Cats Kisses vs Dog Kisses

Like most kids, my little 3 year old niece loves dogs.  One of my all time favorite memories of when she was little, (as if she's really big now, LOL! ), has been when she visited my house as a wee little thing.  She has always had an advanced use of the English language so when she saw my little dog, she pointed and said really excitedly, "Puppies! Puppies!"  I only have 1 dog but with all the jumping around the dog was doing, it may have seemed like more than one!  She even has a "puppy screen cleaner" on her iPad. It's the cutest thing. It is a puppy that looks like he's licking your screen until it's clean. I think there's also ways to customize your "dog screen cleaner" to be different breeds. My breed would be the Pomeranian screen cleaner except in my case, the Pomeranian would stop midway and bark at you, continue licking the screen, then bark at you again before finishing cleaning the screen.

Speaking of dogs and puppies, my patient this morning reminded me of the difference between being kissed by a dog vs being kissed by a cat. That's rather an odd thought, you may say... Read my latest article and find out what goes through my mind when I'm treating patients! Hahaha!

CATS vs DOGS

Our family has always been a “dog family”.  Growing up, we’ve always had an endless parade of dogs in the house. I don’t remember a time when there wasn’t a dog or 2 around.  We have never owned a cat before. The only cats I’ve seen around are the stray ones walking around the neighborhood or the ones that live in the little neighborhood supermarket. There are so many differences between dogs and cats. For one, dogs are much more slobbery with their saliva. Cats don’t show as much drool as dogs do. When you are kissed by a dog, you walk away feeling like you need a shower but when you are kissed by a cat, it feels as dry as sandpaper.

Today I had a patient come in as an emergency. He doesn’t come in as often as we recommend so I was not surprised when he said he thinks he has a cavity.  After x-rays and an exam, turns out that he had 3 teeth that were so badly rotten close to the nerve that there is a big chance that he would need root canal in the future.  The last time he was in my office was about 1 year ago. How did things get so bad so quickly?

Being a good dentist means being a good detective as well so I asked him a bunch of questions. I asked him about his eating and drinking habits; about his brushing and flossing habits; about his health; about stress in his life; about any new medication he may have been taking; about any harmful habits he may have picked up.  The answers were, No, No, No to everything. Nothing has changed. But finally when I asked him about dryness in his mouth, he said, “Yes, actually, I’ve noticed that my mouth has become quite dry at night to the point when I have to get up and drink water several times a night.”  A-ha! This may be the answer to the puzzle! 

When it comes to saliva, I want all my patients to be like dogs and have lots of saliva.  Saliva protects teeth in 3 main ways. Saliva neutralizes the acid in our drinks and in the foods that we eat. That acid can dissolve away the outer part of our teeth. Saliva turns the pH more neutral.

Saliva also contains chemicals that “heal” early cavities.  They help to strengthen the outer layer of your teeth, the enamel.

After a meal, saliva also helps wash away food bits.  The food that sticks around is used by the bacteria in your mouth. These bacteria cause cavities.

So back to my patient that may need 3 root canals, I put in 3 temporary fillings to see how the nerve will react. If the nerve don’t do well and end up dying, he will need to do root canals.  If the nerve survive, I know both he and I will be very happy. Next month, I will talk about possible causes of dry mouth, what to do about a dry mouth and what happened to my poor patient. I hope he’ll be OK!

Happy Monday!!  I almost forgot to post this article. This is part 2 of 2 articles discussing 6 common problems with older teeth. Check on your parents and grandparents. I don't quite remember when was the turning point when it changed from my parents taking care of us to us taking care of our parents. But this is certainly our turn to take care of them.

My Teeth Didn’t Use To Look Like This (Part 2)

As Americans get older, they are keeping more and more teeth in their mouths; and with that, more problems arise.  In last month’s article, I wrote about the first 3 common problems of aging patients that I’m concerned about as a dentist. This time, I will discuss the last 3… oral cancer, crowding and grinding/clenching.

85% of smokers started smoking when they were 21 years old or younger. Every day, people try to quit smoking.  Some succeed, others don’t.  With every exam, I do an oral cancer check. Patients ask me, “I don’t smoke, why would you need to check every time?” Smoking doesn’t cause oral cancer but it increases the risks of it. There are other issues involved besides smoking. Heavy alcohol usages as well as the HPV (Human Papilloma Virus) are also linked with oral cancer. Every year there are close to 43,000 new cases.  The risks increase with age.  As with most cancers, the best chance for survival is early detection at an early stage.  Make sure you have regular visits to your dental office that includes an oral cancer check. Your dentist as well as your hygienist should both do it at every exam.  If your dentist does not check for oral cancer, find another dental office that will care for you.

Crowded teeth… With age, teeth do shift.  It makes it more difficult to clean and along with that comes periodontal disease possibly leading to lost teeth, or decay. 

Your crowded teeth could also be damaged with biting on the new positions.  What are the solutions? The simplest is a retainer to keep the teeth from shifting more.  The more ideal solution is braces to realign the teeth and prevent them from crowding again.  Shifting teeth could also mean gum disease.  Have your dentist check with xrays to be sure what the problem is.  Having fixed a smile with straighter brighter teeth is the easiest way to look younger, my patients tell me!

