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!