Lumineers

Snap On Smile

Snap-On Smile

The California Dental Association completed its annual spring scientific session in Anaheim. The lecture offerings were outstanding and very pertinent to your dental care. This week I want to report about an interesting innovative dental solution I discovered while “walking the floor”.

Dentists and patients have always been somewhat disappointed with temporary removable bridges while undergoing a long term dental solution. I think Snap-On Smile can happily offer people a beautiful temporary cosmetic solution for missing teeth, large gaps, and discolorations until they can get their dental work completed.

When a person goes to see the dentist about enhancements to their “smile profile” they will often get a mock up of what their teeth will look like after treatment. Unfortunately, the mock ups are fragile and have to be removed before they break. Recent improvements in acrylics now allow us to make a thin strong set of teeth that will snap over the existing teeth without shots and drilling.

Snap-On appliances are durable and do not stain. Some care must be taken when inserting and removing and they are not intended for a permanent fix for people’s dental problems. You can wear the appliance during the day and while eating. The appliance must be removed and cleaned when you brush your teeth. It is very difficult for anybody to tell if such an appliance is being worn.

These teeth-like appliances can be used to replace a missing front tooth, cover over crooked teeth, fill up spaces during implant placements, or for “photo shoots” and social engagements. Dentists can use these appliances to diagnose and change biting patterns to assist with more complicated problems. If porcelain veneers are not affordable the Snap-On Smile will certainly be a less costly substitute until porcelain veneers can be placed. Your teeth can be whiter and straighter until you have the ability to get your veneers.

The Snap-On Smile is made from an impression of your teeth. After the laboratory has completed the injection molding process the appliance is returned and fitted to your teeth. Your dentist will instruct you on handling and maintenance and some things you will have to do to get the maximum life expectancy from the teeth.

I am excited about the Snap-On Smile because it fills a time gap that some people require until they can get a permanent fix to their new smile.

Gum Disease and Heart Attacks

You are probably hearing through aired media and perhaps in your dental office the persuasive argument that gum disease can lead to heart attacks. But will treatment of gum disease reduce heart attacks? Unfortunately, this question cannot be clearly answered. Let’s briefly examine where the connection of gum disease and heart disease is known to exist.

There are a certain number of people in a population that have high risk factors for heart disease. This may be due to smoking, genes, life styles, “good and bad” cholesterol levels, and c-reactive proteins (CRP). CRP’s are produced as a result of damage to the inner lining of the blood vessels that supply the heart muscle. Also, C-reactive protein levels rise when chronic inflammation is present. The American Heart Association has recommended using the CRP test as one of the indicators of risk level for heart disease.

Where is the connection with gum disease? Periodontitis or gum disease is a chronic inflammatory disease process that can lead to loss of bone around the teeth. The association seems to be that the chronic inflammation component of gum disease adds to the chronic inflammatory load the body must endure. There is no good outcome to a high chronic inflammatory level.

We have to examine what underlying conditions can cause both diseases as well as the effect gum disease can have on heart disease. For example, smoking has been shown to have an overwhelming affect on gum health. In fact, studies that measure treatments for gum disease become meaningless in smokers. Smoking has also been shown to cause damage to vascular tissues and increase the risk of having a heart attack.

Other underlying conditions also include the genetic factor. Some people are more prone to inflammation and metabolic disease. Studies are mixed, but it seems that a healthy diet low in saturated fats can help minimize the harmful effects of this condition.

Let’s get back to the dental factor. We know that bleeding gums will allow bacteria into the blood stream and these bacteria can grow in damaged vessels perpetuating the heart disease process. The dentist’s role is to help control the infection and inflammation levels with gum treatments and frequent monitoring of home care.

Regular cleanings of the bacteria encrusted surfaces of your teeth is a proven method to stop the destruction caused by these bugs. Surgery may be needed from the periodontist. Maintenance is required because these bugs can double in population every twenty minutes. I have seen periodontal disease that has been in remission only to suddenly (within 6 weeks) strike up again. That is why frequent monitoring is crucial.

Will treatment of gum disease prevent heart attacks? Periodontal disease is just one pathway of inflammation that can further deteriorate the lining of the heart and blood vessels. Your dentist is a very important “team” member along with the cardiologist and physician to maintain a level of general health that will prevent heart attacks.

For answers to your dental questions, contact
Douglas Urban, D.D.S.
Cerritos, CA 90703
562 924-1523
DrDouglasUrban.com

Dr. Urban on Today’s Dentistry/Remote Access

My Impressions of Remote Area Medical

The idea of volunteering dental services in inaccessible locations is very intriguing. Last year for the first time Remote Area Medical (R.A.M) decided to drop itself right into the middle of Los Angeles. The response from the public was overwhelming. RAM provides basic medical screening, vision, and dental services. This year they returned to the Sports Arena to another huge demand.