The last problem with aging is destruction of your teeth and restorations by grinding or clenching.  These are abnormal movements with abnormal strength usually at night.  It’s enough to damage or fracture teeth or crack porcelain crowns. Small fractures associated with everyday biting and chewing can also be more noticeable with age as staining collects in these cracks.  I recommend nightly use of a custom made night guard.  This will not stop you from grinding but it will protect your teeth.  Custom night guards are smaller and more comfortable than the store bought ones. They are more tolerable and patients will wear them more consistently. 

As my mother in law says, “Age is only a number. You are only as old as you say you are. I’ll always be 26!”  

We love seniors at our office and as a courtesy to those 70 and above, we give a "senior courtesy" when they are paying their bill. They usually laugh and wonder out loud whether or not it's good to get old. Fortunately, all the senior patients we have are in good health and have kept the majority of their teeth in good working order.  My MIL (mother-in-law) wonders if I'm able to tell if people have "fake teeth" when they are smiling.

"Sure, Mom, after 4 years of dental school.... I can totally tell!"  

"Even if they look really good?" 

"Mom, usually the better they look, the faker they are!" 

So along with the big influx of seniors this week, I find I've been answering a lot of "senior teeth questions" and giving  a lot of "senior teeth advice".  Here's my newest article for Weekly Biz Japanese newspaper on that topic. Read and enjoy!

My Teeth Didn't Use To Look Like This!

There is always good news in the world of teeth! As my patients get older, I’ve noticed that seniors are keeping their teeth longer.  And on average, according to research, the number of teeth they are keeping are also increasing.

Last week, I had taken a close up smile photo of a patient. When we looked at it on the computer screen, she made a face and said, “My teeth didn’t use to look like that! They’re so yellow and the lowers are a lot more crowded.”

The problem with keeping teeth longer is that different problems come up.  It’s even more important to keep regular dental appointments as you get older. In this article I will go over 3 out of the 6 possible problems of aging teeth. In the next article, I will cover the last 3.

First problem is a big one. Cavities…. Yes, cavities and fillings are not only for young people.  These are cavities around older fillings or at the exposed roots of teeth.

The solution?   Fluoride is also not just for young kids.  The benefit of fluoride is that it helps protect teeth…no matter if it’s young teeth or old teeth.  In addition to the fluoride in your toothpaste and in drinking water, your dentist may have you use an additional fluoride rinse or use a prescription toothpaste with a stronger fluoride concentration. 

Dry Mouth, that yucky feeling…  Saliva also helps protect your teeth against decay. With a dry mouth, this exposes your teeth to more decay.   As you age, the saliva production decreases normally but with certain medications, saliva production is decreased even more. 

Drink more water? You can do that. Some of my patients sip water all day long. Others have found it easier to use a saliva substitute or others have enjoyed chewing a sugar-free xylitol gum.

Gum Disease… With red, puffy, painful gums, there is a big chance for the bone underneath to be affected.  Untreated gum disease can sometimes turn into bone loss which will loosen teeth. 

Keeping regular appointments with the hygienist will keep your gums healthy and teeth clean.  The usual “I’ll see you in 6 months” may not apply in your case anymore.  Ask your dentist which interval you should be on…3 months, 4 months or 6 months. 

If you’re young, speak to your parents about these 3 dental issues. If you’re a senior, ask your dentist or hygienist if you have these problems. That’s your homework. Next article, we will have 3 more topics to talk about!

     With Ebola and the protests in Hong Kong as big stories in the news these days, this may seem like small potatoes to you but I'll pass it on anyway.

     There are new guidelines for fluoride use in children.  NYC tap water has the optimal concentration of fluoride so there's no need to get additional fluoride lozenges or fluoride drops. If you as a parent are taking an active role in keeping your child's teeth clean every day and if you are taking your child to a dental office when the first teeth come in, then you're already ahead of the game.

     Here is my latest article for Japanese newspaper, BiDaily Sun. Have fun reading! Hope you're enjoying and learning something new with the articles.

Dear Diary… New News for Kids

Most people don’t think of cavities as a disease but it is. It is considered the most common chronic disease in children in the United States especially in the poor, young and minority population.  You see, just calling it a cavity makes it seem just OK. But once you call it a disease, well, that makes it seem a lot more serious, doesn’t it?

I was reading in the dental news journal today and I learned something new! In life, I think it’s important to learn something new everyday.  It makes life so much more interesting!  This article quoted a report by the American Academy of Pediatrics in September 2014.   In this report, they gave out new guidelines for fluoride use in children.  Let me share it with you.

Fluoridated toothpaste is recommended for all children starting when they get their first baby teeth. This is regardless of the risk of cavities.

Fluoridated toothpaste the size of a grain of rice should be used up to age 3. 

After age 3, fluoridated toothpaste the size of a pea may be used.

As always, parents should squeeze out the correct amount of toothpaste and supervise and assist with brushing.  This is to make sure all the teeth are cleaned.

Paint-on fluoride in the dental office is recommended every 3 to 6 months starting when the baby teeth come in.

A fluoride rinse is not recommended for children under 6 years old.  This will cut down the risk of swallowing too much fluoride.

With these new guidelines, I hope I can reach a lot of parents.  Every parent wants the best for their child and as dentistry is always improving, I will pass on the information for improving your child’s dental care to you.  If there are any questions about the new guidelines or the anything else, please feel free to call my office. 

