Eat Right. Keep Fit.

Posted on April 28, 2013 by echelman


Healthy snacks are the way to go!

In light of growing rates of obesity, diabetes, cardiovascular diseases, and cancers (all of which may be linked to poor oral health, by the way), good nutrition is becoming a top priority in our society, particularly in the formative years. Yet those are the same years in which your children are likely to be toothbrushing-challenged and also the most finicky and fast-food crazed.

Quite a prospect! But from what parents tell me and from what I see in the dental chair, it’s not impossible. Mostly, it’s creating a common-sense plan and then sticking to it. A lot of this you know…

•    Choose a variety of nutritious foods from the major food groups – the Nutrition Plate is readily available online at ChooseMyPlate.gov and in schools, libraries, and day care centers. If you have a copy of the old food pyramid and you’re used to it, it’s still a very useful tool.

•    Some snacks are obviously healthier than others. Fresh veggies, yogurts, and cheese or dairy substitutes are better than those with high sugar content like candy or mints. A snack that is swallowed quickly, such as a drink, is better than one that sticks to the teeth, like peanut butter. It seems obvious to avoid soft, sticky, sweet foods like caramels and jelly beans and beverages like soda, sweet teas, and juices. And yet, it can get tricky…

You have to get into the habit of reading food labels if you want to choose foods and drinks that are low in added sugars which aren’t only found in pastries, cookies, candies, and soft drinks, but in just about everything these days. And that means vigilance when dining out as well. An increasing number of restaurants are posting nutritional information on their menus or online, or will provide it if asked, but not all do.

As for advice about eating out and tips on how to get your child to eat healthier meals and snacks, there are many excellent and helpful books and magazines that provide child-friendly recipes, and of course, an abundance of information online.

In fact, the sheer volume of information that’s published, even when it’s legitimate and scientific, can be confusing. It helps to understand that tooth decay occurs when foods containing sugars and starches are frequently left on the teeth to form plaque, the sticky film of bacteria on your teeth that you can feel with your tongue. This can break down tooth enamel and cause cavities and gum disease unless it is removed by regular brushing and flossing.

So the common sense solution is to…
•    Limit the amount of decay-causing foods mentioned earlier.
•    Encourage your family to drink water instead of sugary drinks, sodas, or sports drinks, especially after a sweet or sticky snack. Keeping the mouth hydrated also promotes saliva which protects oral tissues.
•    Encourage tooth brushing using toothpaste twice a day and flossing once a day.
•    Visit us twice a year (unless an individual treatment plan indicates a higher frequency) to monitor oral health.

If it’s been a while since you have had your family’s oral health assessed or if you feel you need some instruction on the best home routines for your children, we encourage you to call our office and let on our team help you out.

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From Gum Disease …To Healthy Gums

Posted on April 26, 2013 by echelman


Gum disease is one of the most important dental issues for adults. While most of us will experience it to some degree at some time during our lifetimes, credible estimates of the number of stricken adults run from 75-90%. That’s a lot of potential suffering. Having said that, gum disease is preventable, treatable, and if caught early enough, reversible. It’s what happens when it isn’t caught in a timely fashion that’s the problem.

To appreciate why time is so crucial, it’s important to understand that gum disease is progressive and is caused when unhealthy oral bacteria overwhelm the healthy ones, inhibiting your body’s ability to fight them off naturally. The earlier this cycle is interrupted the greater your chances of restoring your oral health.

Here’s a brief primer that I share with my patients to explain the two broad categories of the disease. (Incidentally, you can experience different stages in different parts of your mouth at the same time.)

Gingivitis: This is the early stage so only affects the gum tissue, not the underlying support structure and bones. The gums may look normal, which is why it’s called a silent disease, but over time you might begin to notice symptoms of infection such as redness or puffiness, a bad odor, and bleeding during brushing.

Periodontitis: It’s a more advanced gum disease where these symptoms become amplified. The infection spreads from the gum into the underlying bone, and if left untreated, teeth may become loose, eventually leading to tooth loss. Periodontal disease will cause the gums to shrink away from the crowns of the teeth and expose some of the roots, making the teeth look longer as well as more susceptible to root cavities.

