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!