Archive for the ‘Oral Systemic Health’ Category

Dental Professionals Role in Early Intervention of Methamphetamine Addiction

Tuesday, October 7th, 2014

By Noel Brandon Kelsch, RDH

iStock_000038322898Small

You never know just who you might get to sit next to on a plane and what you might learn. This past flight for me was a great learning experience.

I had a dental professional sit next to me and she soon discovered I was working on my slides for a course on the impact of meth.  She told me she has never seen anyone with a methamphetamine addiction and that she is sure of it. She saw no reason to attend a lecture about meth because none of her patients would EVER consider doing anything like that, they were educated, well informed professionals in general. She lived in a suburb where things like that just did not happen. “That happens in rural areas and big cities.” She said. She also explained to me that seizure rates had been cut in half in her state and that the war on drugs was well on the way to being resolved there.

Meth does not care where you went to school. Nor does it care what your profession is, how much money you make or what area you live in. The crisis this drug creates impacts all age and economic levels of our society, including adult professionals, teenagers and children. Because most people don’t believe someone they know could be using or don’t realize that this drug is available and abused by people at all levels of our society regardless of income or ethnic background, it sometimes interferes with diagnosis.

The seizure of meth labs across the country has gone down. That is exciting! The problem is that because of new systems of manufacturing it no longer requires a complete lab to create meth. For example the “shake and bake” method uses a liter soda bottle and has increasing emergency room visits as this very explosive process comes into play. Successes are happening with a decline in use in some areas, but the war is not over. Early intervention plays a major role.

All dental professionals have a role that is vital in early intervention because the first signs of meth use appear in the mouth. This non-pre-judicial drug is enormously addictive and eventually rots the teeth down to the gum line.

According to the National Survey on Drug Use and Health 2012 age 12 and older 4.6 percent have used meth sometime in their life. That means for every 100 people that sit in your dental chair 4.6 percent of them have used meth sometime in their life. It is so vital to have that information before you treat them.

Early warning signs and symptoms exhibited by people using methamphamine:

•   Obvious deterioration of teeth

•   Malnourished and disheveled appearance

•   Abnormal vital signs

•   Grinding of teeth

•   Pale complexion and red eyes

•   Aging in appearance

•   Irritability or euphoria

•   Nervousness; sweaty and clammy skin

Dental professionals play a role in early intervention by connecting patients to the resources they need for drug rehabilitation, treatment and recovery. With greater awareness, the odds for early intervention and positive outcomes increase.

 

 

Creating the Ultimate Doctor-Hygiene Patient Exam

Monday, August 4th, 2014

By Karen Davis, RDH, BSDH

Dental Clinic. The dentist explaining to his young patient how t

It seems as though the examination portion of the hygiene visit often lends itself to increased stress, but it doesn’t have to. Creating an ultimate experience is realistic and implementation of these tips will assist.

1.  Let go of the idea that a prophylaxis appointment is all the patient needs!

In practice after practice, dental hygienists are desperately attempting to educate the patient, change behavior, scale all calculus, remove all stain and plaque, perform and record periodontal evaluations, update radiographs, apply fluoride, identify restorative concerns, and so on, all in ONE appointment that lasts 45 – 60 minutes, IF you get started on time!  Sound impossible?  It is. The American Dental Association has done a great job defining the difference between a prophylaxis, scaling and root planing, and periodontal maintenance.  Early in the appointment, if data collected reveals a periodontal diagnosis, it is easy to determine which patients need additional therapy and which patients need preventive care.

2.  Don’t wait until the last five minutes of the appointment to have the exam

In most busy dental practices, waiting until the hygienist is completely finished before notifying the doctor for an exam is almost a guarantee of running behind. Notifying the doctor once data has been collected and potential treatment discussed enables the dentist to look for a natural break in a procedure, interrupt the hygienist during his or her treatment, perform the examination, then both return to completion of their treatments.

3. Use visuals to replace wordy descriptions

Patients will understand and retain information significantly better if audible and visual learning takes place together.  Instead of us doing all of the talking (while working on the patient with sharp instruments) clinicians should intentionally let  “pictures speak 1000 words”.  Intraoral pictures, before and after pictures, educational pamphlets, radiographic pictures, periodontal records, Caesy ®, etc., all assist in the co-discovery process necessary for patients to really understand and desire what we recommend.

4.  Sit the patient upright for communication

Contrary to how most of us commonly communicate with patients in the treatment room, if we are willing to pause, sit the patient upright to describe conditions and discuss possible treatment, we find we actually have to say less, because the patient’s ability to hear and retain information is significantly greater with the use of good eye contact and body positioning.  Sitting the patient upright also allows the patient to feel more comfortable and ask questions and enables us to become the listener. Most patients will not proceed with treatment until their questions have been answered!

5.  Ask for a commitment to treatment

In the treatment room, where value is created and treatment recommendations are made, prior to handing the patient off to an administrator, clinicians need to ask a closing question such as, “So, James are you ready to get started?” Even when the product we are “selling” is optimal oral health, asking the patient to make a commitment fosters ownership of their health.

