It has been said, at least by dentists, that the mouth is a window into what may be going on in the rest of the body. A thorough oral exam can often reveal things that reflect upon one’s overall health status. Signs of nutritional deficiencies, the presence of certain systemic diseases such as leukemia, Sjogren’s syndrome, and diabetes are but a few examples of potentially serious conditions that have been initially discovered by a dentist.

Research has shown a link between the bacteria and inflammation associated with periodontal disease and cardiovascular and atherosclerotic disease (see my blog The Direct Link Between Dental Health and General Health). These are published studies that link gum inflammation and oral infections to heart disease and strokes. People with uncontrolled diabetes often have more severe periodontal problems.

Conversely, the presence of gum disease can make it more difficult for diabetics to control their blood sugar. Chronic conditions such as periodontal disease initiate an inflammatory response by the body. One such by-product of these protective “call to arms” by the body’s natural defenses is the liver’s production of chemicals called C-reactive proteins. The presence of these proteins is somehow linked to vascular disease.

Although periodontitis (gum disease) may contribute to the aforementioned health conditions (and other conditions – see my blog Poor Dental Health Can Lead To Dementia), it is important to understand that just because two conditions occur at the same time doesn’t necessarily mean one condition causes the other (ADA: Healthy Mouth Healthy Body, 2006) More research is needed, but there definitely appears to be a correlation. There is even a link between periodontal infections and premature births and low birth weights.

Brushing your teeth thoroughly (for two minutes) twice a day and regular flossing are important steps in ensuring optimal dental health as is seeing your dentist regularly. For those adults who have been somewhat erratic in seeking dental care, remember that only a dentist or dental hygienist can remove the plaque and tartar that accumulates below the gum line. Plaque and tartar are very tenacious in their adherence to tooth structure. Trying to clean one’s own teeth without periodic professional prophylaxis would be akin to cleaning barnacles off of a boat’s hull with a garden hose.

Having been in dental practice for nearly thirty years, I have seen many middle- aged adults, typically men (as women usually have better track records when it comes to health care) walk into my office after not receiving regular dental care for many years. Often “too busy” for periodic examinations and cleanings and with no history of pain (gum disease often progresses silently without signs or symptoms), a sudden dental emergency brings the 50-60 year old in for treatment. Emergency examination often reveals a host of problems that have been lying- in- wait for quite some time. It is never too late to commit to getting healthy.

While comprehensive dentistry for the neglected dentition can be extensive and expensive, the first order of business is to relieve the pain that brought the patient into the office. Then after a thorough examination and diagnosis, a treatment plan is developed that gives priority to stabilizing the patient’s oral condition, i.e., eliminating infection, treating decay and reducing inflammation. Only after this is accomplished can thought be given to restoring one’s dentition to a state of beauty and long term health. A beautiful smile is a healthy smile. And a healthy smile can be a pathway to overall good health.

Dr. Michael Sinkin has been practicing dentistry for over two decades. He truly cares about the experience his patients have and takes great pride in making them feel relaxed and comfortable during every visit. Come in for an appointment and experience a different kind of dental practice. To find out more about Dr. Sinkin, please click here.

Imagine waking up to the news that dental x-rays cause brain tumors.

Two weeks ago, nearly every major network and newspaper (Fox News, ABC News, The Washington Post, to name a few) reported on a study published in the American Cancer Society’s journal, Cancer citing a link between dental x-rays and a type of brain tumor called meningioma.

Meningiomas are the most common type of brain tumor and are almost always benign. While the study notes that the risk factors for developing meningiomas is poorly understood, it does point out that “ionizing radiation is the major risk factor for meningioma and that dental x-rays are the most common artificial source of exposure to ionizing radiation in the United States.” (guilt by association).

Unfortunately, the methodology used in this study was found by many scientists to be flawed. The data and subsequent conclusions were based on recollections of patients having dental x-rays many years earlier, some even decades ago, when radiation exposure was much higher because of older technology and slower film. In fact, information was gathered via phone surveys in which subjects were asked how many x-rays they had over the course of their lifetimes and how old they were when they were taken.

