Teeth in a Day? by Douglas Urban, DDS

 Radio and TV advertisements claim that you can walk in the dental office in the morning with decayed, loose, and rotting teeth and walk out in the afternoon with new permanent teeth. What is this? How does it work?

First, let’s figure out who is a candidate for this treatment. Obviously, those with loose rotten teeth that have become stained and crooked over time would be the best candidates. However, suppose you have been wearing removable bridges hooked onto the front teeth. Now those front teeth are no longer able to take the brunt of holding bridges, withstand chewing food, and to provide an appealing smile. Is it worth expensive dental treatment to fix up what is left and have another set of removable bridges only to have the teeth fail completely in a few years? I cannot answer that question, but I can suggest an alternative.

Teeth in a day basically involves preplanning a restorative option that includes removing all the remaining teeth in the lower or upper jaw, placing 4-6 permanent implants, and securing a fixed full bridge over the implants at one sitting. This bridge does not come out, allows for strong chewing, and the teeth are brushed as usual. There is no denture adhesive needed, no altered taste, and teeth do not come out when brushing. Visits to restaurants are routine and those live active life styles like surfing and swimming are no longer fearful of losing their removable teeth.

Usually, the “teeth in a day” procedure involves coordination with your dentist, surgeon and laboratory. Your dentist will guide you through this process and make recommendations based on the amount of dental destruction that has gone on in the mouth. Then the dental team will get records (like photos, models, examination) and plan on a path of action. Once teeth are removed, implants placed, and bridge secured there is a rest period of 4-6 months for healing. Then your dental team will manufacture a stronger bridge for secure long lasting wear.

So teeth in a day can happen. It may take a few visits to have everything ready for the big day. It is a good idea to plan for a few follow-up visits to insure a good long term outcome.

Costs will vary so ask your dentist about the affordability of this process.

Is There a Correlation Between Rheumetoid Arthritis and Periodontal Disease?

Obstructive Sleep Apnea and Snoring

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 literally means sleep without breathing. Try holding your breath 10 to 60 seconds thirty or more times an hour. Without our awareness this can happen when we are asleep. Over time this can lead to hypertension, heart disease, weight gain, depression, diabetes, impotence, GERD, liver disease, memory dysfunction, strokes, and death. As a concerned health provider I decided to see if I had sleep apnea and, if so, what remedies existed to treat this silent killer.

I recently tested an “at-home device” for diagnostic screening of sleep apnea. This device slips onto your finger tip and measures pulse and oxygen levels while you sleep. It was discovered that during my sleep cycles my blood oxygen levels were dropping below acceptable levels and my heart rate climbed to the high eighties. I suspected I had a problem when I would awake several times a night without any reason. My dentist recommended a sleep study test at a sleep laboratory and I complied. The sleep lab is very similar to a nice hotel room except the technician affixes monitoring cables to your legs and head to measure such things as random limb movements and REM sleep cycles.

The results showed a mild sleep apnea condition existed so I returned to run another test that included the assistance of a breathing device called a CPAP machine that would exert positive air pressure when I inhaled. This made breathing a lot easier although the CPAP would occasionally dislodge if I rolled over on my side. Regardless, I saw positive results with REM sleep patterns and higher oxygen blood saturation levels. The only problem was finding a more comfortable alternative to the CPAP mask.

Not to be deterred an oral device was ordered for me to help keep my jaw from falling back into a slack position and blocking my airway. Although I have prescribed these devices for many years I have not had a reason to wear one. I have not yet had a third sleep study done to monitor the success of the device, however I have been told that I don’t snore much anymore. These dental devices can be effective in keeping the jaw in a more forward position to allow good breathing and good sleep. They are small and portable and do not make any noise that would keep others awake in your room. The fees range from $500 (for light to moderate snoring) to $2500 (for mild to moderate OSA).

As with any device made for OSA it is highly recommended that a follow up sleep study test be performed to gauge the effectiveness and make any adjustments that are required.

How Do I Get A Cavity? by Dona Fujioka, R.D.H.

Dental caries (cavities) stems from a dental disease that can be prevented. With the combination of biofilm (dental plaque) and fermentable carbohydrates, with an acidic (low pH) environment in the mouth, dental caries occur.

Tooth surface goes through a process of demineralization (mineral loss) and remineralization (mineral gain) several times a day. When dental plaque is present, its presence creates a condition of unsaturation and supersaturation. Unsaturation occurs during acidic conditions (low pH) in the biofilm when there is less minerals present. This is common in the presence of fermentable carbohydrates. Supersaturation happens when there is an increase in minerals (from saliva or calcium fluoride formulations) and an increase in pH due to reduced or lack of fermentable carbohydrates present or different buffering systems. The increase in the saturation level stops the mineral loss of the enamel and allows minerals to return to the partially demineralized enamel. This process is essential in the development of a cavity. A cavity develops when more minerals are lost than gained during the demineralization and remineralization process. The good news is that an early carious lesion (cavity) can be stopped as long as it is non-cavitated.