Too Early on a Monday Morning to be Feeling Like a "*Por"

     This morning, a typical Monday morning was starting out perfectly chipper.
Slept well last night. Just the right amount of coolness for a snuggly feeling in my quilt. I didn't hit the snooze button so I didn't oversleep. Shower water was just perfect. No need to fiddle around with the hot knob or the cold knob. Laundry was all done over the weekend so clean scrubs were all in a stack neatly. Kids took care of morning routines and breakfast themselves without drama. Looks like they left for school with plenty of time to spare too.

     Light traffic today so  I arrived with plenty of time before my first patient. Jackson left me a sweet "Happy Monday" voice mail. ( I sure married a cheerful guy!)  I must have missed my phone ringing cause I was listening to K-Love radio station loudly.... Having my own worship singing session along with commuting is sublime!

     The rest of the morning's happenings pretty much went like this.....
     Here is the latest article for the BiDaily Sun Japanese newspaper...

     * BTW, "Por" or "Paw" pronounced in Cantonese means "old lady" or "grandma".

Dear Diary…. I’m Such an Old Dentist!

They say that you’re only as old as you feel. They say that age is only a number.

Boy, I certainly felt old today!

When I first started practicing dentistry, I was often asked questions like, “How old are you?” and “When did you graduate?”  Those questions really mean, “Are you even old enough to be my dentist? Can I trust you with your hands in my mouth? Do you know what you’re doing? Am I your first patient?”

While I found it slightly embarrassed to answer those questions, I found myself laughing a bit and answering, “Yes, I know, I look young for my age.” “Yes, it’s good to be Asian and look young.” “Yes, you ARE my first patient… for today.” And “I’m old enough to be your dentist; after all, 2 people call me mother!”

I haven’t kept track of those types of questions as the years went by and so I didn't’ even notice that patients have stopped asking. It’s alright, I tell myself, I’m an experienced dentist and it’s OK not to look young anymore! I’m fine with that. I’m not going to start running out and getting injections to stay looking young!

Today, I was chatting with one of my patients and as we are both mothers with kids around the same age, I asked her how are things with the older son.  She said, “Can you believe it? We have to start looking at colleges this year!”  I almost fell off my chair. Looking at colleges? I remember the first time he came in to my office; he was so little that he didn't want to sit in my dental chair by himself. He had to sit on Mommy’s lap as she sat in the chair. That was how I treated him when he was 3 years old.  As he grew older, he was fine sitting in the chair by himself with Mommy sitting in the corner reading a magazine. As he grew even older, Mommy was able to sit outside in the waiting room comfortably with her magazine until he was finished. And now he’s looking at colleges?

I've always said that part of what I love about dentistry is that I get to be involved in my patient’s lives on a regular basis. I get to meet their family, their co-workers, and their friends.  I also get to hear what’s going on in their lives.

It’s all part of how life is, I guess.  As they get older, so do I.

It’s just that I wasn't ready to admit it early on a Monday morning!  

Happy Left Handers Day!

Today is International Left Handers Day!  

I sent a Face Book shout-out for my South Paw Friends today! (BTW, I've never noticed it before but President Obama is a lefty as well!) I did some Google searching for proven and perceived differences in left handers vs right handers. Fun stuff to read!

When my kids were learning to use crayons and markers growing up, I encouraged them to use their right hand.  Allison always stuck to using her right hand but Harrison would sometimes fool around and use his left hand. A few years ago, he had injured his right thumb so he wanted out of doing homework.

"Mommy, I can't do homework today,"

"Why not?"

"My thumb hurts when I write."

"Use your other hand. If that doesn't work, try your foot. No getting out of homework." 

"OK Mommy" He goes back into his room.

After awhile, he emerges with his homework in hand for me to check. 

I looked at it and everything was correct. 

"What took you so long?"

"I told you my thumb hurts when I write."

"So you wrote slower?"

"No, I used my left hand like you told me to."

Surprisingly enough, the handwriting looked the same....Messy preteen boys handwriting.

Ever since then, he's been able to alternate between using his right hand and his left hand. 

Sometimes I see him using his left hand to write, sometimes his right. He will also alternate with which hand he uses to eat.... even with chopsticks! Makes me wonder if he is a reformed left-hander or is he ambidextrous? 

 I'm sure you all know one or two "reformed left-handers". Does it really matter which hand you use? Granted most people are born right-handed, why is society making such a big deal about being left-handed?  There  are proven differences between left handers and right handers. Some are health related, some are career related and some are personality related, and some are sports related. Some are, you guessed it, are DENTAL related!

Here is my latest article for the Daily Sun Japanese newspaper. I just gave it to my assistant to translate so I thought I'd let you have a go at the English version. Have fun and enjoy!

Dear Diary…. Happy Left Handers Day

August 13^th is International Left Handers Day!  Did you know that the hand you write with affects your teeth? It sure does! Right-handed people will tend to chew more on their right side while left-handed people will tend to chew more on their left side.

Being a dentist for so many years, I get to observe certain things with patients. Certain things are noticed even without doing scientific research and writing a scientific paper on the topic.  Things are usually not equal on both sides of patient’s mouths. Usually one side will have more fillings and cavities than the other. Right-handed people will tend to get more cavities on the right side. I know that is true because I have more restorations on my right side as well. I’m right handed.  Right-handed people will start brushing on the outer left sides of their teeth. They will also brush this side the most thoroughly. They will brush the outer right side of their teeth less effectively. This is the opposite for left-handed people. Different quadrants are easier or harder to reach depending on your dominant hand.