There are certain conditions and times of life that can predispose you to gum disease, especially if you’re over age 40…
•    a poor diet that is lacking in vitamins, minerals, calcium, and antioxidants which can help you to fight disease and build healthy teeth and gums
•    lack of effective home-care routines and dental visits to monitor your oral health
•    systemic diseases, such as diabetes, heart disease, and cancer
•    stress, smoking, and alcohol consumption
•    medications that can cause dry mouth or otherwise affect your gums
•    times of hormonal fluctuations including pregnancy, menopause, and male andropause
•    outdated or ill-fitting restorations like dentures that rub your gums, or fillings, crowns, or bridges that interfere with your ability to keep your teeth clean, especially near the gumline.

The good news is, gum disease is preventable, treatable, and sometimes though not always, reversible. Those unhealthy bacteria that alter your mouth’s chemistry build up in plaque – the sticky film that you can feel on your teeth. This is a never-ending process, so unless you want this film to calcify, damage your gums, and spread infection, your oral hygiene campaign has to be equally relentless – no slacking off.

Sticking with routines in today’s busy world can be a challenge, so here’s a simple 4-step program that’s easy to manage.
1) Brush your teeth at least twice a day for 2-3 minutes. (Yes, minutes!) Brush gently and pay extra attention to the areas where your teeth and gums meet.
2) Floss! Get to the spaces your brush can’t reach between and under the gumline. If you don’t floss, it means more than one third of your teeth aren’t getting cleaned.
3) Get checkups regularly. I can spot gum disease in the early stages before you notice anything. A good professional cleaning will also remove built-up and calcified bacteria (tartar) before it has a chance to promote gum disease.
4) Call immediately for a dental appointment if you notice shiny, red, puffy, or sore gums, or a change in gum color, gums that bleed every time you brush, a metallic taste in your mouth, or redness around the base of your teeth.

The truth is that for most people, gum disease worsens slowly, and there’s no way to determine its severity without coming in for a detailed examination. Remember … it’s usually the parts of your mouth that get the least attention that are most at risk.

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Sweet Seduction

Posted on April 5, 2013 by echelman

You can regain control of your diet

Have you ever heard of the Law Of Unintended Consequences? It’s most commonly used in economics, but it has other applications where the best intentions go unexpectedly awry. Think email/spam, dieting/yoyo weight gain, lower fat/higher sugar for taste. It’s this last one that is of concern to me. Our sugar intake has increased at an alarming rate, and it’s not all because of larger portions and succumbing to ad campaigns. Some of it has arisen due to misguided attempts to improve and streamline our food production and reduce our dietary fat intake. Sugar is often added to food to replace the taste loss when fat is reduced.

Is Sugar Toxic?, a comprehensive and rather alarming article written by Gary Taubs and published in the New York Times, explores the confounding and contradictory evidence about the role sugar plays in modern health issues.

You don’t need to be a nutritionist, physician, or dentist to understand that sugar, whether solid or liquid…

  • • has no food value – period
  • • raises your insulin level and creates health problems, including oral health problems, whether you are diabetic or not
  • • depresses your immune system by preventing the absorption of vitamin C
  • • upsets the body’s mineral balance by using more of your body’s stored nutrients since simple sugars have no vitamins or minerals of their own
  • • contributes to weight gain because the body will burn sugar instead of stored fat and will also convert excess sugars to stored saturated fat
  • • causes tooth decay and gum disease by encouraging the growth of bacteria and plaque which affects all ages (including infants with baby bottle syndrome whose teeth are destroyed by consuming too many sugary liquids, including formula, juices, milk or soda, especially at night)
  • • is a major factor in the erosion of teeth enamel, thanks to the soaring consumption of soft drinks, including the new sports and vitamin fruit drinks.

