Dental Care and Holidays!

Posted by drgracesun on December 22, 2009 under Current News Events | Read the First Comment

Wow – 2009 really flew by! As this year draws to a close and another prepares to bloom, take time to reflect on your life and plan for a better future. Did you do well taking care of yourself this year? Could you do better? What is your new year’s resolution? Being happy with our dental health should be one of our top priorities for 2010. It’s up to us to control our future! Have fun and be safe this new year!

Holidays are a joyful time for friends and family, filled with good food and great memories. During this happy time you must remember to take care of your oral health, not only during the feast but beforehand as well! Since most dental offices close for the winter holidays (some for up to two weeks!), it is a good idea to get a checkup before the holiday – especially if you have any pain or sensitivity.

With regards to holiday staining of your teeth, as I have previously mentioned in a wine blog, white wine has an acid content that tends to increase the risk of stain or darkening of your teeth, if combined with other habits of drinking tea, or similar dark beverages. Do not be fooled by the crystal clear appearance of a white wine – they are certainly capable of dulling your teeth. Both whites and reds are equally capable of staining teeth. Certain acidic properties present in wine (white, red or rose) create micro-porosity etching which rough the surface of your teeth, making your teeth much more susceptible to stains from other foods.

If you were to drink a glass of white wine with a red meat sauce, the acidic properties in the white wine could make your teeth more prone to staining from the red sauce in your meal, or the cup of tea after the dinner! Red wine is still more “dangerous” to the pearly opalescence of your teeth than white, however, as it contains pigment molecules known as chromagen, which will stain your teeth. All wines contain tannins, which act as a binding protein, aiding chromogen to saturate upon the surface of the tooth. Just remember to brush and floss after every meal, especially during the holidays!

When you do drink acidic liquids or eat sugary foods, be sure to rinse your mouth with water. Brush and floss twice daily, and after meals – oral hygiene should be routine to avoid problems. Prevention is the most powerful form of self defense from oral health problems!

Apart from keeping your teeth beautiful and pearly-white, remember not to over-do the quantity of the foods you eat during over the holidays. Lean proteins (like turkey and chicken), veggies (like green beans and yams), fruits (like pumpkin and cranberries) are all delicious in moderation – the Christmas ham could be a bit much (taste everything)! Don’t forget the pumpkin or pecan pie for desert! Holiday meals don’t have to be boring and bland to be healthy; sample everything in moderation. Have a happy and safe new year!

Autism Awareness!

Posted by drgracesun on November 4, 2009 under Children, Current News Events, Hygiene, Nutrition and Diet, Orthodontics, Smart Smile | Read the First Comment

On Halloween (October 31st) weekend,  Autism Awareness Walks took place from San Francisco to New York and everywhere in between. Michelle Parris, a walker in Washington, D.C. came out to the Washington Mall ready to walk 2.5 miles for her son Miles. “I just want other people to not have to deal with the same difficulties that my son has dealt with,” she said. “If there’s a way that we can end it that would be great.” The annual Autism Awareness Walk is to raise funds and awareness to help fight autism, a disorder of neural development that hampers certain skills associated with social interaction and communication. Idiosyncratic use of language is also consistent. People suffering from autism also often suffer from restricted and repetitive behavior. The condition begins to show itself in children as young as two years old. Because much of the condition is still fairly mysterious, raising awareness and funds to fight autism is vital.

An autistic child stacks cans, a commonality amongst autistic children.

Often times, children suffering from autism are very difficult to treat by a physician – especially in dentistry. Autistic children often have a very hard time trusting physicians (especially if he or she is unfamiliar with said physician). In regards to dentistry, autistic children can have difficulty sitting still. This can make orthodontic treatment very difficult, especially if the child does not like braces or feels they are causing him or her pain. An autistic child can be treated just as successfully as any child if he or she is treated with patience and care.

Regarding dental home care, brushing and flossing will require a family member’s daily help and guidance. Nutritional needs for Autistic children are extremely important, not just for dental hygiene, but for the brain. There are researches showing how certain foods seem to affect the developing brain of certain children, causing autistic behavior. This is not because of allergies, but because many of these children are unable to properly break down certain proteins. Researchers in England, Norway, and at the University of Florida had previously found peptides (a breakdown product of proteins) with opiate activity in the urine of a high percentage of autistic children. Opiates are drugs, like morphine, which affect brain function. These findings have recently been confirmed by researchers at Johnson & Johnson’s Ortho Clinical Diagnostics.  Gluten-free diets (a protein fraction found in wheat, rye, barley and most oat products) and Casein-free diets (a protein in dairy) are suggested. A professional nutrition consultation is really a must.