 

Davis

Ms. Davis is founder of Cutting Edge Concepts®. She is an international speaker and practices dental hygiene in Dallas, Texas. She has served on numerous advisory boards, is considered a key opinion leader to many corporations in the profession and is recognized by Dentistry Today as a “Top Clinician in Continuing Education”.  She is an accomplished author related to her passion of practicing on the cutting edge of the profession. Ms. Davis is a member of the American Academy of Oral & Systemic Health and the American Dental Hygienists’ Association.

 

You and Your Sleep Deprived Patient

Wednesday, July 16th, 2014

By Dr Uche Phillip Odiatu BA, DMD 

woman in bed awakening

You thought you had it all figured out –  during your new patient exam health history section you ask patients what meds they take; if  they have ever been in a motor vehicle accident; and some dentists ask about specific supplements their patients are taking. Well, that is only part of the equation when it comes to your patients’ health history. Current sleep research has shown if you are regularly sleeping less than 7 hours a night you are more likely to suffer from cardiovascular disease, stroke, cancer, diabetes and any number of other inflammatory conditions. Think gingivitis and periodontitis.

Most dental professionals are aware of sleep apnea and its grave consequences on the heart and brain. If sleep apnea is severe a CPAP machine is prescribed by the patients’ health care professional. If the diagnosis is mild a MAD or Mandibular Advancement Device can be made by the dentist. This article is not about obstructive breathing issues but about patients who simply do not get to bed on time, work shift work or have evening habits that disturb their sleep quality and quantity. If you read this article you will receive insightsthat will help you expand your New Patient exam questions or it will support your own healthy living goals.

“There is plenty of compelling evidence supporting the argument that sleep is the most important predictor of how long you live, perhaps more important than whether you smoke, exercise or have high blood pressure or cholesterol levels” ~ Dr William Dement, one of the world’s most prominent sleep researcher and founder of the Stanford University Sleep Disorder Clinic.

  1. Current sleep research has shown that 4 out of 10 people reported they sleep poorly.
  2. 20-40% of Americans work some type of evening or overnight shift.  Michael Howard PhD has reported that people who do shift work spend most of their waking time in a “jet lag” state.
  3. There is an important part of your brain –SUPRACHIASMATIC NUCLEUS – that  is your brain’s circadian clock which does not function well with cross country travel / time zone changes, poor sleep habits, nights shifts, sleep apnea, etc .
  4. When working into the wee hours of the night, cross time zones with cross country air travel to “four on four off” shifts the body’s reserves do not get replenished. From wound healing to trying to recover from a cold or a flu, a sleep debt can bankrupt your good intentions.
  5. Cumulative sleep debt costs you and your patients. People with disrupted sleep from rotating shifts have 3 times as many GI problems such as constipation, abdominal pain, heartburn and reflux (think acid erosion of lower molars) than those who have regular day time work hours
  6. REM (rapid eye movement) sleep is a vitally important part of your night. For optimal emotional health, adults need approximately 100 minutes of REM a night. (This can only be measured in a formal sleep study – called POLYSOMNOGRAPHY).  REM sleep has also be shown by UC Berkeley experts to help processes stressful memories and experiences and bring enhanced well-being into your life. Are you thinking of certain patients with bruxism habits?
  7. Research has shown that visual learning , especially learning to do NEW things gets consolidated while you are asleep – especially during REM sleep. A 2010 Harvard study on memory had their 100 volunteers do a test on finding their way around a maze on a computer. During a five hour break some stayed awake another group napped before taking the test again. The group who napped did the maze 162 seconds faster than the ones who stayed awake when doing the test again. Those who actually dreamed while napping did  their second test maze 225 seconds faster. TAKEAWAY for dentists on three day intense implant courses or leadership training? Take a nap midday or after an 8 hour workshop to internalize, consolidate the information and make it your own.
  8. A prominent Canadian dental journal Oral Health had a cover story demonstrating a relationship between obesity and periodontitis. This relationship was based on the inflammatory mediators released from visceral fat. CDC reported that 30% of Americans are overweight or obese (BMI over 30). What’s the link between lack of sleep and developing an overweight condition? Case Western University research showed that women who sleep less than 7 hours a night were 15% more likely to become overweight; women who had less than 5 hours were 30% more likely to develop obesity. A 2010 JADA article reported that dentists are interested in giving wellness guidance but felt they needed more evidence that losing weight would make for a healthy oral environment. If you are reading current periodicals the evidence is arriving.
  9. Sleep is a critical time enabling the body to heal, repair, restore, and regenerate itself reports Mary O’Brien MD author of The Healing Power of Sleep. Next time when giving post op instructions after an extraction or periodontal surgery tell your patient to get 7-9 hours sleep for the next week for optimal healing and recovery.
  10. Alcohol is the most common drug people use to get to sleep. Admittedly it does get you to sleep quickly. Downside, your sleep is lighter – you don’t get enough of the DEEP SLEEP where your pituitary gland releases growth hormone (the youth hormone for fat burning and maintaining muscle mass). With a single glass of wine before bed it spikes your insulin which also takes you out of fat burning mode. Alcohol before bed encourages snoring and sleep experts report even snoring reduces valuable oxygen flow to your brain
  11. As dentists we are aware of the link between inflammation in the mouth and a diabetic condition. Did you realize that poor sleep disrupts may disrupts good blood sugar management?  Four nights of shift work has been shown in scientific studies to bring about pre-diabetic blood glucose levels in those workers during their shifts.  If someone is not responding favorably to your soft tissue management therapy, you need to question those patients about their sleeping habits.
  12. Contrary to belief older people still require 8 hours sleep if they want to age gracefully. Sleep architecture changes with age (they spend less time in DEEP SLEEP and more time in LIGHT SLEEP) and with slower wound healing people over 60 needquality shut eye.

