YOUR DENTIST 2008 NEWSLETTER

It’s already the end of 2007, so I wish you the best Holidays and a Happy New Year 2008. Remember, there’s only 28 days in this upcoming February!

We had some changes this past year in the office… You probably met Carol at the front desk who is now working with Sylvie. Her experience made the transition pretty smooth and we are glad to have her teaming up with us.

NEW COMPUTERS

Kodak came up with improved digital x-ray sensors. This improvement forced us to adjust both our software and hardware to meet new standards, so we decided it was time for a new fleet of computers. It seems that upgrading our computers every other year is a must. It is always a challenge to adapt, but we need to stay afloat!

THE HD REVOLUTION

For years, I tried to find the right mounting arm that would allow the TV to move so that you could watch it while seated in the dental chair. Finally, an engineering firm came up with a fixture made for dentists’ equipment that I could add to our dental light tracks. This arm gives complete freedom on positioning, rotation and angle of the flat screen monitor so you can easily watch TV during your treatment. I always believed this screen to be the best distraction for my patients. Of course, I did not miss the opportunity to make the move to high definition in the 16:9 format. You now have the option to watch high definition satellite broadcast as well as any DVD from your collection. You will also enjoy HD quality gaming with the X Box 360, which replaced Nintendo 64 in our office. Every room has these capabilities.

WIRELESS

In order to eliminate wires, the game controllers are wireless and the Bluetooth headphones will guarantee a great quality sound for any TV channel, videogame or Muzak music channel of your choice. For the nostalgics, rooms 4 and 5 will still have the option of the old Nintendo and Super Nintendo. Always feel free to bring your own DVD or VHS movie, CD, MP3 or videogame - whatever will help you relax in our chair...

FLAT SCREENS

You might have already seen our new LCD TVs, such as the one in the waiting room. They display HD quality DVDs and PS3 games. One will have continuous patient education, as usual. At your request, we can put on an HD TV show or a specific Blu-ray DVD.

CANCER SCREENING

Enough about the gadgets and toys - the new thing in dentistry this year is VELscope. You will get the chance to see this new device at your next examination appointment. It came from research done in British Columbia, Canada about oral cancer prevention. Unfortunately, oral cancer has shown no reduction of frequency within the population or the 5 year survival rates. Meanwhile, screenings and earlier treatment has benefited other types of cancer. Actually, cancer of the tongue is on the raise, seriously. Research found that the typical victim is no longer limited to the smoking, drinking, spicy-eater, male over 40 years old. A new factor identified as the human papillomavirus ( HPV ) explains that younger people of both genders are at risk. For now, the fluorescent light of VELscope will be the prevention screening device of choice. We will perform an exam as usual but will add the VELscope check as part of the appointment for young and older adults. Because of the connection between HPV and oral cancer, I can imagine that the next screening device in dentistry would be able to detect HPV.

FOSAMAX

We have recently learned that some serious complications can occur after surgical procedures such as gums surgery, bone surgery or extractions if the patient has been or is taking biphosphonates, a family of medications like Fosamax. This medication is very appreciated by doctors and patients dealing with osteoporosis, radiation therapy or other conditions resulting in bone loss. It prevents loss of calcium but can alter the bone repair process. So, we added the question in your medical history sheet. If you have ever taken a medication in this group and need surgery in the future, you should be cautious when considering treatment options as to avoid healing difficulties. In addition, if you are on Fosamax or any similar medication, I would definitely recommend that you keep up very good, regular dental care at home and at the dentist, so that you can stay away from periodontal or surgical needs.

PREMED

The same is recommended for patients at risk for endocarditis since the “premed” antibiotherapy only protects you at the time of your dental visit! In between “premed” prescriptions, if you have poor oral hygiene and only occasionally give yourself a super cleaning, a heart murmur or other heart ailments could allow the infection to invade your blood stream. By the way, the American Heart Association came up with new guidelines about “premed” that follow the same consideration stated above. According to the new guidelines, you might no longer need the usual premed regimen (check with your doctor) but you will need to maintain the best oral care possible so that you do not increase the risk at the time of your periodontal maintenance. Ask me, Erin or Barbara at your next visit.

Speaking of infections - prevention is always the best way. You'll find a hand sanitizer at the front desk when you come in, like in hospitals, nursing homes, etc. Please use it and protect yourself from hand contamination. It is a first step in preventing the spread of bird flu as well as common colds.

Think about all you touch and bring back to your body...

UPDATE

Please continue to let us know if you have had a change in your medical condition, new medications, allergies, etc. Carol and Sylvie will also ask you to fill out an update for your phone numbers (home, work or cell), address and insurance so we can verify our data. We'll get rid of old numbers in our files.

PARKING-CONSTRUCTION

Even though there may not always be parking available close to the entrance, there is plenty of parking space around the building. You have an area reserved especially for you in front of the building on the north side. Signs designate those spaces as ''customers only'' and it includes you - they are not exclusive to the bank. In my opinion, handicap parking is insufficient, but two spaces with a ramp are reserved on the bank side (east side).

As you are probably well aware, the City of Palm Bay is going forward with the project of enlarging Palm Bay Road and Babcock Street. Whenever the construction starts, we will certainly have to deal with some annoying traffic. Port-Malabar Blvd will most likely be your best alternative to reach our office since it crosses both construction roads. Use it from US1, Troutman or Riviera to skip the congestion. Port-Malabar offers two entrances to the Indian River National Bank Building (the Winn-Dixie Plaza).

