“Acid Reflux & Children’s Teeth?”

Posted by drgracesun on May 17, 2009 under Healthy Smile, Smart Smile | Be the First to Comment

Although you may think acid reflux disease and your child’s dental health are unrelated, but recent studies have suggested the close relations.

Recent studies have linked acid reflux and dental erosion.

Acid reflux disease, defined as chronic symptoms or mucosal damage produced by the abnormal reflux in the esophagus, is nothing short of painful and distracting. When occurring in children, the symptoms can be even more painful and difficult to handle. Just nine days ago, the Pediatric Academic Society released findings of a study conducted by the University of California San Francisco stating children who have severe acid reflux have a much higher risk – up to six times the risk – of dental erosion and gum disease than those without acid reflux disease (or GERD). This is a unique finding and although it should be researched more before being considered fact, if your child suffers from acid reflux, be sure to keep an eye on his or her dental health!

Dental decay, erosion and sensitivity are a result of an overly acidic oral environment, and can often be quite painful and difficult for young children to handle, just like acid reflux. Regular hygiene (like brushing and flossing twice daily and after meals) is important as are regular checkups with your dental professional twice yearly, but what other things can you do to neutralize your child’s acid reflux, and in turn prevent dental and gum erosion? Besides healthy diet that consist of fresh vegetable and fruits, avoid greasy fried food , stay off sugary carbonated beverage,one physician who was a part of the aforementioned study has recommended children with acid reflux disease (even at early stages) should be started on a dental hygiene regiment, to be overlooked by a dental professional regularly, just as medical checkups are. Good dental home care program includes  fluoride treatment might be suggested.

Dental erosion can be uncomfortable and potentially hazardous to your child’s oral health, which is why prevention, early detection and adequate protection are always the best keys to health. By taking the right steps early in your child’s life (especially if your child suffers from acid reflux), you can assure your child has a better chance to live his or her life with a happy, healthy smile!

“Counterfeit Toothbrushes?”

Posted by drgracesun on under Information | Be the First to Comment

Counterfeit Toothbrushes?  You’ve heard of counterfeit DVDs and handbags, but toothbrushes? Believe it or not, brand name toothbrushes are a hot commodity, and some unethical business people are trying to bank on naive consumers. So be careful what you buy and what you use for your dental health.

Watch out for counterfeit brushes!

In February, grocery stores and pharmacies across Ottawa were surprised to find their suppliers had been conned into buying massive shipments of fake Colgate toothbrushes, and they were supplied to the stores to be bought by general public . The brushes that were affected include the Colgate Massager, Colgate Navigator, Oral B Classic 40, Oral B Contura and Colgate 360. These toothbrushes were not made by Colgate! Canadian health officials have released the following statement: “If an imitation is suspected, consumers should stop using them immediately, as the quality, safety and effectiveness of counterfeit products cannot be assured.”

It is true that most of the burden to check for false brushes is on the back of the retailer, but it is still important to be vigilant about your toothbrush – only buy from reputable dealers (like big chain grocery stores) and if your brush looks suspicious – jagged packaging, poorly printed logos or something similar, take it back to the store from whence it came. A counterfeit toothbrush is not made to the same quality control standards as true brand-name brushes: counterfeit brushes (which usually originate in China) have been known to have bristles which fall out quickly, leading to throat irritation and, in a more extreme case, a possible choking hazard for young mouths. A toothbrush’s quality can be measured by specific features such as a well designed handle and thorough rows of columns of properly spaced tufts of end-rounded bristles.

Genuine Colgate toothbrushes will have instructions and labeling printed in English and French only, and should say “Distr. by/par: Colgate-Palmolive Canada Inc” on the packaging. In addition, the Colgate logo should be embossed into the toothbrush handle itself, just under the brush head. These counterfeit brushes have not been detected in the United States as of yet, but due to the globalization of most large corporate supply chains (including those of Proctor & Gamble, the parent company of Colgate), these brushes could easily find their way into American grocery stores and convenience shops. Be vigilant about your toothbrush purchases to ensure you are using a high quality brush – you can only clean your mouth properly with the proper tools, and a genuine toothbrush is an important one!

“Mouthwash That Kills?”

