some of their peers.

In Maryland, an oral surgeon complained to the state dental board about a dentist doing Botox injections, said Gigi Meinecke, D.M.D., who has a private practice in Potomac, MD. That complaint led to a protracted discussion in the state about when and whether dentists should be allowed to do Botox treatments.

At first, the state dental board said dentists could not do such cosmetic treatments, Dr. Meinecke said, with a board member telling her he believed dentists should "only be drilling teeth." But later, the state attorney general said that state law neither allowed nor barred dentists from doing injections. Now, the state dental board has launched a committee to determine whether to support a change in the law.

Dr. Saltz said the ASAPS has been talking to state regulators in Utah, Oregon, California, New Jersey, and other states to educate them about the potential problems with dentists and other professionals performing Botox injections.

In 2009, 18 state dental boards had specific policies on cosmetic usage of Botox, according to the Academy of General Dentistry. All states allow dentists to inject Botox for therapeutic reasons.

But separating therapeutic from cosmetic applications of Botox amounts to making a distinction without a difference, according to Dr. Katz. When you inject it, "it doesn't stay where you put it," he said. So, for example, if patients get injections around their temples and forehead to reduce teeth clenching, they will get an added cosmetic benefit: their smile lines will disappear, too.

Cosmetic dentists, meanwhile, say they have used Botox to replace complicated procedures aimed at eliminating gummy smiles. Rather than offering patients just "horrible surgical options" that involve crown lengthening and veneers, Dr. Meinecke said she can simply inject Botox into one of the five muscles that raises the upper lip.

In fact, cosmetic dentists say they need to go beyond teeth and gum work to improve their patients' appearances. Patients who walk out of the office with beautiful veneers and thin, wrinkled lips simply won't look good, said Dr. Malcmacher, who injects Botox in almost all of his patients who get veneers.

"We've become very tooth-centric in dentistry," he said. "It takes a lot more than teeth to make a great-looking smile."

11 home remedies to beat bad breath

2010-07-08T09:14:00.000-07:00

Let’s face it, bad breath is embarrassing. The good news is that for the most part—with proper dental care—bad breath, also called halitosis, can be avoided. Maintaining good oral health is essential to reducing bad breath, as bacteria that builds up on the back of your tongue or in between your teeth is the main culprit. Bad breath can be caused by foods, smoking, dry mouth, medical conditions, gum disease, and sinus conditions. No wonder dental hygiene is such big business.

If your halitosis hangs on for more than 24 hours without an obvious cause, call your dentist or doctor, says Roger P. Levin, D.D.S. It can be a sign of gum disease, gastrointestinal problems, sinus infection, bronchitis, or even more serious diseases, such as diabetes, liver or kidney failure, and cancer. Bad breath can also be a sign of dehydration or zinc deficiency.

Beat the smelly bacteria in your mouth with these easy tips from Prevention Magazine:

Spice things up
Other herbs and spices in your kitchen are natural breath enhancers. Carry a tiny plastic bag of cloves, fennel, or anise seeds to chew after odorous meals.

Brush your tongue
"Most people overlook their tongues," says Dr. Shapira. "Your tongue is covered with little hairlike projections, which under a microscope look like a forest of mushrooms. Under the caps of the 'mushrooms,' there's room to harbor plaque and some of the things we eat. That causes bad breath." His advice? While brushing, gently sweep the top of your tongue, too, so that you don't leave food and bacteria behind to breed bad breath.

Create your own gargle
Mix extracts of sage, calendula, and myrrh gum (all available at health food stores) in equal proportions and gargle with the mixture four times a day. Keep the mouthwash in a tightly sealed jar at room temperature.

Even when you can't brush, you can rinse. Take a sip of water after meals, swish it around, and wash the smell of food from your mouth, says Jerry F. Taintor, D.D.S.

Eat your parsley
Parsley adds more than green to your lunch plate; it's also a breath-saver, because it contains chlorophyll, a known breath deodorizer. So pick up that sprig garnishing your plate and chew it thoroughly. Or toss a few handfuls (even add some watercress to the mix) in a juicer. Sip the juice anytime you need to refresh your breath.

Watch your intake of odorous eats
Highly spiced foods like to linger long after the party's over. Certain tastes and smells recirculate through the essential oils that they leave in your mouth. Depending on how much you eat, the odor can remain up to 24 hours, no matter how often you brush your teeth. Some foods to avoid include onions, hot peppers, and garlic.