DO's and DON'Ts

Let's start the list with the ''DON'Ts'' in dentistry

DON'T- drink coffee, tea or red wine. They leave stains within the calculus and plaque layer, even if they’re thin, which gives the appearance of stained teeth. If you like those drinks, frequent brushing is recommended.

DON'T- smoke. It is not so much about the tar residues which can be cleaned by hygienists. More importantly, it ''burns'' the core of your teeth which ages them faster than they naturally would. The heat of the smoke turns your inside layer, the dentin, into a darker color, whether it be grayer or more yellow. The darker the dentin gets, the harder it is for a whitening treatment to hide the depths of your teeth. Whitening does not always succeed that well in making the outer enamel layer opaque (it is usually translucent), so you can still see some of the dark color inside. Smokers sometimes need to consider bondings, veneers and even crowns to counterpart the effect of smoking. Dipping (tobacco laying in the mouth) causes more stains than smoking and is as much a factor in oral cancer etiology, especially in addition to other factors such as alcohol, spices, sun, etc.

DON'T- drink soda or citrus on a regular basis. They are acidic and will erode the enamel of your teeth and soften the dentin of your roots. Beware of the popular diet sodas that do not have as much sugar as regular sodas. Unfortunately, diet soda is as acidic as regular soda, so it will erode your teeth just as the well known decay-maker. It is common to see rampant cavities on baby teeth (bottle syndrome) and outdoor workers needing to avoid dehydration. This can happen within a few months! Dry mouth syndrome patients are affected more severely by acidic drinks since they lack the saliva.

DON'T- chew gum all the time. Chewing stimulates saliva production which will help in cleaning teeth and neutralizing the acid made by the plaque. But chewing constantly can aggravate TMJ problems. People with TMD, temporomandibular disorder, are told to reduce chewing gum and hard food so their joints can rest. Of course, a sugar free chewing gum is preferable.

DON'T- clench or grind. Avoid extreme biting pressure. Stress, but also habits, can cause people to use more force while chewing food or simply clench their jaw, more than is necessary. Many people have this reflex during sleep and wake up with soar TMJs. A mouthguard can help protect teeth from excessive wear and fractures. If this is a chronic problem, an appliance, often called a splint, can be worn to help with serious TMD conditions.

DON'T- chew ice or hard candy, and be careful with popcorn. It would compare to biting rocks or stones - who would do that? Teeth are naturally very strong but any weakness such as cavities and fillings will facilitate fractures, even on molars. It is not uncommon to find cracks on large amalgam teeth where only a crown would reinforce and rebuild the tooth. Thank you to all the ice chewers for your business! I always suggest using molars when it comes to carrots since they can be especially tough on front teeth.

DON'T- hold pipes, pens or pins between your teeth. The enamel rods at the tip of your two front teeth will chip and break the teeth line. Rebuilding the edge is usually easy to accomplish but it will break again if the habit is repeated. Bondings do not hold very well at the very tip of think teeth like anteriors.

DON'T- allow silverware to slide or get stuck between your teeth. Metal will cause premature loss of tooth surface. Cutting wires or threads with your teeth will also have this effect.

DON'T- bite into very stiff caramels or similar type of food if you have loose teeth or any crown or bridge work. These may come out, even with our most improved cements.

DON'T- play dangerous contact sports without face protection. Protect your teeth from hitting uppers and lowers against each other. Mouth guards are common and will save you from jaw fractures at the joint level. Facebow and helmets are a better protection for contacts on teeth and joints in general.

DON'T- use abrasive toothpastes for smokers or those that are a part of ''whitening'' kits. Any deviation from the ideal tooth brushing technique will accentuate damages related to the abrasivity of the paste or gel. Powders like baking soda are prohibited! Rather than using anything abrasive, even occasionally for heavy stains, I recommend a proper prophylaxy by our hygienists on a more frequent schedule than usual, if necessary.

DON'T- use hard toothbrushes, even medium grade. Any extra pressure against teeth will cause bristles to leave depression into enamel surface and even cuts into roots after the gums have started receding, which can be a real source of cold sensitivity.

DON'T- stretch your regular maintenance appointments too far apart. It will only get you more gum disease and a more sensitive cleaning next time.

DON'T- delay needed and recommended treatment. By experience, I can guarantee you that any worsening of your condition such as decay to root canal therapy, will only cost you more, many times more... where a filling would have kept it simple and at much less cost to you. Dentistry is not cheap and the dentist's goal is to prevent it from costing you extra.

I sound like there is nothing left you can do! However…

DO- get an electric toothbrush. Oral B-Braun, Sonicare and other brands are thriving to come up with the best tooth cleaning tool. Rechargeable brushes are the most efficient and the safest for you. Be cautious about the inexpensive, disposable battery style toothbrush. The spinning feature on styles can harm your teeth. Vibrations and oscillations are the best approach in the powered brushes so look for quality, safety and durability.

DO- use fluoride toothpaste in the morning, at bedtime and anytime you have some sweets or a soda. I will prescribe a very loaded fluoride toothpaste for patients under radiation treatment, chemotherapy or other conditions causing dry mouth syndrome (often a side effect of medications), as their teeth are more susceptible to decay.

DO- the most important thing... SEE your dentist religiously !!!

Again, have a Happy New Year. Hope to see you soon. As usual, I will ask you to refer family, friends and co-workers if you are happy with our practice. Once we have given you the best care possible, we are available to other people in need, which in return keeps the practice running... Thanks again for your trust and see you soon.

Andre J. Berube, DMD