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Stuart Zak
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July 17, 2009:
The Economy and Your Teeth
As Americans fret over the next round of layoffs or simply try to make ends meet, many are cutting back on items and services that they feel are of least importance-and their mouths are paying the price.
According to a poll of 300 dentists conducted by the Chicago Dental Society in the fall of 2008, more than 40 percent reported seeing fewer patient visits for preventative care, and more than 60 percent said their patients are putting off cosmetic procedures because of the struggling economy.
Despite the best efforts to cut expenses, Americans can't afford to ignore oral health. Dental care, which includes taking care of the gums, teeth, and related structures in the mouth, can greatly affect overall health. Gum disease can allow harmful bacteria to enter the bloodstream, where organs and the cardiovascular system can be affected. In fact, doctors can often detect the earliest signs of serious disease through the mouth.
It is recommended that Americans visit their dentist for routine care twice a year, but in the meantime, they should take steps to keep their teeth healthy, like brushing, flossing their teeth twice a day, choosing healthy foods, not smoking, and maintaining an active lifestyle.
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May 16, 2009:
Dr. Micoli receives Steven's Award
Genesee Valley Region of National Ski Patrol recently named Dr Micoli as their outstanding patroller for 2009. The Steven's award is given annually to one patroller. The region is made up of 6 ski areas and some 250 patrollers. It is considered the most prestigious of service awards given annually. It cites Dr Micoli's dedication to NSP and the GVR with activity beyond the normal scope of ski patrol duties.
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Aug 14, 2007:
Dangers of Gum Disease
For most of us, having our gums bleed when we brush our teeth- often a sign of infected or unhealthy gum tissue- is just a minor inconvenience. Even the fact that periodontal problems cause bad breath and ultimately lead to receding gums and tooth loss may not be enough motivation to get us to floss daily and practice better oral hygiene.
New information may change that attitude. For example, gum disease, which affects 50 percent of people over age 50, has now been positively linked to a significantly greater likelihood of heart disease. Recent research points to a growing list of other health problems in which gum disease may play a role:
- Stroke- There is significantly greater likelihood of stroke in persons with gum disease.
- Respiratory diseases- Bacteria from oral infections can lead to or exacerbate respiratory diseases like pneumonia in susceptible patients.
- Organ transplant- Success of organ transplant procedures is negatively affected by gum disease.
- Pancreatic cancer- The latest news is the men who have periodontal disease have a 63 percent higher risk of developing pancreatic cancer, the fourth leading cause of cancer deaths.
One possible reason is that bacteria responsible for gum loss produce nitrosamines, which are compounds known to cause cancer.
It is also known that people with chronic inflammation, particularly gum disease, produce chemical byproducts that get to the liver where a substance called C-reactive protein is produced. The higher your CRP levels, the greater your risk of all the above complications and diseases. Men with gingivitis (gum inflammation) have a 30 percent higher CRP level than men without gum disease.
On the flip side, some health conditions can raise the risk of gum disease:
- Osteoporosis: Postmenopausal women who suffer from osteoporosis may lose bone support in the jaws, increasing their risk of periodontal disease.
- Diabetes: Diabetics are more prone to infection, including gum disease, and therefore need to be even more diligent than the average person.
Gerald Rosen, DDS
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May 10, 2007:
Helpful Hints for Flossing
Flossing is an important part of good dental hygiene to help prevent disease and tooth decay. Here are suggestions on how to floss properly, courtesy of the American Dental Hygienists' Association:
- Using about 18" of dental floss, wrap each end around your fingers until about 2" remains between your thumb and index finger
- Gently slide the dental floss around each tooth, pulling the floss tight
- Use a back and forth motion, and be sure to guide the floss around each tooth. Never force the floss between two teeth as you may damage gums- gently ease the floss between teeth
- Unwrap and rewrap the floss so that there is clean floss used on each tooth
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May 10, 2007:
Gum Disease Can Trigger a Host of Problems
(Health Day News)-When people think about poor oral hygiene, problems like decaying teeth, bad gums and offensive breath typically come to mind.
