History was made in the NFL as the New Orleans Saints capture the Super Bowl Title.

Posted in PPM on February 9, 2010 by dukeslc

History was made in the NFL as the New Orleans Saints capture the Super Bowl title. The Saints achieved a milestone two weeks ago when they captured the NFC title, a first in their franchise’s history, only to journey to the greatest showdown of their careers and end it with the most spectacular triumph! Tracy Porter, a PPM devotee, intercepted a pass thrown by Colt’s quarterback Peyton Manning, a defining moment leading to the Saints stunning victory. Not too long ago, Jon Gruden, color analyst and former Tampa Bay Buccaneers and Oakland Raiders Head Coach talked about a new sports product created by Dr. Anil Makkar called the Makkar PPMTM. Gruden cited the recent success of the Saints and claimed that the mouth guard has unleashed game-changing performance benefits in balance, strength, flexibility, range of motion and endurance. That product was in the mouths of a number of team members as they experienced their best season and clinched the greatest victory that created a new chapter in the franchise’s history!

How does it work?

“When the jaw is down and forward, the back of your neck starts aligning with the back of your spine. When you have total alignment you have increased strength, balance, range of motion, and an increase in flexibility and endurance,” said Dr. Anil Makkar. Doctor Makkar also points out that a vast majority of the population is not in proper alignment.

The custom fitting process uses the latest in neuromuscular dental technology. The precise proper alignment of the lower jaw is the goal of this process. Two key technologies are used. The first is known as a “TENS” machine and it relaxes and deprograms the jaw muscles. The second is a K-7 and it tracks jaw movement and position to within a tenth of a millimeter. These devices, along with the principles of neuromuscular dentistry are key to relaxing the jaw and de-programming suboptimal nerve patterns to determine the perfect jaw position – “the sweet spot”, unique to every individual similar to a fingerprint – no two people can have the same. The process takes about 1.5 hours. This machine relaxes the major muscle groups of the face, and thereby putting the jaw in a relaxed state. Once the right position of the jaw is found, it is captured in a dental impression. This bite is then sent to a PPM certified lab where the mouthpiece is custom fabricated. This special bite is the foundation to the athlete’s ability in unleashing their true potential. Once the athlete bites into the Makkar PPMTM, the muscles in their face become completely relaxed, which allows them to use more of their upper and lower body strength.

In addition, it also makes sense that proper positioning relieves the pressure against the cranial nerves, thus relaxing the muscles attached to those nerves giving you added strength, flexibility and balance. Those same pinched nerves affect the brain on the flip side and can alleviate migraine headaches. The articular disc is free from pressure. This makes sense for your increased head range in the “over the shoulder look” (great for wide receivers looking for the ball… or quarterbacks looking for 3 extra inches on the blind side). Relieving pressure on the articular disc also promotes spinal alignment… Once again adding to muscle relaxation and increased strength, flexibility and balance.

In addition, proper jaw alignment naturally opens your windpipe increasing oxygen supply. It’s no wonder Pro Boxers like World Champion Andre Berto, a Makkar PPMTM devotee, have high levels of endurance in the 12th round. Jon Gruden was asked in testing to hold his breath for as long as he could. This was done without the PPM. He hit 40 seconds. With the PPM and 15 seconds recovery he held his breath for 57 seconds. Jon couldn’t believe it! With the PPM, clearly he was able to increase his oxygen intake. According to John Gruden “An NFL player would not put a $2,000 mouthpiece in his mouth if it didn’t work. That I do know.” Other well-known athletes in hockey, baseball, basketball, PGA & LPGA, as well as thousands of amateur athletes share his enthusiasm. Regardless of your sport, whether you’re a pro athlete, an amateur or a fitness enthusiast, the Makkar PPMTM has a proven track record of success.

PPM in the News!

