Making Life Easier

As a mom, I subscribe to the theory of KEEP IT SIMPLE.  Having 2 kids, I don't want to keep repeating myself on everything. So I've boiled it down to the base essentials of numbers and lists.
Bedtime routine ever since they were little was: bath, brush, floss, rinse, pjs.  That was condensed down to "Time to go to bed. Do your 5 things." It just makes life easier to remember and prevents me from repeating myself too much. Now mind you, I still have to repeat myself many times when it comes down to having a clean and tidy room now that they are teenagers but I try to keep the repeating down to a minimum.

The ADA (American Dental Association) has come up with 6 easy to remember tips on how to prevent cavities. And just in time, I have an article I need to give to Hannah, my assistant, to translate into Japanese for me.  She has an alert on her iPhone as a reminder.
She asked me in the morning, "Dr Lee.... you need to write an article for me".
"OK, Hannah, I'll give it to you by the end of today."
Later on in the afternoon...."Dr Lee.... remember the article."
"OK, Hannah, I promise you I'll get one out to you before I leave. I know exactly what I'm going to be writing about."
As I hand the newest article for her, with the deepest bow, "Arigato, Hannah, what ever would I do without you!"

For your reading pleasure as always:

Dear Diary… Nothing’s Hurting So I Don’t Need to Come See You

Dear Diary…

Last week, a patient whom I haven’t seen for a few years came back in. We had been calling her every few months as a reminder to have her cleaning and exam. She always returned our phone calls but says she was busy so I was surprised to see her on my schedule.  Sure enough, something was hurting.

A new report from the ADA (American Dental Association) recently states that 91% of Americans from ages 20-64 have had cavities at least once in their lives.  27% of people over the age of 20 have untreated cavities in their mouths that they may not be aware of.  Many Americans that do not plan on visiting the dental office in the next year say that cost and the belief that they do not need dental care to be the main reasons. In other words, “I’d rather spend my money somewhere else than on my health” and “Nothing’s hurting so I don’t need to come see you.”

As a dentist, we are not just here to “fix things”; the other job that I also take seriously is education and prevention.  In my opinion, education and prevention needs to be emphasized as the final answer to decreasing dental disease. 

Education is teaching people the need for them to keep their teeth healthy as they age. What causes gum disease?  What causes tooth decay? Prevention is equally important. What can be done to prevent tooth decay in the first place?  Fluoride added in drinking water, sealants for children, teaching adults to take care of their families’ teeth and gums. 

The ADA has come up with 6 easy ways to prevent cavities. 

-          Beware of dry mouth. Dry mouth is the side effect of many medications and it can cause cavities. Talk to your dentist or hygienist about ways to prevent dry mouth.

-          Brush 2x/day with a fluoride toothpaste.

-          Floss at least 1x/ day.

-          Drink water with fluoride. Limit bottled water, sports drinks, sodas, juices, etc…

-          Eat more fruits and vegetables.

-          Visit the dentist regularly for checkups.

My patient had a cavity that I was able to fix that same day.  It was an educational lesson for her that the cost of prevention is less than the cost of that filling and time spent away from work.  When she left, she made her next appointment for a checkup and a cleaning and she wrote down the 6 tips from the ADA. She told me she would tape it on her bathroom mirror at home and tape to her computer at work so she could be reminded when she was at home and at work. The perfect example of education and prevention!  

Stealth Dentistry

After I treat a patient, I always show them a mirror so they can see what things look like.
If it's something in the front teeth, they always remark with a smile, "Wow, I can't even see what you did!"
"Smile with confidence!", I say, "The more you smile, the better advertisement for us!"
If it's something in the back, they still always remark with their mouth wide open, "Wow, I can't even see what you did!"
"Stealth dentistry! That's why we do here. No one needs to know what's going on with your teeth", I say. "If people can tell, that's not good. Everything needs to blend in."

This blog post is about a different type of stealth dentistry. It should actually be called "Competitive Dentistry". Having 2 kids less than a year apart, my 2 sometimes get as competitive as this set of brother and sister do.  Ain't nothin' like a little sibling competition!

As always, for your reading pleasure!

Shhhh…. Secret Dentistry

My last patient yesterday was a 12 year old little girl. She and her brother have been coming to my office since they were 7 and 8 years old. They are always in competition with each other. Who gets better grades in school? Who plays better tennis? Who runs faster? Who plays better piano? 

Two years ago, their whole family came in and I had to tell their father that Brother had a cavity, Sister was smiling and saying, “Ha, ha! My teeth are better than yours!”

Today, I found a cavity on Sister’s tooth. “Oh no! I’ve never had a cavity before! Are you sure?” she asked me.

