“Given the three most common causes of death as we age-heart attack, cancer and stroke-we can perform screening tests to reassure patients. Hopefully they will not have to suffer from one of these top three causes of death in adults 65 and older,” explained geriatrician Michele Eslami, MD, from UCLA Health System.

Doctor Eslami stated that there are FOUR screening tests that are vital to all older adults:

• Skin Cancer: You need to check your body for any changes in moles, freckles, or spots.  Have someone look at your back and behind your legs. Be sure to see a dermatologist regularly. A semi-annual check-up especially here in sunny Southern California is about right for most people.
• Colonoscopy:  While not a popular test (really?), a colonoscopy is essential to finding polyps that could be life-threatening.  You should get your first colonoscopy by age 50 and every 10 years thereafter.  If you or your family has a history of polyps, your doctor will probably recommend testing more often.
• Blood work:  Each year, you should at least have a doctor check your  cholesterol, blood pressure, and fasting glucose.  Blood may also be drawn to assess hormone levels such as liver enzymes, electrolytes, and other markers.
• TSH (Thyroid) Test: To determine the levels of the thyroid-stimulating hormone generated by the body.  Women 60+ and men 70+  should get yearly TSH tests. The thyroid gland affects a large number of bodily functions and is critical to good health.
• Glaucoma:  A yearly eye exam with a glaucoma screening is recommended. If you experience any impaired vision, you need to get immediate attention. Problems such as a detached retina can be fixed if caught very early.

Dr. Eslami advises that WOMEN also pursue the following four screenings:

• Cervical Cancer:  After the onset of menopause, you should get a cervical cancer screening and then three PAP smears over the next ten years according to Dr.Eslami.
• Mammogram:  Even without symptoms of breast cancer, you should get a screening mammogram beginning in your 40s and then each year or two after that.
• Bone Density Test:  To assess the presence of or risk of osteoporosis scans should start at 60 for those with a higher risk for fractures or with a low body weight, and at 65 for everyone else.

Two screenings are important for MEN:

• PSA Test:  The prostate-specific antigen test should begin around 40 to determine a baseline. This test is controversial.  Elevated scores or family history would suggest higher risk for prostate cancer and lead to more frequent screenings. While false positives are a possibility, most urologists recommend it.
• Abdominal Aortic Aneurysm (AAA) Screening:  You should have at least one test between 65 and 75, especially if you were a smoker or have an immediate family member who needed treatment for an enlargement of the aorta.  A ruptured AAA can prove fatal quickly.

So there you have it. I hope you found something helpful in this information. Personally I do all of the above but I am not much of a fan of doctor office visits. My wife just nags me until I go in.

Tip of the Day. Think about taking Fish Oil dietary supplements. I do. There appears not to be any downside while the upside looks quite good. Fish oil appears to lower triglycerides, reduce inflammation, benefit the heart and have a positive effect on  depression. Check it out on the internet for all the details.

This finding refutes the previous understanding that fluoridated water is only beneficial if consumed since birth.

“We can now show that fluoridated water reduces tooth decay in adults, even if they start drinking it after childhood. In public health terms, it means that more people benefit from water fluoridation than previously thought,” stated Dr. Gary Slade, Professor and director of the graduate oral epidemiology program at UNC.

The study included survey results from 3,779 randomly selected Australians above age 15 from 2004 to 2006. For those inclined, the results can be found online in The Journal of Dental Research, January, 2013.

By comparing participant levels of tooth decay with community fluoride levels, the researchers found that adults who lived in neighborhoods with fluoride for more than three-quarters of their lives had as much as 30 percent less decay than those who spent less than a quarter of their lives in such communities.

This landmark study is important to our evolving knowledge about the impact of fluoride and how it can prevent tooth decay. It comes just two years after a previous study that cast doubt on the mechanism by which fluoride works to reduce decay.  Other researchers lead by Dr. Frank Müller writing in the Australian Journal Langmuir explained that fluoride’s protective layer is as much as 100 times thinner than previously thought.

For the technically inclined in the group, it is widely understood that fluoride enables enamel, the hard white substance on the surface of our teeth, to be more decay-resistant.  The primary speculation is that fluoride converted hydroxyapatite, enamel’s principal mineral, into fluorapatite.  Yet Müller and colleagues discovered that the transformation from fluoride into fluorapatite resulted in a layer only 6 nanometers thick.  To reach the width of a single human hair would require 10,000 layers of the harder fluorapatite.  Müller’s team has not resolved yet exactly how such a thin layer can be so protective. Further research is being done to answer this perplexing question.

