Austin Dentistry and Wellbeing. Austin Dental Blog.

BOSTON (August 5, 2010) — Brushing, flossing, and twice-yearly dental check-ups are standard for oral health care, but there are more health benefits to taking care of your pearly whites than most of us know. In a review article, a faculty member at Tufts University School of Dental Medicine (TUSDM) debunks common dental myths and outlines how diet and nutrition affects oral health in children, teenagers, expectant mothers, adults and elders.

Myth 1: The consequences of poor oral health are restricted to the mouth

Expectant mothers may not know that what they eat affects the tooth development of the fetus. Poor nutrition during pregnancy may make the unborn child more likely to have tooth decay later in life.

“Between the ages of 14 weeks to four months, deficiencies in calcium, vitamin D, vitamin A, protein and calories could result in oral defects,” said Carole Palmer, EdD, RD, professor at TUSDM and head of the division of nutrition and oral health promotion in the department of public health and community service. Some data also suggest that lack of adequate vitamin B6 or B12 could be a risk factor for cleft lip and cleft palate formation.

In children, tooth decay is the most prevalent disease, about five times more common than childhood asthma.

“If a child’s mouth hurts due to tooth decay, he/she is less likely to be able to concentrate at school and is more likely to be eating foods that are easier to chew but that are less nutritious. Foods such as donuts and pastries are often lower in nutritional quality and higher in sugar content than more nutritious foods that require chewing, like fruits and vegetables,” Palmer said. “Oral complications combined with poor diet can also contribute to cognitive and growth problems and can contribute to obesity.”

Myth 2: More sugar means more tooth decay

It isn’t the amount of sugar you eat; it is the amount of time that the sugar has contact with the teeth.

“Foods such as slowly-dissolving candies and soda are in the mouth for longer periods of time. This increases the amount of time teeth are exposed to the acids formed by oral bacteria from the sugars,” Palmer said.

Some research shows that teens obtain about 40 percent of their carbohydrate intake from soft drinks. This constant beverage use increases the risk of tooth decay. Sugar-free carbonated drinks and acidic beverages, such as lemonade, are often considered safer for teeth than sugared beverages but can also contribute to demineralization of tooth enamel if consumed regularly.

Myth 3: Losing baby teeth to tooth decay is okay

It is a common myth that losing baby teeth due to tooth decay is insignificant because baby teeth fall out anyway. Palmer notes that tooth decay in baby teeth can result in damage to the developing crowns of the permanent teeth developing below them. If baby teeth are lost prematurely, the permanent teeth may erupt malpositioned and require orthodontics later on.

Myth 4: Osteoporosis only affects the spine and hips

Osteoporosis may also lead to tooth loss. Teeth are held in the jaw by the face bone, which can also be affected by osteoporosis.

“So, the jaw can also suffer the consequences of a diet lacking essential nutrients such as calcium and vitamins D and K,” Palmer said. “The jawbone, gums, lips, and soft and hard palates are constantly replenishing themselves throughout life. A good diet is required to keep the mouth and supporting structures in optimal shape.”

Myth 5: Dentures improve a person’s diet

If dentures don’t fit well, older adults are apt to eat foods that are easy to chew and low in nutritional quality, such as cakes or pastries.

“First, denture wearers should make sure that dentures are fitted properly,” Palmer said. “In the meantime, if they are having difficulty chewing or have mouth discomfort, they can still eat nutritious foods by having cooked vegetables instead of raw, canned fruits instead of raw, and ground beef instead of steak. Also, they should drink plenty of fluids or chew sugar-free gum to prevent dry mouth.”

Myth 6: Dental decay is only a young person’s problem

In adults and elders, receding gums can result in root decay (decay along the roots of teeth). Commonly used drugs such as antidepressants, diuretics, antihistamines and sedatives increase the risk of tooth decay by reducing saliva production.

“Lack of saliva means that the mouth is cleansed more slowly. This increases the risk of oral problems,” Palmer said. “In this case, drinking water frequently can help cleanse the mouth.”

Adults and elders are more likely to have chronic health conditions, like diabetes, which are risk factors for periodontal disease (which begins with an inflammation of the gums and can lead to tooth loss).