Posted in PPM on November 17, 2009 by dukeslc

If any of you were watching Monday Night Football with the game between the Saints and the Falcons, you might have heard talk about this new amazing mouthguard that the Saints are using that can help achieve better balance, flexibility, stamina, and strength. It uses Neuromuscular principles to achieve the correct bite that aligns the body and opens up the air passages to increase oxygen intake. It’s exciting to see others discover what we have been doing here at Dental Designs of Salt Lake. Dr. David Duke uses those same principles of neuromuscular dentistry to establish bites. We also use the mouthguard (PPM – Pure Power Mouthguard) in all types of sports. Golf is one that you wouldn’t think of, but because of the increase in stability and balance, it has proven itself; just ask Scott McCarren! Let us help you in your sport! Contact our office at Dental Designs of Salt Lake, and Dr. Duke would love to help you.

Here is an article about it in USA Today!


Neuromuscular mouth guard draws performance debate
Updated 2h 18m ago | Comments 4 | Recommend 8 E-mail | Save | Print | Reprints & Permissions |

Enlarge By Andrew Councill for USA TODAY

Redskins defensive tackle Kedric Golston is fitted for a neuromuscular mouth guard, which proponents say helps athletic performance by relaxing body muscles and improving airflow.

UNLOCKING THE JAW’S SECRETS

The concept of a mouth guard that allows athletes to maximize muscle efficiency throughout the body with the perfect alignment of the lower jaw isn’t new, but the technology is.

Many attempts were made to develop such a product since the 1960s, but that was largely done by guesswork. In 1987, however, Seattle-based Myotronics hit the jackpot with Kinesiograph 7, or K7. Founded in 1966 by the late Bernard Jankelson, Myotronics is credited with producing the jaw-tracking machine.

It uses a magnet below the lower teeth, coupled with a sensor that’s attached around the skull, to follow the jaw’s movement via computer program. It can determine when the muscle fibers are at their optimal position, which is supposed to translate into better strength, balance and flexibility.

“It’ll give you the ability to pinpoint the longitude and latitude in the mouth,” says Alex Naini, a Vienna, Va.-based neuromuscular dentist. “If the jaw muscles are stretched too much, they’re too open. If they’re contracted, they’re working too hard. You want them in between.”

Without the J5 TENS (Transcutaneous Electrical Neural Stimulation), however, the K7 can’t work its magic. The J5 is similar to the treatment patients receive in physical therapy, when high-frequency pulses are sent to stimulate muscles.

“It flushes out your system,” Naini says of the J5, which pumps fresh blood into muscle fibers and drains out waste, namely lactic acid that contributes to muscle tightness and soreness. “It’s like getting a deep-tissue massage.”

By J. Michael Falgoust

ShareYahoo! Buzz Add to Mixx Facebook TwitterMore Fark Digg Reddit MySpace StumbleUpon Propeller LinkedInSubscribe myYahoo iGoogleMore Netvibes myAOL
By J. Michael Falgoust, USA TODAY
Fatigue can be as much psychological as it is physical, especially for an NFL lineman who weighs in excess of 300 pounds late in a 16-game season.
After misplacing his neuromuscular mouth guard for a few games, Derrick Dockery, a 6-6 guard now in his second stint with the Washington Redskins, immediately recognized the difference.

Or so he thinks.

“The hardest part is to distinguish if it’s psychological,” Dockery says. “Is it? … I got more winded the games I didn’t have it in compared to the games I did have it. My breathing felt different when I wore it. It seems like you have more energy.”

All mouth guards are designed to direct and distribute the impact of force to the jaw to minimize injuries such as lacerations, damaged teeth and concussions. Neuromuscular mouth guards are different from the traditional boil-and-bite ones that can be purchased at sporting goods stores, and even from the custom-fitted ones dentists often make for individual players of pro sports teams.

Rather than focusing on the pre-existing relationship where the teeth come together and the jaw joints set in the sockets to find the bite like traditional dentists, neuromuscular dentists relax the muscles for a “verifiable position” that usually results in a joint socket position that’s typically more down and forward.

“If you pull the jaw forward, your tongue is forward, you have more space in the back. It’s that simple,” says Alex Naini of AestheticDentalSpa.net, a neuromuscular dentist in Vienna, Va., outside Washington D.C., who fitted Dockery. “Anything that pulls the jaw forward opens the airway and automatically releases tension in your jaw joints. You have more space to let oxygen into your lungs.”