Ease up on cheese
Camembert, Roquefort, and blue cheese are called strong for good reason—they get a hold on your breath and don't let go. Other dairy products may have the same effect.

Ban certain beverages
Coffee, beer, wine, and whiskey are at the top of the list of liquid offenders. Each leaves a residue that can attach to the plaque in your mouth and infiltrate your digestive system. Each breath you take spews traces back into the air.

Carry a toothbrush
Some odors can be eliminated — permanently or temporarily — if you brush immediately after a meal. The main culprit in bad breath is a soft, sticky film of living and dead bacteria that clings to your teeth and gums, says Eric Shapira, D.D.S. That film is called plaque.

At any time, there are 50 trillion of these microscopic organisms loitering in your mouth. They sit in every dark corner, eating each morsel of food that passes your lips, collecting little smells, and producing little odors of their own. As you exhale, the bacteria exhale. So brush away the plaque after each meal and get rid of some of the breath problem.

Rinse out your mouth
Even when you can't brush, you can rinse. Take a sip of water after meals, swish it around, and wash the smell of food from your mouth, says Jerry F. Taintor, D.D.S.

Gargle on minty mouthwash
If you need 20 minutes of freedom from bad breath, gargling with a mouthwash is a great idea. But like Cinderella's coach-turned-pumpkin, when your time is up, the magic will be gone, and you'll be back to talking from behind your hand again.

Chew a mint or some gum
Like mouthwash, a breath mint or minty gum is just a cover-up, good for a short interview, a short ride in a compact car, or a very short date.

Veterans included in new health plan

2010-05-16T12:07:00.001-07:00

A bill signed into law by President Barack Obama takes the first step toward offering dental benefits to all 23 million U.S. veterans and also veterans' dependents and survivors.

“The legislation is very positive, but it is simply too early to comment beyond that.”

— Joe Davis, Veterans of Foreign Wars

The Caregivers and Veterans Omnibus Health Services Act, signed May 5 by Obama, directs the Department of Veterans Affairs (VA) to undertake a feasibility study on selling dental insurance to these groups.

The law is vague on specifics, with much left to the VA to decide. "The legislation is very positive, but it is simply too early to comment beyond that," said Joe Davis, a spokesman for the Veterans of Foreign Wars (VFW).

The insurance program will be voluntary, and the VA "will contract with a dental insurer" to administer the plan, charging premiums high enough to cover its cost.

VA spokesman Drew Brookie said he had no information yet beyond the text of the bill itself, which leaves unclear such key questions as where the pilot program will take place and how patients and providers can sign up.

Covered benefits will include at minimum diagnostic, preventive, endodontic, and other restorative services, as well as surgical and emergency services.

Currently, veterans are only eligible for dental benefits under one of the following circumstances: their dental needs result from their military service, their dental needs affect a covered medical condition, they are disabled or unemployable because of their service, or they are homeless or in rehabilitation. The VA directly employs a team of dentists. The new law specifically leaves these programs in place.

Under the terms of the new law, the pilot dental insurance program will start some time in the next 267 days and will last three years.

The pilot program is part of a larger package of health benefits offered to veterans under the new law. The law offers expanded healthcare for female veterans, such as maternity care for newborn children. It eliminates co-payments for badly disabled veterans, expands homeless support, and extends benefits to people who care for veterans.

"We're forever mindful that our obligations to our troops don't end on the battlefield," said Obama in signing the bill. "Just as we have a responsibility to train and equip them when we send them into harm's way, we have a responsibility to take care of them when they come home."

Oral health declining in the U.S.

2010-05-16T12:05:00.001-07:00

In a recent story on dental health aid therapists, the New York Times noted that "a study last year from the Centers for Disease Control [sic] showed that Americans' dental health was worsening for the first time since statistics began to be kept."

But the gloomy pronouncement may be in error. Last year, the Centers for Disease Control and Prevention (CDC) released its annual report on U.S. health, "Health, United States, 2007." The report had some dismal numbers on access to care, but it noted that the oral health of the nation has improved in recent times.

"Between 1988–1994 and 2001–2004, approximately one-quarter of adults 20–64 years of age had untreated dental caries, down from nearly one-half in 1971–1974," the report noted.