“Type 2 diabetes patients have twice the risk of developing periodontal disease of people without diabetes,” Palmer said. “Furthermore, periodontal disease exacerbates diabetes mellitus, so meticulous oral hygiene can help improve diabetes control.”

This article appears in the July/August issue of Nutrition Today.

When choosing a cosmetic dentist, make sure you meet the doctor for a consultation or some treatment before the actual full-blown makeover. The key is to figure out if you and your cosmetic dentist can understand each other and if your personalities click. It is not just about education, experience, and modern equipment. There are many very educated dentists in Austin, even though it is a small city. But it is also about the level of artistry that the dentist has to have to be able to translate your individual anatomy and your personality into your smile. You don’t want to end up will a smile that’s well-made but absolutely not yours! Take a look at our work: Before and After Gallery

This is a very complicated topic. The intricacies of the insurance system and variables in dental practices make it very complicated to explain, but we will try to share some insights into the world of insurance confusion.
It is a fact that dental insurance is nothing like medical, and you should keep that in mind. The coverage is very different, and there is nothing that dental insurance realistically covers at 100%. Most PPO plans state that they pay 100% of preventive services ( cleanings and exams), 80% of basic services ( fillings) and 50% of major ( everything else). There are some variations in which services fall into which group based on the plan. It is important to know that they pay percentages of their “usual and customary fees” which they define based on some national averages. Also keep in mind that these fees have not been updated for 15 years or so, so do your own math and figure what realistically the payment can amount to, especially if you live in a prominent area, say, such as Westlake Hills in Austin. Another important thing – the yearly maximum that insurance pays on most plans is $1500. While it is better than nothing – it will not help you tremendously if you need a lot of dental work and you need it done in one year. Insurance does not cover TMJ disorder treatment, cosmetic services, implants. Most insurance agents offering better policies do not sell dental insurance at all. So it is up to you to make a choice if dental insurance is worth the premiums for you for these benefits.

It is also a fact that there is a difference between in-network providers and out-of-network providers. While most people don’t realize it, no two dental practices are the same, even without any affiliations with insurance networks. Every dentist is different when it comes to education and experience, has a different approach to dentistry, chooses different equipment and materials, techniques and methods, and also how to run their business. When it comes to determining fees -  all of those factors plus the going rates in the area where the practice is located are crucial. Knowing that, even if you do shop around, you will probably not find a big difference comparing fees of dental practices of similar philosophy. If you find a big difference -  odds are – you are comparing apples and oranges and you may want to ask yourself what that difference gives you and what you might be sacrificing by choosing one practice over the other.

With in- network providers, the insurance company and your employer negotiate the rates and what is covered. So the insurance companies set their level of reimbursements to the doctors for various procedures and the rest of it is your out-of-pocket. Unfortunately, because of being very outdated ( ask any insurance agent) – the reimbursement rates are very low, and the doctors who strive to produce cutting-edge dentistry using the latest equipment simply cannot make it work, otherwise there would be no out-of -network providers. There is a reason why many dental practices choose to be independent -  so they could be the ones setting the bar for themselves. And even then, there are apples and oranges.

Hopefully this helps you a little bit to understand the big picture ( or at least see that it is even bigger). We believe, that one factor in determining your choice of a dentist trumps all others -it  is not insurance, not if the dentist is in- or  out-of-network, but the dentist himself.  The level of continued education, experience, desire to stay current with technology, and if you can trust him or her is what will help you get your money’s worth and get many more benefits in the long run. You want to develop a relationship with your doctor that will help you achieve and maintain your oral health for a lifetime, not just for the time of your appointment. And that is what we do every day and love it!

From Consumer Reports 2010.

Whatever sunscreen you choose, make sure it has an SPF of at least 30 (plenty for most people), and that it is labeled water resistant. Also:

• For full-body protection, adults should apply 2 to 3 tablespoons of lotion or cream 15 to 30 minutes before going out in the sun. Reapply every 2 hours or after swimming or sweating heavily.
• There aren’t any clear guidelines about how much spray to use. We checked the labels of the sunscreen sprays we tested and found that most simply recommended applying “evenly” and “generously” or “liberally.” (Most also recommend using in well-ventilated areas.) Some say to rub the sunscreen into the skin, while others don’t. All warn to keep the product out of the eyes and not to spray directly on the face. So read directions carefully.
• Don’t spray or rub sunscreen on clothes. Most of the products stained fabrics when applied directly and left for a day.
• Don’t use sunscreen after its expiration date because it might have lost its potency. If your sunscreen has no expiration date on the bottle when you buy it, mark one yourself with a permanent marker and throw out after two years.
• Don’t rely on sunscreen alone. Wear tightly woven clothing and a hat, limit your sun time, and seek shade during the hottest hours of the day.