“Yes, I’m sure. “ I showed her an enlarged picture of the tooth with my camera on my computer screen. Having the cavity look so large on my computer made it unmistakable.

“Don’t tell Brother I have a cavity! He will laugh at me!” she made me promise.

“Yes, I don’t talk about your teeth in front of your brother,” I promised her.

With the white fillings, they look so natural that no one can tell what was done.  After I finished filling her tooth, I moved her seat up and handed her the mirror.

“Wow! I can’t even see what you did!” she said surprised.

I told Sister, “No one will know you have a filling on that tooth except for the 3 people in this room. Me, my assistant and you!”

“Good!” she said and made me promise again not to tell Brother.

I promised one more time.

As she was leaving, I said, “I made a mistake, there WILL be one person in your family who will know you had this filling.”

“Who?” Sister asked, worried.

“Your dad. Because he will be the one paying for your filling!”

“That’s OK, as long it’s not my brother!” she said with a smile and left my room with her ponytail bouncing along.

A New Year, A New Cheer!

Happy New Year, Everyone!!
New Year Days are best spent with people you love and who love you back! This New Year Day, we did an early breakfast run and woke up some of our favorite relatives.

Surprisingly, we were all up early for New Year's Day considering we were partying hard and rang in the New Year at Dave and Buster's the night before on New Year's Eve. We even got my Dad to play a few games of 4 people Air Hockey! When he agreed to step up to the arcade game, my first thought was, "Wow, is he really going to forgo the usual Dad-ism of : "This is a total waste of time and money!" as he took an air hockey paddle." We battled hard and competitively with arms flying around and 3 pucks whizzing about. I had such a fun time that I don't remember who won.  I just know it wasn't me.

Breakfast of assorted hot bagels, salmon cream cheese spread, egg salad, whitefish salad, lox slices, and coffee hit the spot! I'm so glad they were home since it was an impromptu visit.  Thank goodness the bagel store was open too! Other people must've had the same idea we had cause there was a line out the door.
As the cousins came into the kitchen rubbing the sleep from their eyes, big hugs were exchanged. Seeing everyone sitting at the long table, chatting and laughing, I felt such a feeling of warmth and blessings. Indeed, getting together with friends and family are the best way to start off celebrating the New Year. Celebrating with food, laughter and ......LOVE!

This new article for the Japanese newspaper is spot on for feeling your best and looking your best for these dark cold days.  Read and enjoy!

Quickest Way to Look Young for the New Year

Happy New Year, Everyone! For all our patients, thank you for choosing our office to be your Dental Home. Thank you for having the confidence in referring your friends, family and co-workers as well! We wish you all health, happiness and years and years of healthy, beautiful smiles!

Getting together with friends and family on New Year’s Day is the perfect way to start off 2015. When patients come into our office, they get a warm “Happy New Year!! How did you celebrate? Did you celebrate with family and friends?” 

One patient said she had gone to see her cousin's family. Some of her cousin's kids were away for college or not living at home anymore so it was great seeing everyone again together. “My cousin had been busy for the past few years taking care of her aging parents as well as her own family and she looked noticeably older this time”, my patient said. “Even her teeth looked really yellow next to her children’s smiles.”  Oh boy, poor Cousin, having a stained smile can really age your looks!

Ladies and gentlemen… never fear, here is the quickest way to look young for the new year! Brighten that smile! It will make you look great and feel fabulous!

Sounds like a TV ad, doesn’t it? But it’s so true. Whiter teeth are associated with youth, energy, beauty and a healthier lifestyle.  When people have a brighter smile, they tend to smile more, are more confident and are seen as friendlier. 

While there are a lot of different whitening products, the custom-fitted tray whitening done at home is most common and easiest. Models are taken in the dental office and a thin custom plastic tray is made for you.  A small amount of whitening gel is placed in the trays and worn for a brief time during the day or overnight while you sleep.  Results can usually be seen in a few days but it usually takes 1-2 weeks to see the full whitening effect.  This gradual whitening of your teeth over time will be less noticeable to others and less sensitive.  Some sensitivity maybe experienced but this disappears when the whitening gel is discontinued.

Whitening is completely effect in 78% of people.  In some cases, whitening may not be the best choice to brighten their smile.  Talk to your dentist to find out if you’re a candidate for whitening.

Day by day, to keep your teeth as white as possible, avoid staining foods and beverages.  Anything that can stain a white shirt can stain your teeth.  Use a whitening toothpaste to brush and floss away plaque that can attract stains.  If possible, drink staining beverages through a straw or rinse with water afterward if you cannot brush.

Above all, have regular dental appointments to keep your smile healthy. After all, it’s good to be beautiful but it’s better to be healthy AND beautiful! 

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.