Oil Pulling – A Dentist’s View

I first heard about oil pulling several years ago when one of my more “holistic” patients asked about it. Recently, the subject has been raised with increasing frequency. “Oil pulling” is an ancient Indian folk remedy in which oil is used as a kind of mouthwash. This technique is touted to improve oral health as well as provide many incredible detoxification benefits.

What is oil pulling and how does it work?

A tablespoon of oil is placed in the mouth and is swished around the teeth for twenty minutes. During this swishing process, bacteria that are present on the teeth and soft tissues of the mouth become trapped in the oil. Certain bacteria like Streptococcus Mutans cause gingivitis and dental decay, and eliminating them certainly leads to improved oral health. After the twenty minutes, the oil is expectorated (spit out) into the trash, not the sink or the toilet so as to avoid causing a clog.

Various different oils are recommended. The original technique apparently called for sesame oil, but more recently there seems to be a trend toward using coconut and sometimes sunflower oil. It is very important that the oil not be swallowed as all the collected bacteria could lead to systemic illness if ingested. Some people recommend performing this technique every day, while others suggest that four to five times a week is adequate.

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So what are the professed benefits of oil pulling?

This technique acts as an antibacterial and antiviral system, and so detoxifies the mouth and indirectly the entire body. The potential benefits of this treatment include:

  • Whiter teeth
  • Healthier teeth and gums
  • Improvement of acne, eczema, psoriasis and other skin conditions
  • Clearing sinuses and helping allergy sufferers
  • Eliminating halitosis
  • Helping with general pain issues
  • And many more

Is there any truth to all of these claims?

As a matter of fact, there is reason to believe that this technique does provide detoxification benefits. This is one of a number of methods which can be used to clean the mouth so thoroughly that the body is better able to heal itself. Apparently there is a study which was published in 2008 in which oil pulling using sesame oil resulted in a significant reduction in Streptococcus Mutans after two weeks. However, this technique was not as effective as chlorhexidine mouthwash which is commonly recommended by dentists and periodontists to control gum inflammation. In addition, a serious limitation of this technique is that the oil only travels about one millimeter deep into the gums around the teeth, and the more damaging infections are more than three millimeters deep. This technique should not be used by people with active gum disease.

The most interesting thing about this technique is that it highlights the fact that as our oral health improves, so does our general health. Everything in the body is connected. So that improvement in the sinuses, the throat, the cardiovascular system, the skin and various other body systems is a very positive byproduct. When the mouth is healthier, the level of inflammation in the body is reduced, the body is better able then to heal, and we feel better and look better.

Oil pulling may be considered as an alternative to an excellent oral homecare regimen. Such a regimen would include brushing for two minutes twice each day and especially before bed, flossing between the teeth regularly, and perhaps using a WaterPik with an antimicrobial agent on a regular basis as well. Ideally people should have their dentist or hygienist recommend an oral care system specifically designed for him or her. In addition, nowadays we even have a DNA test which can determine specifically which bacteria are present in each patient’s mouth, and if they have the specific marker which might make them more susceptible to periodontal disease.

If you have any questions about oil pulling or would like information about developing a homecare regimen for yourself, please feel free to contact us by telephone at 908.359.6655 or via our website at www.DesignsForDentalHealth.com

Cracked Tooth Syndrome – What You Need To Know

We have had several patients recently who have had problems related to cracked teeth. The symptoms of which these patients complain can be difficult for both the patient and the dentist.  Both can become frustrated because the underlying cause of symptoms is frequently difficult to pinpoint.  Often, patients will complain about pain which is caused by biting pressure and sometimes temperature.  It is frustrating for both parties because the described symptoms are often difficult to duplicate in the dental office.  It’s kind of like bringing your car to the dealer with a specific problem which suddenly vanishes as soon as you arrive at the dealership.