What to do about this? I will have right-handed patients start brushing on their outer right side first. That way, they are more aware of the difference in brushing motion and pressure of the toothbrush. They will also tend to spend more time on that unloved side rather than rushing through it towards the end. I will also tell right-handed patients to turn their heads as they’re brushing to get to the outer right side teeth better.

What’s even better, I tell my patients, is if they use an electric toothbrush with a timer.  That way, the movement, motion, pressure and time is controlled and exact every 30 seconds.  Every thing is the same and no side gets left out.

So whether you are left-handed or right-handed, next time you’re brushing your teeth, pay attention to which side you’re favoring. Make sure to pay attention to both sides of your mouth with the same movements and timing. The result in reducing cavities will make me AND you smile!

Just Do It!

Flossing.... gotta do it.... have to do it... need to do it... do I do it every day?No.... But I need to be listen to what I tell my patients... JUST DO IT!   This morning my patient asked me if I floss everyday.  I'm honest with her. No, I don't floss everyday. But I need to be better at it. Let's work on it together. Here's my latest monthly article for Weekly Biz. For your reading pleasure!

JUST DO IT!

As a dentist, two of the more popular questions I get asked are, “When should I floss, before brushing or after brushing?” and “Should I floss in the morning or at night?”

I’m glad that people ask that because it shows that they are flossing or are thinking of starting to floss. Some patients have been flossing all along but they are just wondering if there is a better way. Other patients have not been flossing and want to get started on the right path. It doesn’t matter which group you belong to. I’m just happy the thought is there.

Recently I saw on the internet that a bowler was able to score 280 by bowling backwards. I’m not an expert at bowling. I’m happy if I get over 100! 280 seem pretty close to a perfect score. He originally started bowling backwards as a bet with his friends. He was bowling badly forward so he tried bowling backwards. It worked and he’s been doing it every time.

Same with flossing, I don’t care if you floss before brushing or after brushing. As long as you are getting in between the teeth and cleaning the bacteria out of there, I’m happy.  In terms of flossing in the morning or at night, I would prefer you floss after every meal but if it’s once, at night. In the morning, most people are rushed to get out of the house to work. Most people would tend to rush brushing as well and flossing would be left out. At night, people tend to have more time to include flossing. Flossing at night would also clean out the food and bacteria that have collected there throughout the day. At night there is also less saliva protecting the teeth for all those sleeping hours so I would want a more thorough cleaning routine.

Be like that backwards bowler. Flossing before brushing or after brushing, doesn’t matter. Do whatever feels comfortable for you. But if you can’t floss after every meal, at least floss at night.  Be the bowler that scores high as well!

How Many Cavities Does My Child Have??

On the tail of the most recent blog post with an article about Baby Root Canals, here is another article I recently wrote for Weekly Biz newspaper. This is informative for parents.

Parents, the American Dental Association recommends that a dentist examines a child within 6 months after the first tooth comes in and no later than their first birthday.  I usually recommend even EARLIER THAN THAT.  The first dental visit is a "well baby checkup" visit more for parents. I go over things to watch out for when baby teeth start coming out, drinking from a bottle, cleaning the baby's gums, etc... I also give parents a chart so they can have an idea of when baby teeth come in, and when the baby teeth change to adult teeth. I also discuss good habits vs bad habits such as thumbsucking, etc...

Hopefully, no parent will have to hear that their child has even one cavity.

8 Cavities on a 6 Year Old?

Mr. and Mrs. N are new patients in my office. Yesterday they bought their son in to see me.  He was going to start school in September and have never been to the dental office.

Every time I see an older child in my office for their first ever dental visit, I don’t know what to expect. I don’t know if their friends have told them any scary stories; I don’t know if their parents have tried to scare them into eating less junk food; I don’t know how they will react to the different instruments and noises in my office; I don’t know if there will be any crying; I don’t know if they will even want to come in!

Turns out, I had no reason to be nervous!  He was very well behaved throughout the whole visit.  He sat still while we took x-rays and watched in the mirror while I checked his teeth during the exam. 

When the x-rays were done, I looked at them together with his parents and him. To everyone’s surprise, he had 8 cavities on his back teeth. All 8 of his back teeth had a cavity on them.  The cavities started from in between the teeth. His parents were shocked. “He doesn’t eat any candy at all! He doesn’t drink juice. It’s only water or milk that he drinks! He doesn’t eat sweets! How could this have happened? What is going on? Are you sure there are 8 cavities? How could there be so many in a 6 year old child?”

After putting on my detective hat and asking questions, I found out that there were a lot of problems.  He was only brushing his teeth once a day in the morning. Not good! The best thing is brushing at least 2 times a day. Once in the morning and then, last thing at night. After the night time brushing, nothing goes in the mouth except water.  The bacteria in the mouth will eat the sugars and produce an acid that will cause cavities.  It’s not only sugar that the bacteria eat; it’s also carbohydrates and “hidden sugar”. Breads, milk, fruit, and other foods also contain types of sugar. It’s not just candy, donuts and ice cream that are problems.

He was also not flossing. Not good!  Flossing your child’s teeth will start healthy habits for life. It will also clean out food particles between the teeth that the toothbrush cannot reach.