What can you do? Here’s what I tell my patients…

Try to monitor your sugar intake, even when it’s hidden. The problem isn’t just the sugar you spoon into your coffee and cereal in the morning. The bigger threat is “hidden sugar” that is already in most processed foods. Breakfast cereals are loaded with it, and even a so-called low-fat muffin can have the equivalent of seven and a half teaspoons (37 ml) to replace the taste of missing fat.

Check labels. Food labels containing words ending in “ose,” for example, glucose, dextrose, fructose, levulose, lactose, or maltose all mean sugar. Even salad dressings and ketchup contain an excess of the stuff.

Call and book an appointment. We can identify problems early, provide good information, and take steps to help you lead a healthier lifestyle and are always happy to help you keep all of your best intentions!

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Babies Need Fluoride … And Here’s Why

Posted on March 24, 2013 by echelman

Babies need fluoride before their teeth start to form to help make them stronger as their development begins. How does it work? Fluoride, which is a naturally-occurring mineral, enters the bloodstream through food and water and becomes part of the tooth enamel even before the teeth erupt making them stronger and more resistant to decay. (Later on, fluoride applied topically through toothpaste or at our office also makes the teeth more resistant to decay and strengthens the enamel as it repairs itself from normal wear.)

Whether or not you need to add fluoride to your baby’s diet depends on how he or she is being fed and on the level of fluoridation in your local water supply. Breastfed babies do not need additional supplies of fluoride, and for infants under age 12 months, formula that requires water should be mixed with fluoride-free bottled water rather than fluoridated water.

While fluoride occurs naturally in water in some parts of the country, in close to 73% of communities it is added to the community water supply, which some people find alarming. The American Dental Association, however, compares fluoridation of community water supplies to other safe supplements such as fortifying milk with Vitamin D, table salt with iodine, and bread and cereals with folic acid. In other words, it’s a way to optimize levels of a naturally existing mineral to encourage the prevention of tooth decay.

That said, it’s important that your child receives just the right amount of fluoride. Not enough could leave your child’s teeth without the long-term dental health benefits that fluoride offers. Too much can cause harmless but unsightly discoloration of the teeth called fluorosis. Usually fluorosis causes only a few white spots or patches on the teeth, but more severe cases can cause a brownish mottling and weakened enamel. This occurs only when baby and permanent teeth are forming under the gums. Once teeth break through the gums, they cannot develop enamel fluorosis.

Sometimes we’re asked about fluoride tablets, drops, or lozenges. They are available only by prescription and for good reason. Even children living in non-fluoridated areas who are considered to be at high risk of developing tooth decay may be consuming fluoride at daycare or school or through bottled water and processed foods. We never recommend them for children in a fluoridated community when they are possibly ingesting fluoride from many other sources.

The Centers for Disease Control and Prevention considers community water fluoridation as one of 10 great public health achievements of the 20th century, and studies prove that water fluoridation continues to be effective in reducing tooth decay by 20-40%. In fact, this is so important that the American Academy of Pediatrics, the U.S. Public Health Department, and the American Dental Association have all recommended fluoride supplements for children in either their diet or the water they drink starting at age six months and up to age sixteen. Please feel free to ask us  or your physician if you are not sure if your family is getting the recommended dosage.

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Dangerous Effects

Posted on February 26, 2013 by echelman

Every chance we get, we remind my patients about the negative effects of tobacco – increased risk of cancers, high blood pressure, and heart disease – things you usually associate with age. But tooth loss should never be associated with age… The Academy Of General Dentistry reports that pack-a-day smokers are twice as likely to lose teeth than their non-smoking peers. That means that an 18-year-old smoker could lose between four and five teeth by age 35. If heart disease seems too far down the road to worry about, then maybe losing your teeth at such a young age, or risking the hearing loss associated with that (yes, really!), brings the problem closer to home.

The study used 495 healthy men, including smokers, non-smokers, and those who quit smoking during the study. By examining their teeth every three years, it was discovered that smokers lost an average of 2.9 teeth after ten years of smoking a pack a day. Those who quit smoking significantly reduced their risk, while non-smokers, on average, lost the fewest teeth. Another study of female smokers supported these findings.