Cracked teeth generally occur for two reasons.  First, silver or amalgam fillings expand and contract as we consume hot and cold foods and beverages. The expansion and contraction of the filling is slightly greater than the tooth itself.  So, after years of such cycling in temperature-associated expansion and contraction, cracks frequently develop in the teeth.  Second, cracks may occur while chewing foods.  Commonly patients will describe a sharp pain in a tooth while they had been chewing, and the tooth will remain sensitive to biting pressure and/or temperature.

Cracked teeth are addressed in stages depending upon symptoms.  First, a bonded filling may be placed in an attempt to prevent the cracks from propagating further.  Depending on the depth and severity of the crack, an onlay or crown may be necessary to prevent the tooth from breaking.  An onlay covers any thin walls of the tooth which may be at risk for fracture and is considered a conservative, aesthetic and long-term restoration.  If the tooth has an extensive existing restoration or a more severe crack, then a crown which covers the entire tooth will be required to prevent the tooth from breaking.

In either case, the problem needs to be addressed as quickly as possible to prevent the crack from propagating further into the tooth leading to more severe dental problems.  For example, if the crack reaches the pulp of the tooth, then root canal therapy will be required as well.  The most severe complication would be the vertical tooth fracture which includes the root thereby making the tooth non-restorable.  In such cases removal of the tooth and replacement in some fashion will be required.

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The important points to remember are as follows:

1. Determine the exact source of discomfort first

2. Address the symptoms as quickly as possible

3. Begin with the most conservative treatment and progress as needed to eliminate all symptoms

Such teeth need to be followed on a regular basis to ensure that damage to the pulp has not occurred.  Appropriate x-rays at routine intervals will be helpful for this.  Keeping your dentist apprised of precise symptoms will also go a long way to help in diagnosis.

If you have any questions about cracked tooth syndrome please do not hesitate to contact our office by calling 908.359.6655 or on the web at www.DesignsForDentalHealth.com

New Root Canal System Offers Major Improvements

Several months ago we began using a new root canal technique and have found it to be vastly improved compared to the methods we were taught back in dental school some 30 years ago. If you have ever undergone a root canal, you will remember that we use little files that are twisted with our fingers. This technique, when followed to completion, was a very painstaking  as well as time-consuming one. Some years ago we began using a somewhat different technique which involved using a French-made piece of equipment to clean out the canals using an electric motor and rotary files. This technique was certainly a huge improvement over the finger file techniques we previously used. But, now, our newest system which was developed by Dentsply Corporation and called WaveOne™ offers even more advanced improvements.

The major improvement as far as patients will be concerned regarding this newest system is that cleaning the canals is completed in a fraction of the time that it used to take when we were filing with our fingers. In addition, the files used with this technique are meant to be used one time only. Each pre-sterilized file assures that there will be no contamination since each patient has her own single-use file.

In addition to these improvements in instrumentation, this technique offers an activator, which may more appropriately be called a vibrator, to agitate an antimicrobial or antibiotic solution within each prepared canal. This agitation thoroughly cleans the canal and any adjacent pores in the root where bacteria may hide, thus offering more complete debridement of each canal.

Finally, this system utilizes a filler which is warmed first to allow it to be more flowable. This flowability permits the filler material to better seal not only the canal itself but also any adjacent openings or tubules in the root.

We as dental practitioners have truly enjoyed using this vastly improved system, and patients have expressed their opinions of how simple and straightforward having a root canal felt to them. This was especially true of those patients who had previously undergone root canal therapy with older techniques and systems.

If you have any questions about root canal therapy or would like more information about the system that we use, feel free to contact us @ www.DesignsForDentalHealth.com or by calling our office @ 908.359.6655.

Dr. Nadler Lectures at SMC

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This past Thursday evening, I had the pleasure of speaking to the Diabetes Support Group at the Somerset Medical Center.  The title of the talk was “Diabetes in Dentistry –What You Need To Know.”  Two themes were emphasized during the hour-long lecture.