Another big problem was that he was not using a fluoride toothpaste.  His parents had seen on the internet that fluoride was not healthy. They were concerned that he was swallowing too much fluoride using the fluoride toothpaste.  At 6 years old, my little patient should have been taught how to properly rinse and spit out.  Fluoride really does do a good job at helping prevent cavities.  By avoiding fluoride, it only added to the how quickly the cavities were formed.

After a long appointment, all the cavities were cleaned out and filled. 3 were actually deep enough that he may need a baby root canal in the future.  This was indeed a very tough and expensive lesson that Mr and Mrs N learned.

I found out later on that Mr and Mrs N are expecting their second child early next year.  They laughed and said that what they do with their first child is always an experiment.  Now they know what to do with the second child!

My Child Needs A Root Canal?? No WAY!

My assistant reminded me that I need to give her a new monthly article so she can translate it.
This one is for the Bi-Daily Sun Japanese Newspaper. I get a personal happy kick out of seeing my face with the article. I can't read Japanese but it's still fun to flip the newspaper open to see myself smiling back at me! Kekeke!

This month's article is on baby root canals. Enjoy and hope parents out there learn something new! If you have any questions or comments, please let me know or you can always ask your own dentist as well.

Dear Diary….  My Child Needs a Root Canal?

Dear Diary….  I received a text message that put a frown on my face. It was from Mr S. His whole family are patients at my dental office.  He was out of town with his family and his 7 year old daughter had a toothache.  They took her to the local dentist. After an exam and an xray, the dentist said she needed a baby root canal. Mr S got worried and called me to see what was going on. A root canal on a baby tooth? Isn't this the same tooth I did a filling on a few months ago? Is a baby root canal the same as an adult root canal? Is it really necessary?

There is no age limit for a root canal treatment. A root canal may be needed when a baby tooth has been hurt from a fall or from an infection.  A few months ago, I had cleaned out a very deep cavity on his daughter but because the decay was very close to the nerve, I told Mr S that the tooth may end up dying in the future. His daughter was having a bad toothache in that tooth now.

A bad toothache is a good indication that the nerve is dying. Once the nerve dies, it becomes infected.  If a toothache is related to eating or drinking something cold or hot, eating or drinking something sweet or acidic, the tooth most likely can be repaired with a filling. Once the pain is constant or throbbing, this can mean that the decay has become worse and gotten closer to the nerve. Another indication of needing a root canal may be the change of color of a tooth. The color may vary from pink to red to brown to grey or even black. There may or may not be pain in this case.

The filling of a baby root canal is also different from that of an adult tooth. A baby tooth’s roots will be resorbed as the adult tooth grows so the baby root canal filling material will need to be absorbed at that later time.

If the infection of a baby tooth has become too advanced, the baby tooth may need to be removed. Losing a baby tooth early may lead to other problems in the future like crooked teeth. 

Root canal treatment on a baby tooth is a much better choice for a child than removing the tooth if possible. Having a baby tooth in place with a root canal will help the child keep full function of all their teeth, jaws and tongue. It will prevent speech problems, eating and chewing problems and helps guide the adult tooth underneath into its proper position.

My little 7 year old patient was very well behaved in new dentist’s chair. Not even needing laughing gas for her injection. Her tooth was saved with a baby root canal in 1 hour. I’m glad that it turned out fine. I called them later that day to see how she was doing. Her dad told me that it went well. But even though she was OK at the other dental office; she wanted to come back to seeing me because she said I always have funny stories to tell her. That put a smile on my face!

What's In Your Baby's Water?

Which is the right water to use for your baby? Tap water? Bottled fluoride water? Bottled non-fluoride water?
 Here is my opinion as a dentist AND as a mom:  my latest article for Weekly Biz Japanese newspaper....

What’s In Your Baby’s Water?

After last month's article, “What’s In Your Water?” I’ve gotten questions asking if it’s OK to use NYC tap water in baby formula powder.   I know there is always a lot of debate with this question. What I will tell you here is what I believe as a dentist and as a mom.

There is a concern about enamel fluorosis that some holistic websites talk about.  This type of fluorosis is usually associated with a higher level of fluoride that naturally occurs in certain local water supplies.  The developing teeth may have some faint white or brownish spots or lines. NYC tap water has a small amount of fluoride added to it.  While there IS a possible risk of mild fluorosis that may occur if too much fluoride is swallowed, the actual appearance of fluorosis is minimal while the beneficial effects of having teeth more resistant to cavities outweigh the possible cosmetic concerns.  

 Mother’s breast milk is best and preferred for a baby until at least 1 year old and if you’re using powdered formula, it’s OK to use NYC tap water.  Brita, a popular water filter system does not filter out fluoride.  I’ve used Brita filtered tap water for my 2 kids growing up and I still recommend filtered tap water for parents. Bottled “baby water” with fluoride added can be purchased at stores as well if you are unsure about your home’s water pipes.  If there is a concern about the possible mild fluorosis then there’s always baby bottled water without fluoride. 

In my opinion as a dentist and as a mom, the slight possibility of mild fluorosis on my kid’s teeth is better than a lifetime of cavities, fillings, drilling and possible root canals and crowns. 

With both my kids, my mother in law took care of them when I went back to work full time.  She grew up in Taiwan where it was usual to boil water before drinking it.  With my kids’ powdered formula, she used the Brita filter AND she boiled the water before cooling it down to use it for my children.  I was born and raised in NYC and personally don’t believe that boiling tap water does anything beneficial so I just used Brita filtered water.  I don’t know about Taiwan water and what’s in it that needed to be boiled before using but I’ve always drank non filtered tap water myself.