The puzzle is how such a fine layer which would easily dissolve during chewing can be protective. Nevertheless, fluoride in dental products or drinking water is essential to the ongoing fight against tooth decay, which costs American consumers over $50 billion annually.  Further studies should shed light on not only how fluoride works, but also on the most prudent ways to expose the public to its important benefits.

Tip of the Day: Our Australian friends have shown that you should  get as much fluoride on your teeth as possible. Toothpastes, rinses, water, or dental office fluoride treatments all help both adults and children alike.  We really do like to see healthy teeth more than decayed ones.

For more great information, visit the website for Focused Care Dental in Encino, CA

The study authors, from Anhui Medical University and the University of Hong Kong stated that three out of every four people worldwide have teeth that are sensitive to hot, cold, sweet, or sour foods and drinks, according to published reports. In my practice it is a very common problem seen almost daily.

Several products are now being used with some success to help reduce tooth hypersensitivity. An example of this is Sensodyne tooth paste. These work by closing tiny tubules in the root surface. But there is also a need for substances that rebuild enamel and dentin at the same time.

The researchers reasoned that mussel adhesive could help keep minerals in contact with dentin long enough for the rebuilding process to occur. We dentists know that wet surfaces are notoriously hard to adhere to. To overcome that challenge, they turned to a sticky material similar to the adhesive that mussels use to adhere to wet sea surfaces.

The researchers evaluated the effects of two substances,  dopamine and polydopamine, on demineralized enamel and dentin surfaces. They found that teeth bathed in the sticky mussel material and minerals reformed both dentin and enamel, while teeth bathed only in minerals reformed only enamel.

The researchers concluded that “Polydopamine coating remarkably promoted demineralized dentin remineralization, and all dentin tubules were occluded by densely packed hydroxyapatite crystals,”. “Thus, coating polydopamine on dental tissue surface may be a simple universal technique to induce enamel and dentin remineralization simultaneously.” Once the dentin tubules and enamel reform to original condition, sensitivity will be reduced.

So what does this mean to you and me. Worn and damaged teeth can be restored to a healthy condition with no drilling or filling. Drilling and filling both are mechanical. Application of materials that heal the tooth is a biological process much more in sink with nature. As an Encino dentist that is the direction I want to go. Have a look at my web site for minimally invasive dentistry. You can find us at http://www.focusedcaredental.com

It should be noted that those mussels that did not qualify for the project were eaten by the researchers. Therefore the results may not be unbiased and the testing should be repeated.

Tip of the Day: When ever there is a choice, opt for the treatment that disturbs the tooth the least. In my Encino dental office all the risk, benefits and alternatives are always discussed.

According to a report published in the current  issue of General Dentistry, the well respected journal of the Academy of General Dentistry (AGD), being overweight may also be a factor in the development of gum disease.

“We know that being overweight can affect many aspects of a person’s health.” says Charlene Krejci, DDS, MSD, lead author of the article. “Now researchers suspect a link exists between obesity and gum disease. Obese individuals  bodies relentlessly produce cytokines, proteins known to cause inflammation.” From my own experience, I believe that the cytokines produced can directly injure the gum tissues.”

Statistics show that approximately half of the U.S. population age 30 and older is affected by gum disease. This gum disease is a  chronic infection. Just like other infections in the body gum disease is damaging. Gum disease damages the adjacent and supporting structures of the teeth.

As you may know, we are relentless on planing ahead in my Encino, CA  dental office. Our goal is for you to keep your teeth for your lifetime.

The connection between obesity and gum disease is still being studied by researchers.  AGD Spokesperson Dr. Samer Shamoon said. “What we do know is that it’s important to visit a dentist at least twice a year so he or she can evaluate your risk factors, such as obesity, for developing gum disease.” I agree with Dr. Shamoon and feel that each patient needs to have a unique plan and goal in mind. It is no secret that the best way to minimize the risk of developing gum disease is following the basics of good oral hygiene. This includes daily flossing, brushing, good dietary habits and professional cleanings. In my Encino dental office we design a personalized program of  home care for each patient.  KnowYourTeeth.com is a great resource on this subject.

Best regards,

Allan Melnick D.D.S.

PS: Check out my website at http://www.focusedcaredental.com for more details on gum disease. You also get to see a picture of me!