First, all systems and organs in the body are connected.  And, in this case, diabetics are at risk for more severe periodontal infections than the general population.  In addition, uncontrolled periodontal disease actually aggravates the diabetes as well as the reverse.

Second, it’s all about prevention.   Those with diabetes often have xerostomia or “dry mouth.“  So, not only do diabetics have a compromised ability to fight infections, butdry mouth also contributes to an increased risk of decay and gum disease.  As a result, cavities and gum disease can progress rather quickly in these patients.  And, by the time a person realizes that a problem exists, the issue is often quite advanced and requires more aggressive, costly and involved treatment to be addressed.  Prevention through regularly scheduled care  as well as proper home care is the best way to avoid such major problems. 

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The entire lecture as well as the questions and answers segment that followed was videotaped.  It will be on the hospital television channel as well as online at www.somervilletv.com under “Live TV.”

If you have any questions about diabetes and dentistry, it will be my pleasure to answer them.   I can be reached in the office @ 908.359.6655 or online at www.DesignsForDentalHealth.com  

 

A Healthy Smile Is No Luxury

Teeth Need Not Change with Age!

Healthy AgingA healthy mouth helps to promote general health and wellness through all stages of life.  According to everydayhealth.com, “research shows that people with good dental health are less likely to develop diabetes and heart disease or have strokes”.  So, maintaining a healthy mouth throughout life is a wonderful habit to develop for the sake of preserving your teeth, your smile, and your overall well-being!

The basics of dental care – brushing, flossing, regular check-ups and cleanings, and eating right – are the same as in all other stages of life. However, there are certain oral health concerns that are more common in seniors.  Knowing these can help you know what to watch for as years come and go.

 

Tooth Decay:  Bacteria-filled plaque builds up quickly on your tooth enamel, the hard protective covering on your teeth.  The acid that these bacteria produce causes tooth decay.  As we get older, cavities are more likely to develop around old fillings and crowns as well as on exposed root surfaces.

Gum Disease:  Gum disease or periodontal disease, occurs when plaque accumulates and spreads beneath the gum line.  Again, the bacteria in plaque which work their way onto and under the gumline causes inflamed, bleeding gums and eventually bone loss.  Once the attachment of the teeth is compromised, repair can be either very difficult or impossible.  In its most severe form, gum disease results in the loss of teeth.

Root Caries:  Root caries is decay on the roots of your teeth.  If the gums recede and the soft root surface of the tooth is exposed, such decay is very common.  This surface is more susceptible to decay than tooth enamel and is more commonly seen as we enter our retirement years.

Dry Mouth:  Dry mouth is also called xerostomia.  It often occurs as a side effect of medication or other health problems and treatments, including cancer treatments like radiation therapy.  Menopausal and post-menopausal women also often produce less saliva.  The reduction of saliva leads an increased risk of tooth decay and gum disease because the buffers in saliva which neutralize bacterial acids are no longer present.

Oral Cancer:  There are about 35,000 cases of mouth, throat and tongue cancer diagnosed every year according to the American Cancer Society.  Most are over the age of 40, with an average diagnosis age of 62.  Two of the most common contributors to oral cancer are tobacco in any form and alcohol.  Enough said!  Regular exams which include oral cancer screenings can be life savers.

Denture Problems:  Denture wearers need regular care too.  If dentures become loose or fit poorly, mouth sores develop making chewing very difficult and potentially causing excessive loss of bone.  Dentures must also be properly maintained so that bacterial colonies do not form on their surfaces.

Be sure to ask your dental professionals for assistance in caring for your dentures.

 

The steps to maintaining oral health throughout  life change very little.

  • Brush and floss regularly to eliminate plaque.
  • Have regular dental check-ups and cleanings.
  • Eat nutritious foods and put a limit on “Junk”.
  • Don’t smoke or chew tobacco, and if you do, take the steps to quit.
  • Drink alcohol in moderation.
  • If you have dentures, be sure to give them proper care.

