As you know, I have a heart for down-and-out dogs, so I was very pleased to welcome “Mikey” to my family. We just adopted this “mini golden retriever mix in black” from the shelter. At 14 pounds, he was about 3 pounds underweight, and the poor guy had kennel cough. But trust me…now he is being well fed and taken care of!

Mikey and Joey are fast friends already and sleep curled up together on our bed. Each afternoon they run circles around each other in an expression of pure joy and then take a nap together. I am also touched to watch them groom each other every night. How loving and caring. That is not seen much anymore in my experience.

They say that seniors that are alone live longer with a pet. I understand that better now. Joy is contagious and fills the hearts of both giver and receiver.

Please remember, “Adopt a friend. Save a life”.

Best regards, AM

My Friends,

At this holiday season I find I have much to be thankful for. Always first and foremost I am grateful for my wonderful family. In addition I am grateful to all of the wonderful people who have trusted me to provide their dental care. As I mentioned on my web site our computer showed me that 72% of our patients have been with me over 20 years. I am very proud of that. If any of those people happen to read this I want to send you a heartfelt thank you. All sizes, all shapes, many nationalities and all ages, you are the best and I appreciate each and every one of you.

But as so often happens in life the sweet is often tempered with the bitter. I lost a good friend very recently. Imagine for a moment a guy that is always happy to see you and always greets you with a hug. He was always forgiving and understanding of you in the good times and bad. He asked little and gave much.

I am speaking of my good friend Charlie, my Pomeranian. He leaves behind his brother Joey, my Corgi, and his loving family. Charley disappeared one day last week. He likely became dinner for a coyote. We all miss him terribly but especially Joey. Possibly Joey picked up on our sadness and he has become extra loving. His 6th sense has always amazed me.

There is a bright light at the end of this tunnel. If you have read my web site you know that I am involved in animal rescue. This weekend you can find me at the animal shelters. I have seen so many wonderful dogs turned into the shelters because the family is out of work and out of money and can not afford to feed a dog. I am sure I will find a new loving friend to join our family. Going to a shelter is hard. I can see much sadness in their eyes and I want to take them all home. Unfortunately I can only take home one. If anyone would like a companion for a trip to the shelter I am ready to go with you.

My message to all my friends is this: Think of adopting a shelter animal. You will make two hearts fill with joy.

Warmest regards, AM

* “The Soul would have No Rainbows if the eyes had No Tears” ( Native American Proverb)

Last week I sent out a press release on Canker Sores. Amazingly it was picked up by 74 news sources including Google, Yahoo, USA Today, several major newspapers and the Mayo Clinic News Letter. Not bad for a country boy.
From time to time I like to do some research on a topic and present it in a format that everyone can understand. This time it was canker sores. As I read through the scientific papers for background I was struck by how difficult most of it was for me to understand.

I am not really interested in animal studies on those cute little hampsters. Far away possible cures are far away. Call me when they are ready. I hate it when the arcicle ends with “further studies need to be done”. What did that cost us and what did you accomplish Mr. researcher.

I believe the public wants to know about the here and now. So I distill heavily and cut out the nonesense. My goal is to make the information clear and easy to understand.

I wish the medical community would do the same. I read some of the articles in the New England Journal of Medicine and Lancet. I admit to reading just the beginings and ends of the articles. I skip the middle. I simply can understand it. Regretfully my statistics is a little rusty so the middle is meaningless to me.

I skim the Journals of the American Dental associaton and the California Dental Association. I don’t know what page these folks are on but its not mine. Studies with no product names don’t help me to help you one bit.

If you get a chance Google “Dr. Allan Melnick” and read about canker sores and let me know what you think. I hope I am on the right tract.

Best regards, AM

I decided to take a different tact today and share an experience I had recently. I have a relative who was seriously ill and we went to a large local teaching hospital. I was not impressed to say the least.

The hospital, despite the multi millions of dollars spent and the many years of construction, is lacking in facility and staff in my opinion. After 11 hours in the ER, we got to a room and settled in. The nursing staff was small, swamper and hard to find. Lucky for me that I knew what a charge nurse is. She is the boss and the one to see. The master sargent so to speak.

Being a Saturday, most of the doctors were off so care was minimal and everything on hold. On Monday a doctor was assigned to the case. Things were not going well and I finally reached our doctor by phone. When I got around to ask about his training, I found he basically had none. He had graduated from med school only months before and not a top medical school at that. I am not happy.

His supervisor had just completed his residency and had no experience beyond that but seemed to be a nice man heading towards a research career. I was now really unhappy. The case was complex and we needed experienced doctors. So I became out of neccessity our own patient advocate.

Well my friends I probably better stay away from that part of town now because I was not bashfull. Mild mannered me on the phone yelling. As they say , the squeeky wheel gets the grease. I Got Grease. Things got better and we had a good ending to the horrific 3 week hospitalization.

My point here is, finally, if you are not happy with the care, Speak Up and that includes me and my office. I think it is terribly sad that we have come to this point in health care. Please be assertive and even aggressive when neccesary.

My wish is that you remember my experience and don’t be afraid to stand up and complain when you need to. Your life or the life of a loved one may depend on it someday. Sad but true.