Tip of The Day: A dental hygienist is specially trained to do cleaning. That is their thing. Most dentists, including myself, would rather be doing other things. The hygienist is the expert here so try not to tune out his or her recommendations even if you have heard it a hundred times before. As a guideline, for most people a thorough cleaning appointment takes at least 45 minutes. We allow one hour. It gives us more time for TLC.

Baby teeth hold the space for permanent teeth. That is important for proper speech development. It also allows your child to comfortably chew nutritious food. Plus, infected baby teeth can cause tooth decay with all its serious consequences.  The permanent teeth can also be damaged from baby tooth decay.

So the more can you do to make sure your child’s teeth and gums are healthy the better. This will aid the child’s dental health throughout life. The following is a brief tutorial on the things you can do to improve your children’s dental health.

Wise Eating:
Even if your child isn’t allowed to eat foods with lots of sugars, many foods can still be high in sugar.  Make sure your child is eating a balanced diet and try to avoid sticky or sugary snacks. Try to serve juices at mealtime and water in between. Look at the labels on milk, formula, juice and even crackers. You will be surprised.

Try to never put your baby to bed with a bottle. The absolute worst thing you can do is fill the bottle with carbonated beverages. That is a sure way to destroy your child’s dental health. As an Encino dentist I have seen small children with crumbling abscessed teeth several times. It is heartbreaking for me to see.

Taking Care:
The earlier you can start a cleaning and brushing habit, the more it becomes just a normal part of the daily routine. Starting at birth, wipe your baby’s gums with a damp washcloth after feedings. If your baby has teeth, brush them at least twice a day. Once in the morning and at bedtime are best times.

Be an Example:
Children aren’t able to really brush their teeth properly until they are about 8 years old. Studies show that when parents have their own healthy habits, children are likely to follow.  Let your child watch you brush and floss or bring him with you to the dentist. At my Encino dental office we try to make it fun for the kids.

Dental Visits:
I like to check to make sure the child’s teeth are coming in properly. We go over fluoride and the correct way to brush a child’s teeth.  I have found that regular visits before age 3 get your child used to the dental experience. This can help to avoid anxiety and make dental visits a positive experience.

This article is dedicated to my grandson Matt who is now experiencing the right of passage called teething. Love you Mattie!

Tip of the Day: For the years you child is teething, check out the Raz-Berry Teether. The unique shape allows active tikes like Matt to sooth his gums hands free. There are just too many things for those busy little hands to explore to tie them up with teething.

Just type “sensitive teeth” into Google and you’ll see that it is among the top search listings. In fact, sites like Experience Project even have groups for people suffering from sensitive teeth to share their experiences with. It may not need AA, but it’s an issue in need of support.

Causes of Tooth Sensitivity (Dentin Hypersensitivity)
While it can seem like you were born with tooth sensitivity, it’s quite possible that you did something somewhere along the line to bring it on in your own mouth.  Improper brushing is the most common cause of dentin hypersensitivity, according to DentalFearCentral.org.

Many of my patients I see as an Encino dentist use improper brushing. That can include unhealthily rough brushing in terms of the pressure applied and the use of tooth brushes with overly stiff bristles. It’s also possible that harsh acids were coating the teeth when they were brushed. Brushing immediately after eating citrus without properly rinsing first is damaging and a bad ides.

Aside from brushing issues, dentin hypersensitivity can also come from tooth grinding, thinning gums, excessive bleaching, physical trauma damage, or gum disease. It can also result from more innocent factors such as age and recession.

Basically what this all boils down to is a wearing-down on your teeth, exposing the thin layer of dentin beneath your enamel. Similar to our own skin, your teeth become more sensitive to touch and pain the deeper you go beneath the surface. Think of it like peeling off a sunburn or scab.

What This Means for Your Teeth
The example above may have been oversimplified, but it’s an apt description. The technical cause of sensitivity in your teeth is that the tube-like structure of that layer of dentin, without its covering enamel, allows extreme sensations like heat and cold to penetrate deeply. Even flavors like sweet and sour make contact with the nerve endings in your teeth. The result: ouch!

Tooth decay is another cause of tooth sensitivity, as well as periodontal disease. If the latter is the case, over time it can cause separation between the teeth and gums, allowing bacteria to grow in between and destroy supporting tissues.

The best thing to do is ask us if you have sensitive teeth to ensure there’s nothing major going on. We may also be able to recommend a treatment or product to help curb the pain.