Posted by drgracesun on May 9, 2009 under Healthy Smile, Information, Smart Smile | Read the First Comment

A patient of mine recently sent me this message – I was briefly shocked for a brief second, but then agreed! It is known that alcoholic mouthwash can pose a health risk to your body (and even cause cancer), but I never thought a product marketed as “safe” would actually kill mosquitoes!

“Dr. Sun, I was at a deck party awhile back, and the bugs were having a ball biting everyone. The host at the party sprayed the lawn and deck floor with Listerine, and the little demons disappeared. The next year I filled a 4-ounce spray bottle and used it around my seat whenever I saw mosquitoes. And voila!”

This little anecdote really makes you think twice about using alcoholic mouthwash! Ethanol contained in some mouthwash rinses dramatically increase the ability of cancer-causing substances to penetrate the lining of your mouth, and other harmful chemicals such as Acetaldehyde – which forms in a person’s mouth after using alcoholic mouthwash – are suspected to be carcinogenic. These chemicals are not only harmful to the body, but as we’ve learned, are strong enough to kill certain organisms, which should make you think twice about using alcoholic mouthwash!

If you are concerned about cleaning your mouth with a rinse, try a non-alcoholic alternative which is often natural, safe and just as effective as an alcoholic mouthwash. My favorite is Tooth & Gum Tonic. If you have any questions about mouthwash or how to find an effective and safe rinse, consult with your dental professional!

“Can Sleep Deprivation Harm My Teeth?”

Posted by drgracesun on under Healthy Smile, Information | Be the First to Comment

Getting a good night’s sleep is one of the most fundamental rules of good health. Getting 7 to 8 hours every night not only rejuvenates you for tomorrow’s activities, but sleep is essential for a well functioning immune system! Improper sleeping habits can also affect your oral health, including grinding and jaw problems which can lead to severe issues down the road.

A good night's sleep is essential for your health!

When trying to understand your sleeping habits, it is essential to understand the difference between REM and non-REM sleep. REM, which is short for rapid eye movement, accounts for about 1/5 to 1/4 of a typical person’s total sleep in a night, and is characterized by a rapid flickering of the eyes, irregular breathing, major voluntary muscle paralysis and decrease in body temperature. It is high in brain activity and it is when most of our dreaming occurs. REM sleep is the fifth and last stage of sleep that occurs in the sleep cycle, which repeats itself about five times throughout a period of sleep. It is preceded by four stages of non-REM sleep.  The 3rd and 4th stages of NREM sleep are the deep sleep stages, there is evidence that brain cells reset their sodium and potassium level during this deep sleep, and in fact the body repairs and regenerates tissues, builds bones and muscle, and strengthen the immune system during this stage!

Usually the deep sleep represented with Delta waves in brain activity are long, slow undulating waves. Certain frequencies in the Delta range trigger the release of Human Growth Hormone and are thus beneficial to healing and regeneration. Quality sleep by definition must include deep sleep, which is the deepest, first cycle of your sleep – synchronizing your sleep with your body’s natural sleep cycle will help you obtain better quality sleep. For most of people, going to bed before 11 PM would follow the body’s natural biological rhythms. Your body’s call for sleep is essential, we need it to stay healthy.

Bruxism (grinding and clenching your teeth during sleep) is brought up with the contraction of your jaw muscles, which most intensively happens at the 2nd NREM sleep cycle stage, moving in and out of the REM cycles. If you don’t go to bed on time every night, or your sleep pattern gets interrupted repeatedly, you will not be able to get into the restful stage 3 and stage 4 sleep that your body needs. You will end up getting more of the shallower stages of sleep, and going through more clenching and grinding. As we have learned, the consequences of excessive force bought up with clenching and grinding of the teeth can lead to excessive wear on our teeth, breaking up dental restorations, overloading the mouth’s supporting structure, gum recession and even TMJ symptoms, if these destructive forces are not properly managed. Of course, we should all work on establishing healthier lifestyles, and  better rest. We can also work on better diet and cutting back on stimulants at night that can interrupt your sleep cycle. Having a custom-fitted nightguard made from your dentist might also be an idea worth exploring – consult with your dental professional, and stay healthy!