I had the opportunity to volunteer for one morning shift on Sunday and was generally impressed by the organization and efficiency of the set up and handling of patient flow. Although my personal check-in was about 20 minutes longer than it should have been (early morning rush) I was quickly able to make my way down to the floor level of the Sports Arena. The number of volunteers that showed up that morning was magnificent. Every available dental chair had a dentist or hygienist working. My chair was in the screening area. There were about 8 dentists screening nearly 50 each for basic services such as extractions, fillings, some root canals and cleanings.

Since this was a one-stop-shop RAM is not able to provide crowns, extensive dental therapies, or dentures. Some minor denture repairs were available if time permitted. I am happy to say that a lot of your area dentists volunteered their time and weekends to support this project.

The patients were very gracious for the services RAM was able to provide. There were some grumpy types of people who did not get what they expected, but most accepted the situation. I am sure the dentists wished to do more in some cases, but, remember, we were in the middle of the Sports Arena, not in a modern dental office. Some specialty services like oral surgery and root canals were done in mobile clinics that were towed into the Sports Arena.

The attitude of the volunteers was heartwarming. Everyone I saw pitched in with more energy than they would show in their own office. It was a team, but very few of us knew or even met before this event. There was one common force that made everyone commit to a duty and give it their best. The energy came from the heart knowing that we were doing something for a greater good.

At the end of my 6 hour commitment I quietly left. There was no one to give a thanks or “atta boys”, but none was needed. It was my pleasure to take a very small part in this noble endeavor. We do live in a very nice section of the world with relative peace and stability. It is easy to forget there are others close by not so fortunate. I hope RAM returns again next year.

For answers to your dental questions, contact
Douglas Urban, D.D.S.
Cerritos, CA 90703
562 924-1523
DrDouglasUrban.com

Dr. Urban on Today’s Dentistry/Making Teeth Stronger

Last time I discussed using xylitol sweeteners to lower the incidence of tooth decay. This is good prevention. But what happens when decay first begins and teeth become sensitive? There is now a dental cream that can be applied at home that will help harden teeth by remineralizing the soft enamel of the tooth.

The active ingredient of this cream is RECALDENT™ (CPP-ACP). It is marketed by GC America Inc. in the product named MI Paste Plus. It is also available in the Trident XtraCare with Recaldent and Trident Recaldent Calcium Sugar-free tablets.

MI Paste is pleasant tasting and adheres to the tooth surface acting like a magnet for minerals to bond back onto the tooth surface. This makes the tooth tougher and more resistant to acid etching from bacteria, foods, and saliva.

Who would benefit from MI Paste? It is safe for 1 year old children to senior citizens. MI Paste is dispensed by dentists to people who have a moderate to high decay rate. It is good for people who have a high acid level in their saliva. MI Paste helps reduce the erosion caused by dry mouth. If bleaching your teeth causes them to be sensitive you should apply the cream immediately after bleaching. If you are undergoing chemotherapy or radiation therapy to the head and neck area, MI Paste will help protect the teeth during this trying time.

MI Paste without fluoride is a better dentifrice for little kids who can barely brush their teeth. When they become older they can use regular toothpaste and then apply a small amount to their teeth before school and before bedtime.

This cream is also recommended for kids wearing braces. It is very difficult to fully clean every nook and cranny while the brackets and wires are on the teeth. MI Paste helps neutralize the acid levels caused by the remaining bacteria. Despite all efforts to protect the teeth white spots may appear after removing the brackets. The cream can then be applied to help remineralize these white spots (some white spots can be the beginning of decay).

Dry mouth is a common symptom due to age, stress level, smoking, dehydration, mouth breathing, caffeine, alcohol, medication, medical condition, and chemotherapy. Erosion of the tooth surface will occur even faster if the mouth is dry. MI Paste will help restore the hardness of the enamel and reverse the erosion process.

The cream should be used until the dentist determines that the decay rate has stabilized, white spots disappear, and remineralization has occurred. Thereafter you can use the Trident products containing Recaldent to maintain the remineralized teeth. MI Paste can be purchased through your participating dentist or through Amazon.com.

If it is so wonderful, why doesn’t everyone use it? Well the need must be compelling and the cost is about five times more than an equivalent amount of over the counter toothpaste. There is one last thing about MI Paste. It is sweetened with xylitol.

For answers to your dental questions, contact
Douglas Urban, D.D.S.
Cerritos, CA 90703
562 924-1523
DrDouglasUrban.com

Dr. Urban on Today’s Dentistry/Feeling tired all the time?

Does it seem like you go to bed early, get your eight hours of sleep and still feel tired? Perhaps you are not getting the sleep you think you are. Many of us suffer from obstructive sleep apnea or OSA.