The American Dental Association recommends that children have their first dental visit by age1.  That is a good time for parents to discuss these concerns with their dentist.  What’s better is to have the discussion even before 1 year.  In my office, when my patient tells me they are expecting, I will discuss these and other questions with them and give them pamphlets on how to take care of their teeth while they’re expecting as well as how to take care of their baby’s teeth.  Knowing what’s in your water as well as your baby’s water makes sense!

My Homeless Friend, Ron

This is an article I had written for Daily Sun Japanese Newspaper. My assistant, Keiko, translates it into Japanese for me.


Enjoy!

Dear Diary… Dental Supplies for My Homeless Friend, Ron

When I drive to work from Queens everyday, I usually take the same route. LIE to Queensboro Bridge to FDR Drive. On my way from the Queensboro Bridge to the FDR Drive, I usually see a homeless man with a sign on the sidewalk.  As a New Yorker, I personally don’t give money to homeless people but instead I’ll give him snacks that I have in the car. Once in awhile, I will give him the sandwich I made myself for lunch. He certainly needs it more than I do. I can definitely afford to lose some weight and go without lunch for a day!

After a few years of sharing my food, one day, my car was stopped right next to him waiting for the light to change. He looked at me and I looked at him. I asked him, “What’s your name?” I figure that after all these years, if I’m to see him on a regular basis, might as well say Hi properly and address him by his name. “My name is Ron”, he replied.  After that, whenever I hand him a snack in the morning, I say, “Hi, Ron!” with a smile. He smiles back and thanks me for the food.  I noticed that he doesn’t have any teeth in the front. I’m guessing that doesn’t affect his eating habits because Ron is not a skinny guy!

It also made me re-think about the snacks I’ve been handing out to him. Since he’s homeless, he may not be brushing often enough for me to be giving him sugary snacks or cookies each time. As a dentist, I would not want him to be leaving all that food around his mouth and not being able to clean it out properly. It got me thinking; instead of giving him food and snacks, I could give him a toothbrush and toothpaste! That would make sense.

I haven’t seen Ron all winter but now that the weather has warmed up, I’m sure I’ll be seeing him again. I’ll have to remember to keep a toothbrush and some toothpaste in my car so I can give them to him next time. After all, for Ron, going through a difficult time in his life doesn’t mean he needs to lose more teeth because of tooth and gum problems.

What's In Your Water?

My Dad is a huge fan of NYC tap water. Every time he sees any of us drinking soda, we know to brace ourselves for a lecture. Nothing we say fazes him and his lectures of knowledge and experience.

"Dad, I don't even have soda in my house on a regular basis."
"Dad, this is not soda, it's a flavored seltzer."
"Dad, this is at least DIET soda."
"OK, Dad, this is just a plain seltzer!"

According to Dear Dad, everything is bad to drink except:

COFFEE... with milk it's OK (not half and half , certainly no cream! And not just whole milk, it's gotta be skim!)... with some type of sugar substitute. (Somehow, Mr I'm-So-Concerned-About-Healthy-Eating has nothing to say about sugar substitutes when it comes to his coffee. I forget which colored one he uses but according to him, there's a difference. Coffee is also good for preventing Alzheimers. Just NO SUGAR ADDED! He always adds in, "Do you know how many grams of sugar a can of soda contains?? How many of those little restaurant packets of sugar that is?"  Actually, yeah I do, but I'll let you tell me again.

TEA... green tea's the best  but other teas are fine. Just not AS good. And it's gotta be the tea with the loose leaves. Somehow bagged ones are not as good.

MILK... See above comment about whole milk vs skim milk. If he sees my kids drinking milk, he checks the fridge.
"You know, there's no reason to drink whole milk. There's all this extra fat and it's so unhealthy!".  
"Dad, we're doing 1%.  Skim milk tastes gross."
Dad shakes his head.

JUICE... According to Dad... "Ah Yah! All that sugar in the juice. Why not just eat the fruit! You get fiber that way too!!"

WATER... NYC tap water is THE ABSOLUTE BEST!! If he sees us drinking from a water bottle, he'll sigh and shake his head as if we were the town idiots. Why BUY water that comes from an ambiguous source when NYC tap water is the cleanest, best tasting and most of all.... FREE!!  While we do drink tap water at home, we don't refill water bottles and the empty plastic Poland Springs you see on our kitchen  counters are the bottles that we buy when we're outside.We bring the empty bottles home to be recycled. According to Dad, he takes those home because he's afraid our idea of recycling is just putting it to the curb every other Tuesday as part of regular trash recycling.  Dad-recycling means getting cash back.
"Dad, we DO do recycling into machines when we go to the supermarket".  
"No, I know you guys, you are too busy to do it and will just throw it outside out of convenience so I will take it home and get the five cents back myself! You guys are too busy working and earning money and no time to save five cents!"
This discussion never goes anywhere. Hahaha! Asian kids will laugh at this cause you all know this conversation will always go on to mention how we have it so easy these days and how ungrateful we are for the hard work of the parents. Right? Am I right?

So my newest article for Weekly Biz newspaper is on the benefits of fluoride in our tap water. Enjoy the reading!

What’s In Your Water?

