Tag Archives: health and wellness

Gum Disease, Inflammation, and Your Health

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All of our body’s organ systems are interconnected. What happens in one system can and often does affect other systems. One prominent and currently emphasized interrelationship is the one between periodontal (gum) disease and cardiovascular disease. And in particular, it is inflammation which is the common link between these two conditions.

Inflammation by itself is not a bad thing. Acute inflammation is the body’s normal response to injury and infection. This type of inflammation is experienced as redness, pain and swelling. Immediately after an injury, there is a biochemical reaction which improves blood flow to the affected area. Nerve and other cells send out signals to recruit white blood cells which help fight foreign bodies. This acute inflammation is absolutely necessary for normal good health.

There is another kind of inflammation which is our main concern in this article. That is chronic inflammation which is also known as low–grade or systemic inflammation. This inflammation is long–lasting and examples include autoimmune disorders like rheumatoid arthritis and lupus. In these cases the body mistakenly initiates an inflammatory response even though there is no actual infection or injury to be fought. Other examples of chronic inflammation include inflammatory bowel diseases like ulcerative colitis and Crohn’s disease.

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Chronic “hidden” inflammation occurs throughout the body when something engages the immune system. This engagement varies from person to person but may include repeated or prolonged infection, smoking and gum disease. Obesity also makes one prone to inflammation as fat cells turn out inflammatory proteins called cytokines. Most people don’t know that they are inflamed. There is a test which measures the inflammatory marker called the C–reactive protein but it is not used routinely to determine increased risk of associated diseases. The important point is that inflammation is the primary cause for most of our serious chronic diseases including cardiovascular disease, diabetes, cerebrovascular disease, rheumatoid arthritis, and Alzheimer’s disease to name but a few.

As far as the connection between gum disease and cardiovascular disease, research indicates that heart disease, clogged arteries, stroke and bacterial endocarditis may all be linked to oral health. Researchers believe that gum–disease–producing bacteria enter the bloodstream and make their way to the heart. And just as these bacteria create chronic inflammation and damage of the gums and bone around the teeth, the same bacteria can cause a similar response in the blood vessels. Inflammation can begin and accelerate the build-up of plaques with in blood vessels – called atherosclerosis or hardening of the arteries. These plaques decrease the flow of blood to both the heart and the brain, and if such a plaque breaks free can result in a heart attack or stroke.

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What can you do? Roughly 75% of adults have some form of gum disease and 30 % have moderate to advanced periodontitis. Those with more advanced gum disease are much more likely to develop associated inflammation-related heart disease or stroke or the other inflammation-related illnesses. Having a thorough periodontal examination and following up with necessary gum disease periodontal therapy is the best first step. Avoid the obvious creators of inflammation which have been proven to be unhealthy. Prime examples are smoking and heavy drinking of alcohol.

There are many who advocate an “anti-inflammatory” diet. Many of the recommended foods would be typical of Mediterranean cuisine and certainly represent good nutrition. Such a diet would include:

• Generous amounts of fruits and vegetables

• Using healthy fats like olive oil

• Eating small portions of nuts

• Drinking red wine in moderation

• Eating fish regularly

• Limiting or eliminating red meat

If you would like more information about inflammation, gum disease and your health, please feel free to contact us by telephone at 908.359.6655 or via our website at www.DesignsForDentalHealth.com

Crooked Teeth and Sleep Apnea

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As I mentioned in our last blog, we will be describing various connections between oral health and systemic (or total body) health. Today, I’d like to report on a very interesting class which I attended about a week ago. This was an Invisalign Study Club meeting which was meant to increase our skills in planning Invisalign orthodontic cases. But, every now and then, we watch a gifted speaker provide you with much more information than the announced topic would suggest.

My longtime patients know that I have been a lifelong student of dentistry and especially occlusion’s (the bite’s) role in preserving dental health for the long term. I have studied the various connections between occlusion and overall health including TMD and head/neck pain, occlusion and advancing gum disease, as well as occlusion and the airway to name but a few.