Sleep apnea is characterized by pauses in breathing from a few seconds to a minute. These pauses can occur a few times during the night or over a hundred times an hour. It can allow a low oxygen saturation level in the blood resulting in oxygen starvation of the tissues and organs. It can result in strokes, hypertension, heart disease and death.

Sleep study tests can determine the incidence of breathing cessation. A medical doctor can confirm a diagnosis of sleep apnea after carefully reviewing the results of a sleep study test. These tests monitor the blood oxygen level, REM cycles, and the frequency of obstructive episodes per hour.

You can ask yourself these questions to see if you should seek help. What are my chances of dozing when I sit and read, watch TV, sit in public places, wait for red lights while driving or sit as a passenger in a car? What is the likelihood of falling to sleep after lunch? If you are tired or fatigued easily during the day it would be very prudent to consult with your physician for advice.

Sleep apnea can be initiated from the brain or from physical factors that obstruct and collapse the breathing space. Exactly where the collapse occurs in the back of the throat can determine the treatment alternatives.

Treatments for OSA can vary from anti-snoring devices made by dentists, sleeping on specially tilted pillows, neck slings, or wearing facemasks attached to positive pressure air pumps (CPAP). As with all treatment options these CPAP pumps cannot be tolerated by everyone and may have a limited success with some individuals.

In severe cases where respiratory arrest is possible surgery may be the only option. Surgical removal of excessive soft tissues in the throat and nasal sinus surgeries have been performed to open up the airways with limited success. In the most severe cases skeletal surgeries are performed to open up airways. This type of surgery, although extensive, has had great success. It sounds like a lot of treatment, but we are talking about a life-threatening situation if left untreated.

Regardless, I hope that you can appreciate that snoring may be a sign of a more serious problem and that it should be discussed with your physician or dentist. Your dentist can do a quick airway analysis, ask a few questions, and refer you to a physician that specializes in sleep apnea. Depending upon the results you may just have a snoring problem that can be alleviated with a simple appliance. Remember that OSA is not condition about a lack of sleep, but a medical condition about a lack of oxygen.


For answers to your dental questions, contact
Douglas Urban, D.D.S.
Cerritos, CA 90703
562 924-1523
DrDouglasUrban.com

Dr. Urban on Today’s Dentistry/Oh No! Not another cold sore!

Cold sores are common lesions that typically occur outside of the mouth. The lips, chin, face, and nasal areas are most affected. They are caused by the herpes virus (a little different strain from genital herpes) and are very contagious. Once you get infected you have it forever. So now that you have it what do you do with it?
Let’s first discuss the infection process. Someone in your past inoculated you with the active herpes virus. I am sure it was unknowing and innocent. During this primary stage the virus could infect inside or outside the mouth and produce very painful blisters. The blisters will last from 3-21 days and then disappear. The virus will then enter a latent period where it calmly resides in the nerves only to be reactivated in the future and start the process all over.
It is very important not to pop and drain the blisters because they contain the virus. Even when the blisters are crusted over they will have the live virus. Keep your hands washed and do not share lip balms and towels and eating utensils. You can spread the herpetic sores to other parts of your body-so no scratching. Did I mention no kissing? Use the same common sense you would use during a flu epidemic.
We really have no real answer to what triggers an outbreak. It seems that sun exposure, stress, sickness, compromised immune systems, and lack of sleep may initiate an outbreak. Other times it seems the outbreaks just occur to mess with you-like before a vacation, senior prom, graduation or wedding.
The first sign of an outbreak is the tingling and itchiness. At this time it is advised to “freeze” the lesion with ice or overwhelm it with an antiviral drug like Famvir. Using a mega dose within the first hour of the outbreak will eliminate or reduce the severity and duration. We can’t all walk around with Famvir in our pockets so this chance of stopping it in the first hour is small.
The second stage is puffiness and blistering. Topical applications of antiviral creams may reduce the severity and possibly the duration. Other medications like Abreva , Blistex, and Zilactin allow you to tolerate the blister and keep it moist so it will be less likely to crack. Health food stores sell lysine lip ointments and drops and red algae capsules. I have personally used all of these methods with varying degrees of success. I am very impressed with the lysine and red algae supplements since they helped the most to shorten the duration. You have to evaluate your own outbreak to determine if the treatment would be of any value. In other words, sometimes we just have to deal with it and not spread it around to the nose or eyes.
Medical advice should be sought if the lesions do not go away in a couple of weeks or quickly return. Herpes infections can cause complications with eczema, compromised immune systems, organ transplants and deliveries of newborns.
For answers to your dental questions, contact
Douglas Urban, D.D.S.
Cerritos, CA 90703
562 924-1523
DrDouglasUrban.com