Sports Drinks

Sports drinks Erodes Tooth Enamel

Energy drinks are a $10 billion business, and you are getting more than your money's worth of energy. You are getting tooth decay from the corrosive acids in those drinks.

Dental erosion and decay occurs when acids leach calcium and phosphorous out of your tooth's enamel, the strong cover that protects the visible part of your tooth. Dental erosion is irreversible. Once the enamel is gone, it is gone forever.

Dental erosion is an epidemic amongst our youth because their teeth are not yet hard enough to withstand constant acid attacks.

Teens and young adolescents are the biggest group of soda consumers, and advertisers target this market. A spokesperson for the Academy of General Dentistry states that his teen- to 20-year old patients are flirting with needing full mouth reconstructions to repair their damaged teeth unless they change their beverage of choice.

Dental erosion from sports drinks and non-colas can be 11 times greater than drinking other beverages. The worst offenders are energy drinks, canned iced tea and bottled lemonade. Exposing teeth to those beverages for only 14 days produces damage equivalent to 13 year's normal beverage drinking exposure!

Stopping dental erosion and decay can be done by limiting how much and how often you drink acidic beverages.

1. Drink an acidic beverage only with a meal.
2. Wait at least 20 minutes before brushing because your tooth enamel will be soft and vulnerable during that time. In the meantime, rinse your mouth with plain water.
3. Drink 100 percent fruit juice, fluoridated water, milk or a less acidic beverage.
4. To increase saliva flow, chew gum that is made with the natural sweetener, xylitol. An increased saliva flow neutralizes acids that destroy enamel.

During your regular check-ups, we watch for signs of dental erosion and can make recommendations that will help you keep your dazzling smile! Is it time for your check-up? Call us today.

Halloween was One Week ago

Post Halloween Tips

Halloween is, let’s face it, a holiday built around candy consumption. There are lot of good reasons to restrict your child’s intake of candy but doling it out one piece at a time might not be the best idea for protecting their teeth.

When you dole out a continuous stream of single candies, instead of allowing larger portions less frequently, you’re keeping the level of sugar high throughout the entire day. Decay-causing bacteria feast on the sugars in candy and produce acid that dissolves minerals in tooth enamel. Once the enamel is weak and soft, teeth are more vulnerable to toothbrush abrasion, abrasive toothpaste products and decay. Each acid attack can last about 20 minutes, so giving your child one piece every hour is a constant acid attack from which the enamel never has a chance to recover.

Current recommendations are:

• Brush before eating sweets to get the teeth as clean as possible.
• Let your child eat several pieces of candy at one time.
• After finishing the candy, rinse with water or a fluoride rinse but don’t brush.
• Wait at least 40 minutes for saliva to reharden the enamel, then, brush with fluoride toothpaste.

Another recommendation is, after a sugary treat, to offer chewing gum or mints that list xylitol as the first ingredient. Xylitol is a natural sugar that prevents bacteria from producing decay-causing acid. Note: Xylitol is poisonous to dogs. Don’t allow your dog to eat anything that contains xylitol.

And not all candies are created equally. In order from worst to best:

1. Sour candies (enamel dissolving acid plus sugar)
2. Sticky candies like taffies and caramels (clings to teeth)
3. Hard candies and lollipops (lingers in the mouth longer)
4. Powdered candies (dissolves on tongue. Requires no chewing)
5. Sugar-free candies and gums

And the same rules apply to you, too. Indulging that adult sweet tooth must be done thoughtfully to avoid dental disasters. The trick is to enjoy that treat without forgetting your oral health. A little planning and regular dental checkups will keep your holidays happy.

Part 24: USDA's New Food "Plate"

Life just got easier.  One of the few good things out of the government lately.  Out with the Pyramid and in with the "Plate".  Here is the info.

http://www.choosemyplate.gov/

It shows easy to remember portion sizes for your plate and how to have a balanced meal.  Let's see if that sinks in to the public!

Part 23: Snoring - Who's Problem Is It?

More and more evidence is showing that sleep disorder breathing is bad for your health as well as your partner's sleep.  Sleep apnea has been linked to dying from cardiovascular disease.  The issue for your health care providers is to accurately determine the degree of the disorder.  It ranges from simple snoring to severe sleep apnea.  Fortunately, there are treatments available for the various stages as well as things you, the patient, can do to prevent or lessen the problem.

Apnea is defined as stopping breathing for 10 or more seconds or taking less than 25% of a normal breath.  15 million Americans have sleep disorder breathing with up to 90% being undiagnosed.  4-9% of the male population and 1-5% of the female population are affected.  There is a higher incidence in African-Americans, Native Americans and Hispanics, as well as an increase with age and weight.