These few simple steps lay a solid foundation for excellent oral health and help you to maintain a smile to last a lifetime!

LINKS AND RESOURCES

VIDEO: Adults Over 60

Health Aging: Oral Health

Adult dental health: aging healthfully

Oral Health Concerns for People Over 60

What Are You Afraid Of? –The Scariest Dental Procedures Explained

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Image courtesy of Gregory Szarkiewicz / FreeDigitalPhotos.net

According to reports and our experiences, nearly half of all adults dread going to the dentist. From root canals to TMD to the smallest filling, many adults are afraid of the dental procedures they need to maintain or improve their oral health. Many even avoid going to the dentist altogether because of these fears. Check out this slideshow put together by Everydayhealth.com that explains some of the procedures that people find the most frightening. A little education can go a long way to allay patients’ fears about dentistry!

SLIDESHOW: THE SCARIEST DENTAL PROCEDURES EXPLAINED

UN Mercury Free Treaty Seeks to Phase Out Metal Amalgam

Mercury Free Dentistry May Soon Be Required By UN Treaty

Mercury Free Dentistry

Dr. Nadler has offered only mercury free dentistry for over 20 years!

The American Dental Association officially states that the mercury in amalgam fillings is safe. Be that as it may, our office has taken no chances with your health, having offered only metal-free fillings for the past twenty plus years. While several countries have banned the use of amalgam fillings, its use in the U.S. is still prevalent. A recent report by the Concord East/West consulting firm stating that 32 tons of dental mercury is used annually in the U.S. Besides possible health effects, there is concern over the environmental impact of amalgam fillings. According to the E.P.A., “approximately 50 percent of mercury entering local waste treatment plants comes from dental amalgam waste”, costing taxpayers an additional $41 per filling for environmental costs, cleanup and waste treatment.

However, all of this may soon change. As reported by foxnews.com, by next year, the United Nations Environmental Programme will have completed the text of a legally binding, global treaty on mercury pollution. The treaty is supported by the U.S. State Department, and will serve to phase out the use of products containing mercury. Amalgam fillings on are on the treaty’s list of products to be phased out. If the treaty passes all dentists may be facing a global mandate to stop the use of silver amalgam fillings completely.

The treaty and the phase out of amalgam in dental restorations are not without controversy. The treaty is supported by organizations such as the World Health Organization, but others see it as a scare tactic used simply to enforce further regulations. There is ongoing debate among dental and other health professionals about the possible health risks of mercury exposure from amalgam fillings and whether the mercury present in the fillings is enough to cause any risk.

If the treaty passes, whether or not there are in fact health risks related to the use of mercury in fillings, dentists across the country and the entire world will be affected and forced to change their treatment choices. The ADA “has expressed the view that any proposed ‘phase-down’ of dental amalgam should be linked to a ‘phase-up’ of dental preventive programs. We have also focused on the safety of dental amalgam, the need for further dental materials research and the proper management of dental amalgam waste”, addressing both health and environmental factors in its response.

The next conference of the UNEP to discuss the progress of the “mercury free treaty” will be held in June.

LINKS AND RESOURCES

Read more about the proposed U.N. “mercury-free” treaty 

More on the environmental impacts of mercury fillings from the International Academy of Oral Medicine and Toxicology

ADA Leadership Report response to the UN treaty meetings

NOTE: Originally posted April 24th, 2012

Dental Decay on the Rise? Tips for Preventing Cavities

Is Dental Decay On the Rise Again?

Dental Decay on the Rise?Well it certainly has seemed like it in our office this week. Not only have we seen more “cavities” than normal, but more of them PER PATIENT! And, naturally, none of these people are too happy. We’ve heard this question on several occasions: “Why am I getting cavities?!?” So, consider the following at least a partial answer to that question.

As has been discussed in earlier blog entries, cavities result according to this simple formula:

Bacteria + Food + Time = CAVITIES or GUM DISEASE or both

Bacteria are in the plaque which sticks to the teeth and grows every 24 hours.