But experts say an unhealthy, bacteria-filled mouth can also lead to a host of problems throughout the body, such as heart disease, diabetes, blood infection and even low birth-weight babies. And the culprit more often than not is gum disease. "When you're looking at people who have gum disease, they are suffering from a chronic low-grade infection," said Jean Connor, a dental hygienist in Cambridge, Mass., and president-elect of the American Dental Hygienists' Association. "Your whole body is a little bit compromised." A growing body of research is finding that gum disease-sometimes called periodontal disease-can exacerbate a wide array of health problems. And it is not something that just affects a small segment of the population. Four of every five Americans suffer from some form of gum disease, according to the National Institute of Dental Craniofacial Research, part of the National Institutes of Health. Gum disease is suspected of contributing to ailments through the bloodstream. Bacteria from the mouth flood into the circulatory system and travel to other parts of the body, causing widespread inflammation.
Another possibility is that oral infections trigger the immune system, producing inflammation elsewhere in the body. "If you had an infection in your finger and you left it, it eventually would affect the rest of the body," Connor said. "It's the same with your mouth." Recent studies have shown an increased risk of heart disease and stroke in people with gum infections, according to the U.S. Centers for Disease Control and Prevention. The risk appears to increase with the severity of the infection. "Gum disease produces a tremendous amount of bacteria, "Connor said. "If you have a valve problem with your heart, the bacteria can invade and infect the heart."
There also appears to be a link between gum infections and diabetes as people with diabetes are more likely to have periodontal disease, according to the CDC. Researchers are now looking into whether there's a two-way connection between the conditions to see if diabetes can be better controlled through treatment of gum disease.
Blood infection from gum disease can even cause joint replacements to fail by aiding the body's efforts to reject the artificial implant, said Diann Bomkamp, a dental hygienist in St. Louis, and vice president of the American Dental Hygienists' Association.
Other researchers have found that women with moderate-to-serious gum disease are twice as likely to give birth to premature babies. Problems ranging from low birth-weight to birth defects can result. "If you are pregnant and you have gum disease, there may be problems in your pregnancy and with birth," said Bomkamp.
Gum disease ranges from gingivitis- a mild and common form that causes inflammation of tissues and the teeth- to more serious forms like periodontitis, where the inflammation affects the connective tissue supporting the teeth. An estimated 20% of Americans have periodontitis, and it is the primary cause of tooth loss in adults. Regular and thorough brushing and flossing is the first line of defense against gum disease, Bomkamp said. A good diet that avoids sugary snacks and sodas is another. "We are seeing people who are drinking soda for breakfast and drink it all day long," Bomkamp said. "Even with diet soda, you have acid in the soda that can attack the teeth and gums." People should limit the number of snacks eaten throughout the day, according to the CDC. They should also keep in mind that the recommended five a day helpings of fiber rich fruits and vegetables have oral health benefits as well, stimulating salivary flow to aid remineralization of tooth surfaces with early stages of tooth decay. Parents should take care not to share drinks with their children, particularly if the adults have gum disease, Bomkamp said. Even an act as simple as blowing on food to cool it can pass oral bacteria from parent to child. It is a bug thing, and bugs can be transmitted from caregiver to child. People should also make sure they drink fluoridated water and use a fluoride toothpaste- something to reconsider in these days of bottled water. Lots of people today re drinking bottled water, and they are removing one of the best sources they have for preventing tooth decay and they don't even realize it. You should also avoid tobacco- smokers have seven times the risk of developing gum disease than non-smokers- and limit alcohol intake.
Finally, visit the dentist regularly. Check-ups can provide early detection of oral problems, and lead to treatments that can prevent further damage.
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May 10, 2007:
Dental Implants for a healthy beautiful smile
The loss of a tooth can strong affect the attractiveness of a smile. One remedy for this is a dental implant.