Another CDC report released in April 2007 -- "Trends in Oral Health Status: United States, 1988–1994 and 1999–2004" -- noted that "for most Americans, oral health status has improved since 1988–1994." Both reports relied for oral health statistics primarily on the National Health and Nutrition Examination Survey, for which 2004 statistics are the most recently available.

The second CDC report also noted that since the early 1970s dental caries levels have declined significantly among school-aged children, fewer adults have experienced tooth loss because of dental decay or periodontal disease, and complete tooth loss among adults has consistently declined.

But even though the oral health of the nation has improved, "oral health disparities remain across some population groups."

Mouthwash facts

2010-05-16T12:04:00.001-07:00

Most of us have a bottle of mouthwash in our medicine cabinets or on our bathroom counter. Maybe you use yours everyday or simply keep it around for those times when you need a quick breath freshener without having to pick up your toothbrush. Although the common belief is that mouthwash kills bad breath, experts have conflicting arguments about the benefits of mouthwash, or lack thereof. It's time to sort through the evidence and learn the truth about mouthwash once and for all.

Do You Know Your Mouthwash?

There are two schools of thought when it comes to formulating mouthwash. One style contains a high percentage of alcohol. For example, Listerine contains 26.9% alcohol, which is 5 times more than most beers and twice as much as wine.

Contrary to popular belief, the alcohol in such mouthwashes does not kill the bacteria responsible for bad breath. Rather, the alcohol is used as a carrier of essential oils, which are the active ingredients in the formula. In the case of Listerine, eucalyptol, menthol, methyl salicylate and thymol dissolve in the alcohol so they can reach your gums and effectively target plaque.

The problem with alcohol-based mouthwashes, argue some critics, is that alcohol is known to dry out the mouth. People with dry mouth are more prone to bad breath because they do not have enough saliva available to naturally wash away the bacteria, which release mouth odors. While dry mouth seems like a valid concern, members of the American Dental Association have noted that alcohol-containing mouthwashes do not exacerbate bad breath.

Research supports this claim. One study showed that people who already suffered from dry mouth who rinsed with Listerine threes times a day did not experience any additional dryness.

There may, however, be a more pressing problem with alcohol-based products. They can be a danger to children, who may be curious enough to drink such products. If there are children in your home, you might consider using an alcohol-free mouthwash, such as Crest Pro-Health.

Do They Really Work?

Regardless of what formula you choose, the question about mouthwash remains: Do they really work?

It is estimated that 25% of Americans suffer from chronic bad breath. While Listerine and various other products may be effective for preventing conditions like gingivitis, they do not kill bacteria in the mouth. Bad breath is the result of sulfur compounds released by bacteria. Everyone collects bacteria throughout the day. People with cavities or swollen gums have an additional challenge, however, because there is more damaged tissue where bacteria can grow. Studies have demonstrated that ingredients chlorine dioxide and zinc are effective at neutralizing some mouth odors.

To fight bad breath at its source, you need to get rid of bacteria. Unfortunately, mouthwash alone will not accomplish that goal. Experts suggest that twice or even three times daily brushing and flossing is the best defense against bacteria. Using a tongue scraper to remove additional bacteria is highly effective for many people with chronic bad breath. When you brush, floss or scrape, you are physically removing the odor-causing bacteria. Mouthwash may promote healthy gums and provide a fresh clean feeling, but it does not eliminate bacteria.

The final verdict?

If you enjoy using mouthwash in addition to regular brushing and flossing, there is no need to change your routine. If you are struggling with bad breath, you should focus your efforts on physically removing bacteria by brushing, flossing and any other solutions recommended by your dentist. Mouthwash can indeed mask and even neutralize unpleasant odors, but it will not solve the problem on its own.

Preventing and controlling diabetes

2010-05-16T12:02:00.000-07:00

The American Diabetes Association feels so strongly about the link between periodontal disease and type 2 diabetes that the group invited a number of dentists to share their thoughts on this growing problem during a special symposium at the 68th annual meeting of the American Diabetes Association this week in San Francisco.

According to the American Dental Association, nearly 10% (21 million) of the U.S. population has diabetes, which means U.S. dentists can expect to have more than 120 diabetic patient visits per year. Some 5% of diabetic patients are type 1, while the other 95% are type 2 -- the form that develops in adulthood and is linked to excess weight and a sedentary lifestyle.