“Michael Phelps’ Teeth & Your Oral Health?”

Posted by drgracesun on May 7, 2009 under Healthy Smile, Smart Smile | Be the First to Comment

What do Olympic divers, your local swim instructor and you – if you’re a swimmer – all have in common? Apart from a love for the water, exercise and the sport, there is a common risk of developing dark yellow or brown stains on the teeth of all avid swimmers who spend at least six hours a week in the pool!

The Academy of General Dentistry (AGD) has recently concluded a study on athletic swimmers who swim laps more than six hours a week, which has shown that exposure to chemically treated pool water can cause organic deposits to form on the teeth of these swimmers. Pool water is routinely treated with chemicals to keep the water clean for swimming, but these chemicals inadvertently raise a pool’s pH level to a level more basic than saliva (higher pH). By opening the mouth and exposing your teeth to pool water which contains antimicrobial chemicals, the water causes salivary proteins to break down and form deposits on teeth.

Why does this matter? Unfortunately, as deposits are formed on swimmer teeth, calculus buildup – hard, brown tartar deposits – appear predominantly on the front teeth and can be difficult to remove. Apart from keeping the mouth closed while swimming, avid swimmers should have their teeth professionally cleaned up to twice as often as non-swimmers (approximately four times a year). In addition to calculus deposits, the pool area can be a dangerous place for the mouth. When coming to the surface of a pool, rise gracefully! Many people hit their front teeth on a pool ledge, which can cause serious damage to the teeth and supporting jaw. Slippery pool decking can also cause falls which often chip , break or severly damage your teeth or mouth. Take precaution, be safe and healthy,  but enjoy and have fun with swimming – it’s a great exercise and a lifetime sport that benefits the body and the whole person !

“Numb and Number, Please?”

Posted by drgracesun on April 30, 2009 under Information | Be the First to Comment

“Doc, can I have more Novocaine? I don’t feel very numb.” Of course, it is nice to feel numb before dental surgeries! Have you ever been in a situation in which you had difficulty getting numb?

Local anesthetic is effective in most situations, however approximately 15% of dental patients experience a partial or total lack of numbness after receiving anesthesia injections. This phenomenon usually occurs in the lower jaw, when mandibular bone is too dense for infiltrated anesthetic injections to take, unlike the upper jaw which can receive the anesthetic solution easily. The dental nerve within the lower jaw is essentially buried within the dense bone itself,  so it requires a mandibular block injection for proper numbing (numbing which includes the teeth, tongue and lips in the same quadrant).

Variations in the anatomy of the “entry window location” (where the mandibular injection deposits its solution) makes it difficult for some people to receive proper numbing, even when the dentist follows the usual landmarks – don’t blame the dentist right away if your anesthesia doesn’t work! The physiology of each individual varies besides the anatomy, which will lead to different thresholds or reactions to various dental injections. Different dental injection solutions also gives different numbing effects – your dental professional should choose what is most applicable to your situation, usually epinephrine (the blood vessel constrictor) is added to give a better local numbing effect.

Speedy injections or anxious patients can cause a racy heart beat, which could be very uncomfortable. If you’ve had too many cups of coffee or if your blood sugar is low from having not eaten, you may feel uncomfortable after receive the dental injection. The wine from last night can also alter the effectiveness of the numbing. This all makes anesthesia a very delicate science. The technique of the operator (the dental professional) can occasionally be at fault for improper anesthesia, but more likely than not it is a complication with a patient variable. It is important for you to communicate with your dental professionals if you’ve had a history of difficulty with dental anesthetics.

Special oral local anesthetic techniques, such as intraosseous anesthesia, which can enhance deep pulpal anesthesia, may help to increase the numbing sensation. This process injects novocaine directly into the bone marrow – because the needle penetrates the hard cortex of the bone, it penetrates to the jaw’s deepest level and can adequately numb the site. It is important to remember that every mouth can be anesthetized, however because intraosseous anesthesia is considered a specialized procedure, it is important to find a dental professional who is experienced with such techniques.

“Do I Need Laughing Gas?”

Posted by drgracesun on April 27, 2009 under Information | Be the First to Comment

” May I have some laughing gas please?” is a popular request among the “high anxiety” or “wants to get away” group.