RECOMMENDATONS:

  1. Sleep in a cool (65-68F) bedroom for deeper sleep
  2. Create a pitch black environment so your melatonin levels remain high during the night
  3. Don’t eat before bed as it subtracts from the rejuvenating role sleep plays as your body is trying to digest a meal that should have been eaten at supper time
  4. If you have to cross multiple time zones and want to perform well in business or a sporting event, give yourself an extra day for each hour off your regular time zone.
  5. Sleep scientists say if you are going to workout 4-7pm is the ideal time in terms of supporting muscle adaptation and also to take advantage of the post exercise body temperature adaptation that sets the mood for sleep in the following 3-4 hours. Early AM workouts is still very productive  and they are the best strategy  to make time for exercise in a busy life. It’s just that current research by Michael Howard PhD has shown that late afternoon evening exercise sets the tone for a healthy sleep later that night
  6. “If you are not sleeping well it is almost impossible to heal well”  – NATIONAL SLEEP FOUNDATION
  7. Guided visualization and relaxation exercises are two of the best ways to support healthy rejuvenating sleep
  8. A clear conscious and a peaceful mind make for a short “sleep latency” (the time it takes to get to sleep – ideally 5-15 minutes).
  9. If you want to support healthy REM sleep and utilize its ability to process emotion and consolidate memory, give yourself a mental suggestion right before you sleep to focus on a specific subject or challenge you are currently undergoing
  10. Napping for 20-30min in the mid afternoon has been shown in numerous studies to enhance emotional well-being and productivity. As long as the naps don’t go longer than 30 minutes night time sleep is not impacted
  11. Find the right mattress for your body type. There is no one best type. Studies have shown that medium to firm is most likely to fit most people’s needs
  12. If you get up in the AM earlier than you wanted to, stay up. After a long continuous sleep, expose yourself to bright full spectrum light or sunlight and get your Sleep-Wake routine formalized.
  13. Don’t do anything else in bed except for the two S’s (sleep and _____). Watching TV, doing your taxes, eating  willdistract you from one of the most important health habits you might have. The brain loves cues that it is preparing to sleep. Lugging your laptop onto your lap to answer emails is highly distracting for your night-time brain
  14. Develop a bedtime ritual which cues your brain for slumber. Following the same steps before bed gets your brain ready for zzzzz.
  15. Many over the counter sleep aids are meant only for short term challenges with sleep. Prescription meds work wonders but they too have a number of side effects and many are not designed for long term use. There are herbal supplements but they too pale in comparison to learning relaxation techniques and developing good sleep hygiene rituals (evening/ pre-night time sleep habits).

This subject is new for the dental industry and I hope to share with you further information in the future. In the meantime “sleep well tonight and don’t let the bed bugs bite.”

REFERENCES:

  • Wamsley&Stickgold, Current Biology, 2010, 20(23)
  • National Sleep Foundation
  • CDC
  • Obesity and Periodntal Health: What’s the link? Should I be concernded? W. Ward et al. OralHealth October 2012
  • Sleep and Your Memory by Michael Howard PhD © 2010 Biomed
  • The Healing Power of Sleep by Mary O’Brien MD Biomed © 2012
  • “Dentists Attitudes About Their Role in Addressing Obesity in Patients” Curran et al.  JADA 2010
  • Geyer, Talachi& Carney, Introduction to Sleep and Polysomnography, 2005

 

OdiatuDr Uche Phillip Odiatu BA, DMD is the author of The Miracle of Health and Fit for the LOVE of IT! This busy practicing dentist is also a NSCA Certified Personal Trainer and a professional member of the American College of Sports Medicine (ACSM). He lectures at most of the major dental conferences in the USA, Canada, the Caribbean and England.www.fitdentist.com

 

Staying Fit on the Road

Tuesday, April 8th, 2014

By Dr. Uche Odiatu, B.A., DMD, NSCA Certified Personal Trainer

woman deciding whether to eat apple or chocolate

Travel, whether it is for business or pleasure, does not necessarily mean throwing all of your hard work in the gym out the window. There are proactive steps that will ensure your trip takes you closer towards your health and fitness goals rather than farther away.

“Twenty years from now you will be more disappointed by the things that you didn’t do than by the things you did. So throw off the bowlines. Sail away from the safe harbour. Catch the trade winds in your sail.  Explore, dream, discover.”