Finally, take a quiz if you want to know what those ingredients in your sunscreen are all about.

By Consumer Reports Health.

This far-reaching legislation brings in some changes that affect consumers almost immediately, but the major changes don’t happen until 2014.

Here are some key dates in the health-reform timeline:

Late June 2010

New high-risk insurance pool for people with pre-existing conditions is supposed to be up and running by this date. To be eligible, you have to have been without insurance for at least six months. The pool will exist either until its funding runs out, or full reform begins in 2014, whichever comes first.

July 2010

All states are supposed to establish public Web sites where you can look up the available coverage choices, including private plans, Medicaid, Children’s Health Insurance Programs, and high-risk pools.

Various times in 2010

Medicare patients who fall into the Part D “doughnut hole” will get a one-time $250 rebate, in 2010 only.

Sept. 23, 2010

Several consumer protections begin at the start of the first plan year after this date, which is Jan. 1, 2011 for most people with job-based coverage, but can start at any time of year, so check with your insurer or plan administrator to be sure. So in September, check when your open enrollment period runs and how these new protections will affect you. Changes include:

• New group and individual plans must start covering proven preventive care, such as mammograms, colonoscopies, and immunizations.
• All health plans, new and old, must allow adult children to stay on their parent’s health plan until their 26th birthday, unless they have access to job coverage on their own.
• All health plans must start covering minor children with pre-existing conditions.
• Health plans can no longer rescind your coverage if you come down with a serious illness.

Nov. 15-Dec. 31, 2010

This is the time of year when people on Medicare can switch plans. If you have been covered under a private Medicare Advantage plan, carefully review your options for 2011. That’s when these plans start losing the extra subsidies they’ve enjoyed up until now, and some may respond by changing prices or benefits.

Jan. 1, 2011

More changes to Medicare begin. All plans must start covering the full cost of proven preventive services, with no deductibles or copays, and provide a free annual “comprehensive health assessment”—a checkup, plus discussion of your personal risk factors and ways you might address them. And anyone who falls into the “doughnut hole” will receive a 50 percent discount on brand-name drugs. This subsidy will increase in subsequent years until the doughnut hole closes completely in 2020.

2013

Changes begin in preparation for full reform in 2014.

• Medicare taxes go up on adjusted gross incomes of more than $200,000 for individuals or $250,000 for couples. They’ll have to pay an extra 0.9 percent tax on all earnings above that threshold. And for the first time, these high earners will also have to pay a 3.8 percent assessment on unearned income such as stock dividends.
• If you have a Flexible Spending Account, starting this year you’ll be able to contribute a maximum of $2,500 a year, adjusted annually by cost-of-living increases (until that date, the law allows employers to set the limit they choose.)

2014

Full reform starts.

• All citizens and legal residents will be required to have health coverage. Those who decline to purchase coverage will be charged a tax penalty. Exemptions will be available for reasons of financial hardship and other reasons.
• Every state will have an exchange where individuals and small businesses (up to 100 employees) can purchase coverage. All plans sold on the exchange must offer unlimited annual and lifetime coverage, and must offer a comprehensive set of “essential benefits.”
• Insurers must sell individual or group coverage to anyone who wants it, regardless of pre-existing conditions. They can’t charge people more, or limit coverage, on account of health status.
• Families and individuals who meet income requirements will receive subsidies in the form of refundable tax credits and reduced out-of-pocket costs in order to make required coverage more affordable.
• All individuals under 65 with an income of less than 133 percent of the federal poverty level will automatically be enrolled in Medicaid, even if they don’t have dependent children.

Read more.

An online poll of 289 general dentists and consumers confirms the traditional stereotype that men are less likely to visit the dentist than their female counterparts, according to the Academy of General Dentistry (AGD), an organization of general dentists dedicated to continuing dental education.