"Implants provide a stable foundation for tooth replacement that are closest in look, feel and function to natural teeth. Dental implants also replace the dental roots, which prevents bone deterioration," said Kathia Steel, a dentist and assistant professor of surgery at UT South Western Medical Center.
Patients need to have good general health, including healthy gums and a jaw bone that is strong enough to support the implant, to receive a dental implant. There are treatment options available to enhance the bone and gum in order to be able to support an implant.
"It is important to remember that even though a dental implant will not develop tooth decay, a meticulous oral hygiene routine, including flossing, brushing and regular dental visits, is a must in keeping your natural teeth nice and healthy," Dr Steel said.
Putting off treatment for the replacement of a lost tooth can lead to dental problems like tooth decay, gum disease, changes in biting force, speech difficulties, loss of jaw bone and/or additional tooth loss.
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May 10, 2007:
Cracked Tooth?
Here are common causes for tooth cracks, courtesy of the American Dental Association:
- Chewing or biting foods like hard candy, nuts or ice cubes
- Injury to the mouth
- Grinding or clenching of your teeth
- Chewing unevenly
- Loss of parts of the tooth, often from fillings or wear
- Procedures like root canals that cause teeth to become brittle
- Teeth being exposed to extreme temperatures, such as from eating very hot foods or drinking ice water
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March 28, 2007:
Dentist Could Help Save Your Life
Regular teeth cleanings may prevent heart attacks, other chronic disease
By: Corey Binns
More than just a pretty smile, clean teeth and gums are a sign of total body health. And those painful sessions with the dental hygienist could save your, life new findings suggest. Most people know that the tedium of good oral hygiene- regular brushing, flossing and trips to the dentist's office- reduces tartar, plaque, cavities, gingivitis and bone loss and helps the breath smell like roses. But recent research shows that diabetes; low birth weight babies and heart disease are also linked to gum and bone disease in the mouth that can be prevented by teeth cleanings. Treating gum disease might even prevent heart attacks, a new study suggests. "Systemically, visits to the dentist and hygienist may reduce the risk of cardiovascular disease, stroke and possibly heart attack, and can decrease the likelihood of tooth loss for diabetics," said Gwen Cohen-Brown, a dentist and lecturer for the New York State Department of Health.
The tooth-heart link:
When people neglect to brush their teeth or floss, bacteria accumulate between the teeth. These bacteria can make their way into the blood stream. "Certain bacteria present in the mouth may be related to clogging up the arteries by contributing to the plaque that builds on the walls of the arteries," said New York University oral microbiologist Walther Bretz. And treating gum disease, or periodontal disease, can improve the long-term function of endothelial cells that line blood vessel walls, according to a study conducted by researchers at the University of Connecticut Health Center. With better performing endothelial cells, plaques that cause heart disease will decrease, diminishing the risk of triggering a heart attack. The authors of the study, detailed in the March 1 issue of the New England Journal of Medicine, estimate that severe periodontitis affects up to 1% of adults in the U.S., and as many as 80% of American adults have some form of periodontal disease.
Unclear pregnancy results:
Periodontal disease is also quite common among pregnant women. Expectant mothers' gums react differently to the bacteria due to their increased levels of estrogen and progesterone. Women may experience swelling, bleeding or tenderness in the gum tissue. Several studies have linked gum disease to an increased risk of giving birth to a premature and underweight baby. Yet, an article published in a 2006 issue of the New England Journal of Medicine reported that, although treatment of gum disease in pregnant women is safe and improves periodontal health, pre-term birth and low birth-weight babies were unaffected by the treatment. The jury is still out on whether a mother's unhealthy gums can affect her unborn baby, but scientists are learning more from a large clinical trial currently under way at the University of Minnesota, focusing on whether treating periodontal diseases in pregnant women may prevent pre-term and low birth-weight babies.