Well, at this particular lecture, the speaker showed slides of various patients with crowded teeth as well as some with narrow dental arches. Many of these patients, like many of those I see every day in my office, have what we call, tori, on the inside of their lower jaws. Patients are often aware of these tori, most are generally not bothered by them, but some ask if they should be concerned about them. I had always considered these to be a sign of patients who are chronic clenchers of their teeth, and many of them are. However, the speaker made a legitimate case for the chronic growth of these tori in patients whose teeth are tipped towards the tongue.

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But perhaps I am getting off of the point. The combination of people who have narrow jaws and tooth crowding are very likely to have sleep apnea. I have always known that there is a connection between narrow jaws and sleep apnea, but this presentation made it so clear that patients like those described above do not have adequate space in their mouth for their tongues. As a result, their tongues are forced back into their airways, and the result is sleep apnea.

Such patients may have had orthodontics when they were children,and had four teeth extracted because of their crowding. Such patients are quite likely to have sleep apnea because their jaws are narrow and their teeth have been moved back to where the tongue wants to be to close the space created by the extracted teeth. The tongue is thereby forced to rest towards the airway. Now, I am considering whether or not to treat such patients orthodontically to expand their arches. This is one means of improving their airways and reducing their likelihood of developing obstructive sleep apnea.

When such patients come to my office, they must be carefully screened for obstructive sleep apnea, high blood pressure, adult onset diabetes, cardiovascular disease and other systemic issues which are related to obstructive sleep apnea.

If you have a bite which sounds like the type that I have described above, please contact us so that we can perform a proper screening for obstructive sleep apnea. If you have any questions about your occlusion or sleep apnea, please feel free to contact us by telephone at 609.359.6655 or via our website at www.DesignsForDentalHealth.com

Why We Love Spring!

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After this long winter, with its record setting low temps and more snow storms than we could handle, it’s safe to say that we are all ready for some warm weather.  For some of us, it’s not just the change in temperature that get us excited for spring, but the activities and life that comes with it. Some of the staff at Designs for Dental Health took a brief moment to share why we love spring. See our answers below!

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Dr. Nadler:

 “Spring is definitely my favorite season. Everything comes back to life, brown turns to green, flowers start to bloom and everyone comes out of their winter funk.  Spring also means that the golf season will soon be under way.  That REALLY makes me happy.  And, spring is when days are getting longer giving us more daylight to enjoy the outdoors and just be alive!  I love spring.”

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Liz:

“I love spring because it means the cold weather is almost gone. It’s great to see everything getting green again. And most of all it’s one step closer to Summer!”

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Maria:

 “I’m looking forward to spring because the weather is perfect.  It’s never too hot or too cold.  I can go on a bike ride with my family and spend more time being outside.”

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Remi:

“I Look forward to Spring every year! Especially after cold, long winters. But like all the seasons I find beauty in them all..(Fall is my favorite)

I love the colors that pop up everywhere you look, from the green grass to the leaf buds beginning to grow. I love how the air smells fresher almost cleaner, and you can’t help but enjoy the rebirth of almost forgotten flowers.

The poor confused crocus can finally come up and enjoy the sunshine! I don’t suffer from allergies (knock wood) and when I smell fresh cut grass it invigorates me! I love to watch the tulips that my daughter and I planted awaken from their long hiatus. And my daughter loves to pick me daffodils almost every other day. She tells me it’s because she loves me. I sometimes smile and reminisce of the first pedals/flower heads she used bring me when she was a toddler(the poor things). We are all grateful she is a more skilled gardener now. I love how even the department stores have all the vibrant colors on display!  And of course the Easter dresses and bonnets for the little ones. What is not to love about Spring?  And yes the “Golf” it’s a promise I made to myself…to get back on the course this year…with my husband.”