The statistics collected were never correlated to the actual dental charts which would have shown exactly how many x-rays were imaged. Anecdotally, I have found that in my 30 years of clinical practice new patients rarely report with accuracy when the last set of x-rays was taken and how many films were exposed.  That’s why we always wait to see the radiographs from the previous dentist before taking new ones.

The cancer article also failed to take into account other sources of radiation including CAT scans, chest x-rays and the environment. The American Dental Association recognized some of the shortcomings in the article and encouraged further research.

What does this mean for the patient?
Good clinical judgment on the part of your dentist is paramount in deciding when dental x-rays are necessary. The need varies with the individual depending on such factors as clinical presentation, age, diet (the amount of refined carbohydrates consumed), past dental history (does the patient have extensive restorations or a pristine cavity-free dentition?), and medical history including medications that may cause dry mouth and increased susceptibility to decay.

While the aforementioned study has reached questionable conclusions about the safety of x-rays, ionizing radiation does pose potential health risks that cannot be dismissed out of hand.  (See my previous blogs about the use of thyroid collars and cone beam radiology).

Just as it is irresponsible to overdo the use of x-rays, so it is foolish to negate the need for periodic radiographic examination. One must always weigh the risk vs. the benefits of any treatment or diagnostic modality.

One point that I must emphasize: most patients in this tumor study had x-rays taken in the 1960′s. With the advent of digital radiography, radiation exposure has been reduced by as much as 100% or more.

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Dr. Michael Sinkin has been practicing dentistry for over two decades. He truly cares about the experience his patients have and takes great pride in making them feel relaxed and comfortable during every visit. Come in for an appointment and experience a different kind of dental practice. To find out more about Dr. Sinkin, please click here.

According to a recent study conducted in Japan, poor dental health has been linked to a greater risk for developing dementia. The study, which tested over 4,000 elderly Japanese adults found that those who had few teeth and did not use dentures or who did not visit a dentist regularly had significantly greater chances for developing dementia than participants who partook in healthy dental behaviors.

Data was collected from 4,425 adults older than 65 from the Aichi region of Japan. Each participant, interviewed in 2003, was asked questions about their number of teeth, denture use, ability to chew, how regularly they visited a dentist, and overall dental attitudes. From 2003 to 2007 dementia onset was determined from the insurance databases in the region.

The Results

• 220 participants experienced onset of dementia from 2003 to 2007.
• The participants who had few teeth without dentures had a significantly higher risk of developing dementia than those who had 20 teeth or more.
• Not having a regular dentist was also a significant risk factor for dementia onset compared with those who had regular dental appointments.
• Other risk factors included not taking care of overall dental health and not being able to chew well.

One surprising fact is that participants with few teeth and no dentures were at a high risk for dementia onset, but those with few teeth and dentures were not at an elevated risk level. The implication is that denture treatment for patients with few teeth may help in preventing mental deterioration.

There are several possible connections between the lack of dental health and dementia. One such connection addresses the actual process of tooth loss, which is most commonly caused by periodontal or gum disease. Active gum disease is a bacterial infection, which induces an inflammatory response in the body that among other things causes the release of certain chemicals produced in the liver (such as C-reactive proteins). These chemicals have been implicated in a wide variety of ailments including cardiovascular disease, atherosclerotic disease, cerebro-vascular events (strokes), and premature birth to name a few.

The exact mechanism by which these inflammatory proteins promote such conditions is the subject of much research, but since they seem to have such far-reaching effects on systems reliant on good circulatory health, it is easy to propose a link between chronic gum disease and poor brain health and dementia.

The other connection deals with the importance of good nutrition and brain health. Those patients in the study who experienced tooth loss and replaced missing teeth with dentures fared much better in avoiding dementia than those who did not have dentures. The correlation is striking because of the obviously better nutritional intake of those patients who maintained a functioning dentition, i.e., dentures vs. toothlessness.

In terms of brain health, it might just come down to you are what you eat, and you aren’t when you can’t eat.

To read more about this groundbreaking study, please click here

“Brain Freeze” is the intense headache people often get when they eat ice cream, popsicles, milkshakes, frozen drinks and other really cold foods. It is a very sharp, stabbing pain in the forehead and most of us have experienced it at one time or another.