GALLERY: Making a neuromuscular mouth guard

Pro athletes from various disciplines, including the NBA, soccer, mixed martial arts, boxing, golf and Major League Baseball, have worn neuromuscular mouth guards because they believe they can maximize their natural abilities such as endurance, strength and flexibility.

By aligning the lower jaw over the C1 and C2 vertebrae, which sit atop the spinal column to connect the skull to the spine, a clear path is created to increase air intake. The oxygen bump is supposed to help the muscles perform stronger tasks and repeat those tasks longer.

Use of the appliance — originally developed to treat jaw joint disorders, which includes migraine headaches and ear, neck and joint pain — still isn’t widespread and has yet to gain acceptance among athletic trainers.

“Everybody’s looking for that edge over their opponent,” says Dockery, who also cites better balance and isn’t paid to endorse the product. “If it works, why not try it?”

The power train

It began with a theory in 1950 by the late Bernard Jankelson, the father of neuromuscular dentistry. He coined the name in 1967 after researching with H.H. Dixon, a muscle physiologist, at University of Oregon School of Medicine.

Jankelson graduated from dental school at Oregon in 1924, but biophysics had the imaging technology he needed to test his theory that stimulation could restore muscles to their normal function and resting length to eliminate muscle pain. That technique could then be applied to the jaw and facial muscles to kick-start a chain reaction to make the human body perform at a higher level.

“What we hypothesized is if you can get the muscle healthy before you set the jaw position, you will have a much more desirable muscle to help you generate efficiency for either force or speed,” says Robert Jankelson, 70, who joined his father in 1963 and has practiced for 45 years in the Seattle area.

The teeth function as the “gears,” he says, and it is imperative that they’re in sync with the joints and muscles to make recruitment of strength throughout the body easier.

The key lies in the temporomandibular joint (TMJ) — two three-dimensional ball sockets, one on each side of the face, that connect the lower jaw to the skull. The goal is to restore the ideal position of the balls in those sockets to align the muscles.

“That’s where that mouthpiece comes in. It allows the best joint function and recruitment of the power muscles of the jaw, that’s when you increase your athletic efficiency,” Jankelson says. “This power train goes all the way down, from the teeth, to the neck, the vertebrae, the back. The more you can get those articulations in a chain that will recruit the power muscles, that is your ultimate goal in repositioning the jaw.”

Since the advent of Gatorade in 1965, researchers of all stripes, athletes, athletic trainers and even dentists have sought alternative methods, liquids and devices to boost performance. Most notably, the U.S. Olympic bobsled and luge teams wore custom mouth guards produced by an orthodontist at the 1980 Winter Games. They claimed it was responsible for the bobsledders’ best results in 16 years and best-ever results for the lugers.

The mandibular orthopedic repositioning appliance, or MORA, was touted as a stress reliever for the TMJ that made decathletes stronger and college pitchers throw harder.

The Journal of the American Dental Association, however, published a 1984 study after 14 Louisville football players were tested using no mouth guard, a placebo and a MORA. It concluded there was no difference.

While the MORA was a start, it amounted to educated guesswork.

“It was hard for it to be reproducible, so the studies on its effectiveness were mixed because there was no predictability behind the technique,” says Gary Lederman, a New York-area neuromuscular dentist who has fit athletes such as Shaun Ellis (New York Jets) and Paulie Malignaggi (junior welterweight boxer). “There was no way to evaluate the athlete and find the precise point that it worked.”

David May, his West Coast partner at Fightdental.com, has fit a number of mixed martial artists, including Anderson Silva (UFC middleweight champion) and Lyoto Machida (UFC light heavyweight champion).

The difference between the MORA and a neuromuscular mouth guard?

Science, Jankelson says. The MORA relied on an orthodontist’s pinkie fingers being inserted into a patient’s ears to determine if the TMJ is misaligned. Then, in an attempt at realignment, the jaw was pushed forward.