~Mark Twain

  • Affirm to yourself the importance of staying true to your nutritional goals before you leave. Remind yourself of the hard work and effort you have put into your training. Decide ahead if and when you will allow yourself to have a treat night. This will give you peace of mind and the strength to say no to the free airplane cookies.
  • Call the hotel and find out if they have coffee makers in the room. This will be very new for you. You can use this to prepare hot water for instant oatmeal, which you can easily bring in a Tupperware container (bring your own electric kettle if there is no coffee maker). Pack a plastic bowl and a spoon for easy in-room dining. This will save you time and money in the morning. Mix in some tasty chocolate whey protein powder and/or nuts for a great start to your day!
  • Call ahead and pre-order your airplane meals at the time of booking. You can request meals that are low in fat, kosher, vegetarian, or sodium-free to name a few. The bonus about special ordering is that you are often served before everyone else.
  • Pack healthy snacks in your carry-on luggage. Vegetables, fruit, rice whole wheat pitas, nuts, protein bars, and meal replacement shakes will come in handy if you are delayed. Don’t forget your “shaker bottle” for the protein shakes!
  • Drink plenty of water before you leave and remember to stay hydrated during the trip. A well-hydrated body is less prone to jet lag, headaches, and water retention. Avoid alcohol and coffee on the plane as they both can dehydrate you.
  • Don’t let boredom tempt your taste buds into mindless eating. Bring your laptop, a book, a journal, or a copy of your favourite dental or fitness magazine to keep you occupied. Did you know there are many inspirational books available for your Kindle or Kobo?
  • Hit the grocery store as soon as you arrive at your destination. Stock up on non-perishable food items for your hotel room. Excellent choices are bagels, apples, rice cakes, bananas, nuts, rye bread, tuna, and salmon (buy the cans with the pull-off lids if you forgot a can opener). This idea will save you from the late night “hotel vending- machine munchies”.
  • If you are travelling with people who have free license to eat and drink, ask for their support before you leave. Sharing your goals will get them on your side and will save you from the teasing as you reach for your filtered water and your fifth can of wild salmon or Greek yogurt.
  • Maintain your discipline at restaurants by asking for special food preparations. Ask for grilled or broiled meat, sauces and dressings on the side, egg white only omelettes, and steamed vegetables. Everyone will admire your willpower.
  • Make sure you are well rested on your trip. It is easy to make poor food choices when you are lacking energy. Like Vince Lombardi (famous football coach) said: “Fatigue makes cowards of us all.”

There is more to travelling than wining and dining. Remember to have FUN and to create some lasting memories of your trip. Instead of focussing on food, try different activities, meet new people, and enjoy your surroundings. By keeping your self promises you will increase your focus and strengthen your commitment to your personal health goals. Everyone will be amazed and surprised when you return from your trip in better condition than when you left!

 

OdiatuDr U.Odiatu DMD is the author of The Miracle of Health and Fit for the LOVE of It! This busy dentist is also an NSCA Certified Personal Trainer and a professional member of the American College of Sports  Medicine. Www.fitdentist.com

Oral Cancer – A Patients Perspective

Tuesday, February 4th, 2014

By Eva Grayzel

Eva Grayzel, a professional interactive performance artist, was diagnosed with late-stage oral cancer at age 33 and told she had a 15 percent chance of survival. A non-smoker, she was bounced among dental professionals while the ulcer on her tongue grew more prominent and painful. “It was two years and nine months from my first appointment with a dental professional until the day I was finally diagnosed with stage IV squamous cell carcinoma of the lateral tongue. During that time, no one EVER mentioned the words ‘oral cancer’ as a possible cause. Finally, I made an appointment with Dr. Mark Urken, the chief of head and neck surgery at Beth Israel Medical Center. I took the bus into Manhattan that fateful day of April 1, 1998 not having the slightest idea that what was on my tongue was remotely serious, and received the cruelest April Fool’s joke of my life.”

Eva

Eva endured a partial tongue reconstruction, a modified radical neck dissection and a maximum dose of radiation therapy. Through an extraordinarily successful treatment plan, Eva not only survived but also regained her ability to speak clearly. With a second chance at life, Eva couldn’t let the same thing happen to someone else. A champion for early detection, Eva founded Six-Step Screening™, an oral cancer awareness campaign for dental professionals and the general public. For her initiative, she was recognized by the American Academy of Oral Medicine and awarded honorary membership.

Eva2

After speaking at the 2003 ADA Annual session, Eva realized the impact she could have on saving lives by sharing her personal story. The audience doesn’t just hear her story, they ‘experience’ it, as they travel the journey with Eva from a delayed diagnosis of late-stage oral cancer, through the surgery and treatment. When dental professionals hear Eva’s presentation they say, “I never want what happened to Eva to happen to any of my patients.” Because of the personal nature of her story, and the fact that someone such as themselves could have prevented it, motivates them to change how they practice. In contrast to the clinical perspective at educational conferences, Eva humanizes oral cancer, inspiring the audience both professionally and personally. “I share my personal story hoping it will inspire dental professionals to perform oral cancer screenings on all their patients, as well as demand them for themselves and for those they love. Together, we can save lives. It’s more than my mission to educate. It’s my tribute to all those that came before me and my obligation to those that will follow. By publicly sharing my personal journey to help others, I’m gaining back all the years and more of life that oral cancer took from me.”

 

GrayzelMs. Grayzel a nationally recognized Master Storyteller was diagnosed at age 33 with stage IV oral cancer and given a 15% chance of survival. After regaining her deep vibrant voice, Ms. Grayzel applied her stage skills to communicate the depth of her experience in a unique and powerful way. A champion for early detection, Eva founded the Six-Step Screening™ oral cancer awareness campaign for which she was recognized by the American Academy of Oral Medicine. Ms. Grayzel is the author of two children’s books, ‘Mr. C Plays Hide & Seek’ and ‘Mr. C the Globetrotter,’ in the Talk4Hope Family Book Series.