Brain Freeze (sometimes called an “Ice Cream Headache”) is caused by the blood vessels above the roof of your mouth responding to prevent a loss of heat in your head and therefore protect your brain. The blood vessels in your head widen to let in more blood (more heat). This rapid swelling of the blood vessels, which contain sensitive nerves, is what causes the headache.

At one time it was thought that this phenomenon happened only in hot weather, but in fact, it can happen in any temperature. It’s the temperature of the food that you are eating that causes the effect.

7 Ways to Stop “Brain Freeze” in its tracks:

1. Press your tongue against the roof of the mouth to warm the area.
2. Tilt your head back for about 10 seconds.
3. Drink a liquid that is warmer than the cold substance that caused the headache.
4. Take small bites or sips and let them warm on your tongue before they touch the roof of your mouth.
5. Make a mask with your hands and cover your mouth and nose; breathe quickly.
6. Press your thumb against the roof of your mouth.
7. Since Brain Freeze starts after you swallow, you can actually prevent it by holding the cold substance against the roof of your mouth before you swallow. But this technique seems so illogical most people won’t even try it!
8. Give up all frozen treats (just kidding).

So, next time you reach for that Frozen Daiquiri, remember these 7 ways to prevent Brain Freeze, and enjoy!

Bad Breath (also known as “Halitosis”) is a concern for most people, proven by the fact that Americans spend over $500 million dollars per year trying to combat it. This shouldn’t come as a surprise considering magazines routinely list “Bad Breath” as a top 10 faux pas when meeting someone for the first time. The men’s lifestyle magazine AskMen.com recently placed bad breath as number two on its list of the biggest turnoffs for women!

For most people Halitosis is a result of one or more of the following:

1. Poor dental hygiene (number 1 reason!)
2. Diet (garlic, onions, curry, and other strong flavorings)
3. Acid Reflux (heartburn)
4. GERD (a form of acid reflux in the lower esophagus)
5. Poorly controlled Diabetes
6. Periodontal (gum) disease
7. Smoking
8. Dieting (especially low carb diets)
9. Alcohol
10. Prescription medicines that cause “dry mouth”

The bad odor brought about by poor dental hygiene cannot be masked, any more than perfume can cover poor personal hygiene. While there is no substitute for good dental homecare and regular visits to the dentist, there are some basic halitosis remedies that can be very effective:

• Tongue Scrapers: These products are gaining popularity and are very effective in reducing the amount of sulfur-producing Bad Breath-causing bacteria residing on the tongue. Brushing one’s tongue accomplishes the same thing-one or two swipes with your toothbrush is sufficient.
• Mouthwash: There are some concerns with the regular use of mouthwashes, including the high alcohol content in most products. The presence of high alcohol concentration can exacerbate symptoms for patients with dry mouth. Dry mouth can be caused by a host of reasons, including use of medications such as antidepressants, blood pressure and cardiac meds, certain auto-immune conditions, and cancer treatments.
• Non-Alcoholic Mouth Rinses: Because many people are trying to avoid the high-alcohol content in conventional mouthwashes, a huge emerging market for specially formulated alcohol-free rinses has been developed. Biotene® rinse as well as related products have taken a share of the market. Biotene® is a product that I regularly recommend. It kills bacteria just as effectively without the burning sensation you might experience from regular mouthwashes, particularly if you have a mild irritation in your mouth and gums to begin with. Biotene® and similar products also work to maintain a normal balance of electrolytes usually found in healthy mouths

Whatever the remedy you choose for your Halitosis, incorporate it into your regular oral hygiene regimen. Your blind date will thank you for it. But remember that persistent Bad Breath is often a sign that something serious is wrong and you should be evaluated by your dentist or physician (or both!).

Dr. Michael Sinkin has been practicing dentistry for over two decades. He truly cares about the experience his patients have and takes great pride in making them feel relaxed and comfortable during every visit. Come in for an appointment and experience a different kind of dental practice. To find out more about Dr. Sinkin, please click here

Did you know that sugar free products could actually lead to tooth decay? Our image-driven culture and national obesity crisis has given rise to an entire industry of products containing sugar substitutes. Supermarkets are stocked full of sugar free products that supposedly reduce the possibility of tooth decay and weight gain. This includes diet soda, sugar free candy, and more. But few people realize that there is a relationship between sugar substitutes and dental health.