Dental disease and the associated inflammation is an early warning sign of diabetes and its complications. In addition, diabetics with periodontal disease have a harder time controlling blood sugar levels.

"One of the many complications of diabetes is a greater risk for periodontal disease," said Maria E. Ryan, D.D.S., Ph.D., a professor of oral biology and pathology at Stony Brook University, New York, at the diabetes association dental symposium. "If you have this oral infection and inflammation, as with any infection, it's much more difficult to control blood glucose levels."

A key finding to be reported at the diabetes meeting was the fact that in prediabetic patients -- those who are insulin-resistant but are not yet presenting with the disease -- the level of oral disease seems to correlate with the insulin resistance, she added.

"We have found evidence that the severity of periodontal disease is associated with higher levels of insulin resistance, often a precursor of type 2 diabetes, as well as with higher levels of A1C, a measure of poor glycemic control of diabetes," Dr. Ryan said at the meeting.

Recent studies have also shown that having periodontal disease makes those with type 2 diabetes more likely to develop worsened glycemic control and puts them at much greater risk of end-stage kidney disease and death, according to George W. Taylor, Dr.P.H., D.M.D., an associate professor of dentistry at the University of Michigan.

What dentists can do:

While patients with well-controlled diabetes can often be treated in similar ways as nondiabetic patients, diabetic patients often do have special needs.

The American Dental Association offers these tips for working with diabetic patients:

• Emphasize soft-tissue management to help avoid infections.

• Establish a more frequent recall schedule if indicated -- three to four months rather than six to 12 months.

• Emphasize proper home care, including brushing twice a day, flossing daily, and possibly using plaque-reducing toothpaste and mouthwash to help control gingivitis.

• For nonsurgical procedures such as periodontal debridement, restorations, orthodontic adjustments, fluoride treatments, and intraoral x-rays, try to schedule morning appointments and offer regular bathroom and snack breaks.

• For surgical procedures such as extractions and implants, try to schedule morning appointments and treatment breaks. Also consider systemic antibiotics for patients who have frequent infections or heal poorly. Consult with the patient or his or her physician about meal schedules and timing/dosage of insulin.

He pointed to an analysis of the National Health and Nutrition Examination Survey of the U.S. population data between 1988 and 1994, in which he and his colleagues found that people with periodontal disease were twice as likely to be insulin-resistant than those without such disease. This result was found after controlling for other characteristics that would be associated with insulin resistance, such as obesity, lipids, exercise, and other markers of inflammation, and whether they had diabetes.

Dr. Taylor also reported on studies at the University of Michigan and elsewhere that further demonstrate the association between periodontitis and the complications of type 2 diabetes.

"Given the numerous medical studies showing that good glycemic control results in reduced development and progression of diabetes complications, we believe there is the potential that periodontal treatment can provide an increment in diabetes control and subsequently a reduction in the risk for diabetes complications," Dr. Taylor said.

For example, a recent set of observational studies of southwestern U.S. Pima Indians, a population with a very high rate of type 2 diabetes, investigated whether those with periodontitis are more likely to develop poorer glycemic control. Dr. Taylor noted that those with periodontitis were more than four times as likely to develop worsened glycemic control after two years of follow-up.

Dr. Ryan recommends that the medical and dental communities work together to play a more proactive and preventive role in treating diabetic patients. In addition to checking for bleeding gums and other signs of gingivitis, if a patient's glycemia has been difficult to control, the physician should ask when the patient last visited a dentist, whether periodontitis has been diagnosed, and, if so, whether treatment has been completed. A consultation with the dentist might then be appropriate to discuss whether periodontal treatment has been successful or if a more intensive approach with oral or subantimicrobial antibiotics is in order.

"Just as it is difficult to control diabetes while the patient has an infected leg ulcer, the same applies when there's infection and inflammation of the gums," she said. "Diabetes educators and healthcare providers need to be informed of this and refer their patients to dentists for evaluation," she noted in an interview with DrBicuspid.com.

In addition to helping diabetic patients manage their disease through better oral health and regular checkups, dental care providers can also play an important role in helping to diagnose patients whose diabetes has not yet been detected, Dr. Ryan added.