Neuromuscular dentistry relies on the J5 and K7, the latter of which received the Seal of Acceptance from the American Dental Association in 1986 for its safety and effectiveness. The J5 machine uses low-frequency pulses to relax the facial muscles so the optimal position of the jaw can be found by the K7 using computer-assisted tracking.

Struggle for acceptance

Although there are notable athletes who have worn the mouth guard, such as Terrell Owens (Buffalo Bills), Shaquille O’Neal (Cleveland Cavaliers), Michael Redd (Milwaukee Bucks) and Suzann Pettersen (LPGA), it has not become mainstream or picked up by a pro sports league the way Breathe Right strips became commonplace in the NFL.

The New Orleans Saints this season began using neuromuscular mouth guards, which are not available over the counter. Marketing of the product has been minimal, and depending on the fee charged by the lab that makes it, it can cost as much as $2,000, though Naini says she can produce it for less.

The ADA, however, doesn’t recommend neuromuscular mouth guards. Even though it gave the K7 its Seal of Acceptance, the organization doesn’t recognize neuromuscular dentistry as one of the nine specialties. As of 2006, there were 179,594 active dentists in the USA, but neuromuscular dentists aren’t accounted for in those numbers (estimates are about 3%, or 5,388).

“Dentists push your jaw back. That’s what’s taught in dental school. Even though the science is overwhelming, there’s still resistance,” Jankelson says. “Nobody wants to be proven wrong that pushing the jaw back doesn’t make sense.”

John Norwig, the president of the Professional Football Athletic Trainers Society, wants to see the science tested through independent study in the USA, which has yet to happen.

“In the athletic training literature, there hasn’t been any landmark studies. This appliance may be a great breakthrough, but there’s not any hardcore research in any of my professional journals,” says Norwig, who has worked with the Pittsburgh Steelers for 19 years.

“What we try to do is use something that has some science behind it. Years ago, they didn’t use sports beverages, but now sports beverages are the standard of care. … If it’s something that works, I’m sure it’ll make its way into the NFL.”

Says Naini: “A lot of people just haven’t been exposed to it. They don’t understand it. And let’s face it, a lot of athletes who use it like keeping the edge to themselves.”

Invisalign

Posted in Dental on September 25, 2009 by dukeslc

Does your smile reflect the real you?
Invisalign makes it easy to straighen your teeth without band, brackets, or wires. Invisalign is a virtually invisible solution so you can smile during as well as after treatment. In fact, virtually no one will know you’re wearing them unless you tell. By using a series of clear removable aligners, Invisalign straightens your teeth right before your eyes. Change them about every two weeks and your teeth will move- little by little- towards the smile you have always wanted!
Invisalign is comfortable to wear and it doesn’t require you to change you busy lifestyle. You visit your doctor every month or two to chek your progression and get new aligners. Average treatment time is only about a year. Because aligners are removable, you can continue to eat your favorite foods while brushing and flossing normally to keep your teeth and gums healthy.
Hundreds of thousand of people have already discovered Invisalign. Maybe it’s time you were one of them. For more information, visit www.invisalign.com or better yet come visit Dr. Duke and get started as soon as possible. Call for a consultation. 801-355-2202
It’s your turn-Show the world who you really are!!!

Dental Visit (A Classic)

Posted in Uncategorized on July 6, 2009 by dukeslc

Sleep Apnea Dentistry

Posted in Uncategorized on June 16, 2009 by dukeslc

sleep apnea dentistryObstructive sleep apnea, or OSA, occurs when a person stops breathing for 10 seconds or longer, repeatedly during a sleep session. This form of sleep apnea is often accompanied by snoring because the obstructing tissues tend to vibrate as air enters the body.