Most current sugar-free products contain one or more of these three substitutes: Sorbitol, Mannitol, Saccharine. These sugar substitutes can turn into teeth-attacking acids in the mouth. How are these acids produced? Here’s how it goes:

1. Carbohydrates and sugars become adhered to the tooth enamel and remain there if the teeth aren’t brushed.
2. Bacteria recognize the sugars as a potential food source and begin to feed upon it.
3. The bacterium begins to multiply as it consumes the sugar, expanding in numbers very quickly.
4. As the bacteria continue to feed, they convert the sugar into acid waste.
5. The acid waste begins to eat away at the enamel and causes tooth decay!

This process has proven to take place both with sugar substitutes as well as with ordinary sugar. Enter Xylitol. Xylitol is different than other sugar substitutes in that it cannot be broken down into acids by bacteria the way that Sorbitol, Mannitol and Saccharine can. This discouragement of bacteria growth greatly reduces the amount of acids that form on tooth enamel and actually helps prevent tooth decay.

• Xylitol is used in dental health products because it can actually strengthen tooth enamel, resist decay-causing fermentation, and reduce plaque build-up.
• Xylitol has tested to be a lot milder on the stomach than Mannitol or Sorbitol, so less embarrassing dashes to the bathroom.
• Xylitol has the same weight-controlling features of other sugar substitutes.

Some small manufacturers and organic food producers are already using Xylitol in their products. Epic Industries in Utah, for example, touts a whole line of products, including gum and toothpaste. And Spry chewing gum also uses Xylitol as a sweetener. It might take a little research, but it is well worth the few minutes to consider your entire health when deciding which substitute sweetener to start phasing into your diet. Check Whole Foods or your local health food store.

So, beware of sugar substitutes. They’re not as safe as you may think.

Dr. Michael Sinkin has been practicing dentistry for over two decades. He truly cares about the experience his patients have and takes great pride in making them feel relaxed and comfortable during every visit. Come in for an appointment and experience a different kind of dental practice. You may even receive a healthy dose of Dr. Sinkin’s famous comic relief! To find out more about Dr. Sinkin, click here

Similar to changing the batteries on a smoke detector, many people often wonder how frequently they should replace their toothbrush with a new one. Statistics seem to bear out that most people don’t bother replacing their toothbrush until the bristles start to fall out, or they shop around for an electric toothbrush they think will last forever. When should you replace your toothbrush, and what sort of electric toothbrushes are on the market for your needs?

It is interesting to note that, according to Worldental.org, Americans spend about $1.25 billion on toothbrushes and $1.8 billion on toothpaste every year. Given the U.S. population stands at 300 million, these numbers aren’t exactly staggering. Just for comparison sake, Americans on average drink 600 cans of soda each year and last year, according to the National Confectioner’s Association, over $2 billion was spent on Halloween candy. That’s just Halloween. We’re not counting Christmas, The Super Bowl, Valentine’s Day, or Easter. In short, people are hanging on to their toothbrushes probably long past their due.

The American Dental Association recommends:

• Toothbrush bristles should always be relatively straight or only slightly bent
• Toothbrushes be changed every three months
• Toothbrushes should be tossed out after one has combatted a cold

Toothbrush bristles should be relatively straight or only slightly bent. This bears repeating because many people aren’t aware of when their toothbrush is past its prime. Relatively straight or only slightly bent, it’s still OK, but if it looks like it was used to scrub the bathroom tiles, it needs to be tossed.

Electric Toothbrushes – An Overview

As far as the electric toothbrush market goes, there are two big players: Sonicare and Oral-B. Both companies make excellent products, which fit most budgets. For high-end performance, I personally like the Sonicare Diamond Clean. It has many bells and whistles including timers, and pressure sensors “informing” the user when too much pressure is being applied to the teeth. Unlike the Oral-B, which has a rotating head, the Sonicare oscillates, thus giving more mechanical advantage. But, at a whopping cost of $220, the Sonicare Diamond Clean may be a bit much. Oral-B makes a great product, and the Oral-B Vitality, at a cost of around $23 also has a timer, and is a great electric toothbrush.