While all the reasons for this dramatic increase in tooth loss are still to be determined, gum disease is known to be the main culprit. One theory is that smoking reduces blood flow to the gum tissues, reducing the amount of nutrients to the bone, and decreasing the amount of support the gums can provide to the teeth. Another theory is that smoking causes a chain of events beginning with a reduced flow of saliva and an increase in plaque buildup on the teeth, leading to tartar which can lead to gum disease, and eventually, loss of teeth.

If you smoke, be especially careful to examine your mouth for white or red patches, check for unexplainable numbness or soreness, and for sores that don’t heal within a couple of weeks. If you notice any of these, call your doctor immediately. Up to 10% of people with these patches will develop oral cancer.

We’ll do a thorough check for signs of oral cancer every time you come in for a checkup whether you smoke or not. There are surgical procedures for its treatment, but there is no guarantee of a cure, so in the long run, the best solution is to stop smoking.

And as far as tooth loss goes, in addition to avoiding tobacco, everyone needs to maintain a regular routine of flossing and brushing. Our team is ready to provide you with encouragement and guidance in all of your efforts to stay healthy.

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Making Smiles Last- Healthy Habits For A Healthy Future

Posted on January 24, 2013 by echelman

We’d like to point out a very interesting piece of information that emphasizes the importance of brushing and flossing in a rather dramatic way. While many studies have shown that gum disease can affect your general health, a University of Southern California twin study suggests that those who suffer from periodontal disease prior to age 35 may be four times more likely to get Alzheimer’s! The link appears to be the inflammatory nature of gum disease. When you consider that we are all living longer and that our aging population cohort is growing every decade, that really got our attention.

As you know, for every Alzheimer’s patient there are many others affected. It brings with it the frustration of dementia, an escalating need for care, and it saddles families with long-term medical expenses. The emotional toll of Alzheimer’s on friends and family is impossible to calculate, so if you ever needed motivation to establish a proper routine of oral care, this would be it.

The good news is that gum disease is easily prevented and highly treatable. The rule of thumb is to brush your teeth twice daily and floss once – bedtime is a good time. If you’re lacking confidence in your technique or noticing some bleeding during your home care routines, don’t hesitate to book an appointment for an exam and some assistance with improving your skills and selecting the type of toothbrush, floss, and toothpaste that is most suited for your needs.

The fact that we are living longer also increases the likelihood of encountering problems that challenge our one and only set of permanent adult teeth. In addition to gum disease and root cavities, these include chips, cracks, and fractures in addition to general wear and tear and staining.

Staining is normal and you can stay ahead of it by limiting food and beverages that you know are problematic like coffee, tea, juices, and wine and with regular thorough professional cleaning in addition to your home care routines. You can also opt for home or professional whitening procedures that are both fast and cost effective.

A combination of today’s more active lifestyle combined with thinning enamel and aging fillings and restorations also make your teeth very susceptible to chipping or cracking as you get older. Corrective options include crowns which can be used in numerous ways. The damaged tooth can be prepared to receive a new ceramic or porcelain restoration that looks, feels, and behaves like a real tooth, a bridge can be created by combining multiple crowns, and a crown can be attached to an artificial root or implant.

For restoring moderately damaged teeth, veneers can be created from the same enamel-colored bonding material we use to create white fillings. Porcelain veneers are another option. These wafer-thin ultra-durable restorations can be adhered directly to existing teeth with minimal alteration to the original surface. Veneers are natural looking, color-matched to existing teeth, and they can strengthen and brighten your smile by disguising stains for up to fifteen years with care.

Young or old, as you can see, maintaining a healthy mouth and a healthy body for your lifetime is really about paying attention – to home care, regular dental visits, and even something as simple as wearing a protective sports mouthguard.

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Good Habits Start Early…

Posted on January 18, 2013 by echelman

A study discussed in the May/June 2010 issue of General Dentistry, the peer-reviewed clinical journal of the Academy of General Dentistry,  states that oral health education is vital if we want to prevent early childhood tooth decay and gum disease, both of which have been shown to affect general health for a lifetime.