Tip of the Day: You may be able to save yourself some money with this tip. Try Sensodyne or Colgate Pro-Relief  toothpaste for a few weeks. If the problem is simply exposed root surfaces Sensodyne or Pro-Relief  will help. If the sensitivity does not go away it’s time for a visit to you favorite Encino dentist – me, of course!

According to a Discovery.com blog, brushing teeth alone only covers 5% of the mouth. As an Encino dentist of many years of experience I agree completely. Sure we call it brushing teeth, and sure brushing those canines, incisors, and molars like you always have is a solid basis for good oral hygiene, but if you’re missing out on cleaning these areas of the mouth, you could be causing more oral health problems than you realize.

The Tongue
While this one isn’t likely to lead to any serious complications or health issues, it does bring some baggage with it.

As the tongue is able to move around and is a constant source of saliva, it stays relatively clean on its own. However, it’s also in constant involvement with food whenever you eat.

While most food particles won’t adhere to the tongue and develop bacterial growth like they tend to do with our teeth, when food particles and bacteria get caught up in the papillae along its surface, it can cause a condition known as white tongue.

White tongue on its own isn’t serious, and is mostly just an aesthetic problem, but it can be the sign of bigger issues.

Brushing your tongue thoroughly is a good way to defend against white tongue, and many people with bad breath issues find it helps in that area as well. If brushing the back of the tongue is hard for you to do without gagging, try a tongue scraper.

The Back of the Molars
Which teeth do you use most when chewing food? Depending on your diet and mouth, odds are the bulk of your chewing is done with the molars for almost everything you eat.

As such an important part of chewing up food, the molars get food stuck not only on top of them where you’re likely to brush, but way back behind them as well. It’s a tricky area, but be sure to brush all surfaces of all of your teeth – including molars – and swish and floss well back there, too to prevent cavities and bad breath caused by decaying food particles.

Gums
Be sure to do this one gently. Gum health is essential and often overlooked, but being too vigorous could be problematic. Just remember that food doesn’t just get caught between teeth, it gets caught between teeth and gums as well, and flossing may not catch all of it.

Roof of Your Mouth
Also called the palate, the roof of your mouth is just another surface for bacteria to collect. It’s a part of the mouth very few people think about, but taking care of this region should help you bring more complete oral hygiene techniques into practice.

Cheeks
The inside surfaces of the cheeks cover a large percentage of the surface area inside your mouth. Like all the other oral surfaces, food particles, odors and bacteria reside in large numbers there. Actually, the larger the surface area the greater the amount of villains. A vigorous rinse after brushing is good at removing the larger particles. So then what should I do? Brush it too. Only then will we be talking about really clean.

Tip of the Day: Let’s assume you floss on days other than the one day before you go to the dentist. Oh yes, I know. For best results, pull the floss down, wrap it around the teeth to the front and rear and then pull it straight out (not upward). Down, forward, backward, out. This will give you the most benefit for your time and money. I would say that less than 10% of the people that I see in my Encino dental office really get the full benefits from their flossing. You get a better result with the same amount of work when you floss as I just described. A sweet Deal!

If this sounds like you every year and you’re ready to move on to more effective solutions that really last, it’s time you looked beyond the temporary aids. Here’s what doctors have to say about preventing chapped lips in the winter.

Forego the Chapstick for a Lip Scrub
Topical moisturizers like lip balm and chapstick are great for protecting new skin, but that’s not even quite skin-deep, so to say.

By using a lip scrub you can remove dead skin from your lips and renew them with a fresher, more vital layer. From there, it’s essential to begin protecting that new skin immediately with your favorite moisturizer to ensure healthy lips from the beginning.

While this can be a tremendously helpful solution, it shouldn’t be done regularly or often, as constantly removing skin can cause bigger problems with your lips that take much longer to heal than just a bit of dryness.

Put the Night Time to Good Use
While you’re awake your lips are in regular use. You eat, drink, smile, laugh, cough, yawn, and more, stretching that skin repeatedly and removing any topical treatments you’ve put on. You also may go in and out of the house, exposing them to the wind and dry weather of the winter months.

So why not fight this off as you sleep?

Try starting by putting a humidifier in your room to coat the dryness inside your house, helping to prevent drying out as you sleep. Next, coat your lips with a moisturizer just before you go to sleep. In the morning you should find that your lips feel moist and healthy, and this treatment, if kept up, should strengthen your lips throughout the day to help them stay moist.

Stop Self-Lubricating
It may seem counter-intuitive, but it can do a lot of good to stop licking your lips.