Diabetes and dental health:
Unlike the case for pregnancy, researchers have found direct links between gum disease and diabetes. Gum disease is known to increase the risk of diabetes, and vice versa. Studies show that inflammatory periodontal diseases may increase insulin in the same way that obesity increases insulin. Meanwhile, doctors recognize diabetes as an important risk factor for severe gum disease and infection that may result in the destruction of tissues and bone surrounding the tooth. Taking care of teeth can combat complications of diabetes and may reduce inflammation throughout the body associated with diseases such as cardiovascular disease. In addition to biannual visits with the dentist and hygienist, Cohen-Brown recommends patients' brush after every meal, of course. If that's impossible, she said, brush in the morning and at night before bed, floss daily and stay away from carbohydrate-rich and sugary foods. "When oral health improves, overall health improves," says Cohen-Brown.
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March 22, 2007:
The Future of Oral Health
By: Vyvyan Lynn and Frappa Stout
Research focuses on new technology, preventive care and the link between mouth health and other diseases.
A healthy mouth is about more than a sparking white smile. Not taking proper care of your teeth can lead to gum disease (gingivitis or periodontitis), which has been linked to heart disease, stroke, even pancreatic cancer. Because your mouth is a barometer for your overall health, dental visits are critical. In the near future, they likely will involve more than just fillings and x-rays.
Tooth regeneration: Scientists at the University of Alberta in Canada have found a way to regrow human dental tissue. The treatment, which has been tested on humans, uses low-intensity pulsed ultrasound (LIPIS) in the form of a computer chip that fits directly into the mouth to stimulate the formation of new dental matter. Research partner Jie Chen, who holds a doctorate in electrical and computer engineering, say that possible candidates for this treatment include patients whose teeth roots have been shortened by orthodontic force (pressure that's put on teeth form braces, retainers), people with chipped or knocked-out teeth and those with underdeveloped jaws. Chen expects the device to be available in dentists' offices in about two years.
Cavity Vaccination: Researches at the Forsyth Institute in Boston are working to develop a vaccine that will prevent cavities. "Tooth decay is an infectious disease. If you have one cavity, you're more likely to get another" says Daniel Smith, who holds a doctorate in immunochemistry and is a member of the team behind the long-term research, part of which was published in the scientific journal of Infection and Immunity last month. "Our vaccine is aimed at creating an immune response in the mouth at a young age to prevent the bacteria from attaching to the tooth or accumulating on the tooth surface." The vaccine already has been shown to be effective in rats, and an earlier iteration was clinically tested for safety on young adults. The next step? To gain FDA approval so that the vaccine can be tested on the target population: young children. Smith says that the vaccine should be available in some form within a decade.
Disease Detection: Scientists at UCLA are working to transform saliva into a clinically useful diagnostic fluid. David T. Wong, director of UCLA's Dental Research Institute, says that because saliva contains biomarkers for certain diseases, in the not-so-distant future, your doctor will be able to place a drop of it onto a microchip and detect the early presence of oral, breast and other cancers, as well as metabolic and neurological disorders. Wong and other research teams hope this technology will be available in dentists' or doctors' offices by 2011.
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November 27, 2006:
Young Smiles Can Fall Prey to Tooth Decay
(Health Day News)-Add cavities to the growing list of health problems plaguing American kids.
More than 25% of preschoolers suffer from tooth decay, a federal study found.
National studies are showing that early decay is on the increase, and that's shocking, actually", said Dr Mary Hayes, a Chicago dentist and spokeswoman for the American Dental Association. "It's really a silent epidemic.
The US Centers for Disease Control and Prevention study found that more than 4 million preschoolers are affected by tooth decay, a leap of more than 600,000 children in a decade. Dental professionals suspect the problem is being spurred by the increased consumption of sugary drinks and snacks, as well as lax tooth cleaning.
"The science now is we aren't worried about teeth being hard or soft," Hayes said. "The issue more is the bacteria living in your mouth, and how happy they are there."
Plaque, a sticky film of bacteria, constantly forms on teeth from foods containing sugars or starches, according to the American Dental Association. The bacteria in plaque produce acids that attack tooth enamel, and the stickiness of the plaque keeps these acids in contact with your teeth. As the enamel breaks down, a cavity forms.