Summer is almost here and when I’m thirsty, there’s nothing I like to drink more than fresh, cold water straight from the faucet. Most patients I ask tell me that they drink bottled water or filtered water.  Why, I ask them. NYC tap water is wonderful! When I travel I’m always curious about the taste of different local tap waters.  When I visit my relatives in Toronto, the water tastes fine but I have to hold my nose to drink it. It does not smell good. All of my relatives in California have their water delivered to their house. The water in California does not taste good and it does not smell good. I’m sure it’s fine to drink but no one does. My sister’s town in New Jersey uses well water. She uses it to cook and clean but doesn’t drink it. She even buys bottled water for her two precious doggies. She says the well water upsets their stomachs!

Between now and July, water suppliers across the US have to send their yearly report on water quality. These reports which tell us the quality of our water and what’s in it may be mailed to our homes, in local newspapers or even online on the computer.  I received my report last week.

As a neighbor, I always check to see how clean my local water is and what the government has found in it. It’s always fine. As a dentist, however, I check for one thing… FLUORIDE!

Fluoride is a mineral that occurs naturally in all water sources, including oceans, lakes and rivers. Research shows that fluoride helps prevent cavities in children and adults by making teeth stronger to the acid attacks that cause cavities. Fluoride is nature’s cavity fighter, helping repair the early stages of cavities even before the decay can be seen. Over 70% of the population is currently receiving the benefits of fluoride through their drinking water. While teeth are forming under the gums, the fluoride taken in largely from drinking water and other beverages strengthens tooth enamel making it stronger and more resistant to cavities. After teeth erupt, fluoride helps repair (remineralize) weakened tooth enamel and reverse early cavities.

Studies show that with the addition of fluoride to water to a recommended level for preventing tooth decay, at least 25 percent of tooth decay in children and adults can be prevented. In fact, public water fluoridation is noted as the single most effective public health measure to prevent tooth decay.  The Centers for Disease Control and Prevention has proclaimed community water fluoridation as “one of 10 great public health achievements.”

If you or your family drinks filtered or bottled water, you may be missing out on those benefits. That’s because many bottled waters do not contain fluoride. If you want to know if the bottled water you drink contains fluoride, be sure to check the label. Also, if you use a home water filter and bottle your own water, you may be removing the fluoride from your tap water.  Check your filter and check your bottled water labels. Find out…. What’s in YOUR water?

Things I've Learned from Jackson

Yes, folks, Jackson has made it as a topic of my latest dental article for Weekly Biz Japanese print version newspaper. I write this monthly column in English for them. The monthly dental column for Bi Daily Sun Japanese print version newspaper is translated into Japanese but I'll try to post the English version here too.
As always, enjoy!

One Thing I’ve Learned From My Husband

My patients that come on a regular basis know that I often share fun stories about my family. While most of my stories and newspaper articles center on my 2 kids, once in awhile, my husband is also the topic. 

I've been married to my husband for 17 years but we've been best friends since high school. You can say we've known each other for a very long time.  There’s a saying about people in your life.  Some are there to teach you, some are there to learn from you. They’re all there for a reason.  I've done some of my best learning by being around my husband. One of the best lessons is “Be more friendly and give the world your best smile.”

Those of you who have met my husband know that he loves to be around people. He is one of those super friendly people. He loves to talk to people and engage them in conversation.  If we’re at a gas station, the whole family is in the car waiting for him. Where’s Daddy? He’s outside talking with someone.  If we’re at a restaurant ready to order our dinner, when the server comes over, we usually have to wait because he will want to chat with our server. While at first I found myself impatiently waiting, I've come to realize that in life, it’s always best to get to know people around you. And always, always, give them your best smile!

Spring is finally here in NYC and after a long, cold winter filled with grey skies and dirty snow, we’re all welcoming the warmer weather and colorful flowers blooming.  No other season says FRESH quite like spring! It’s a breath of clean air! Time to put away those thick sweaters and boots and stop hiding under layers of clothing!

Spring is also when our office has a lot of new patients calling in for appointments.  Their friends and co-workers have been telling them about our office and now there are no more excuses for not coming in. No more “It’s too cold” or “It gets too dark after work” or “I’ll just wait for next month”.  It’s not cold anymore, there’s still a lot of sunshine after work and before you know it, “next month” is here already!

Patients usually set appointments for a dental cleaning and a checkup.  Nothing says welcome to warmer weather than a clean and healthy mouth.  There are also patients asking for ways to whiten their winter-dark teeth.  Patients are also asking about how to freshen their breath.  It makes me wonder… are dirty yellow teeth, bleeding gums, and bad breath OK in the winter? I hope not! It’s never a good idea anytime!

So the lesson I've picked up from my husband about being more smiley and friendly, I definitely need to practice it more. If more and more people are smiley and friendly, especially in NYC, I think we’ll be on our way to achieving world peace. Join me and give the world your best smile this spring. But do it with clean teeth, healthy gums and fresh breath!

Braces at Last! The Long Wait is Over!

I just gave this article for my assistant to translate into Japanese.
Here it is in English for your reading pleasure! Enjoy!

Braces, at last!

In 2011, I had written an article about my son wanting braces to close the spaces between his teeth. He has what I call “Big mouth, small teeth”.  He was worried that girls would not want to dance with him during the ballroom dancing class in school. At that time, I told him no braces yet. I was waiting to see if the spaces would close up over time on their own. They haven’t.  So, for 2014, my dear son, your wish for straight teeth comes true.

