I think laughter does a body good. We do a lot of it in our Encino dental office. We provide the utmost in cosmetic and general dentistry care, but we think friendliness and humor complement the professionalism. So, here’s a joke that’s made the rounds for years. It’s an oldie, but a goodie.

One day, a woman walked into a dental office and asked how much it would cost to extract wisdom teeth.

“A bag of gold,” the dentist replied.

“That’s ridiculous,” the woman said. “Isn’t there a cheaper way?”

“Well,” the dentist said, “if you don’t use an anesthetic, I will charge you only half a bag of gold.”

“That’s still too expensive,” the woman huffed.

“OK,” responded the dentist. “If we forgo the anesthesia and simply pull the teeth with pliers, I can knock the price to a quarter pound of gold.”

“No-o-o,” groaned the woman. “It’s still too much.”

“Well,” said the dentist, scratching his head, “I could find a dental student to do it for 15 bucks.”

“Awesome!” said the woman. “Book my husband for next Friday.”

This joke is light-hearted, but it brings up a serious topic. Wisdom teeth.

Wisdom Teeth: A Third Set of Molars

Wisdom teeth are third molars that start to form around your 10th birthday. They are the last set of teeth to come in – usually making their debut between 17 and 25 years of age. Because this is the age when most young people are gaining knowledge at a rapid pace, these extra molars have been dubbed “wisdom teeth.” A misnomer? Perhaps, but that’s a topic for another time!

Evolutionary biologists classify these third molars as vestigial organs, kind of like the appendix. Perhaps they were useful in grinding raw food and roughage at one time, but in this modern day and age, they tend to be more trouble than they are worth and are the source of many dental problems.

Wisdom teeth typically cause grief when they begin to emerge from the gums, because our jaws are too small to accommodate extra teeth. Some lucky souls have no problems or very mild symptoms. Others get hit with severe – even life-threatening – complications when impacted wisdom teeth cause an avalanche of side effects.

Good oral hygiene is hard to maintain when erupting wisdom teeth cause pain in the back regions of your mouth. People tend to slack off on the brushing to avoid discomfort. Germs and bits of food accumulate under the gums, compounding the problem. Bad breath and gingivitis ensue as infection spreads. Opening your mouth and chewing becomes a chore too, so nutrition may suffer. It’s a vicious cycle.

Here at FocusedCareDental.com, we’ve compiled a list of problems that can occur with troublesome wisdom teeth. If you experience any of these, seek medical treatment. I’d be happy to take a look and make an assessment. I promise that I won’t charge a bag of gold or use tool shed pliers!

Signs of Erupting or Impacted Wisdom Teeth

• Bad breath
• Pain and infection
• Fever and lethargy
• Redness and bleeding gums
• Ear aches and headaches
• Swelling of gums and jawline
• Tooth decay and loss of bone
• A funny taste in your mouth
• Difficulty chewing and painful swallowing
• Overcrowding of neighboring teeth

These symptoms should never be ignored. In severe cases infection can spread, putting oral health and even one’s life in danger.

Wisdom Teeth and Braces

Orthodontic treatment also can fail if wisdom teeth are not considered. If you plan to go through the expense of getting braces, be sure you discuss your wisdom teeth and jaw size with your dentist/orthodontist. Complications can be avoided if wisdom teeth are removed before roots get too long or teeth tilt at crazy angles and cause overcrowding.

With medical advances, dentists and oral surgeons are able to remove third molars with much less pain, trauma and down time than when our forefathers went to a blacksmith to get teeth pulled. Now, oral sedation dentistry is offered for peace of mind, and medications are prescribed to manage pain. Size, shape, root length and physical orientation affect the ease with which wisdom teeth are removed. Some cases are complex, and some are easy. Healing time varies, but ice-packs, antibiotics and specific post-op guidelines speed recovery.

Best regards, AM

Tip of the Day: Follow post-operative guidelines religiously after wisdom tooth extraction. (Remember no straws, no spitting and only soft food.) Plan to take a few days off to rest and promote healing. This is no time to play volleyball or go jogging. You don’t want to disturb healthy clotting, break stitches or cause extra swelling. You’ll have gauze in your mouth anyway, so it’s best to stay home, nap and watch a few movies.

Talking, chewing, tasting and swallowing are things we do every day without a second thought. This isn’t true for a person with chronic dry mouth.

A glass of water would seem to be the simple solution, but not for most “xerostomia” patients. Their problem is usually more than dehydration. It stems from a reduced production of saliva – with any number of contributing factors.

I see this problem more and more frequently in my practice – weekly rather than just occasionally as in the past. I believe the wide use of many medications contributes to this issue. Dry mouth is highly destructive to teeth, and I think this condition needs to be treated aggressively. It affects many other aspects of living, too.

Without “spit,” talking is difficult. Have you ever gotten nervous and had your mouth go dry? Not pleasant. The croaking voice is not particularly attractive either.