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 Allison:

“I love spring not only because the temperatures are near perfect, but because the warmer weather allows me to get outside and go for long runs, spend time horseback riding, and work on projects outside. I also look forward to watching the trees and flowers slowly come back to life.”

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Why do you love spring? Let us know in the comments section below!!!

Oil Pulling – A Dentist’s View

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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

All-on-4®, A Dental Miracle

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All–on–4® is the name for a technique used in the total rehabilitation of patients who have lost or will soon lose all of their teeth in one or both arches. This system was developed in the 1990s through studies which were funded by Nobel Biocare which has been a corporate leader in the implant industry since the early 1980s.

The All-on-4® treatment concept is a miracle because patients arrive at their dentist’s office in the morning with either no teeth or teeth which cannot be saved in one or both arches.  At that appointment, the implant surgeon (usually a periodontist or oral surgeon), the prosthetic dentist (in this case, me) and a lab technician work collaboratively.  A few hours later the patient leaves the office with a complete set of teeth which are not removable, which function well and which look amazing.

In addition, no grafting is required before placing the implants with this system. Therefore, most patients who have been told that they are not good candidates for implants because of a lack of bone, or large sinuses, or other anatomical circumstances are perfect candidates for the All–on–4® procedure.

There is no grafting, and no lengthy healing time required. Four implants are placed in each treated jaw. This procedure takes advantage of the dense bone which is available in the front of both the top and bottom jaws and places two implants there. Two more implants are placed in the back of the jaws and at an angle to both avoid sensitive anatomic areas as well as to take advantage of available dense bone there. Permanently fixed bridges can then be secured to these four implants immediately because of the solid primary stability which is gained by these strategically placed implants.

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The full dental bridge which is attached to these implants is not removable, has no coverage of the palate, and can be used immediately to eat a complete diet without restriction. After four to six months, a final fixed prosthesis is placed over the implants once total healing is assured.

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The advantages of All–on–4® are many:

1. Get implants in one day with minimal surgery.

2. Entire procedure completed in one location and one day.

3. Avoid the expense and healing time of bone grafting.

4. Have fixed, not removable teeth.

5. Have a complete new set of teeth which look and feel natural – Smile Again!

6. Have the ability to again eat all the foods that you desire.

If you have any questions about the All–on–4® procedure or if you know someone who would benefit from it, please contact us at 908.359.6655 or via our website at www.designsfordentalhealth.com

Your Shimbashi Number And Your Bite

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I am writing this article in honor of Dr. Henry “Hank” Shimbashi, a practicing dentist and researcher from Edmonton, Alberta who passed away this week. Dr. Shimbashi was a very influential friend of comprehensive restorative dentists and his research is used every day in offices like mine where problems with the bite and TMJ’s are treated.

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As a result of his research, the Shimbashi number was established to indicate an ideal relationship between the upper and lower jaws. When there is an optimal position of the lower jaw relative to the upper jaw, the muscles which are connected to them will also be at their optimal length and can function ideally.

If the relationship between the upper and lower jaws is altered, one or more of the many muscles of the head, neck and face may be overworked causing them to go into spasm — i.e., be painful. This can happen if the lower jaw is too close to or far from the upper jaw, too far forward or back, or shifted in any direction relative to the upper jaw.

Dr. Shimbashi’s research measured muscle activity in over 500 patients. He found that there was an ideal vertical dimension at which the jaw muscles functioned at their maximum potential. In addition, at this ideal position, patients had no symptoms of muscle pain. This vertical dimension was found to be universally applicable in all age groups and all races.

This simple number which we use is the measurement from the gum line of the upper front tooth to the gum line of the lower front tooth. Dr. Shimbashi found this ideal distance to be approximately 19 mm plus or minus one mm (about three quarters of an inch) when a patient bites.  In our office, we often see patients with bite problems whose Shimbashi number is significantly less than ideal  measuring as little as 10 mm or even less. In such patients, the lower front teeth are often nearly completely covered by the upper teeth. Such patients are much more likely to develop tooth and pain problems resulting from their bad bites.