Part of my decision to wait on putting braces on my son was to make sure he was responsible enough to keep his teeth clean.  Keeping teeth and gums clean and healthy are especially important for people wearing braces. Brushing regularly, as directed by your hygienist or dentist, flossing daily and scheduling regular dental visits can help keep your teeth and gums healthy.  Brushing and flossing remove plaque, a sticky film of bacteria that forms on teeth. If plaque is not removed regularly, it can lead to decay and cavities. 

While my son has been keeping his teeth clean and healthy and he’s not big on eating sweets, there has been another side effect of braces that I was not prepared for.  Every night, there is a request for a slight menu change of what I cook for dinner. My kids are not picky eaters so I’ve never had to make special foods for them at dinnertime.

This time, it’s different.

“Mommy, I can’t have the carrots.”

“Why can’t you eat carrots?”

“Remember? My braces…? Can you make me some mashed potatoes?”

“No, I will cook the carrots to a mushy death for you. I’m not making special mashed potatoes for you.”

The next night…

“Mommy, I can’t have the chicken leg.”

“Excuse me? Why not?”

“Remember? My braces..? I can’t get my teeth to where the bone is. Can you make me a hamburger?”

“No hamburger. Use a knife and fork with your chicken leg.”

Patients with braces should also maintain a healthy diet and limit between-meal snacks. Your dentist may recommend avoiding certain foods that could interfere with braces, accidentally pop off the metal brackets or accidentally bend the wires. These foods may include nuts, popcorn, hard candy, ice and sticky foods like chewing gum, caramel or other chewy candy. 

Eventually my son got used to eating dinner without making special requests. I’ve learned to leave the harder vegetables steaming a little longer just for him. I asked him what would be the first food he eats when he gets his braces off. He answered,” A big fat juicy chicken leg so I can bite into it eat it right up to where the bone is! You can’t just eat a chicken leg with a knife and fork, Mommy. It’s just not the same! ” Everyone’s happy now and everyone will be happier when the braces come off in the future. Straight healthy teeth AND being able to eat whatever he wants to again! 

"I Know What You Had for Breakfast"

I know I've been MIA about my blog for awhile...
It's been a tough year 2013 being a dentist and I've been brainstorming marketing ideas.

As you may or may not know, a large part of my patients are Japanese.
2 newspapers have asked me to contribute monthly columns, Weekly Biz and Daily Sun.
The Weekly Biz column is in English while the Daily Sun column is translated into Japanese by my SuperStar Assistant, Keiko.

So I'm starting out 2014 with committing to post the articles I've written for the Japanese newspapers here as well. I have a whole bunch of them from the past but I figure I'd post the more recent ones as I write them. 

These will be all in English. If you do wish to read them in Japanese, check out Daily Sun. It's  free and available in the Japanese-frequented haunts like Mitsuwa in Edgewater, NJ; Sunrise Mart all over Manhattan; Dainobu in Midtown, etc...

Other healthcare professionals also have ongoing articles in those papers but (patting myself on the back), my patients have told me that mine are fun to read and they're not so serious and scary. I'll have to take their word for it, I can't read Japanese.

 And always, these stories are gathered from decades of being a dentist. Over the years, these stories have details changed or eloquently added onto so any similarities to actual patients are to be disregarded. They are only told and printed to make a dental point or lesson.
Enjoy the reading and arigato!!

I Know What You Had for Breakfast

One of the things that I’ve learned as a dentist which I don’t think other people know how to do, or would want to do, is the ability to identify previously chewed up foods that are stuck between patient’s teeth.  As yucky as that sounds, it’s actually useful because it lets me know when the last time the patient flossed or brushed their teeth was. I can just picture all my readers making a face just about now. This is not exactly what you wanted to read about opening the newspaper today, right?

I had a new patient come in complaining about a hole in her back tooth that needed a filling. When I looked into her mouth, the hole was so big that there was a sesame seed stuck in there. When I asked her when the last time she had eaten sesame seeds was, she looked surprised. “A sesame seed? That’s not possible, that would’ve been breakfast 2 days ago when I had a sesame bagel. It’s probably a strawberry seed from this morning.”

My dear readers, it wasn’t a cute dainty strawberry seed, and it wasn’t from this morning. It was definitely a sesame seed and it was from 2 days ago. The hole she came in for ended up so big and deep that after cleaning it out, the cavity was into the nerve and the tooth needed a root canal and a crown.   But even after all that, she was still convinced it was a strawberry seed.

Most of the time, in the office, patients are polite and go to the restroom and clean their teeth before sitting in the dental chair. Others just say with a smile, “I’ve just come from lunch so if you find anything in there, haha, sorry!” 

If there are areas in your mouth that tend to catch food, please let your dentist know.  Also, during an exam, your dentist or hygienist will point out areas that you are collecting food. Be sure to clean those areas extra well, pay careful attention to flossing and brushing especially after meals. If you don’t have a toothbrush handy, swishing or rinsing vigorously with water after meals will help as well.  Areas that always collect food in between teeth may sometimes be fixed with replacing a filling or a crown to tighten the spots.  Areas that collect food on a regular basis over time may lead to cavities or gum problems.  So while I find it interesting that after all these years of being a dentist, I am able to identify food bits in my patient’s mouths, I’d much rather not see any at all!