"The Centers for Disease Control estimates that 40% of people with diabetes don't know they have it," she said. "And certainly dental care providers are in a position to help identify people at risk of diabetes. We know that periodontal disease leads to heightened levels of C-reactive proteins, and studies are now showing that people with elevated C-reactive protein levels are the most likely to convert to diabetes within five years. But if you treat the periodontal disease, you can reduce the levels of A1C. Now we need to find out if treating periodontal disease will delay the onset of diabetes, and this we don't know yet."

Elderly have barriers to proper dental care

2010-05-16T12:00:00.001-07:00

An inability to pay for treatment, lack of transport to the dental office, and lack of perceived need are some of the biggest barriers to dental care for elderly patients, according to a new ADA survey.

The ADA Survey Center conducted the survey on behalf of the Council on Access, Prevention, and Interprofessional Relations in response to a resolution that called for initiatives related to the oral health of vulnerable elders, according to an ADA news article.

"As we learn more about the oral-systemic relationship of disease, and as our population ages, we as a council are increasingly concerned about the quality of life faced by those elderly who have dental needs and little or no ability to have them addressed," stated Jerald Boseman, D.D.S., a council member from Salt Lake City, in the article.

Other results from the survey include:

• In 2007, more than 92% of all dentists provided care to the vulnerable elderly -- patients who are over age 65 and have limited mobility, limited resources, or complex health status.

• More than 24% required dentists to consult with dental specialists, and more than 37% required dentists to consult with physicians.

• More than 68% of dentists said that they needed more information on managing patients with complex medical histories, managing xerostomia (63.6%), and managing dementia patients (49.1%).

• Some of the major barriers to care reported by the dentists included inability to pay for services (88.7%), lack of transportation to dentist's office (68.4%), inadequate financial support for care from local, state, and/or federal programs (65.5%).

2010-04-03T12:58:00.000-07:00

This article from "heartwire" (http://www.theheart.org/, a website for cardiologists, brought joy to all of the chocolate lovers we know!

Largest Study to Date Links Chocolate to Lower BP and CV Risk

Lisa Nainggolan

April 1, 2010 (Nuthetal, Germany) — The largest observational study so far to examine the association between chocolate consumption and risk of cardiovascular disease has found that those who ate the most chocolate--around 7.5 g per day--had a 39% lower risk of MI and stroke than individuals who ate almost no chocolate (1.7 g per day) [1].

Lead author Dr Brian Buijsse (German Institute of Human Nutrition, Nuthetal, Germany) told heartwire : "This shows that habitual consumption of chocolate is related to a lower risk of heart disease and stroke that is partly explained by blood-pressure reduction. The risk reduction is stronger for stroke than for MI, which is logical because it appears that chocolate and cocoa have a pronounced effect on BP, and BP is a higher risk factor for stroke than for MI." Buijsse and colleagues report their findings online March 31, 2010 in the European Heart Journal.

However, Buijsse cautions that only small amounts of chocolate were associated with the benefits and it is too early to give recommendations on chocolate consumption: "Maybe it's a boring message, but it's a little too early to come up with recommendations, because chocolate contains so many calories and sugar, and obesity is already an epidemic. We have to be careful." However, he added, that if people did want to treat themselves, they would be better off choosing small amounts of chocolate, preferably dark chocolate, over other sweet snacks. "We know it is the cocoa content in chocolate that is important, so the higher the cocoa content, the better."

Dr Steffen Desch (University of Leipzig, Heart Center, Germany), who was not involved with this study but who has performed research on the effects of chocolate on blood pressure, told heartwire : "This is an interesting study that adds to the growing body of evidence that flavanol-rich chocolate might be associated with health benefits. Several epidemiological studies (including the Zuphten Elderly Study, by the same first author) and even more physiological trials have been published before."

"What is missing now is a large-scale randomized trial of flavanol-rich chocolate versus control. The most reasonable end point would probably be the change in blood pressure between groups." However, Desch added, "the major problems in designing such a study are the lack of funding and finding an appropriate control substance. To the best of my knowledge, there is no commercially available flavanol-free chocolate that offers the distinct bitter taste and dark color inherent to cocoa-rich chocolate."

Biggest Chocolate Consumers Had Lowest Blood Pressure

Buijsse and colleagues followed 19 357 people, aged between 35 and 65, who were participants in the Potsdam arm of the European Prospective Investigation into Cancer (EPIC). They received medical checks, including blood pressure and height and weight measurements at the start of the study (1994–1998), and they also answered questions about their diet, lifestyle, and health, including how frequently they ate 50-g bars of chocolate.