Whether you’re using a traditional toothbrush or an electric one, be mindful of the wear-and-tear your toothbrush is sustaining and make sure you swap it out frequently. A helpful reminder (similar to daylight savings time for smoke detector batteries) is to change your toothbrush on the start of each new season, winter, spring, summer, and autumn. This way you continue to use a toothbrush that will achieve what it’s supposed to: healthy gums, and white, cavity-free teeth.

Dr. Michael Sinkin has been practicing dentistry for over two decades. He truly cares about the experience his patients have and takes great pride in making them feel relaxed and comfortable during every visit. Come in for an appointment and experience a different kind of dental practice. You may even receive a healthy dose of Dr. Sinkin’s famous comic relief! To find out more about Dr. Sinkin, click here

For most of us, life is lived on the go. We rush from one meeting to the next, one appointment to the next, from work to school to soccer practice to dance classes. With living on the go, comes eating on the go, despite how conscious we are of our health and body weight. In an attempt to offset this, we sometimes stop at the local fruit juicer and pick up a fruit smoothie.

Fruit smoothies are also a common preference for weight-conscious folks who are trying to avoid sodas and sugary punch drinks. A fruit smoothie during our cool-down period after the gym can hit the spot, and the antioxidants that can be found in berry juice (when you are actually drinking authentic berry juice and not “natural flavors”) can actually be quite beneficial to your overall health. But did you know the negative effects of fruit smoothies on teeth?

Recent studies show that the high volume of acid and sugar in these fruit smoothies can actually wear down the enamel that protects your teeth from decay. Factor in that some popular smoothie stands will actually add sugar to the smoothie and every sip you take is coating the gums and enamel with sugar that eventually turns to acid and assists in the buildup of bacteria and the dreaded “P” word: Plaque.

So never drink a fruit smoothie? Run away from that Orange Julius stand at the mall? No. There are some helpful tips to enjoying your fruit smoothie without suffering the effects it has on tooth enamel:

• Use a Straw: Drinking your smoothie through a straw allows the drink to bypass your teeth and avoid direct contact with the tooth enamel.

• Brush Your Teeth Beforehand: Most people might also read this and decide to quickly brush their teeth right after they drink their smoothie. Reverse that. Try brushing your teeth before you plan to have any sugary drink, as the fluoride in the toothpaste will actually help harden the enamel and adds a layer of protection to the coming assault. Brushing your teeth afterward only contributes to the breakdown of tooth enamel and allows the acids to penetrate deeper.

• Pass on the Added Sugar: When ordering your smoothie, ask the preparer to leave out the added sugar. Most fruit smoothies are sweet enough to be delicious just from the sugar in the fruit.

By all means, enjoy the healthful aspects of drinking fruit smoothies, especially when they’re prepared with actual fruit. But keep your total health in mind and be aware of the negative effects sugary drinks can have on teeth.

Dr. Michael Sinkin has been practicing dentistry for over two decades. He truly cares about the experience his patients have and takes great pride in making them feel relaxed and comfortable during every visit. Come in for an appointment and experience a different kind of dental practice. You may even receive a healthy dose of Dr. Sinkin’s famous comic relief!

Many people (including yours truly) who are at least old enough to have college-age children are walking around with “medals of valor” in their mouths, reflective of a dental age gone by. These “medals” or actually “metals” that I playfully refer to are of course silver-mercury amalgam fillings.

Silver-mercury amalgam was the mainstay  of restorative dentistry for generations long before the advent of dental bonding and protective occlusal sealants. Amalgam fillings predate water fluoridation, which began in earnest in the 1950′s (and no, fluoridation was not some Communist plot to poison Americans as some had theorized!).

In those days, was not uncommon for a child to come from the dentist’s office with the news of five or six cavities, each of which would subsequently be treated and restored with silver-mercury amalgam. While I don’t mean this in a pejorative way, “drill-and-fill” was a common moniker for that process of treating cavities. Quite a few of us baby boomers are walking around with veritable mouthfuls of silver-mercury amalgam fillings.