Reduced saliva makes eating problematic. Saliva softens food and helps with chewing. Amylase – one of the enzymes in saliva – helps break down simple starches, aiding digestion. Without saliva, foods can be abrasive and swallowing is hard. Little cuts or scrapes in the mouth can ulcerate, leading to painful canker sores.

Saliva, which is produced by three different sets of salivary glands, is made up of water, mucoproteins, enzymes and antibodies. Because it is slippery, it lubricates the tongue, gums, hard palate, teeth and throat area, making talking and eating easier.

Dry mouth, however, is more than an inconvenience. It puts your dental health at risk. Saliva acts like a bodyguard in the mouth. Without it, teeth are vulnerable and prone to decay. Chronic bad breath becomes an issue, too.

In a healthy mouth, saliva constantly baths the teeth, washing food particles away. It minimizes plaque buildup on the teeth and exposure to plaque acids which contribute to cavity development. Saliva also has antimicrobial properties that fight fungal and bacterial growth, and it aids tooth remineralization by bathing teeth in fluoride and minerals.

So what Causes Chronic Dry Mouth?

All sorts of things can cause this condition. Here are just a few.

• Stress
• Periodontal disease
• Mouth breathing
• Hormonal changes
• Antihistamines anddecongestants
• Nerve damage or injury to glands
• Prescription medicine: antidepressants, blood pressure meds
• Diseases: diabetes,
Alzheimer’s, Sjogren’s, etc.
• Radiation therapy or chemotherapy
• Tobacco, alcohol, caffeine

If you have any of these contributing factors or suspect that your medications are causing chronic dry mouth, consult your MD or call us for a consultation. I have often worked with my patients MD to deal with the problem. Sometimes switching dosages or making lifestyle changes remedy the situation. Fluoride, oral rinses and prescriptions that stimulate salivation also can alleviate symptoms.

I know chronic dry mouth is a trying condition, but I am here to help. Your comfort and oral health are important to me!

Tip of the Day: When your mouth is dry, chewing sugarless gums or sucking on lozenges or mints will help stimulate saliva production. Look for brands containing the sugarless sweetener xylitol, which is a powerful cavity fighter. Be sure to avoid products with sugar which can rapidly damage your teeth.

Best regards, AM

New Dental DNA Technology

Two new DNA tests of saliva are in the final stages of preparation for use in dental care. Developed by a division of Quest Diagnostics this testing will help you to avoid and treat infections in the gums and in some cases the possible loss of bone around the teeth.

One new saliva DNA test helps us determine which patients are at higher risk for losing teeth. The test can measure “genetic risk factors”. With this information we can then develop the most effective treatment options to prevent gum disease. For those patients that already have active gum disease, a second DNA test can identify which bacteria are active in the infection and measure their quantity.  That allows planning to be made to customized antibiotic treatment specifically targeted for each patient. This is a highly effective way of using antibiotics.

If a patient is about to have dental implants or major dental care the test helps us to determine the best plan for post treatment care. In addition we know that the gum disease bacteria that enter the body can create inflammation in other areas of the body beyond the mouth. This inflammatory process is believed to increase the risk for diseases such as heart attack, stroke, Alzheimer’s, diabetes, and pancreatic cancer. When we can reduce the bacteria in diseased gum tissue, the patient can reduce their overall risk for these medical problems.

We are monitoring the testing closely and intend to be the first dentist in the Encino area to use this hi tech product to benefit our patients. Other salivary tests are being developed to measure the risks of oral cancer. It has been found that saliva contains a wealth of valuable information. The research on it is just beginning.

I know this material is a little heavy but interesting at least to me. It’s nice to see the large medical companies devoting time, energy and money on improving dental health. We have been neglected for many years. Hi tech dentistry here we come. Dentistry in Encino welcomes you.

Tip of the day: Dip your tooth brush in mouthwash before you put it away. The bacteria will be killed and it will taste fresher in your mouth.

Best regards,     AM

Allan Melnick, DDS     Encino, CA

This sounds like a boring subject to me so I will do my best to make this a little different and a bit interesting. We have all heard the brush and floss lecture over and over and I am as sick of it as you are but there are a few aids to healthier gums that many people have not heard of and could be useful to know about. Many older dental aids have fallen out of use lately but are still worthwhile. For example, the rubber tip is a pointed round rubber end on a straight round handle. It also know as a “gum stimulator”. It has be around for at least 50 years. Tested by time, it is really a nice little addition to your cleaning routine. It easily goes between the teeth from the inside and outside and removes both food and plaque. In addition it massages the gums which improves the circulation and tightens them, reduces bleeding and gives them a healthy pink color. Gum pockets can be reduced by about 2mm with daily use. It sounds like such a small number but is a world of difference where the gums are concerned. The rubber tip can be washed off with a bit of soap and rinsed off after use and unlike a toothbrush does not carry germs from day to day. The best news is that you can not hurt anything by using it unless you somehow poke your self in the eye with it. I know Dr. Butler company makes these and they cost about $2.00. I think this would be a good investment for everyone unless you have absolutely perfect gums. If you have trouble finding these tips call my office for a freebe. The tip of the day: When flossing, pull the floss down between the teeth and rub the sides of each tooth up and down with it. Let go of one end and pull it through. Presto, no more shredded floss. Best regards and happy holidays, AM

I am so impressed with myself. I am in the news! (Read the Article here.)