Best regards, AM

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

 How to Deal with Canker Sores

About one in six people get them. They hurt like hell and can make talking, eating and swallowing miserable for days.  Like a bee, canker sores are diminutive in size, but can wreak their own brand of misery.

I’d like to be the one announcing a permanent cure, but no one really knows what causes recurrent mouth ulcers – or aphthous stomatitis. These nasty little nuisances afflict about 20 percent of the population, causing painful sores on the tongue, gums, throat and cheeks. Sorry, ladies. You seem to be more prone to canker sores than us guys.

Canker sores appear suddenly, take about two days to form and stick around 10-14 days on average. They look like white areas, surrounded by red irritated tissue. These circular sores can erupt singly or a dozen at a time for the very unlucky. They tend to be less than ¼ inch in diameter, although I have seen some that are nickel-sized.

Canker sores are not to be confused with cold sore lesions, which are caused by the herpes virus and often appear on the outer lip. Canker sores are not thought to be virus-born, but are believed to be linked to an immune system malfunction, heredity, hormonal fluctuations or environmental stressors, such as a bacterial invasion to damaged mucosal cells in the mouth.  

Brushing too vigorously with a hard toothbrush can result in an errant jab to the gums. These minor injuries can become ulcerated – and BINGO, a canker sore!

There’s no known way to categorically prevent canker sores, but there are precautions you can take. If my patients complain of pain, I suggest a number of options to make them more comfortable. Some of the remedies numb the affected tissue, others promote healing, and some treatments are preventive in nature.

A Few Canker Sore Tips

• Brush your teeth with a soft-bristled brush. Slow down. Be gentle.
• Stay away from toothpaste and mouthwashes that contain whitening agents as some are very irritating.
• Avoid abrasive foods such as nacho chips, gum drops or crusty bread. Well, at least try to.
• Eat fewer acidic or spicy foods. Skip the OJ and the hot salsa for a while if you have active canker sores.
• Rinse your mouth with a warm salt water solution (2 tablespoons in 8 ounces of warm water) or use a commercial antimicrobial rinse, such as TheraBreath Oral Rinse or PerioTherapy Oral Rinse. Some find relief with a gentle rinse made of one teaspoon of baking soda mixed into half a cup of warm water.
• Cover sores with topical gels. Over-the-counter products such as Anbesol, Orabase B, Kank-A and Orajel offer anesthetic relief. There are junior and adult strength variations. Homeopathic remedies include baking soda pastes or daubs of milk of magnesia applied to lesions.

At times some of my patients need stronger intervention. Aphthasol is an FDA-approved canker sore treatment, available by prescription only. It reduces pain and speeds healing. Debacterol, another prescription medicine, cauterizes sores chemically and can cut healing time in half. Serious canker cases may require a corticosteroid.

• Reduce stress. Go for walks. Do yoga or tai chi. Listen to chill music. Cross off some things on your calendar. Stress is a known factor.
• Take a vitamin/mineral supplement that includes B-6, B-12, zinc, folic acid and iron, but don’t overdo it.
• Quit smoking. Cigarette use may make you more prone to canker sores.

Tip of the Day: Each year 15 million dental injuries occur during sporting events. Trauma to teeth and soft tissue can become ulcerated and painful and difficult to restore. Invest in a good sports mouth guard to avoid injury, pain, healing time and the outrageous expense of dental restoration.

Best regards,  AM

Some of the most frequent questions I am asked these days regard implants. So here is a quick review of some of the facts on the subject.

~Can everyone who has lost a tooth have an implant?   Well, almost everyone. There are a few things that  would be reasons not to have an implant. For example, osteoporosis, inability to keep the area very clean and smoking are problems. Smoking is such a negative factor in the success of an implant that I do not do implants on smokers.

~What is an implant made of ?   Titanium is used because of the body’s friendly acceptance of this material. The use of titanium has been the standard for over 40 years with a success rate over 90%. Occasionally I use a ceramic implant for people who can not tolerate any metals.

~How much bone will I need to have an implant?   As a rule of thumb, 50% of the original bone is usually enough. Fortunately, there are several procedures to augment or graft in new bone when inadequate bone is present.

~Does the process hurt?   A small amount of local anesthetic is placed in the area and the procedure becomes pain free. After the procedure mild pain medications are given for a day or two. My patients often comment that the procedure was much easier than they had  expected.

~How many visits are required?   Simple cases involving one or two implants typically require four visits from start to finish. The highest success rates are achieved when the procedure is spread over several months so that the bone and implant can grow together.

~Will I be able to chew normally ?   Research has found that chewing ability becomes as good as with natural teeth. The same pressure and force can be applied to food with an implant as a natural tooth. In addition, the implant crown will look like a natural tooth.

~Is age a problem?   Age is not a problem. Health is much more of a factor than age. People that are in average health and can tolerate normal dental care can usually tolerate implant placement. I have seen several people in their 90s doing very well with implants.

~How long will my implants last?   There really is no time limit that can be given. Implants last indefinitely. I have seen a very few failures but these were in situations where the persons health had taken a turn for the worse. In some cases a new implant can be placed after the failed one is removed.