Non-cavitated carious lesion can be reversed in several ways; decreasing the amount of dental plaque, reducing the frequency of carbohydrate ingestion and increase in the amount and concentration of fluoride.

Understanding the disease process rather than just treating the condition is a better way of looking at dental caries. With a better understanding, it allows for a preventive approach, especially for those who are at high risk.

Biomarkers in Saliva Help Detect Early Stage Pancreatic Cancer by Dona Fujioka, R.D.H.

Research and studies are ongoing using saliva and its constituent biomarkers to aid in early disease detection, the monitoring of its progression and the prediction of therapeutic outcomes. Salivary biomarkers for disease detection, such as oral and systemic, is showing promise where blood markers are still proving ineffective.

An example sited by Dr. Wong is in pancreatic ductal adenocarcinoma. This is the most common, and also one of the most deadly forms of pancreatic cancer. His studies have shown that salivary diagnostics may be helpful in the fight against this form of pancreatic cancer.

In a study published in Gastroenterology, changes in the molecular signatures were found in the human saliva with an early stage pancreatic cancer. By analyzing the altered gene expression, biomarkers in saliva were found to be different between a patient with pancreatic cancer and one who did not have the disease.

One surprising finding is that various systemic diseases that were studied (pancreatic cancer, breast cancer, lung cancer, gastric cancer, ovarian cancer) have yielded highly discriminatory salivary biomarkers; particularly using their diagnostic tools. More studies are needed to confirm this early promise of using saliva samples, and its ease of obtaining samples, to identify diseases.

Snoring and Sleep Apnea by Douglas Urban, DDS

We all know what snoring is and how it affects those around us. Half of snorers may suffer some level of sleep apnea or sleep “without breath”. A simple test can be conducted at home in your own bed that can screen your sleep pattern and help determine if a monitored sleep study test should be ordered.

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 result in low blood oxygen saturation levels causing oxygen starvation of the body organs. The pulse rate will rise as the heart tries to pump more oxygenated blood to the body. This stress can result in strokes, hypertension, heart disease, weight gain, depression, diabetes, impotence, GERD, liver disease, memory dysfunction and death.

Your dentist can help detect screen sleep apnea patients by checking for worn or flattened teeth, scalloped tongue, enlarged tongue and uvula, extra boney growths and excessive gum recession. Your dentist can order a diagnostic at-home test (this can be free of charge) and have a sleep center read and interpret the results with you to help determine your risk for sleep apnea.

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 such things like 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.

Treatments for OSA can vary from anti-snoring devices made by dentists, sleeping on specially tilted pillows, neck slings, or wearing nasal cushions 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. 

I recently tested the at-home device for diagnostic screening of sleep apnea. It was discovered that during my sleep cycles my blood oxygen levels were dropping below acceptable levels and my heart rate climbed to the high eighties. No wonder I would occasionally wake up sweating!  A sleep study test is currently being ordered and I will keep you updated.

If you know you’re snoring or your loved one is keeping you awake at night please talk to your physician or dentist to help determine the seriousness of the problem.

For answers to your dental questions, contact

                                                    Douglas Urban, D.D.S.

                                                    Cerritos, CA 90703

                                                    562 924-1523       

                                                    DrDouglasUrban.com

USING SALIVA TO HELP DIAGNOSE AND ASSESS PATIENT’S HEALTH; BOTH IN MEDICINE AND DENTISTRY by Dona Fujioka

Salivary diagnostics has been an ongoing and developing technology used to assess and diagnose a person’s health. It has been found that the saliva provides many of the same molecules found in the systemic system. These include tissue levels of natural substances, and large variety of molecules introduced into the body for therapeutic, dependency or recreational purposes, emotional status, hormonal status, immunological status, neurological effects and nutritional and metabolic influences. Collection of saliva has been made so easy for the clinician, that a saliva sample could be collected in a minimum amount of time.

Salivary diagnostics is currently used to diagnose diseases or conditions based on certain biomarkers present in the saliva. Among these conditions are cardiovascular disease, diabetes, pancreatic cancer, and viral and autoimmune diseases. In dentistry, saliva is used to test for the presence of HPV (Human Papilloma Virus), which is one of the most common sexually transmitted diseases in the United States. There are more than 100 different HPV types. HPV-16 and -18 are the high-risk types associated with oropharyngeal cancer. It is the 10th most common malignancy, with more than 30,000 diagnoses yearly. There is a 50% survival rate, killing one American every hour. The survival rate is the lowest of the major cancer sites.

Another disease diagnosed in dentistry is periodontal disease. There are now tests that allow us to find out the person’s susceptibility to periodontal disease (My PerioID). A test is also available to determine the pathogens or bacteria involved in causing the infection (My PerioPath). Identifying the specific pathogens allow us to treat the condition with antibiotics specific to the bacteria present. A more personalized therapy will yield a better outcome.

With the ease in collecting saliva, salivary diagnostics is an avenue that should be implemented to help assess a person’s health. Determining a person’s systemic susceptibility to oral disease allows for early detection and treatment of diseases.


SOURCE: Salivary Diagnostics in Medicine & Dentistry: A Review
Herbert I. Bader DDS