No, I did not rob a bank. They don’t have any money any ways these days. It’s not worth it any more.

Well, I have been researching a new medication that reverses the dreaded numb lip after a dental visit. Let me tell you, this is good stuff. It’s called OraVerse® and made by Novalar in San Diego. Well along comes some media people and they write a story about me and bingo, I am in the news. My mom would be so proud. Even my kids are impressed.

Anyway, a small amount of this medication is injected into the numb area with no sensation and the numbness goes away in a few minutes. Amazing! Would you believe this medication has been around for years in medicine and no one thought to use it in dentistry.

They didn’t spend a billion dollars developing a whole new drug like the big guys. They just adapted an old one. Pure Genius. I have some now and it really works just as advertised. I hope that it will make people more comfortable with their dental visits. I try very hard to do just that.

There is no completely “save” sport or leisure activity for your teeth. For example, water sport accidents are the most common dental emergency. A slip or bump and teeth are broken severely injured or knocked out completely.

Protective pads for games and sports activities are worn all over the body. A survey by the Association of Orthodontists found that 70 percent of parents do not have their child wear a mouth guard for sports. An active child falling on a hard surface is not a pretty thought. The damage can be for a lifetime. We believe a mouth guard should be standard safety issue and required equipment for every sports participant.

Mouth guards come in 3 varieties:

1. $2-$20 – Off the shelf at your drug store
2. $20-$60 – Bought at sporting goods stores or large department stores;
3. $75-$100 – custom-made and available through your dental office.

The custom-made mouth guard is the only one to provide the full protection you need. It fits better and feels more comfortable in your mouth, so you will use it more and it lasts many times longer.

We hear often that a mouth guard is ugly or is uncomfortable. On the other hand, when a tooth is lost due to an injury it can cost thousands of dollars over the person’s lifetime to repair the damage. A mouth guard is really the best equipment you can buy.

Contact our Encino Dental Office and schedule an appointment so we can get you and your family fitted for a mouth guard. A custom mouth guard helps your beautiful teeth and smile last a lifetime.

I am amazed to hear from so many of my patients that their toothbrush is 6 months old, which translates to about a year . . .

Using a toothbrush that old is about as good for you as eating leftover chicken from the fridge that’s six months old. The bacterial count is probably higher on the toothbrush. Add to that that the brush is useless as far a cleaning off any germ filled plaque and things are not looking too good.

 I ask my patients how often they floss. I guess it’s bad karma to force someone to lie, but I can tell any way. Did you really think you could fool the grey fox? (me)

So let me put it to you straight. When you are 90 years old and in that retirement home your kids picked for you (treat them nice), do you want to be eating steak and lobster or gumming down some oatmeal? So I am revealing  to you “The Secret” – buy yourself a Sonicare  Electronic brush at Target. Get the Top of the line model. Do not skimp here. In my 99 years of practice I have always seen an improvement in oral health when this is used twice a day. If that is not doable, get Two brushes and alternate. Soft ones like Dr. Butler or Oral B clean best. It’s a long story why, but that is how it works.

Stay tuned!

The fee an insurance company pays is so low that the dentist has to cut corner to break even. Get of dentist skimp everyway possible on insurance cases. Get to know one dentist  and ask him if he uses generics. Pay for the real thing.

Generic quality is usually so bad  that the final result is poor. Well done dentistry will be in your mouth for years. When you amortize it out we are talking pennies. Would you believe that a major insurance company has a deal for the dentist to have crows made in CHINA. Ask who, how, where, why, when and any other question you can think of.

If you don’t get a full answer, move on. There are lots of dentists. You have every right to a full, unhurried explanation. And by the way, if you don’t see the same dentist every visit, run, don’t walk.

Back to insurance companies. Can you tell I don’t like them very much? Well why should I. I am trying to save your teeth for a lifetime and they prevent me from doing that. Say you need three cleanings a year. Sorry. There is a “contractual limitation” of two cleanings. Where do they get the right to diagnose your needs. Where did they study dentistry?

Unfortunately you will lose on this one. But look, your dentist does not make money on cleanings, just do it. Periodontal disease is a nasty tooth killer and if you are like me, I like to chew my food. Note, most dentists hate to clean teeth. Find an office with a good dental hygienist. They are the pros here. About 45 minutes to an hour is about right for a complete job.