Teeth Healthy Snacks for Kids

Monday, January 6th, 2014

By Dr. Andrea Beltzer

Happy carrot chomping girl

Feeding my kids isn’t always easy.  As parents, we are constantly bombarded with information about what is healthy and what is potentially harmful for our children’s little bodies.  As a parent, I take these decisions very seriously knowing that the choices I make for my kids now will likely impact the choices they will make for themselves when they are older.

I have two children, Lucy who is five and Charlie who is two.  They couldn’t be more different in their eating preferences and habits.  Lucy has a major sweet tooth.  We were recently at her friend’s birthday party at OaksPark.  There were lots of treats being served, including lemonade, fruit punch, cotton candy, chocolate cupcakes, and cups of ice cream.  The kids were sitting at a long picnic table, and the adults were chatting at another table.  It was crowded, and I wasn’t really keeping a close eye on what Lucy was choosing to eat at the other table.  As the kids’ table emptied out, Lucy was still sitting there finishing her chocolate cupcake after having a cup of lemonade, most of her cotton candy and the cup of ice cream.  Most of the other kids had abandoned their treats half-eaten, but not Lucy.  This was her chance, and she was going to consume as much sugar as possible in one sitting, since I wasn’t right there to monitor what she was eating.  I went over to her, and we had a little conversation about making good choices, and how eating all of those treats so quickly was probably going to make her feel a little sick later on.   Then I proceeded to try to wipe off all of the gooey chocolate and sticky cotton candy that was all over her face and hands and have her drink a cup of water to try and neutralize some of the acid that was being produced by those sugar-loving bacteria in her mouth.  Some of the parents who were standing around us chuckled with me knowing that I am a pediatric dentist, and it’s my kid who is the last one sitting at that picnic table trying to devour every last gram of sugar that she can.  Parenting fail?  No, not really.  I was more amused by the situation than embarrassed.  I know that what really matters in the long run is the every day choices that we make, not the very occasional big treat that sometimes happens during special occasions and holidays.

Charlie, my two-year old, is the exact opposite of Lucy in many ways, including his eating preferences.  He enjoys something sweet here and there, but will typically have a few licks of a popsicle after dinner in the summertime, and then decide he’d rather get down and play instead of finishing his treat.  My challenge with him is that he’s a grazer.  He is two years old and easily distracted, so unless he is starving, mealtime can take a very long time, and sometimes can result in him not eating much at all.  As a result, he likes to snack or “graze” in between meals.  His top choice of snack would be crackers or chips, and he could graze on chips and crackers all day long if we let him.  We know though that a diet of chips and crackers is not good for his body or his teeth!

Many parents are surprised to learn that even snacks like crackers can contribute to tooth decay.  Any snack that is rich in carbohydrates can lead to tooth decay, even it’s not necessarily considered a “sugary” snack. This is particularly true for kids that tend to graze all day long on carbohydrate-rich snacks, including crackers, chips, cereal bars, fruit snacks, raisins and dried fruits.  Studies have shown that it is not only the quantity of sugar consumed that can lead to decay, but it is also the frequency with which the sugars are consumed.  It is much worse for a child to sip on juice or snack on crackers if they are sipping or snacking over a long period of time, than if they were to have a few ounces of juice with their breakfast.  I’ve alluded to the role that bacteria play in tooth decay.  We all have bacteria in our mouth and some of these bacteria are responsible for contributing to decay.  The bacteria consume the sugars that we consume, and then produce acid which breaks down tooth enamel causing cavities.  If the bacteria are fed all day long by those who graze on carbohydrates throughout the day, they are constantly producing acid, and the mouth remains at an acidic pH for long periods of time which results in tooth decay.  Preventing your children from grazing throughout the day on carbohydrate-rich snacks is important for the health of their teeth.

Limiting juices, flavored milks, and other sweetened beverages, as well as encouraging your children to drink a lot of water in between meals can go a long way to prevent cavities.  Chewy snacks that are high in sugar, such as fruit snacks, raisins and dried fruits should be avoided in general, but especially for children with deep grooves on their molars.  These snacks really stick to teeth and are hard to remove from teeth even with good tooth brushing.

I have discussed a lot of things to avoid, so now I will talk about some of my kids’ favorite “teeth-healthy” snacks.  My kids love avocado, and that makes a great snack all on its own or sliced lengthwise with sliced turkey or ham rolled around it.  If your child is old enough and doesn’t have any nut allergies, nuts are a great snack food too.  My kids love almonds and cashews.  Whole fruits (not dried) and veggies are great.  My kids really started taking more of an interest and were more adventurous with trying different fruits and veggies when we planted a vegetable garden.  They love picking strawberries, cherry tomatoes and yanking carrots from the ground in their own backyard!  Other favorite fruits and veggies in our home are celery sticks with cream cheese, apple slices, Satsuma oranges, and carrot sticks.  Bananas are always a good portable snack when you are on the go.  They are nutritious and filling.  For kids that can tolerate dairy, cheese sticks are another easy “tooth-healthy” snack.  My kids also really love hummus, and almost any veggie tastes good dipped in a little hummus.  Costco sells boxes with individual servings of hummus that are very convenient for snacking.  Olives are popular in my house, not only because you can have fun putting them on your fingers but because they taste good too.  I also try to ask Lucy for ideas when I think she is getting bored with our usual lunches and snacks.  She often sees her friends at school eating things that I would never think to pack for her!  One of her school friends often enjoys red peppers stuffed with tuna salad for her lunch.  I would never think that a 5-year-old would enjoy something like that, but Lucy was interested in that because she saw her friend eating it.  Now she loves red bell beppers!  For some reason, kids always think their friends’ lunches look better than their own, so ask your kids what their friends are eating, and if they are interested in trying some new things!  You might just be surprised at what your kids will eat!