I was luckily blessed to have the opportunity to treat some special people who needed special care. Of course, every patient is special in my dictionary, but when dealing with someone who cannot communicate (or resists treatment), the challenge is greater to make that person better. You can also feel the love in between the family members – the special person actually plays the “glue” role to get the family together! When you see them together, it is such a beautiful scene.

Treating Autistic or any other special people can be an extremely rewarding experience. Everything is possible if we determine how to make things better; with patience, love and knowledge, we can experience miracles!

An EyeTooth Saves An Eye?

Posted by drgracesun on October 3, 2009 under Current News Events, Information | Be the First to Comment

In a story that spread across the news (and the web) in a matter of hours, a revolutionary surgical procedure took place in Florida that essentially used a female patient’s own eye tooth (canine ) as a base to hold a prosthetic lens inside her eye, which was blinded nine years ago due to Stevens-Johnson Syndrome. Blind for nine years, Sharron “Kay” Thornton recently regained her vision through a first-in-the-U.S. surgical procedure at Bascom Palmer Eye Institute at the University of Miami Miller School of Medicine. The surgical procedure — modified osteo-odonto-keratoprosthesis (MOOKP) — implanted her canine eyetooth in her eye, as a tissue base to hold a prosthetic lens in place.

The disease, which claimed Sharron Thorton’s vision for so many years is an idiopathic condition (read: spontaneous and of unknown-origin) which causes the epidermis to separate from the dermis in what is often a life-threatening battle. The condition destroys the cells on the surface of the eye causing severe scarring of the cornea. Because the eye is such a sensitive part of the body – which rejects foreign material, including plastics and other man-made objects – a piece of hard natural tissue was needed for the implantation of the prosthetic lens. Because the body would normally reject an artificial base, the eye tooth was chosen as a hard, durable tissue which was composed of natural minerals that the body would not reject.

Corneal specialist Dr. Victor Perez said of the procedure, which was developed in Italy, “MOOKP has proven effective as a solution to end-stage corneal disease where severe corneal scarring blocks vision and corneal transplants are no longer an option but the eye’s internal structures and optic nerve remain healthy. For certain patients whose bodies reject a transplanted or artificial cornea, this procedure ‘of last resort’ implants the patient’s tooth in the eye to anchor a prosthetic lens and restore vision,” he explained.

Before the eye-opening procedure, the eyetooth was actually implanted in the patient’s stomach for several months, in order to expose the tooth to other bodily tissues (blood, plasma etc), preparing the tooth for implantation within the eye. Had the tooth not been cocooned by the body before implantation, the chances of bodily rejection would have been rather high. Medical technologies like these (and revolutionary medical procedures) have helped improve our life so much – dental or other bodily implants have been used routinely with great success, but the bottom line is that prevention still is the best answer for our  health and quality of life. When tragedy strikes – as it did with Kay Thorton – a combination of science and fortune just might save the day.

Codeine Can Kill?

Posted by drgracesun on September 27, 2009 under Children, Current News Events, Information, Smart Smile | Be the First to Comment

How could this be happening? Medication that is supposed to help and make a patient feeling better produces a deadly reaction?

Simple outpatient surgical procedures – which are performed in clinics, doctor offices and dental practices on a daily basis – which require mild to moderate painkillers is customary and routine  may turn out to be fatal. The case in question occurred last weekend when an otherwise healthy 2-year-old boy died after being prescribed codeine to relieve pain from having his tonsils removed. The sad fact is that cases like this even the protocol of post operative was followed, and very little could have been  done to avoid such a tragedy.

The child mentioned above had a history of snoring and sleep apnea (when a person momentarily stops breathing during sleep throughout the night). In an effort to clear the boy’s airway, he had a routine tonsillectomy outpatient surgery and was sent home. Doctors prescribed codeine syrup and told the boy’s mother to give it to him for pain, but two nights later, the child developed a fever and wheezing. He was found dead the next morning, according to the report.