Why? Nearly 45 percent of respondents felt that men don’t see a need to go to the dentist, and about 30 percent of those polled reported that men may not visit the dentist because they are afraid or embarrassed to go. Almost 18 percent revealed that men just don’t have the time for a dental visit, and about 5 percent felt that men don’t even have a regular dentist.

This long-standing trend and excuse, however, may be disappearing as more men are climbing back into the dental chair – for a surprising reason.

“In my practice, more men are coming in and requesting bleaching, veneers and bonding,” says AGD spokesperson J. Nick Russo, Sr., DDS, FAGD. “Many have noticed the positive effects from a colleague’s improved smile and realize that a great smile has a lot of value in the business world.”

Dr. Russo also points to the fact that not long ago, most men worked for one or two employers throughout a lifetime and many did not think about the way their overall appearance affected their professional life.

“That’s not the reality today, with lay-offs and company closings across the board,” says Dr. Russo. “Today middle-aged men are competing for jobs with younger men, making appearance a heightened factor in their lives.”

Taking a back seat to new cosmetic concerns for men is the increased awareness of the overall health benefits of seeing a dentist biannually.

“As a dentist, I want men to come see me because they’re concerned about their health, however I’m glad to see them for whatever reason they come in,” says Dr. Russo. “Many times after men come back to the dentist they realize that proper maintenance and biannual checkups are the key to improving the way one looks and feels.”

Article from AGD patient resources. 2007.

By Consumer Reports

Spring misery
Most people who saw a doctor for their allergy symptoms said the visit helped a lot, our survey found.

Allergies are hard to treat—60 percent of the springtime allergy sufferers we surveyed had limited success managing their itchy eyes, sinus pain, sneezing, and other symptoms. But if you are miserable every time the trees bloom, don’t give up. Our nationally representative online survey, conducted by the Consumer Reports National Research Center, polled 1,814 adults in April 2009 during the spring allergy season. Here’s what allergy sufferers said might help:

Avoidance

It’s not easy to steer clear of pollen and other allergens. Only one in five respondents said they were “highly satisfied” with the avoidance measures they tried, such as staying indoors with the windows shut and the air-conditioner on, having someone else mow the lawn, or doing outdoor activities on low-pollen days. But when these tactics worked, they were even more effective than taking over-the-counter medicine for allergies.

Staying indoors and taking other avoidance measures may be most important between 5 a.m. and 10 a.m., when allergen levels are typically highest. If you try this approach, set your air conditioner to recirculate the air so you reduce the amount of pollen and other outdoor allergens from flowing into your home.

Check the pollen count in your area before going out. When you return home, take a shower to wash the pollen off your skin, and wash your clothes.

Prescription medicine

Only about one in four said they were highly satisfied with prescription allergy drugs. But most who were felt they had successfully managed their symptoms. Common medications included fexofenadine (Allegra and generic), a “second-generation” antihistamine that’s less likely to cause drowsiness than older antihistamines; fluticasone (Flonase and generic) and mometasone (Nasonex), corticosteroid nasal sprays; and montelukast (Singulair), which blocks molecules that can cause inflammation and allergies.

Overall, 8 percent of respondents received allergy shots, which can provide relief by gradually increasing the tolerance to specific allergens.

Over-the-counter medicine

More than two-thirds of our respondents relied on nonprescription drugs, including: diphenhydramine (Benadryl Allergy and generic), an older antihistamine that can cause drowsiness; loratadine (Claritin and generic) or cetirizine (Zyrtec and generic), second-generation antihistamines; and pseudoephedrine (Sudafed and generic), a nasal decongestant. Overall, nonprescription drugs were less likely to help manage symptoms than either avoidance or prescription medications, but they were better than doing nothing at all.

What you can do

Consider discussing your symptoms with a doctor. Most people who saw a doctor said the visit helped a lot, and 59 percent of those people said they had managed to rein in their symptoms.

Part of that benefit may be that the people who saw a doctor were more likely to take prescription drugs. And those medications, notably the steroid nasal sprays, often do work well, research suggests. Seeing a doctor also helped respondents pinpoint the OTC drugs and allergy-avoidance strategies that worked best for them. That may be because choosing from all the options can be confusing, and some are clearly better than others.