In fact, it is important to keep children’s teeth healthy even before birth by looking after your own oral health. There are two reasons for this. The first is that expectant mothers with poor oral health may be at greater risk of developing toxemia or gestational diabetes, and their babies may be born prematurely and/or have a low birth weight. The second is that once babies arrive, parents can actually transmit oral bacteria to them simply by kissing, and later on by blowing on their food or sharing eating utensils.

Although a first dental visit won’t happen until about age one (approximately 6 months after the first tooth), it’s crucial to establish good home care early. While it may seem odd to clean your infant’s gums with a clean damp cloth after each feeding, it’s an excellent routine to get into. It is healthy for the gums and a clean mouth is less likely to create bacteria that could cause cavities even before first teeth come through. And although it might be easier said than done, from a purely dental point of view, it’s best to wean your child by age one or close to it, if you can. This is to avoid baby bottle tooth decay caused by milk, juice, or sweetened liquid at naptime or bedtime, and to avoid teeth and bite misalignment due to sucking. The same bite issues exist with pacifiers, fingers, and thumbs, common comforts which often continue after weaning.

As soon as the first teeth come in, we usually suggest brushing them with a small soft-bristled toothbrush and water.  Toothpaste isn’t recommended before age two. Children can be sensitive to strong or spicy flavors like peppermint and cinnamon, so we  recommend a mild-tasting one and using only a pea-sized amount. Fluoridated pastes should be kept where kids can’t get at them without your help.

At home, set up a little stool so they can look in the mirror “eye to eye” and reach the faucet without stretching.  Good brushing takes at least three minutes, which is a long time for a child to focus, so it’s okay to work up to it gradually, although you may have to follow up to ensure the job is thorough. This is especially important before sleep (naps and nighttime) when less saliva means greater risk of cavities.

By the time they’re five, kids are pretty confident, and by six or seven they can brush at minimum twice a day on their own. In our experience if you keep making it a high point in their day, they’ll be more than happy to brush!

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Drink To Your Health

Posted on January 3, 2013 by echelman

We are all concerned with our own well-being.  While supplements, eating right and exercising are all important, being healthy can sometimes be as  easy as brewing a simple cup of tea.

For example, green tea has been shown to protect against oral and other cancers, and a study has found that it freshens breath better than mint, parsley, or chewing gum. Scientists have also found that polyphenols, which have about 100 times the antioxidant effect of vitamin C, are present in green tea, pomegranates, and cranberries. Each of these plants has been shown to protect against heart disease.

Peppermint tea can help with digestive problems, but if herbals and exotic flavors aren’t really your preference, you’ll be pleased to hear that five cups of ordinary tea boosts the body’s defenses against infection. A substance called L-theanine can prepare the immune system to attack invading bacteria, viruses, and fungi. Tea has been linked to combating osteoporosis, lowering heart disease, and lowering cancer risk through the action of flavonoids, a type of antioxidant. Each of these diseases has been linked to periodontal disease.

Here are some simple steps from Twinings to ensure that your tea is served perfectly every time.

• Use freshly drawn cold water, and ensure a de-scaled kettle and a spotlessly clean teapot. • Teapots should be warmed with hot water which is poured away prior to steeping the tea. • Use the recommended number of tea bags or one teaspoon of loose tea per cup. For one person use a 10 oz tea pot; for two persons a 20 oz tea pot is recommended.                           • Water should always be freshly boiled and boiling when added to tea.                                    • Leave to brew for 3-5 minutes and stir before serving.                                                                • Pour a little milk into each cup before pouring the tea. Sweeten – but only if you need to.

Also, give don’t be afraid to try red, green, black, or white tea. Remember – they all have interesting flavors, can provide a little break in your day, and have great health benefits too.

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What Is Oral Health, Anyway?