Food is any carbohydrate, but especially sugar in any of its forms.

Time means how long it takes bacteria to produce acid from the food – about 20 minutes.

Want to prevent cavities? Eliminate any one of these three contributing factors. That’s it!

So, if you remove the plaque well every day — no cavities.

If you don’t ingest “bad” foods or drinks (e.g., candy, soda, etc.) OR if you clean such foods off your teeth shortly after ingesting them (i.e., cut down the TIME) –no cavities!

Brush Your Teeth!Yes, we understand that everyone eats some junk and has some plaque on their teeth, but applying a few simple rules will go a long, long way to help you prevent cavities and gum disease in your own mouth! Generally, when we see patients with cavities, we see substantial plaque. And, these patients are all brushing their teeth. Maybe these suggestions can help:

1. Use an electric toothbrush! Our favorite is the Sonicare, but any electric brush will accomplish more than a manual brush from our experience.

2. Brush the vulnerable parts of the teeth and gums. Especially the gumline where the teeth and gums meet. Cheek-side and gum-side. Aim the brush at an angle towards the gumline, and the biting surfaces of the back teeth where all the food and plaque catches in the grooves.

3. Do something to get between the teeth where we have seen a lot of decay lately. We used to call these “flossing cavities” because of the plaque stuck between the teeth. If you hate flossing, use a pick, mini brush, electric “flosser” (which are pretty cool and quite popular now) or whatever…

4. Use a good toothpaste with fluoride. Forget the whitening toothpastes as they can cause sensitivity and some may be too abrasive. We really like ClosysII which has worked really well for many patients and me. We insist that patients undergoing “major” dental work use this product to stay healthy during treatment.

5. BRUSH BEFORE BED always and then do not eat or drink anything except H2O!

6. Be careful what you eat or drink a lot of. Sports drinks have sugar, soda in all forms, or whatever can get around your teeth and cause cavities. Moderation or quick removal are the keys.

7. Call us if you have any questions or would like some Oral Hygiene Instruction. It will be our pleasure to help!

We can be reached at 908.359.6655 or via our website at www.DesignsForDentalHealth.com. We’ll follow up and expand on some of these suggestions in future blogs. Let us know if you have any suggestions for topics you’d like addressed. May you have a happy, healthy and cavity-free 2012!

NOTE: Originally posted January 12th, 2012

Mercury Amalgam Fillings Banned

In 2008, the American Dental Association, (ADA), announced that the use of mercury-silver, or amalgam, dental fillings has been banned in Sweden, Denmark and Norway. There has been much discussion about the health and environmental risks of mercury fillings in the United States as well as Europe for some time. This new broader ban was instituted because mercury is considered in those countries to be a dangerous environmental toxin as well as a potential health risk.

However, in the USA the use of mercury in dental fillings is still approved by the government and the ADA. It is only in recent years that most American insurance companies have approved payment for alternatives to mercury amalgam fillings. It is considered unethical for a dentist to advise a patient to have mercury fillings removed for health reasons. However, any patient may choose to have their existing amalgams replaced with an alternative material if they so desire.

From a dental point of view, amalgam fillings are inferior to their alternatives for various reasons. Just like a mercury thermometer, as they are exposed to heat, amalgam fillings expand. And with cold, they contract. The problem is that they expand contract at a slightly greater rate than the tooth structure which surrounds them. After years of hot and cold cycling, small cracks develop in the teeth. Eventually, these cracks propagate and the teeth fracture. Then, a larger and more complicated restoration is required to repair the damage. In addition, unlike the alternative materials used to repair teeth which are bonded into place, amalgams do nothing to hold the remaining tooth together. And, from a cosmetic point of view, silver fillings cause the teeth to appear grayish. Such discoloration often increases over time. Although ethically, I am not permitted to recommend removal of amalgams for strictly health issues, I decided over fifteen years ago to stop using mercury-containing fillings. My patients’ experience with the alternative materials has been excellent in terms of longevity of service, comfort, and appearance.