A patient is anesthetized with nitrous oxide.

Nitrous oxide gas (nitrous oxide and oxygen (N₂0-0₂)) is affectionately known as “laughing gas” due to its euphoric qualities when inhaled. Discovered in 1772 by Humphrey Davy, he had this to say about its effects: “On the day when the inflammation was the most troublesome, I breathed three large doses of nitrous oxide. The pain always diminished after the first four or five inspirations; the thrilling came on as usual, and uneasiness was for a few minutes swallowed up in pleasure.” When the gas is inhaled (at an approximately 50% nitrous oxide + 50% oxygen dilution), after several minutes nearly all pain dissipates from the body and a euphoric warmth spreads throughout the body. This pleasant feeling is not only pain-reducing, but can calm anxious nerves and relax all but the most fearsome patients. The calming, relaxing and euphoric qualities of nitrous oxide make it a prime candidate for anesthetizing patients who have irrational fears about dental procedures who are unable to get comfortable in the chair. Because laughing gas can be highly effective in treating moderate dental anxieties, nitrous oxide gas can also benefit the dental physician working on a patient – calm environments benefit everyone! Patients with high blood pressure, or who have had heart attacks in the past and are at risk from traditional IV anesthesia are prime candidates for nitrous oxide sedation.

The level of sedation and warmth felt in the body after inhaling nitrous oxide gas depends on the concentration of the dosage, and how long the gas is administered. Because the gas is administered into the lungs, it is saturated into the blood stream very quickly  and once the procedure is finished, there are no lingering “hangover” effects, meaning it is safe to drive home without an escort. Local anesthesia is still necessary for the treatment site, but needle-phobia will disappear with laughing gas. If you suffer from dental anxieties and have tried different techniques, seen different dentist and you still can not  face dental work with ease, it is worth while for you to try nitrous oxide during your next dental procedure. Have a discussion with your dental professional.

“Do I Need A Root Canal?”

Posted by drgracesun on under Healthy Smile | Be the First to Comment

Mark came in with a severe tooth ache, and after an examination, I could see the tooth was severely broken down. The basic options were to either save the tooth – going through root canal therapy and finishing with a post and crown restoration, or to remove the tooth and restore with a dental implant and crown. “Should I save my tooth, or should I pull it!” This is the eternal question!

Root canal therapy (also known as endodontic therapy) is a procedure of treatment for the pulp of a tooth once it has become infected – the inner pulpal material  must be removed, in order to protect and decontaminate the tooth from future microbial invasion to the jaw bone. Once a root canal procedure is performed, however, the lack of nutritional supply in the tooth (once the organic tissue is removed from the tooth during the procedure) will render the tooth brittle, the weakened tooth should be reinforced and restored properly, with a post and crown.

Root canal treatment does have a bad reputation due to the pain and the stigma associated with the procedure. Often times, a patient will have a root canal performed and think the procedure was a success, only to have pain and infection return several years down the line. The complexity of the anatomic root variation could be an obstacle and techniques can often be tedious, which is why specialized service is usually performed by a highly trained dentist or endodontist. Special tools like microscopes are also often necessary for a successful procedure. Advanced instrumentation and technique will ensure long-term success.

Regular dental checkups are vital to properly maintain your dental health. If the unhealthy dental condition requires a root canal treatment or an extraction, have your dental professional explain the pros and cons of each option, then make an educated decision. If there is a mystery pain, a 3-D image (Morita Survey of CT scan ) would be invaluable for proper diagnosis . Regular dental x-rays are not capable of capturing images of a cracked tooth nor accessory root canals (which are small and difficult to see). These tiny cracks or canal issues can lead to prolonged discomfort, which you may have thought was a figment of your imagination! If the prognosis was poor, or a tooth has broken down so much that it has become unrestorable, extraction and a dental implant might be a more sustainable investment to you dental health.  Prevention is always the best treatment! Brush and floss your teeth twice daily and after meals. If you have any dental pain, schedule an appointment with your dentist sooner rather than later.

“Why Is My Tongue Black?!”