Although the coroner’s office noted that toxicology tests showed the mother had given the child the proper dosage, the boy had high levels of morphine in his system, which is metabolized from codeine. Further investigation determined that the child had an ultra-rapid metabolism genotype, which causes the body to metabolize codeine at a faster rate than the norm. The only true way to have avoided this tragedy would have been to keep the child in the hospital overnight, for 24 hours, for observation to see whether his breathing had improved, and whether pain medications (such as codeine, which suppresses the respiratory system) could have put him at risk.

The take home message here is that common, routine dental procedures which involve pain relievers (like wisdom tooth extraction or implant surgery) must always be treated with the utmost care and attention.Be aware the potential risk of toxicity and allergic reaction of any medication . If you are unsure of your body’s reaction to certain medications or pain relievers, consult with your dental professional or primary care physician. If you have a child who is about to undergo an outpatient procedure, speak with his or her physician before the procedure. Are there any potential risks associated with the procedure, or with the post -operative medications ? Know your child and know their body – proper supervision is essential, especially with children.

“Do Redheads Feel More Pain?”

Posted by drgracesun on September 14, 2009 under Children, Current News Events, Information, Smart Smile | Be the First to Comment

Redheads feel more pain! New research published in the July 09 Journal of The American Dental Association found that painful experiences at the dentist might cause more anxiety for men and women with red hair, who were twice as likely to avoid dental care than people with dark hair. Red-headed children or adults might avoid dental visits and might be at a higher risk of affecting their dental health!

A child that has an unfounded fear of the dentist (or even a founded one, instilled by parents who aren’t very fond of their dentist or past experiences in the dental chair) are common, however due to a scientific quirk (thanks to mother nature), redheaded individuals do feel pain more intensely than non-red-headed persons. These extra sensitivities to pain might lead to negative experiences with dental visits, which as being parental health care providers, we should be aware of these phenomena.

There are two studies that exist. In 2004, research showed that people with red hair need twenty percent more general anesthesia than blonds or brunettes. A 2005 study indicated that redheads are more sensitive to thermal pain and are more resistant to the effects of local anesthesia. Researchers believe variants of the melanocortin-1 receptor gene play a role. This MC1R gene produces melanin, which gives skin, hair and eyes their color.

While blond, brown and black-haired people produce melanin, those with red hair have a mutation of this receptor. It produces a different coloring called pheomelanin, which results in freckles, fair skin and ginger hair. About 5 percent of whites are estimated to have these characteristics. The relationship between MC1R and pain sensitivity is still under study, researchers have found MC1R receptors in the brain and some of them are known to influence pain sensitivity. Non-redheads can also carry a variant of the MC1R gene. In this dental study that had 144 participants, about a quarter of the non-redheads had variants of the MC1R gene. These people also experienced heightened anxiety and avoided dental care compared with others who did not have the variant. There is no commercial test available for variations of the MC1R gene.

The best tips for redheads are to work on the prevention of dental problems, inform your health provider that you are highly sensitive, use TLC and be patient, wait a bit longer to let the anesthesia start to work and finally inform your doctor that you might require additional amounts of local anesthesia – because you are a special redhead!

“More Plaque = High Fever?”

Posted by drgracesun on July 19, 2009 under Current News Events, Healthy Smile, Hygiene, Information | Read the First Comment

It’s  known that gum disease can lead to other health problems such as cardiovascular disease. Interesting new research results, however, have named plaque a key contributor to fever and illness in the elderly.

In an all-too-common trend in dental research, university researchers are discovering that poor oral health almost consistently leads to systemic problems throughout the body. In the latest example reported in The Archives of Gerontology and Geriatrics, the following was released: “Researchers studied 271 older people who were long term hospital patients. The study lasted one year. In that time, people with high oral plaque levels and at least 10 teeth were more than 5 times as likely to have fever as were people with 1 to 9 teeth.” Among the elderly with no teeth, those with more plaque on their tongues were 5 times as likely to have fever as people with cleaner tongues.

Several studies like the one described above have suggested that poor oral health and poor oral hygiene in all patients can affect overall health. The bacteria that cause cavities and periodontal (gum) disease may be risk factors for some types of pneumonia in older adults, as poor oral hygiene may be linked with pneumonia or difficulty breathing in patients with chronic obstructive pulmonary disease.