"Parents need to realize that even though baby teeth are destined to be replaced by permanent teeth, they still need to be cared for," Hayes said. "For starters, a decayed baby tooth can cause pain and suffering for years if left untreated. Baby teeth are with us longer than people think; people think if a baby tooth gets decay, that's OK because the tooth is disposable. But the last ones don't leave until kids are about 12."
Tooth decay in baby teeth also tends to predict future tooth decay and orthodontia problems in permanent teeth, according to the American Dental Association.
Care for a child's teeth should start before the first tooth is even in the mouth, experts say. Parents can get infants used to having their teeth cleaned by running a wet washcloth around their mouth before the first tooth erupts. Once the first tooth emerges, parents must be ready to kick-start dental-health habits that can help their children for a lifetime, said Dr. Kimberly Harms, a dentist in Farmington, Minn. "Most people don't understand they have to start cleaning those teeth the minute they erupt into the mouth," Harms said. "Bacteria can form on that tooth; plaque can form on that tooth, as soon as the tooth erupts. Parents can use a gauze pad to clean toddlers' teeth, or rubber brushes that fit over their fingertips. They also should clean and massage gums in areas that remain toothless.
Early tooth decay also can be avoided by never allowing a child to fall asleep with a bottle containing milk, formula, fruit juice or sweetened liquids, according to the American Dental Association. Generally speaking, parents should avoid filling a child's bottle with sweet liquids such as sugar water or soft drinks.
Harm says, "It is not the amount of sugar a child eats that cause the problem, but the number of exposures. Every time you expose your mouth to that, you get that bacteria active. Children sipping or drinking any drink other than water, every time they sip, it increases the amount of bacteria. Once all the baby teeth have grown in, flossing should be added to the regular dental health regimen."
Once a child is 2 years old, parents can begin using a pea-sized amount of toothpaste on a toothbrush for cleaning. At that age, kids are able to spit out the toothpaste and not swallow it. However, experts advise parents to continue brushing their child's teeth up to at least age 6 or 7m before handing over the task to the child. Most kids under 6 don't have the fine motor skills to brush their teeth. The brush is in their mouth, but they aren't cleaning anything.
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October 30, 2006:
Brushing and Flossing………Help your Heart?
Brushing and flossing not only keep your teeth clean, healthy, and prevent tooth loss, but these dental hygiene measures may also positively impact your overall long-term health. Recent studies show that decay-causing bacteria can produce infections in the gums or teeth and can contribute to the risk for heart disease, stroke difficulty controlling diabetic blood sugar, lung infections and even premature birth.
In order to keep your teeth and mouth healthy, you should follow these simple rules:
* Brush your teeth twice a day with a fluoride toothpaste
* Clean between teeth daily with floss or an interdental cleaner. Decay-causing bacteria still linger between teeth where toothbrush bristles can't reach. Flossing removes these bacteria, plaque and food particles from between the teeth and under the gum line.
* Replace your toothbrush every three to four months, or sooner if the bristles become frayed. A worn toothbrush will not do a good job of cleaning your teeth.
* Eat a balanced diet and limit between-meal snacks.
* See a dentist regularly for cleanings/checkups, and follow up on any recommendations your dentist makes.
So…do your part for healthier teeth and a healthier you…
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April 17, 2006:
Our Infection Control Program
Our infection control practices exceed the current OSHA standards and meet all the new CDC infection control guidelines. We take great care to insure our patient's safety as well as that of the staff.
With each patient the treatment room is shut down in order for us to remove all contaminated instruments and products. The room is disinfected with chemicals that destroy all organisms preventing cross contamination for the next patient. Some surfaces are difficult to disinfect and therefore require a new covering for each appointment. Instruments that are used intra orally must be sterilized or disposable. Instruments are processed in our sterilization area going from contaminated, through an ultrasonic, then are bagged and put through a heat and pressure sterilizer.
We offer a rinse prior to your procedure. This rinse removes approximately 96% of the bacteria in your mouth. This reduces the bacteria we introduce into your bloodstream when we are probing your gum tissue. It also reduces the amount of bacteria that could fly into the air when we use drills and power scalers.