Finally, explore our allergy trouble tracker, which allows you to compare your symptoms to those of our survey respondents to help you find a remedy that may work for you.

This cartoon was in Austin American Statesman today. We love it!

By Debra Fulghum Bruce, PhD
WebMD Feature
Reviewed by Brunilda Nazario, MD

The kiss. The smile. The breath. What’s most important to you (and to your significant other)? Chances are it’s good breath. Let’s get personal. Bad breath (halitosis) may be common in dogs — but for people, bad breath affects how you feel about yourself, not to mention how others perceive you. In fact, you may not know you have halitosis until a brave friend tells you. How can you tell if you have bad breath? A simple way is to stick a clean finger in your mouth and scrape saliva from the back of your tongue. Put it on the back of your hand, wait a minute, then smell your hand. Is it something you’d want to kiss? If not, check out these 15 tips about causes and cures for bad breath. Start freshening your breath today!

5 Common Causes of Bad Breath:

1. Blame bacteria for bad breath. Bacteria breed inside your mouth. These micro organisms lurk between your teeth and cover your tongue. When bacteria stagnate, they multiply and give off toxins and stinky odors.

2. Say “Ahhh.” The deep holes in your tonsils, called crypts, are a common cause of halitosis. If your tonsils are too wide and pitted, a cheese-like smelly substance collects in these holes. These nuggets sometimes smell, and may cause bad breath.

3. Pungent foods and bad breath. Foods such as onion, garlic, and fish can cause bad breath — even hours after you brush your teeth.

4. Bad habits = bad breath. Any type of smoking (cigarettes, cigars, pipe) or chewing tobacco can leave you with a really nasty taste — and smell — in your mouth.

5. Tummy troubles. Sometimes GI problems such as GERD or an ulcer can cause bad breath when you burp and gas is released. Also blame low-carb diets, which cause ketosis, a fat-burning state in the body that produces dragon breath.

10 Tips to Banish Bad Breath.

Now for the fix, here are some simple tips from oral health experts on how to have breath that’s “kissing fresh”:

1. Brush your teeth — and tongue — twice a day to banish bad breath. While you’re brushing your teeth with a fluoride toothpaste, brush your tongue – especially the back of the tongue. Brushing your tongue will remove smelly bacteria that cause bad breath. One study found that by brushing the tongue, volunteers reduced their perception of bad breath by 70%. You can also buy inexpensive tongue scrapers at most pharmacies.

2. Floss once a day for fresh breath. Flossing is must-do. Flossing gets out hidden food particles and removes plaque, a coating of bacteria that forms around the tooth. Flossing also helps prevent periodontal disease — another common cause of bad breath.

3. Gargle with peroxide to fight halitosis. An antimicrobial mouthwash is important if you have a problem with excess plaque. “You can also gargle with peroxide for fresher breath,” says Mike McIlwain, DMD, a dentist at McIlwain Dentistry and an assistant clinical professor in Pediatric Dentistry at the University of Florida. McIlwain recommends gargling with peroxide to his patients. “Treat it like your favorite mouthwash. Just swig, swish, and spit. The oxygen in the hydrogen peroxide kills mouth bacteria that cause bad breath,” McIlwain says.

4. Use a fluoride mouth rinse for sweeter breath. Not only do decayed teeth hurt, they have an awful odor. Tooth decay can be prevented with fluoride toothpaste and proper dental care.

5. Drink lots of water to avert bad breath. “Lack of fluids can lead to dry mouth (xerostomia) and cause bad breath,” says Murray Grossan, MD, a board certified otolaryngologist at Cedars Sinai Medical Center in Los Angeles and coauthor of The Sinus Cure. Dry mouth or reduced saliva can be the result of not drinking enough liquids, mouth breathing, or medications like antihistamines.

6. Reduce upset stomachs to ease bad breath. Over-the-counter antacids may ease a sour or acidic stomach, which can cause halitosis when you burp. If you are milk intolerant and have GI problems, try lactase tablets.

7. Check your sinuses; infections cause bad breath. Bad breath is often a clue to an underlying sinus infection. “The purulent post-nasal drip is the culprit,” says William Sears, MD, also known as “America’s Pediatrician,” an associate clinical professor of Pediatrics at the University of California, Irvine, School of Medicine. Post-nasal drip is most noticeable after sleeping at night, which is why many people rush to brush their teeth first thing in the morning.