The research was conducted before the health benefits of chocolate and cocoa were recognized, so no differentiation was made between milk, dark, and white chocolate in the study. But in a subset analysis of 1568 participants later asked to recall their chocolate intake over a 24-hour period, 57% ate milk chocolate, 24% dark chocolate, and 2% white chocolate.

Participants were divided into quartiles according to their level of chocolate consumption. Those in the top quartile, eating around 7.5 g of chocolate a day, had blood pressure that was about 1 mm Hg (systolic) and 0.9 mm Hg (diastolic) lower than those in the bottom quartile.

In follow-up questionnaires, sent out every two or three years until December 2006, the participants were asked whether they had had a heart attack or stroke, information that was subsequently verified by medical records from general physicians or hospitals. Death certificates from those who had died were also used to identify MIs and strokes.

"Our hypothesis was that because chocolate appears to have a pronounced effect on blood pressure, chocolate consumption would lower the risk of strokes and heart attacks, with a stronger effect being seen for stroke,” explained Buijsse.

Those Eating Most Chocolate Had Half the Risk of Stroke

During the eight years, there were 166 MIs (24 fatal) and 136 strokes (12 fatal); people in the top quartile had a 27% reduced risk of MI and nearly half the risk (48%) of stroke, compared with those in the lowest quartile. The relative risk of the combined outcome of MI and stroke for top vs bottom quartile was 0.61 (p=0.014).

The researchers found that lower baseline blood pressure explained 12% of the reduced risk of the combined outcome, but even after taking this into account, those in the top quartile still had their risk reduced by a third (32%) compared with those in the bottom quartile over the duration of the study.

To put this in terms of absolute risk, Buijsse said if people in the group eating the least amount of chocolate increased their chocolate intake by 6 g a day, 85 fewer heart attacks and strokes per 10 000 people could be expected to occur over a period of about 10 years.

He says it appears that flavanols in chocolate are responsible for the beneficial effects, causing the release of nitric oxide, which contributes to lower BP and improves platelet function.

Dr Frank Ruschitzka (University Hospital, Zurich, Switzerland) agrees. He said in a European Society of Cardiology statement [2]: "Basic science has demonstrated quite convincingly that dark chocolate particularly, with a cocoa content of at least 70%, reduces oxidative stress and improves vascular and platelet function."

Only Small Amounts of Chocolate Beneficial; Don't Eat Too Much

Buissje said this work builds on his earlier small trial--the Zuphten Elderly Study--performed in 500 men in Holland, which showed that chocolate consumption lowered overall cardiovascular mortality. "Due to the small size of this study, we were not able to differentiate between stroke and MI in this, but now we are able to look at stroke and MI separately, so it's a nice addition," he notes.

And the findings are in line with an intervention study that showed that eating around 6 g of chocolate a day--one small square of a 100-g bar--might lower CV disease risk, he says. "So the effects are achieved with very small amounts."

British Heart Foundation dietician Victoria Taylor made the same point: "It's important to read the small print with this study. The amount consumed on average by even the highest consumers was about one square of chocolate a day or half a small chocolate Easter egg in a week, so the benefits were associated with a fairly small amount of chocolate.

"Some people will be tempted to eat more than one square; however, chocolate has high amounts of calories and saturated fat . . . two of the key risk factors for heart disease," she noted in a statement [3].

Ruschitzka similarly urged caution: "Before you rush to add dark chocolate to your diet, be aware that 100 g of dark chocolate contains roughly 500 calories. As such, you may want to subtract an equivalent amount of calories, by cutting back on other foods, to avoid weight gain."

Teeth whitening

2010-03-21T12:52:00.000-07:00

There are many teeth-whitening products on the market, but they are very similar in that they use the same active ingredients. Over-eager patients can damage their gums and even turn their teeth translucent, so it's best to have a dentist guide you to the best products.

Whitening oxidizes by sending oxygen into the tooth, through the enamel and into the layer (the dentin) that brings color to your teeth. Teeth have "base colors" (hues) of gray, yellow or red-brown, but after using a whitening product, they all turn whiter (They actually have a higher value...another property of color). This oxygen is supplied through the breakdown of carbamide peroxide or hydrogen peroxide in the whitening product (WARNING: DO NOT USE HYDROGEN PEROXIDE OR HOUSEHOLD BLEACH (CHLOROX) FROM A BOTTLE. THEY WILL SEVERELY BURN YOU!)