As you can see your health and safety are as important to us as the quality of dentistry we provide.
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Coffee Companions- the other demineralizers
(By: Kimberly S. Beistle, BA, RDH, MSA, and CDA)
Mocha lattes, coffee chillers, iced coffees, flavored creamers and sweetened espressos are some of today's popular companions to traditional coffee. These companions are sweet, flavorful, trendy, and readily available for all ages. Beyond the sodas, exercise drinks and juices, coffee and their companions are the other group of silent enamel demineralizers. Hygienists need to include this category of beverages in their professional responsibility of nutritional counseling for patients.
First, consider the location and popularity of coffee companions. There is a growing trend in North America (and perhaps throughout the developed world) toward increased consumption of non-cola drinks and nontraditional beverages (for example, pre-packaged coffees and teas). Coffee houses and coffee drinks have become more accessible nationwide. Conversations in the break rooms at the coffee pot are just as common as discussions around the office water cooler. College campuses have invited coffee cafes as tenants. Just take a look at all of the sugar-laden coffee drinks available on your local store shelves. Lastly, drive-thru coffee availability has increased, and some fast food chains mix your creamers and sugars for you!
Nutritionally, coffee companions are made up of corn syrup solids, sucrose, flavorings, and sugar. As hygienists, our nutritional education has taught us that these particular ingredients are activators in the decay process. The frequent consumption of fermentable carbohydrates, such as sucrose and glucose, produces the acids that cause tooth destruction, which leads to demineralization. Prolonged exposure of these ingredients in the oral cavity has negative repercussions. Once the sugar has entered the oral cavity, it attacks one of the most vulnerable structures, the enamel of our teeth. The enamel is the armor that protects our teeth. Thus, when the armor is attacked, the tooth is susceptible to decay and destruction. Demineralization is the major stage of the destruction process in which minerals, calcium, and phosphate are dissolved from tooth structures by acids. As the acid increases in the oral cavity through frequency of sugared intakes, the pH drops below 5.5. This is the environment necessary for demineralization to occur. As sugared coffee drinks are consumed over long period of time, the pH is consistently lowered for several hours. During this time, acid continually bathes and attacks enamel, causing demineralization. Studies indicate that foods to which table sugars are usually added before consumption, such as coffee, chocolate, and tea drinks, are associated with high DMFT (decayed, missing, filled teeth) scores. Thus, through the repeated exposure of various liquid sugars concentrated in the maxillary anterior sextant, evidence of incipient to gross decay - lingual and interproximal- may become apparent.
In conclusion, an integral part of our oral hygiene instructions and patient education should consist of nutritional counseling. So many variations of hot and cold sugared coffee drinks are readily available and consumed by many people throughout the day. Hygienists need to be cognizant of the fact that sugared coffees could be the culprit in causing demineralization in patients. If demineralization is evident in a ptaitnet, the hygienist should ask if coffee and its sugared companions are being consumed.
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Surgeon General's Report Excerpts
* Heart Disease is America's #1 killer of men and women.
* Each day 2600 people die from cardio-vascular disease- an average of one death every 33 seconds.
* About 32,000 babies are born each year with heart failure
* Research shows that one of four children already has high blood cholesterol
* 95% of Americans who suffer from diabetes also have periodontal disease. Severe periodontal disease can also increase the risk of developing diabetes.
* Respiratory ailments like pneumonia, bronchitis and emphysema affect millions of Americans annually. Bacteria associated with periodontal diseases can lead up to or aggravate these diseases.
* Premature low birth weight babies studies have shown that expectant mothers with periodontal diseases are seven times more likely to deliver low birth weight babies than women that do not have the disease.
* 75% of the population has some form of periodontal disease
* Age 45-54-14% of the population has severe periodontal disease
* More than half of people aged 55 and older have periodontitis.
* Recent studies indicate that 25% of people in their 20's have early periodontal disease.
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