There are two main amalgam alternatives. For fillings which are less than one-third the width of the tooth, composite restorations are wonderful. They are relatively inexpensive, bonded into the tooth for strength, and match the tooth color. Larger restorations are best replaced with porcelain inlays or onlays. These, too, are bonded to the surrounding tooth structure and match in color. They are very strong and can be used to conservatively restore teeth which, in the past, required crowns or caps.

If you have any concerns or questions about such filings, please feel free to call our office at 908.359.6655 for more information. Or, you may send email to info@DesignsForDentalHealth.com.

NOTE: Originally posted on January 10th, 2008

How to Never Have Another Cavity!

Preventing Cavities and Dental Decay

Dental decay seems to be the main concern of patients when they come into our office for an examination. Fortunately, the incidence of decay (how frequently it is seen) has decreased very significantly in the last fifty years owing mainly to the availability of fluoride in drinking water which makes teeth harder and, therefore, more resistant to decay.

For a cavity to develop, there are three variables which must be present. The secret to never again having dental decay is to eliminate at least one of these. Theoretically, the prevention is not difficult.

First, plaque must be present on the teeth. Plaque is a nearly invisible deposit of sticky goo (for lack of a better word) which is LOADED with bacteria. It is this plaque which we try to remove each day by tooth brushing and flossing. The purpose of the brush is to loosen the plaque from the exposed parts of each tooth so that it can be rinsed out. Floss does the same thing between the teeth where the brush cannot reach.

Everyone in our office agrees that an electric brush is FAR more effective than any manual brush at removing plaque. We have tried many brushes, most recently the new Sonicaire brand. I had tried this brand in the past and could not get used to the way it tickled my palate. The company has addressed this issue, and I now love this brush. We have never before seen an instrument perform so well! We highly recommend it, and can provide one for you at significant savings under the retail price.

Second, food must be available for the bacteria. They love certain carbohydrates which they ingest. Then, the little devils produce acid as a by-product of this ingestion. It is this acid which causes cavities. And what foods result in the most damage? Sugar in all its forms – soda, gum, sports drinks, candy, raisins, fruit roll-ups, etc. There are other contributing substances, but in my experience, SUGAR IS THE ENEMY!

I recently was visited by one of my favorite patients. She has a history of developing serious cavities very quickly. She had always attributed the decay to some hereditary flaw, but on further discussion she admitted to sucking life savers frequently every day at work to keep her breath fresh. She also uses sugar in her coffee and drinks several cups per day. It is likely that these habits are contributing to her dental problem if not causing them. So, if you think that you have too many cavities, perhaps an inventory of your dietary intake may shed some light on the problem. It is interesting that in the last few years, a new syndrome of rapidly advancing decay has developed among people who ingest sports drinks frequently…

Time is the third variable in the dental cavity equation. People will only develop decay if the plaque and food are allowed to remain on the teeth for extended periods. So, if you brush thoroughly and remove all the plaque, no decay will develop. Similarly, if you eat a candy bar, but quickly remove the bits that stick in your mouth, you will not have a cavity. We were taught in dental school that it takes the bacteria about twenty minutes to turn sugar into acid in high enough concentration to cause problems. So, perhaps eating junk food before bed without brushing is not a good idea. Similarly, sugary foods that are also sticky remain in the mouth a long time, and, so, are the worst for causing decay.

To summarize:

Bacterial Plaque + Sugary Foods + Time = Cavities

Eliminate any one of these variables, and you will never have a cavity again!

If you have questions or comments, please feel free to call our office at 908.359.6655. Or you may send email to info@DesignsForDentalHealth.com.

P.S. Thanks to new technology, we are better able to locate cavities and judge their severity. We now employ the Diagnodent Laser Cavity Detection Aid. It looks like some day, the dental “pick” will be a thing of the past…

NOTE: Originally posted November 26th, 2007