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So what is your Shimbashi number?  If you have any questions about your bite as a result of this article, please feel free to call our office at 908.359.6655 or via our website at www.DesignsForDentalHealth.com

Designs For Dental Health VIP Plan

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Starting this month, we will be offering our Designs For Dental Health VIP Plan!!
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The Designs For Dental Health VIP plan* offers new and existing patients more affordable dental care on the most common and necessary dental services. This discount plan will save patients 15% off treatment fees for most of our services at no extra cost to you! In addition, there is no yearly maximum coverage limit, no deductibles, or waiting periods

What’s included in the plan?

  • 15%* discount on fillings, periodontal deep cleanings, crowns, bridges, implant crowns, dentures, extractions and root canal therapy.
  • Two regular exams per year, regularly $122.
  • Two regular cleanings per year, regularly $230.
  • All x-rays included with your cleaning visits, regularly up to $153
  • Oral Cancer screenings
  • One Fluoride treatment per year (up to age 16), regularly $48        (15% courtesy does not apply only to in-office bleaching or bleaching products, Invisalign Orthodontics, SixMonthSmiles Orthodontics, All-on-4 procedure, TMJ therapy, Sleep Apnea appliances, Arestin treatment, and full-arch or full-mouth rehabilitation)

With Designs For Dental Health’s VIP Program there are NO worries!

  • No yearly maximum coverage limit
  • No deductibles
  • No waiting period
  • No pre-existing condition exclusions
  • No ID cards necessary
  • No Insurance consultants

What is the cost of membership?

Only $325 for one entire year beginning on your registration date. That’s an automatic savings of up to $180 on your regular exams, cleanings, and x-rays alone!

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Making high-quality dentistry even more affordable!

 Designs For Dental Health has many options to help you pay for quality dental care. We accept cash and checks. We even offer a 5% prepayment discount for all treatment prepaid in full with cash or check when scheduling a service, and when dental insurance isn’t being billed.  That means when you use the Designs For Dental Health VIP Plan and pay in full you can save 20% on treatment! 

We also honor Visa, Discover, MasterCard and American Express. And, we offer 0% financing (if paid in full over 12 months*) and flexible payment options through CareCredit and Springstone. For those with insurance, our team will file all your claims and work with you to receive the absolute maximum benefit from your dental insurance.

How do I sign up?

Come on into our office and we will be happy to sign you up ASAP! No appointment necessary, and new patients are always welcome. And if you have any questions about the Designs For Dental Health VIP Plan and would like to get more information, just ask us and we will be happy to help.

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Call us at 908-359-6655 or visit our website at www.DesignsForDentalHealth.com

*This plan is subject to change without notice

*Discounts cannot be combined with any other offers

*Fee discount is limited to 5% with any financing offer

Is the “Clean” Program for You?

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On January 2, as has been the case for many years, I began a nutritional program in order to rid my body of all the excesses which have been inevitable during the holidays. In the office, we truly appreciate the many gifts we receive during December, and are always amazed that 95% of them are either sugar–laden delectables or adult beverages. In addition, there are the holiday parties and family celebrations all of which involve lots of wonderful food and wine. Couple the opportunity for all this overindulgence with under–performing self-control and I face the usual weight gain coupled with some minor gastric distress and a subtle feeling of malaise.

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So, this January 2nd I began the twenty-one day cleanse known as “Clean”. This is the same program that I wrote to you about last year. It’s a program designed by Dr. Alejandro Junger which is rather strict yet uncomplicated. Basically, I have given up all gluten, dairy, alcohol, and specific other foods as outlined in the book. During this three-week period, there is one solid meal at lunchtime. Breakfast is a smoothie and dinner is a soup. All foods are organic whenever possible.