This recent study only serves as further evidence of the importance of oral hygiene and upkeep: a healthy mouth contributes to a healthy nervous system and defense system. Brush and floss twice daily, as well as after meals. Using tongue scraper or brush to remove plaque build up on the tongue. Avoid alcohol and tobacco when possible, and brush / rinse after such activities. Curtail poor oral habits in order to save your mouth from excessive plaque build-up.Have regular dental check up, early detection and treatment of dental and gum problem will allow a cleaner oral environment enable decrease the plaque build up.

Getting old is part of life cycle, but not with our attitude nor our oral condition. With proper care, our teeth will outlast us, keepup our oral health can do tons of good for our quality of life.

“Bleeding Gums = Losing Memory?”

Posted by drgracesun on July 7, 2009 under Current News Events, General Dental Knowledge, Gum Disease and Treatment, Healthy Smile, Information | Be the First to Comment

We all know that brushing and flossing is not the only key to preventing dental disease (tooth decay and gum disease) – you probably also know that a healthy smile and fresh breath can actually reduce risk of a heart attack and stroke.  What may surprise you, however, is this: researchers at West Virginia University have discovered that a clean mouth may also help preserve memory!

Thanks to a grant awarded by the National Institutes of Health, West Virginia University has found an obscure link between periodontitis (gum disease) and memory loss. A test sample (of over 270 seniors) was chosen to be part of the university study, during which School of Dentistry researchers checked the oral and cognitive health of patients every day over a period of roughly two years. Initial conclusions showed that 23% of the group who suffered from mild to moderate memory loss also had relatively poor oral hygiene habits.

Dr. Crout of the WVU School of Dentistry explains that although the specific genetic link between periodontitis and memory loss has not yet been defined, the team hopes to have more details soon. “If you have a gum infection, you’ll have an increased level of inflammatory byproducts,” Crout explained. “We’re looking for markers in the blood that show inflammation to see if there is a link to memory problems. We’d like to go full circle and do an intervention — to clean up some of the problems in the mouth and then see if the inflammatory markers go down.”

We’re not quite sure about whether bacteria or the body’s inflammatory response is the contributing factor of observed memory loss; it may be a combination of both, or a result of other environmental and physiological factors. What we do know, however, is that the rate of Alzheimer’s cases is skyrocketing. Imagine the benefits of knowing that keeping the mouth free of infection could cut down cases of dementia – it could be revolutionary!

Keep brushing and flossing to keep the mind sharp – or maybe we need a sharp mind to keep brushing and flossing?  As a clinician, when I see a patient who can’t keep their oral hygiene in reasonable condition, I become concerned. The risk of heart attack and stroke are heightened in patients who suffer from poor oral hygiene. Knowing that memory loss is somewhat associated with inflammatory factors in the mouth, we should all improve our oral health in order to keep our mind sharp!

“What Killed Michael Jackson?”

Posted by drgracesun on June 27, 2009 under Current News Events, Information | Be the First to Comment

We were all stunned and saddened with the passing of Michael Jackson – it’s natural that we have a hard time accepting the early lost of such a talented person. Why did Michael past away in such sad and unexpected circumstances? Questions surrounding his prescription medications are being raised and the toxicology report might take up to eight weeks to reveal the facts. It is times like these that remind us to be cautions about using prescription drugs, especially potent painkillers, which should be discussed and brought to the public’s attention, to lower the risk of potential abuses.

Michael Jackson at The White House, 1984

Suffering from intense physical pain is one of the most unpleasant life experiences a person can go through. Modern medicine allows us to manage pain with over-the counter and prescription medications. When the pain level is intense and acute, prescription drugs will “take the edge off” of pain, and risks of adverse effects is low. On the other hand, when the physical pain becomes chronic, or repetitive, pain management with prescription drugs can become a very difficult task to sustain one’s physical and mental health and facing high risk of abuses. In America, problems of abusing prescription drugs can often times be bigger than street drugs.

The two narcotic analgesics (pain medications) mentioned in the media which were prescribed to manage Michael’s physical pain were Oxycontin and Demerol (from when he had suffered burns and over the years never stopped using prescription pain meds). Both of these drugs are opioid agonists which include such pharmacological effects as anxiolysis, euphoria, feelings of relaxation, respiratory depression, constipation, cough suppression and analgesia with abuse liability similar to morphine. When the 911 call happened, the description of ” not breathing”, which was respiratory arrest, could have been a consequence of the adverse effects of opioid agonists. There should not be any speculation as to what really happened to Michael as the toxicology report will not be ready for many weeks – he was under the care of a private physician, although an experienced cardiovascular nurse could have been an important person on staff for better patient monitoring and care.