~How do I care for an implant?   A person cares for an implant just like you would care for your natural teeth only better. The area around an implant must be kept very, very clean or the implant can fail. You just need to be sure you are keeping your mouth extra clean.

For a detailed review of  implants click to see our dental implant page.

Tip of the day: The type of floss you use makes very little difference. Pick what works best for you.

Best regards,     AM

Before you come to the conclusion that I have lost my mind, please read on. Yes, chocolate is ok for your teeth and is good for your  health. Chocolate contains polyphenols and flavinoids which are strong antioxidants that inhibit the growth of bacteria that can cause decay. Here is how it works. Decay is caused by certain bacteria called oral streptococci that are found in you mouth.  This results in the production of  acids that damages  the tooth  enamel. Polyphenols prevents the bad bacteria from turning sugar and starches in chocolate into decay producing acids. The sugars are in the form of starch and dietary fibers  with a small portion of simple orally active sugar. This is good news.

Actually chocolate candy has several ingredents. Cocoa, cocoa butter, sugar, and various flavorings and preservatives. The polyphenols are actually good for your health. They are anti-oxidant, anticancer, and  anti-inflamatory . They reduce the chances of hypertension and stroke. They are also know to protect the heart. Some research have also shown beneficial effect for problems of cognition and diabetes.

The next issue of concern is the cocoa butter and sugars  in chocolate. The cocoa butter has a coating effect the reduces the ability of plaque to stick to the teeth. Although the sugar is high, yum, is dissolves quickly and has little time to increase acid levels. Cocao butter and chocolate have been  shown to not raise cholesterol. Once again, good news.

Another concern with chocolate is caffeine. There is actually very little caffeine in chocolate.  A regular cup of coffee has about 150 mg of caffein. One ounce of chocolate has only 5mg .

 Also nice is that dark chocolate has about four times the antioxidents of green tea. The same anti-bacterial effect of flavinoid and polyphenols is shared by the now popular green tea. As an extra benefit  seratonin and phenylethamine that are used as mood enhancers are present.

Plant polyphenols are found in many foods. A very tart fruit that makes you pucker as they are high in tannins which contain polyphenols so they too are  beneficial. The following are some of the foods with especially high polyphenol content. You have probably seen a similar list as foods that have beneficial health effects. Foods such as red wine , grapes, black tea apple juice, cinamin, cumin, cranberries and of course dark chocolate. These foods are high in a substance called flavanoids, a part of several components of polyphenols that were mentioned earlier.

In amounts of  one ounce portion per day, chocolate can be good for you. It tastes good, doesn’t hurt your teeth and has beneficial effects on  your body. In an Italian study, all the benefits are achieved in three one ounce pieces  a week.

Now the down side. You knew it was coming. Dark chocolate has lots of calories. It has been measured at 150 caleries in one ounce . So if you are on a diet, and who is not, you have to watch the quanity. Try to control yourself.

So, as a dentist I recommend dark chocolate three times a week as perfectly safe for your teeth  and good for your body. Yea.

Tip of the Day:  Only Listerine has lasting antibacterial properties. Spend you money on it if you use a mouth wash. The others really don’t have much effect.

Best regards,     AM

I had the opportunity a few day ago to do something that was really meaningful to me. I would like to share that with you. My web site advisors are probable cringing about now because I am not on a dental topic but since I pay the bills I will let them stew. In fact, I am my own webmaster and have written and designed virtually every word of this web site myself. I guess that makes me the boss.

A few days ago I had the honor and privilidge of speaking to one of my heroes Coach John Wooden. I don’t think any introduction is necessary. I would say he is the the greatest coach that ever lived, but I will not argue the point as there were many great coaches out there and everyone has their own opinion.  A good part of my admiration comes from the fact that he was always a gentleman, on and off the court. In addition, I have great respect for his philosophy of human relations.

The Coach and I exchanged just a few words. Now at 99 years old I could see a sparkle in his eyes and an amazingly sharp mind. What a thrill that was. We spoke about  some of his players but I could not get him to singe out any one  as the greatist.  Smart man. In those few brief moments you could tell that there was something special about this man.

Later in the day I did a Google search and discovered that the Coach has a web site and I checked it out.  It didn’t take long to see that Coach Wooden is not only a world class coach but a very wise man. His philosophy is very impressive. Very briefly, he never chose to criticise, yell at or berate his players to get them to achieve. He chose to encouraged them. He built their self esteem and taught them how to put a situation into the best possible perspective and keep a positive attitude. How much wiser it was to built them up rather than tear them down.  You can look at his results to see that he was right.

Each day I walk into the office and give each case my very best effort. I often see people that have neglected their mouths badly. Sometimes it is just terrible to look at the extent of the neglect. I have had a philosophy of  “no guilt” for a long time and I always apply it no matter what the situation is.

 Reading what the Coach has said and looking at his results reinforced for me that I have been doing the right thing all along.  I always try to build  up and never tear  down. Funny thing, the results of that philosophy just keep getting better and better. We want to make relationships not just fill teeth. People seem to appreciate that attitude very much. Thanks Coach.

Best regards,    AM