8. Eat yogurt for sweeter breath. Yogurt replenishes the good bacteria in the gut and “promotes a healthier mouth,” McIlwain says. Sears recommends celery “to remove stinky bacteria.” You may also try eating parsley between meals to fresh breath. Parsley reportedly has antibacterial and antifungal properties.

9. Chew gum with xylitol to banish bad breath. Chewing gum makes you salivate if your mouth is dry and causing bad breath. Saliva is what washes away the bacteria in your mouth.

10. See your dentist. At least every six months, see your dentist for teeth cleaning and an oral exam. Your dentist can check your mouth and teeth for open cavities and gum disease that cause bad breath. If self-care tips don’t work to stop your bad breath, see your doctor. Occasionally bad breath is a sign of a more serious problem, such as an infection, chronic bronchitis, diabetes, or kidney or liver disease.

An integral part of maintaining overall health is good oral health. It is important to understand the connection and be able to make educated decisions regarding dental care.

Recent studies have proven that oral infections can have great impact on your body’s total wellbeing. As a matter of fact, after many years of disconnect and treating people for only a specific health problem, medical doctors are now advised to send their patients to have a periodontal assessment to be able to see the whole picture.

Cardiovascular disease, the leading killer of men and women in the United States, is a major public health issue contributing to 2,400 deaths each day. Periodontal disease, a chronic inflammatory disease that destroys bone and gum tissues that support the teeth affects nearly 75 percent of Americans and is the major cause of adult tooth loss. And while the prevalence rates of these disease states seems grim, research suggests that managing one disease may reduce the risk for the other.

For patients, this may mean receiving some unconventional advice from their periodontist or cardiologist. Periodontists now may not only inform their patients of the increased risk of cardiovascular disease associated with periodontal disease, but also assess their risk for future cardiovascular disease and guide them to be evaluated for the major risk factors. The physicians managing patients with cardiovascular disease may also evaluate the mouth for the basic signs of periodontal disease such as significant tooth loss, visual signs of oral inflammation, and receding gums. Read more…

Important Simple Facts About Gum Disease.

FALLACY: Tooth loss is a natural part of aging.
FACT: With good oral hygiene and regular professional care, your teeth are meant to last a lifetime. However, if left untreated, periodontal (gum) disease can lead to tooth loss. It is the primary cause of tooth loss in adults 35 and over.

FALLACY: Gum disease doesn’t affect overall health.
FACT: Emerging research links periodontal disease to other health problems including heart and respiratory diseases; preterm, low birthweight babies; stroke; osteoporosis; and diabetes.

FALLACY: Gum disease is a minor infection.
FACT: The mass of tissue in the oral cavity is equivalent to the skin on your arm that extends from the wrist to the elbow. If this area was red, swollen, and infected, you would visit the doctor. Gum disease is not a small infection. Its result, tooth loss, leads to a very different lifestyle—dentures. The changes in your appearance, breath, and ability to chew food are dramatic and have many other undesired consequences.

FALLACY: Bleeding gums are normal.
FACT: Bleeding gums are one of nine warning signs of gum disease. Think of gum tissue as the skin on your hand. If your hands bled every time you washed them, you would know something is wrong. Other signs of gum disease include: red, swollen or tender gums; sores in your mouth; gums that have pulled away from the teeth; persistent bad breath; pus between the teeth and gums (leaving bad breath); loose or separating teeth; a change in the way the teeth fit together; and a change in the fit of partial dentures.

FALLACY: Cavities are the number-one cause of tooth loss.
FACT: Periodontal disease is the number-one cause of tooth loss. According to the 1996 American Dental Association/Colgate survey, U.S. dentists say gum disease is a more pressing oral health concern than tooth decay by a 2-to-1 margin.

FALLACY: Treatment for gum disease is painful.
FACT: New periodontal procedures including local anesthesia and over-the-counter medications, have made patients’ treatment experiences pleasant and comfortable. Many patients find they are back to normal routines on the same day or by the next day. Read more…

Assess Your Risk of Gum Disease Here.