The PDR (Physician’s Desk Reference) states that Oxycontin tablets are to be swallowed whole and not to be broken, chewed, or crushed (which can lead to the rapid release and absorption of a potentially fatal dose of oxycodone). When Demerol is intravenously administered, overdose can lead to circulatory collapse, cardiac arrest or death.

We need to be sympathetic with one’s suffering and pain – everyone should have an individualized pain management program depending upon certain physical and mental conditions, physical activity, diet and other habits. As for any health care provider, one needs to think about the long term health and well being of a patient, which at times might mean saying “no” to excessive requests for potent narcotics. Seeking solutions to correct the root of the problem and prevention should be at the forefront of any physician’s agenda. Initiating therapy at the appropriate point along the progression from non-opioid analgesics, like anti- inflammatory drugs (such as Ibuprofen) and acetaminophen (Tylenol) to opioid in pain management must be considered.

Michael, we all miss you! Strenuous 8-hour day rehearsals for shows set to open in London, combined different medications for treating chronic pain combined with ongoing mental stress proved a fatal combination for a true genius of our time.

“Level 6 Pandemic?”

Posted by drgracesun on June 14, 2009 under Current News Events, Hygiene, Information | Be the First to Comment

I canceled the trip to China – it’s just not worth the risk of being quarantined for a week! Swine Flu, also known as H1N1 Influenza, has been gaining interest in the news and at health organizations worldwide, and not for bad reason – at the moment, it is the Chinese government’s nightmare that an outsider will bring in swine flu,  and that the pandemic will spread just as quickly as bird flu in densely populated China. The World Health Organization (WHO) on May 11 upgraded H1N1 to a “level 6 pandemic,” the highest grade of pandemic and the first global flu epidemic in 41 years.

Countries affected by H1N1 influenza

Swine Flu is in fact a mutated form of the common flu, which behaves like a seasonal influenza- H1N1 influenza is made up of genetic elements of four rather common flu virus. H1N1 is a type A virus, the most virulent human pathogens known that cause the most severe disease among humans. Type A viruses are more prone to widespread outbreak (as H1N1 has spread to 74 countries now). It is no surprise that airports and hospitals around the world have set up screening areas and quarantine rooms for suspected influenza carriers, so be prepared if you are planning on traveling, especially to a densely populated country. It is natural that lesser developed, densely populated countries must take flu pandemics seriously as they often lack the technology, medical manpower and/or resources necessary to keep a potentially large outbreak under control.

Swine Flu spreads faster but is less fatal than Bird Flu.

Although H1N1 influenza is currently present and spreading in both pigs and humans, and can spread quickly and silently from human-to-human, it is not transferable by eating cooked pork – don’t panic over that BLT! The CDC advises using regular soap and water or an alcohol-based hand cleanser frequently to clean your hands before touching your facial features (like the eyes, nose or mouth) to lower the risk of catching the flu.

“Normally the influenza virus is spread from person to person through droplets in the air — from a person with a cough for example,” said Dr. David Satcher, a professor at the Morehouse School of Medicine and former U.S. Surgeon General. Droplets in the air can be inhaled by another person, which is probably the most common way a virus spreads.

H1N1 Swine Influenza

Also posing a risk, he said, are items that have recently touched or handled by someone infected with the flu – a fork or a doorknob, for example. Some experts endorse occasionally disinfecting household surfaces and appliances with a diluted chlorine bleach solution.  You should also disinfected your toothbrushes by soaking them in an OTC strength hydrogen peroxide ( 3% H2O2) for 10 minutes – or get new tooth brushes.
Once infected with the flu, it’s difficult to know what actual strain of influenza you may have. H1N1 flu symptoms are similar to the common flu: fever, cough, sore throat, body aches, headache, chills and fatigue. It can be difficult to distinguish between the common cold and influenza in the early stages of  infection, so if you experience any of these symptoms for a prolonged period, consider a visit to your primary health care physician for a check-up.