Here are some questions to help you determine if this is a problem.

  1. Frequent or heavy snoring?
  2. Significant daytime drowsiness?
  3. Have you been told you stop breathing while sleeping?
  4. Do you gasp at times when waking up?
  5. Do you feel unrefreshed in the morning?
  6. Do you have morning headaches?
  7. Are you aware of any teeth grinding at night?

Typical  Obstructive Sleep Apnea (OSA) patients have one or more of these:

  1. Large necks:  Men - 17 inches or larger; women - 16 inches or larger
  2. Small chins (overbite).
  3. Over weight - % increases dramatically over 200 lbs.
  4.  Scalloped tongue - Sides of tongue show imprint of the teeth ( a 70% predictor).
  5.  Eroded enamel - Enamel worn off teeth.
  6. Enlarged tonsils - Graded by amount of blockage (Pharyngeal grade 1-4)
  7. Crico-mental  space < 1.5 cm. (Turkey Gobble neck)

If you have a Turkey Gobble, an overbite, and a Pharyngeal grade >II, there is a positive predictive score of 95%!

The final diagnosis of OSA is done with polysomnography (PSG) at a certified sleep lab.

So, let us say "You've got OSA".  Now what?  Here are your options.

  1.  Sleep hygiene
  2. Over the counter nasal aids
  3. Oral Appliances
  4. CPAP, CPAP Pro, Nasal CPAP, and BiPAP
  5. Surgery

Let's look at each one a little closer.

Sleep Hygiene:
  Avoid sleeping on back (sleep position training).
  Avoid alcohol for 2 hours prior to bedtime.
  Lose weight
  Avoid CNS depressants
  Stop smoking

Over the Counter:
  Breathe Rite Strips
  Lubricants (Ayr,etc.)
  Nasal sprays (Afrin, etc. and my favorite - Xlear)

Oral Appliances: Over 40 types available, here are some I like.
 Silent Nite - For snoring only
 Aveo TSD - For snoring, no impressions
 Myerson EMA - For snoring and mild OSA
 TAP III -  For mild to moderate OSA
 Somnomed MAS - For mild to moderate OSA

CPAP (Continuous Positive Airway Pressure):  The Gold Standard
  Machine with various masks to provide pressurized air to the lungs to override obstructions.

Surgery:
  Various surgeries on the throat to open the airway by removal of tissue.  This is usually the option of last resort.  One, a tracheotomy, bypasses the throat altogether.

The object of all these methods is to get oxygen (air), to the lungs.  The dental versions do this by holding the lower jaw and tongue in a forward position which opens the airway.  It is a low cost, non surgical option that doesn't restrict sleeping patterns.  I would recommend it as a primary choice for mild to moderate OSA or for people who cannot adapt to the CPAP.  A before and after sleep study will tell it's % of effectiveness.

The main thing is to do something.  Your life may depend on it! 

Part 22: Dental Fees- Why the Variation?

Just as all dentists aren't the same, so are their fees.  A lot goes into what is a "fair fee".  The standard definition of a fair fee is "That fee which the patient will pay with gratitude and appreciation, which will enable the dentist to render the best possible service for that fee". So, that means the fee has to be fair to both the patient and the dentist.  It should be a win-win.

But what actually goes into the dentist's decision of what to charge for each service they perform?  Here are some, but not all the answers:

  1. Overhead
      A. Cost of Materials - Can vary a lot.  Is it a Brand name or generic?  Is it an ADA approved product? Is it the latest generation?  Was it purchased at a discount house or a full service supply house?  What dental lab was used?
      B.  Facility - Is the office owned or rented?  Is it in a good neighborhood?  Does it have convenient parking?  Is it clean, neat, and nicely decorated?
      C.  Equipment - Does the dentist have new or old equipment?  Does the office have the latest technological advancements?  Has the office gone digital?
      D.  Staff - Does the dentist have competent, well trained staff?  Are they experienced or seem to be "new" each time I come in?  Are they happy?
      E.  Constants - Utilities, phone, mailing, office supplies and equipment, etc.

   2. Profit
       A.  What does it take for the dentist to provide an acceptable return on his investment (ROIC) of education, time and money? 
       B.  What does the dentist feel  his/her care, skill, and judgement is worth?  Actually, this is usually very accurate as each dentist evaluates how they compare themselves to their colleagues in the area. 