Posted by drgracesun on April 23, 2009 under Healthy Smile, Information | Be the First to Comment

Have you ever felt sick, taken some Pepto Bismol and then a while later, had a black tongue? You may be thinking you’ve eaten something strange, or that you are having an allergic reaction! This is actually not a rare side effect of Pepto Bismol however – read on to find out why your tongue is black!

Black Tongue is harmless.

Numerous brands of nausea medication, including Pepto Bismol, have an active ingredient called Bismuth subsalicylate, a multi compound drug useful in treating nausea, heartburn, indigestion, diarrhea, and other temporary discomforts of the stomach and gastrointestinal tract. In a tablet form, Bismuth subsalicylate is meant to be swallowed with water – however, when exposed to the surface of your tongue (from chewing), the drug will often turn the tongue black after several hours, and can last several days. A black tongue and black stools in some users of the drug is not harmful, but the color is produced as a side effect of the drug interacting with saliva and the gastrointestinal tract.

The good news is this discoloration has no adverse affect on your health; there is nothing to worry about if your tongue has gone black or if it is staining your teeth with black strips after taking Pepto Bismol. The stain can be removed easily by thorough brushing or seek help from  your dental professional. If a thorough brushing was followed after taking the Pepto Bismo, the staining issue would be eliminated.  You must be aware of your body if you have a upset stomach in the first place; getting a good assessment and managing the root of the problem rather than just masking the symptoms should be the overall, long-term goal. Maintain a healthy diet, full of fruit, vegetables and lean proteins to control the PH of your body (which should be neutral or mild alkaline). Getting 7-8 hours of sleep every night will ease and equip your body to deal with the stress. If you do have an upset stomach, have a cup of peppermint or chamomile tea with honey on me, which will help with your upset stomach. We can all work on respecting our body and mind to take better care of ourselves.

Staining due to Pepto Bismol

“Why Metal Taste?”

Posted by drgracesun on April 14, 2009 under Healthy Smile, Information | Be the First to Comment

“Dr. Sun, can you check why I taste metal in my mouth?  I have no metal fillings; I checked on line, and I’m afraid I might have a cavity or gum infection!” So, I checked, and the oral department was cleared.

” Your mouth is healthy, tell me what has changed in your life?”
” I lost my job, I’ve been taking anti depressants and Ambien for sleep, but I had a physical exam that was fine.”
“Have you been good to yourself, healthy diet, taking supplements, exercising and proactive on job hunting?”
“Ha! Funny, Dr. Sun, I was going to ask you for a job! I exercise, but  not eating well and maybe drinking more.”
“Well, keep yourself in the best condition. The metallic taste has lot to do with the medications you are taking; poor diet and alcohol intake don’t help either. My advise to you is be positive, count your blessings, treat yourself right, maintain a healthy diet, cut down on alcohol and keep up your good oral hygiene. You may rinse your mouth with warm salt water or rinse with warm water with added baking soda (1/4 teaspoon to 8 oz warm water) to neutralize the taste. Also talk to your physician about this, see whether GERD or other gastrointestinal issues play a role.”

It is common to get the funny taste in your mouth (dysgeusia), it might taste metallic, acidic or bitter, it usually goes away on its own, but if is lasts more than two weeks, consult with your health care professional.

Dysgeusia is related to a multitude of adverse health conditions. It is a sign of imbalanced body chemistry, associated with changes of your physical, mental or oral condition: medication and diet also are contributing factors. Starting  with the mouth, make sure there is no caries, infection or poor oral hygiene. Think about whether you are taking prescription medications to treat hypertension and anxiety, (like lithium) antibiotics, antidepressant or others which may cause the metallic taste. The last would be possible physical illness likes cancer, a peptic ulcer, food allergies, or excessive metal elements (iron, copper, iodine, mercury, selenium, lead) in your body. Effects of radiation therapy may also cause dysgeusia.

Get a good assessment of the condition, then improve your health and feel better. Apart from consulting with your health care professional, do your part of eating right. Keep up good and clean habits, including oral hygiene, balanced stress level and a positive life outlook.  You can also try brushing / scraping the tongue, rinsing with herbal mouth wash (like Tooth & Gum tonic), or swishing with warm salt water or baking soda rinse to neutralize the metallic taste.