But times have changed. Thanks to preventive dentistry, healthier diets, and the aforementioned fluoride and sealants, numerous teenagers and young adults have never had a single cavity! But there have been recent reports, such as the one cited in this New York Times article, A Closer Look at Teeth May Mean More Fillings, that heretofore pristine mouths are being diagnosed and treated for a condition (I use the term loosely) called “microcavities”. “Microcavities” are not a new phenomenon. In fact, they are essentially a very early stage of the tooth decay process that may or may not develop into a full-blown cavity. Today’s “microcavities” are what dentists have for decades referred to as incipient caries, or to put it more simply, “surface cavities”.

What Causes Cavities Anyway?

A cavity begins with a bacteria-induced acid attack of the enamel surface of a tooth (enamel is the hardest substance in the body). If this acid attack persists, pitting and softening of the tooth structure occurs and renders it susceptible to breakdown. Thus a cavity is born. But incipient caries affect only the enamel of the tooth. They are superficial and do not penetrate beyond the outer half of the tooth’s protective enamel. Incipient caries can be treated with fluoride to re-mineralize the tooth structure and reverse the destruction, thus eliminating the need for a filling.

As mentioned before, not all incipient caries will progress to true cavities. Good clinical judgment is required to make the right decision. “To treat or not to treat, that is the question! Sometimes watchful waiting (along with dietary counseling and fluoride application) is the most prudent course of action. New technologies can help with monitoring and aid in treatment decisions and one such development is Diagnodent, a diagnostic laser that can measure the relative depth and progression of a cavity.

Unfortunately, many of the so-called “microcavities” are being rushed into treatment with fillings. What’s important is this: once a filling is placed into a tooth, the greater the likelihood that the filling will need to be replaced someday.

So, remember, all cavities are not the same. If you are diagnosed with an uncharacteristically large number of cavities, ask questions! While it is not uncommon to see your kids go off to college with perfect teeth and come back with their first cavities (blame it on increased sugar and junk food intake accompanied by a slackening in oral home care) I fear that the “discovery” of “microcavities” has led to over-treatment of what is often a reversible condition.

Over the course of my nearly 30 years of dental practice, I have referred many patients to the orthodontist to correct their misaligned, crowded, or widely spaced teeth. These patients used to be predominantly teenagers, horrified at the thought of how unsightly metal braces would affect their fragile social lives. In the past decade however, more adults are seeking orthodontic care to set their smiles straight. The reason that there is such an avalanche of interest in adults straightening their “crooked teeth” can be summed up in one word—Invisalign.

In the past, orthodontic treatment was synonymous with metal braces, and even with the advent of the more esthetic ceramic brackets and lingual braces (attached on the tongue side of the teeth), metal wires and elastic bands remain an integral part of traditional orthodontic care. Invisalign has changed all of that.

So what exactly is Invisalign?

Invisalign is a minimally visible method of moving teeth without band, wire or bracket. Therapy consists of a series of clear aligners that are worn to gradually move teeth to a more desired position. The Invisalign aligner is a removable and comfortable dental retainer that is fabricated on virtual models that are created using CAD/CAM (computer-aided design/computer-assisted manufacture).

Each aligner is worn approximately 22 hours a day over a two week period. (Simple math leaves one 2 hours a day for eating, tooth brushing and flossing). Obviously because they are removable, an important social occasion or business meeting need not pose a problem, but compliance is critical to treatment success. Generally, aligners are replaced every two weeks to allow for gentle tooth movement over time. Treatment duration varies according to the individual situation, but uncomplicated treatment for crowded overlapping teeth can span 6-12 months. (Richard Bouchez, DDS, Clinical Success in Invisalign Orthodontic Treatment)

I’m a Certified Invisalign Provider in New York

As more of my patients were being treated for their orthodontic problems with Invisalign, I began to study the technique. I became so intrigued with Invisaign methodology that I completed certification requirements and am now an Invisalign provider, and am offering Invisalign treatment to any interested patients.

While I am very excited to broaden the scope of my practice (those of you who know me also know how passionate I am about being a dentist!), I will still refer to my orthodontist colleagues when appropriate. Invisalign is not the solution for all dental crowding problems or misaligned teeth, and for that traditional orthodontic care is very much alive. Schedule a consultation or ask me about Invisalign care at your next visit.

A fast, invisible solution to crooked teeth? Yes please!