So, "you usually get what you pay for" is true.  The harsh truth is not all dental care is the same.  There are different "levels" of care for the different values patients place on dentistry.  And there are likewise different dental practices to meet those needs.  It is for you, the patient, to determine what best suits your needs and perceived values, and seek out a dental office that meets those needs and values.  Then you can pay the fee with "gratitude and appreciation".  The dentist has already determined what the fee needs to be for him/her to provide their best  possible service.

Part 21: Direct Reimbursement- Simply the Best

Whether you are an employer or an employee, this is for you!  Direct Reimbursement offers the best bang for the insurance buck.  It is a self directed fund set up by the employer.  Here's how it works:

1.  Employer decides how much he/she wants to provide per employee for dental benefits each year.

2.  The employee knows exactly, up front, the amount  they have for dental care each year.

3.  Employee keeps their own dentist.

4.  Employee and their dentist decide what treatment is best.  No pre-determinations.  No limitations.  No third party involved in any way.

5.  Employee pays for the dental care.

6.  Employee presents paid receipt to employer.

7.  Employer reimburses employee.  No fuss- no muss!


This has several obvious advantages over traditional dental insurance.

A.  For the employer:

      1. Can control this line item of the budget

      2.  No third parties to negotiate or deal with.
   
      3.  Lower cost.

      4.  Minimal in-house administration.

       5.  Happier employees.

B.  For the employee:

     1.  Keep your own dentist.  Not forced to see a "Participating Dentist".

     2.  Can spend your allowance on whatever dental care you want - cosmetic, orthodontics, oral surgery,  etc.

     3.  No waiting on pre-determinations or consultant reviews.

     4.  No waiting for reimbursement from insurance company.

     5.  Usually higher benefits because employer doesn't have to pay a third party.


     So if you are an employer look into providing the best (and cheapest) insurance.  Or if you are an employee, share this information with your employer, union rep or HR person.  Tell them this is truly a win-win.

The American Dental Association has free information about Direct Reimbursement and assistance in setting it up in your business.  Here is the link.  Since we feel this is "Simply the Best", our office is happy to assist in any way.

http://www.ada.org/1330.aspx


      

Part 20: Dental Insurance- The Good, the Bad and the Ugly

Like any insurance, when you need it, it's nice to have.  What those of you who have dental insurance need to know is the "cost-benefit ratio".  How much is it costing you for your needed benefits versus a larger paycheck.  Getting the answer to that question takes some investigation and knowledge about dental insurance. Here is some background information that should be helpful.

Dental insurance benefits differ greatly from health insurance benefits.  In 1971, dental insurance benefits were approximately $1,000 per year.  In 1995, benefits were only $1,000 to $1,500 per year.  As of 2010 only a few policies have $2,000 per year coverage.  Figuring a 6% rate of inflation per year, benefits should be over $10,000 per year.  Premiums have increased, but benefits have not.  Therefore, dental insurance is never a pay-all; it is only meant as an aid.

Many plans tell their participants that they will be covered "up to 80% or up to 100%" but do not clearly specify plan fees, schedule of allowances, annual maximum or limitations.  It is more realistic to expect dental insurance to cover 35% to 65% of major services.  Remember, the amount a plan pays is primarily determined by how much the employer paid for the plan.  You get back only what your employer puts in, less the profits and admistrative costs of the insurance company.

You may receive notification from your insurance company stating that dental fees are "higher than usual and customary".  An insurance company surveys a geographic area, calculates and average fee, then takes 80% of that fee and considers it customary.  Not suprisingly, the "usual and customary" fee for the same procedure varies from policy to policy.  Again, they are in business to make a profit, so controlling pay outs versus premiums is how that is done.  If your employer purchased a bare bones policy - a lot more fees are "higher than usual and customary".

Your dental insurance is based upon a contract made between your employer and an insurance company.  Should questions arise regarding your dental insurance benefits, it is best for you to contact your employer or insurance company directly.  The policy holder has the most influence with the company.  Our office will submit any necessary pre-determination of benefits or treatment claim forms. If necessary, we will work with you to finance any charges that are remaining beyond the coverage amount.  Remember, unlike some medical bills - dental care won't break the bank.

Professional care is provided to you the patient, and not to an insurance company.  Therefore, you are ultimately responsible for the services rendered, and your insurance company is responsible to you the insured.

Lastly, do not let policy limitations determine your dental care.  Treatment should be based on an informed decision by you and not an insurance representative. The company will be more concerned as to what is the cheapest treatment, not what is the best treatment for your particular situation.