 

090725PTTBBELTZNERA11Dr. Andrea Beltzner received her certificate in Pediatric Dentistry from the University of Connecticut in 2007, and became board-certified in the specialty of Pediatric Dentistry in April 2008.  Along with her husband, adorable children and  two adorable dogs, Dr. Beltzner lives and works in Portland, Oregon. Passionate about helping underserved children receive the dental care they so desperately need, Dr. Beltzner volunteers regularly at Creston Children’s Dental Clinic, on the Tooth Taxi, at the annual Children’s Health Fair along with being a co-lead for the pediatric department at Oregon Mission of Mercy, and a volunteer on the Emanuel craniofacial team.

Weight-training…an Anti-Aging Tool?

Monday, November 4th, 2013

By Dr. Uche Odiatu, B.A., DMD, NSCA Certified Personal Trainer

iStock_000005687240XSmall

Many dental professionals are strategically mapping out their future financial security. They are tax planning and using the 10% solution to save and invest their hard-earned money. Freedom 55 used to be the catch phrase championed by many financial advisors. But with the recent economic challenges I can easily see it being called Freedom 75. The irony is that most people over fifty do not enjoy excellent health and physical fitness. How can anyone indulge in their monetary abundance without the ability to physically take care of him or herself?

Robin Marantz Henig, Scientific American magazine writer reported that almost half of North Americans over 75 require some assistance with their daily tasks. Unless there are major advancements in senior fitness levels, aging North Americans may spend their latter years in conditions of debilitating dependency.

Dr. Steven Lamm (author of Younger at Last) found that non-active men and women lose one percent of their muscle mass every year after 30. This will result in many consequences in the quality of life: lack of ability to take care of your dream home; inability to enjoy travel; problems with posture; and greater incidence of falls with diminished leg power for balance and movement. Less muscle a (very active tissue) means slower metabolism, which will eventually result in more bodyfat (inactive, useless tissue).

It is downward spiral. The less muscle you have, the fewer calories you burn each day. And the less strength you have the weaker you become. Daily activities like going grocery shopping and climbing stairs become more challenging. Result? You become even less active.

Do these sound like dire consequences? What can you do to stem the tide? Try adding strength-training or weight-training to your weekly activities. That’s right – those dumbbells and barbells in the gym are not just for the bodybuilders on the beach!

Recent research has shown that one of the most important steps in not just retarding the aging process, but in reversing the process, is resistance or strength training. It is not just a suggestion, it is recommended! Studies at Tufts University have shown that people in their 70’s, 80’s and 90’s have benefited from safe and effective strength training in many ways, especially their balance and motor skills.

Can resistance training help you fight chronic illness? New research by the American College of Sports Medicine has shown that a simple 12 week resistance training program decreases inflammation (a key player in every chronic disease) in the body. In Medicine & Science in Sports and Exercise Journal November 2012 a study showed that after just three months of a moderate intense weight training program circulating C Reactive Protein (CRP) decreased 33%, leptin 18%, and TNF (tumor necrosis factor) by 29%. Don’t those numbers get your workout juices flowing? If not now…when?

Sadly, only 10% of all regular exercisers include any strength training programs. The types of exercise they choose for the most part are aerobic in nature: walking, running, cycling and dance classes. These are excellent activities for maintaining cardiovascular health and fitness, but they do not contribute in a significant way toward maintaining or building muscle mass. The best exercise program combines aerobic activity, flexibility and strength-training exercises.

Why not include physical fitness to ensure your enjoyment of the golden years? Seek out a certified personal trainer or join a strength class at your local health club. Remember, always check with your health care provider before starting any new exercise program.

See you at the gym.

 

OdiatuDr U.Odiatu DMD is the author of The Miracle of Health and an NSCA Certified Personal Trainer. This busy dentist is also a professional member of the American College of Sports Medicine. He lectures at the largest dental conferences in North America. www.fitdentist.com

There is No Excuse for No Dental Care – Overcoming Dental Phobias

Tuesday, April 2nd, 2013

Scared girl at Dentist's teeth checkup

By Harvey Levy, DMD, MAGD

I have been practicing clinical dentistry and been on this planet long enough to have heard every reasonable excuse for avoiding dental care. I have yet to hear a good one.

Our dental practice has successfully treated thousands of phobic, anxious, mentally challenged, autistic, and medically compromised patients. We’ve been able to accommodate infants through Alzheimers patients. What I have learned is whatever the reason given for avoiding the dental office, there’s always a way to overcome the problem.