According to Dr. Woolery-Lloyd, “repeated lip licking removes the skin’s natural lipids, which then causes the person to develop a cycle of licking lips to try to relieve the dryness.” As an Encino dentist my experience has been just the same.

What this means is that while licking your lips may seem to help alleviate dryness, it actually creates an endless cycle of detriment to your lips; the more you lick them, the worse it gets. The chemical problem this causes only gets worse as you try to fix it, so stop the process as early as you can and start training yourself not to lick your lips.

Ingredients to Look for and Avoid
As with all products, not every ingredient is equal. Try looking for petrolatum in your lip-care products, as this is great for providing long-lasting lip protection that keeps moisture well. For those looking for more natural ways to keep lips healthy, look for beeswax or soybean oil, which are some of nature’s lip balms.

As for what to avoid, always be wary of lip products that act as a sunscreen, as many people are allergic to the ingredients that promote those effects. Also look out for any type of alcohol, which is notorious for drying out skin (i.e. hand sanitizer), as well as a generic ingredients that aren’t specific, such as for color or smell.

Tip of the Day: If you didn’t get an electric toothbrush this year for a present, I know it will take some time to get over your disappointment. When you do, get yourself a Sonicare unless you are world class brusher and flosser. The latest research shows that the ultrasonic action of a Sonicare breaks up plaque, even in hard to reach areas. As you know, plaque is enemy number one in the battle for good dental health and I have seen great results on my patients in my Encino dental office.

The fact is that Type 2 diabetes drastically increases the risk of gum disease.

Survey: Diabetes and Oral Health
With diabetes rates continuing to rise, a major factor in health issues seems to be a lack of education on the various factors at play behind it; over a third of Americans surveyed by Harris Interactive revealed that they were unaware that oral health is in any way relevant to diabetes. What may be more significant yet is that about half of those who did report to be aware of the connection knowingly neglect to talk with their physicians about it despite a 54% rate in exhibiting one or more diabetic symptoms.

Further results of the survey are equally essential in providing impetus for improved oral health awareness in the diabetic community. One of the primary numbers reported is that two thirds of surveyed individuals do not even know that diabetics are two times more susceptible to developing serious gum disease than non-diabetics. The most troubling finding, however, could be that when surveyed individuals learned this, only 56% reported intent to increase awareness of their oral health, while about 60% said they were not even concerned about contracting gum disease.

Survey Details
Harris Interactive’s survey was conducted via the internet from September 5th through 13th, 2012 and taken by over 650 American adults professing to suffer Type 2 diabetes. Racial spread included Caucasians, Hispanics, and African-Americans.

The Link between Diabetes and Oral Health
The specific link between diabetes and oral health is a matter of susceptibility. According to President-Elect of the American Diabetes Association Lurelean B. Gaines, “… people with diabetes [are] much more susceptible to serious gum disease.” What makes this an even greater complication, according to Gaines, is that “gum disease may also have the potential to affect blood glucose control and contribute to the progression of diabetes.”

How to Help Yourself
In essence, those who exhibit one or more symptoms of diabetes or who already have been diagnosed with Type 2 diabetes need to be very careful with, among other health-related issues, their oral health.

If this sounds like you, then be sure to brush thoroughly – at least twice daily for two minutes, but preferably after each meal – and floss at least nightly. Rinsing your mouth with a gum-healthy mouthwash doesn’t hurt, either.

Tip of the Day: Porcelain crowns and fillings are not indistructable contrary to what many people think. They are about as strong as your natural teeth. Use the same common sense with your dental work as you would with your teeth. For example, don’t chew ice or bones. Just like fine china, hit the crown with something hard and it will break. Should you be lacking in common sense, I look forward to seeing you soon.

The best part for me was seeing the groups that were at the bottom of the list. Bringing up the bottom were Members of Congress and car sales people. In talking to patients in my Encino office I saw 99% agreement.I especially liked the shortest answer, “duh.”

In another new report US News and World chose dentistry as the best profession to go into.  Following closely were pharmacy and nursing. I have spoken to friends at the USC School of Dentistry and they tell me that there are over 1000 applications for 100 seats.

I hope you all have had a good holiday season so far and that the year 2013 brings you much joy.

Allan Melnick DDS

Tip of the Day: I am seeing many people with diffuse pain in their jaws and teeth with no specific problem.  The cause is likely what I call  ”Holiday Stress.”, also known as clenching and grinding. Try a warm compress several times a day . It will probably help. If not, feel free to call me!”