I had forgotten much about the experience during last year’s cleanse. I can truly say that the results are amazing. I am sleeping so much better and perhaps that is the main reason why I have so much energy. Even my mood is different. I feel much more optimistic and upbeat than in the recent past. I have already lost six pounds and my osteo-arthritic knees are feeling better.

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I had first heard about this program from a fellow dentist who had been battling cancer. In addition to his regular cancer treatment, this man also began the Clean program. He too shared his feelings about how wonderful he felt after the initial three-week cleanse. And, I am happy to report that he is totally healthy with his cancer in remission. I am not saying that this program is the single cause of his current health, but his impassioned description of his experience while on the program had convinced me to give it a try.

Anecdotally, I had been rather ill during December with the upper respiratory infection which was being passed around at that time. Since beginning the Clean program my health has continued to improve and I now feel one hundred percent. Around me, however, are people who had similar illnesses which continue to linger or even seem to resurface. I wonder if this program might be helping my body to better fight disease.

If you have put on some weight, just feel a bit sluggish, or have any interest in getting a body tune-up, perhaps this program is for you. You can find the book entitled CLEAN with the subtitle The Revolutionary Program To Restore the Body’s Natural Ability to Heal Itself written by Alejandro Junger, M. D. You may also Google this program to get a better sense of what it’s about. A series of products are offered online but not necessary. For what it’s worth, I only use foods and beverages which are easily available in your grocery store.

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If you have any questions about this program, feel free to contact me in the office at 908.359.6655 or via our website at  www.DesignsForDentalHealth.com   .

Is It Really A Migraine??

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Last week in the course of a routine examination, I asked a standard question of our young woman patient: “Do you have any problem with headaches?” She replied that she does have “migraines”. So I asked a few relevant questions about the headaches, and as is often the case, this patient’s answers led me to believe that her headaches are, in fact, not migraines.

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In our office, we often treat patients with head and neck pain who have been diagnosed by their doctors as having temporomandibular joint dysfunction. Oftentimes, such patients visit their doctors because they assume that the headaches from which they suffer must be migraines.

What are the typical signs and symptoms of a migraine headache? A typical migraine may last several hours to as many as three days. The pain is moderate to severe, pulsating, and usually on one side of the head. Typical associated signs of migraines include nausea and/or vomiting, as well as sensitivity to light and noise. Many migraine patients describe an “aura” just before the migraine begins. Auras are exhibited as a change in vision or hearing. Episodic migraines occur fewer than fifteen times per month with only some of these headaches being actual migraines. Such headaches occurring more than fifteen days per month with pain lasting four hours or more over a three-month period are considered to be “chronic migraines”.

Migraines may be triggered by various factors, and three out of four migraine sufferers describe specific triggers. Common examples of these triggers are physical exertion, stress, hormonal changes, weather changes, and others.

Tension headaches are the most common primary headaches. Such headaches may be misdiagnosed as migraines and vice versa.

Cluster headaches are severe attacks of pain on one side of the head lasting between fifteen minutes and three hours. These headaches may occur every other day or as often as eight times each day. Cluster headaches may be associated with facial sweating, restlessness, agitation or nasal congestion.

Other types of headaches include those brought on by exertion or coughing.  They may be described as feeling like stabbing pain or other equally unpleasant feelings.

If you or someone that you know suffers from headaches, we can generally help determine whether or not migraine headache is a proper diagnosis. The determination is made based upon the patient’s history and description of the pain as well as a screening examination to rule out the possibility of TMJ-type pain. We even have a computerized evaluation system to diagnose which muscle or muscles may be causing the problem. Patients often find it hard to believe that their headaches may be related to their jaw joints or their bite. The truth is, the connection between head and neck pain and the muscles involved in moving the jaw as well as those holding the head erect are commonly the source of such pain.

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If you have a question about headaches or would like additional information please feel free to contact us via our website www.DesignsForDentalHealth.com or by calling our office at 908.359.6655.

Cracked Tooth Syndrome – What You Need To Know

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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