Are you afraid of the dentist? Perhaps a dry-run walking through the office will calm you down, or learning more about the treatment using videos or demo models will make you less afraid. If it doesn’t, we can prescribe pills or liquid drugs that you can take right before your appointment. If you’re even more apprehensive, you can also take an oral sedation pill before going to bed the night before your appointment, and be treated with nitrous oxide (laughing gas) to relax you during treatment. Other options to deal with anxiety include behavior modification, hypnosis or acupuncture.

If your loved one is an infant, or is mentally challenged, autistic, or suffers from Alzheimers, they can and should still receive effective dental treatment. Intravenous sedation can be offered in an office setting, or these patients can be treated in a hospital or surgical center operating room. There, the patient is totally asleep while all the needed work is being performed, and has no recollection when they wake up.

An extremely anxious patient can also be treated in this manner, with the advantage that work that would typically require multiple office visits can be successfully performed in only one visit to the O.R.

If you cannot come to the office due to mobility issues, age, or medical complications, dentists with portable equipment can come to you, be it in a nursing home, private home, institution, or in-patient facility. Mobile vans are fully equipped to handle most dental problems. Mobile teams use hand-held x-ray units with self-developing films or laptop instant imaging systems to diagnose problems. Portable x-rays with protective radiation barriers, are coupled with mobile dental carts, and provide the same dental procedures available at the office.

Whatever reason kept you or your loved one away from the dentist, the road back is readily available and easier than you think! Over the past 38 years our practice has successfully performed over 32,000 oral sedations in our office. Three percent of the time, oral sedations at our office couldn’t be done, or failed due to autism, severe combativeness, or major medical concerns. All those patients were able to receive treatment, safely and successfully, with the help of an anesthesiologist in a hospital operating room.

Whatever excuse I hear for someone not going to the dentist, know that there’s always a way to overcome it. What is not acceptable are the complications resulting from the lack of dental care – from bad breath to infections that start in the mouth and threaten your health.

 

LevyHarvey Levy, DMD, MAGD is a 1974 Tufts Dental graduate who practices general and hospital dentistry in Frederick, MD. He holds eight fellowships, four diplomats, Board certification in Integrative Medicine, and has earned Mastership and three Lifelong Learning Service recognition awards from the Academy of General Dentistry. He is a recipient of the ADA Access to Care Award, the AGD Humanitarian Award, the Maryland Governor’s Doctor of the Year Award, and ran the 2002 Winter Olympic Torch in honor of his dental care for special-needs patients in Maryland. He has written and lectured extensively on management of anxious and special-needs patients. For more information, visit  www.DrHLevyAssoc.com or contact him at drhlevy@gmail.com

An Analogy of Tooth Decay – How our Teeth Stay Strong

Monday, January 7th, 2013

Dr. Terri Baarstad

I have a little analogy that I use with my patients that seems to help them understand. I say something like:

There are bacteria in your mouth that “eat” carbohydrates. These bacteria have waste products and those waste products are acidic. Acid “dissolves” our teeth and makes it so we get cavities.

Imagine that your teeth are brick walls. They have all these bricks going in and out of the wall all the time- they are not static, they change. So when your mouth is at PH7 –that is neutral- the bricks go in and out at the same rate- there is no net change. Teeth stay healthy. But, when you eat or drink anything that has carbohydrate (sugar, bread, pretzels, even croutons) the PH of your mouth drops and the environment becomes acid. When your mouth is in acid- more bricks go out than come back in, so there is net loss of tooth structure. It takes about 20 minutes for your mouth to return to neutral after eating, so, if you are snacking, taking a bite or a sip of a soda pop every few minutes over an period of time, say 2 hours, then your mouth will be in acid for 2 hours and 20 minutes. If this occurs regularly over time, there is more net loss of “bricks” and eventually there begins a cavity. Once the cavity begins there is more acid because the bacteria have multiplied and they make more acid, leading to more cavities. The cure for the cavity is to have it treated with a filling or a crown. But the cure for not getting more cavities is reducing “exposure” to the acids. Fluoride on and in the teeth is like having mortar for those bricks- it makes it so much more resistant to acid.

Knowing the way that teeth “dissolve” you can understand what might help slow down this process

If you brush your teeth, chew sugarless gum, or rinse vigorously with water after eating, the Ph raises to neutral more quickly. Conversely, a dry mouth doesn’t return to neutral very quickly. The dry mouth patient is also at a higher cavity risk because the acid is that much more concentrated. Water, mints and gum, or even a change of medications might be in order.

Since it is all about acid, and acid comes from bacteria, and the bacteria live in plaque, reducing plaque (by brushing and flossing) reduces acid and therefore cavities. Xylitol (gum and mints) reduce bacteria and increases saliva flow, thereby minimizing acid exposure. Eating your food less frequently (eating the entire candy bar or drinking the entire soda all at once) will decrease exposure time, thereby reducing the risk.

 

Dr. Baarstad appreciates the value of community service, and devotes herself to improving the dental health of those who live around her.  After attending the University of Oregon, Dr. Baarstad graduated as a DMD from the Oregon Health Sciences University in Portland. She is an active member of the American Dental Association, the Oregon Dental Association and the Academy of General Dentistry, and a recipient of the Dr. William Howard Award for Excellence in Fixed Prosthetics. She donates services to charitable organizations and sponsors many community events, including high school fundraisers. Dr. Baarstad expresses a special interest in helping young men and women explore a career in dentistry through volunteering at local high school career symposiums.