Posted on December 6, 2012 by echelman

A healthy mouth has pink firm gums, the tongue is pink and not coated, and the teeth are clean and have minimal or no plaque deposits. A healthy mouth smells clean and fresh and is free from gum diseases and other disorders – including oral cancer. Isn’t that what everybody wants? Yet while many people are diligent about their dental care, there are still some who steer clear of the dental office until it really hurts. They skip cleaning appointments and checkups thinking that somehow they are immune to dental diseases … until they have one! Studies show that despite years of dental health education, millions of people simply don’t show up for needed cleaning or treatment. This translates into millions of lost workdays as these people take time off for more extensive dental treatments later on. The fact is, without regular, professional, preventive care, dental disease is almost inevitable and treatment is always more complex and costly than prevention. You may think you’re saving by missing a few dental appointments, but odds are you’ll pay a lot more later. Alarmingly, this year, as every year, thousands of people will contract oral cancer. Caught in its early stages, its cure rate is excellent. Keeping up with your annual dental appointments are essential to your oral health, as most people can’t identify ailments on their own, such as hairline fractures, impacted wisdom teeth, deterioration of fillings, crowns, and other restorations, the beginnings of root cavities, pockets of infection caused by gum disease, and new decay tucked under the gumline or under existing older fillings. Think about it: a healthy attractive mouth is far more than vanity. It’s common sense. After all, the mouth is also the gateway to the body, and research continues to reveal new relationships between oral bacteria and systemic diseases. This is not only true for adults, but children too. According to the Centers for Disease Control and Prevention, more than one quarter of 2- to 5-year-olds and half of kids 12-15 years old have one or more cavities, and tooth decay has affected two thirds of 16- to 19-year-olds. These are just some of the reasons why we are committed to keeping you informed so that you can make choices that will keep you and your family happier and healthier, longer. So don’t wait to discuss a plan with us to prevent and maintain your optimal oral health.

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The Evolution Of Your Diet

Posted on November 20, 2012 by echelman

Here’s something you might want to think consider:  how did our  ancestors manage when there were no dental teams to care for damaged teeth or clean away plaque? It seems logical to assume that a lot of early humans must have been walking around with toothless grins, yet the truth is quite the contrary. Evidence shows that these people were in excellent health, and their mouths were almost free of dental disease.

Back in the old days, a natural diet and a few twigs and bones were all the preventive tools our ancestors needed. Today we have grown to rely on toothbrushes, toothpastes, floss, water irrigation, mouthwashes, and dentistry to keep dental disease away. Of course, we live longer than our ancestors and have greater potential to succumb to oral health issues. And while we may no longer be able to live the simpler life they did, we can pay more attention to what we eat.

Here are some simple steps that will go a long way to keeping your mouth healthy…
•    Try to eat balanced meals every day. And if you eat sweets, have them with a meal, not as a snack.
•    Brush, floss, and rinse your mouth often. Otherwise, chew on a piece of sugarless gum or munch on fibrous fruits and vegetables like apples or celery.
•    Be smart about snacking. A healthy snack doesn’t have to be boring, although some snacks are better for you than others. Below are some examples.

Potato chips or popcorn?  Plain dry popcorn is best, but a little oil, butter or margarine won’t do too much harm. Just don’t chew the kernels!

Chocolate milk or OJ? Chocolate milk or flavored and fortified non-dairy milks have nutritional goodness and contain no more sugar than an equal serving of unsweetened orange juice. Even though they’re nutritious, foods like this shouldn’t be served too often during the day.

How about fruits? Fruit punch with real juice added doesn’t stack up to a drink that’s 100% juice. Fresh fruit is superior to raisins and other sugary dried fruits and fruit leathers that stick to your teeth.

Plain toasted oat cereal or granola? No doubt about it, plain unsweetened cereals are far better. Granola and granola bars are often high fat, and they’re sweet and sticky enough to give your teeth something to worry about.

Just like our ancient ancestors, savvy snacking and a nutritious and balanced diet are as important to your teeth and gums as to the rest of your body. Your teeth and your smile will thank you!

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