Tooth sensitivity is very common after use of these products, but your dentist can supply the type of product that has a built-in desensitizer...or you can shorten the length of time you bleach...or you can change to a product with a lower concentration of active ingredient. In-office, "while you wait", bleaching will typically cause a LOT of sensitivity, since the concentration of bleach is 35%. You will get the same results with at-home bleaching...it just takes a little while longer, typically two weeks at the most.

Whitening trays that don't touch the gums are best because you then avoid gum irritation and tenderness and use less of the whitening product each time you put the tray in.

Avoid the whitening kiosks that are popping up all over at malls. Rarely is ANY dental professional involved and unknown dental conditions can lead to expensive problems. The safest, most reliable way to whiten is to see your dentist.

Gum disease quiz

2010-02-14T13:18:00.002-08:00

Over 80% of adults have gum disease. Take this quiz. If you answer yes to any of the following questions, you may have periodontal disease:

1. Do your gums bleed when you brush, floss, or eat?

2. Do your teeth feel like they are moving?

3. Are your gums receding?

4. Do your teeth look longer?

5. Do you have persistent bad breath?

6. Does your bite feel different?

7. Is it difficult for you to chew?

8. Have you noticed pus around your teeth?

9. Do your gums feel tender or look swollen?

10. Do your teeth or gums hurt?

Health and your gums

2010-02-14T13:18:00.000-08:00

Contrary to what you have been told, bleeding gums are not normal and shouldn’t be ignored. Would you be concerned if your hands bled every time you washed them? Your gums are no different.

Bleeding that occurs when you floss, brush, or eat is usually caused by a bacterial infection and represents one of the first symptoms of gum disease (periodontal disease). Researchers have found links between periodontal infection and other diseases. Heart disease, diabetes, respiratory diseases, osteoporosis, artificial joints, and pregnancy complications seem to be connected to your oral health.

The current theory is that bacteria present in infected gum tissues and jaw bone breaks loose, travels though your bloodstream, and attaches itself to your heart and other organs. A recent study found that 85% of heart-attack patients have periodontal disease, making this connection higher than the relationship between high cholesterol and heart attacks.

Doggie Dentures

2010-02-14T13:17:00.001-08:00

If you're a dog lover, you know that it's important for Fido to have healthy teeth. We found this website for those dogs who lost their teeth to gum disease:

http://www.pedigree.com/default.aspx

We think that cats are next!

2010-02-14T13:16:00.001-08:00

Dental Quackwatch

We found an excellent site for those of you who have questions about quackery in dentistry. It has very useful, accurate information about implants, silver filling safety, teeth whitening and other dental conditions.

http://www.dentalwatch.org/

Star Spangled Banner

2010-01-20T19:32:00.000-08:00

We love our country and wanted to share these two versions of our National Anthem with you. They are pretty different from each other but both stir the hearts of tried-and-true Americans!

Enjoy them at

http://www.youtube.com/watch?v=QKCVS57j284&feature=related

and at

http://www.youtube.com/watch?v=9ETrr-XHBjE&fmt=18

May God continue to bless America.

2010-01-18T09:10:00.000-08:00

We know that gum disease is the leading cause of tooth loss for American adults. It also causes an increased risk for health problems, from heart attack and stroke to diabetes complications and low-weight births. But new evidence shows that periodotnal disease can impair mental function, outside of the established connection between gum disease and Alzheimer’s or dementia. The newly found link may stem from inflammation in the body that originates in the mouth.

The study, led by Dr. James Noble, involved 2,350 subjects of various genders who were tested for periodontal disease, then underwent a series of mental skills assessments. Adults over 60 with a high level of a bacterial species that causes gum disease, were three times more likely to forget a three-word sequence after a time lapse. The higher the bacterial level, the greater the potential for forgetting the sequence.

Published in the Journal of Neurology, Neurosurgery, and Psychiatry, this US study by Columbia College of Physicians and Surgeons in New York relates periodontal disease to cognitive dysfunction. More research is necessary to support the findings.

2010-01-16T08:47:00.000-08:00

If you are looking for a gentle, courteous, and friendly dentist, you've come to the right place! Advanced Family Dental's dedicated staff provides advanced family and cosmetic dentistry for every major dental need. To see more about us, go to http://www.stlafd.com/.