Oral Health: A Window To Drug Addiction

Monday, October 8th, 2012

By: Victor J. DeNoble, Ph.D. & Kimi F. DeNoble, MS

Research has shown that oral health problems are very common among people who are addicted to drugs.  Many abused drugs produce chronic tooth decay, cracked teeth, gingivitis and other forms of gum disease.  For example, alcohol is high in sugar which contributes to an increase in tooth decay and frequent chronic consumption can de-mineralize tooth enamel.  Stimulants like ecstasy, amphetamines or cocaine cause severe clenching and grinding of teeth, as well as dry mouth when the individual is under the influence of the drug.  Users of stimulants are also known to have a high intake of sugar.  This combination of side effects can cause serious tooth decay.  Methamphetamine prevents saliva from being produced that results in a condition called “meth mouth” which is characterized by discoloration, rotting and broken teeth, as well as  extreme tooth decay.  The chemical composition of methamphetamine includes a wide range of highly toxic chemicals such as lithium, and muriatic and sulfuric acids all of which are highly corrosive.  Tobacco can cause a wide range of oral problems such as delayed wound healing, sinusitis, soft tissue damage and oral cancer.

Because the relationship between substance abuse and oral pathology is well documented, the dental visit can provide the ideal setting for drug abuse identification and intervention.  In addition, having an understanding drug addiction will assist dental professionals in making decisions when medications with potential for abuse are being considered as part of the overall treatment paradigm for these patients.

Years ago, drug addiction was viewed as a character flaw, an inability to control one’s own behavior.  Today, we know that drug addiction is a disease.  Further, it is a self-inflicted disease; no one addicts us, we addict ourselves.  The motive for drug addiction varies from person to person but the decision to use and eventually abuse the drug is still an individual choice.  Drug addiction is not an event that happens all at once.  It’s a biochemical process that takes time and will eventually result in long-term changes in brain function.  These changes are the underlying mechanism for compulsive drug abuse.  The time it takes to complete this biochemical change varies for each drug.  For some drugs like methamphetamine or crack cocaine, the brain changes can occur in one to three weeks. However, with other drugs such as alcohol or tobacco, the process can take several months.  No matter how long or short the process is the first time, re-addiction for all drugs is fast – – sometimes it can occur within a day.  Therefore, once you are addicted to a drug, you are at risk for re-addiction for the rest of your life.  This makes the choice of pain management medication in dental and medical procedures more difficult.

Everyone is born with specific areas of the brain that recognize and respond to addictive drugs; therefore no one is immune from addiction.  In fact, we are all at risk for addiction.  Once an addictive drug enters our blood, it will be transported to the brain and the process of altering brain function begins.  But why do people use addictive drugs?  Simple.  Addictive drugs make us feel good, at least for a brief period of time.  The major neurotransmitter mediating the addictive process is dopamine.  Dopamine has a wide range of functions in the brain, however, the feeling of happiness is mediated in the mesolimbic system. The mesolimbic system is commonly called the “pleasure center”.  When dopamine levels are normal, we feel comfortable.  If they fall, we can be depressed and, if they rise sharply, we can experience euphoria.  All drugs that are addicting change the way dopamine functions in the mesolimbic dopamine system.  The mechanism for dopamine alteration for each addictive drug is different.  These different mechanisms explain why we can be addicted to several drugs at the same time.  Unlike the normal release of dopamine, when drugs are used to activate this system the resulting dopamine response goes far beyond what the system is supposed to produce and the process of addiction begins.

Addictive drugs make us feel good but the feel good feature of these drugs does not lead to health problems.  Aside from the oral manifestations, these drugs have a wide range of pharmacological side effects that have  other health consequences.  For example, cocaine makes us feel good for about 40-60 minutes, however, the side effects of cocaine put the user at risk for potential life threatening conditions for days.  Atrial fibrillation induced by cocaine has been shown to last for up to 3 days whereas cocaine is metabolized and excreted within 24 hours.  Cocaine renders the addict at risk for heart attacks, strokes, kidney failure and pulmonary embolisms.  Each addictive drug has its own constellation of unique side effects that can be further reviewed at the National Institute of Drug Abuse website.

Research has shown that drug addiction results in dental complications many of which will appear before other less visible complications, e.g., organ failure.  Since many Americans visit their dentists more often than they visit their physicians, dental professionals have an increased likelihood of detecting drug abuse and therefore an increased potential for intervention.

 

Dr. DeNoble has a Doctorate in Experimental Psychology from Adelphi University, NY and two postdoctoral fellowships from NIAAA and NIDA.  He was recruited by Philip Morris to study the behavioral and physiological effects of nicotine on the brain.  He subsequently conducted drug discovery research in CNS diseases for the pharmaceutical industry.  In 1994, after a congressional release from a confidentially agreement with Philip Morris, he testified before Congress and became a key witness in the federal government’s case against the tobacco industry. Currently, he is the Vice President of Hissho, Inc., a scientific and medical communications company.