Research and media attention have made some of the effects of sleep apnea commonly known. They include but are not limited to:

• Anxiety
• Attention problems
• Daytime fatigue
• Depression
• Diabetes
• Falling asleep at inappropriate times
• Fibromyalgia
• Gastric reflux
• Heart attach
• Hypertension
• Impotence
• Increased risk for heart attack
• Irritability
• Memory, concentration problems
• Muscle pain/fatigue
• Snoring
• Stroke
• Weight gain

New research from Emory University tells us that an enzyme called NADPH oxidase play a role on blood vessels located in the lungs of sleep apnea patients. One in 50 women and one in 25 men have sleep apnea, a potentially serious condition that can increase risk for heart disease and vascular disease. In the study performed on mice, oxygen deprivation caused pulmonary hypertension, which means the heart’s right side could not effectively pump blood through vessels. The oxygen deprivation (chronic intermittent hypoxia) also causes blood vessels in the lungs to make more NADPH oxidase. While NADPH oxide is good in that it makes superoxide, a free radical that helps the immune system eliminate bacteria, it also inhibits nitric oxide, a chemical that relaxes blood vessels. Read the full article in American Journal of Respiratory Cell and Molecular Biology.

A number of factors contribute to a patient developing sleep apnea. Anatomy, heredity, weight, and diet are a few. In the US, an estimated $1.9 billion is spent on healthcare for sleep apnea patients in the ER and ICU. In addition, the 10% decrease in productivity for sleep apnea patients results in about $75 billion lost annually.

What are dentists doing to combat sleep apnea in their patients? Dentists can work with physicians and sleep labs in an interdisciplinary approach for oral appliance therapy (OAT). This conservative treatment often works well for CPAP-intolerant patients. An oral appliance holds the lower jaw forward so that soft tissues do not collapse and block airflow during sleep. A few oral appliances reposition the tongue or force nose breathing, but these are less common.

Popular appliances include:

• Adjustable PM Positioner
• AMP Ultra
• aveoTSD
• Clasp-Retained Mandibular POsitioner
• CPAP Pro
• Elastomeric Sleep Appliance
• EMA – Elastic Mandibular Advancement Appliance
• Herbst Telescopic Appliance
• Hilsen Adjustable Positioning Appliance
• Klearway Oral Appliance
• MDSA – Medical Dental Sleep Appliance
• MIRS – Mandibular Inclined Repositioning Splint
• NAPA – Nocturnal Airway Patency Appliance
• NORAD Appliance
• Nose Breathe Appliance
• OASYS
• OPAP – Oral Pressure Appliance
• OSAP
• SAAMS – Sleep Apnea Management System
• SEGA – Sleep Apnea Goldilocks Appliance
• Silencer System
• Silent Nite
• Snore-Aid
• SnoreFree
• SnoreGuard
• SNOR-X
• SomnoGuard 2.0
• SomnoGuard AP
• SomnoGuard AP Pro
• SomnoMed MAS
• TAP – Thornton Adjustable Positioner
• TheraSnore Adjustable
• TRD – Tongue Retaining Device
• Z-Appliance

What is the Perfectly “White” Smile?

Posted in Uncategorized on June 16, 2009 by dukeslc

smile-and-dental-mirror1A bleach-white smile doesn’t look sensational on everyone, according to a study in JADAtitled, “Assessing the Influence of Skin Color and Tooth Shade Value on Perceived Smile Attractiveness.”

By altering skin tone and tooth brightness on photographs of smiling women, researchers created a way to test how people perceive beauty in regards to tooth enamel color. Seventy dentists and 70 laypeople answered questions about the photos. The findings show that skin color affects the shade that is attractive on teeth.

According to the report:

“Dentists and laypeople did not perceive the brightest tooth shade to be the most attractive, and they did not perceive all skin colors to be equally attractive with bright white teeth. Respondents perceived dark skin with bright white teeth and fair skin with dark teeth as relatively unattractive.”

SOURCE: http://jada.ada.org/cgi/content/abstract/140/6/696

What’s in Your Water??

Posted in Uncategorized on May 19, 2009 by dukeslc

 What is Fluoridation?

Fluoride is a mineral that occurs naturally in most community water supplies. In the 1940s, scientists discovered there was an optimal level of natural fluoride in these water supplies that was high enough to significantly reduce dental cavities among the residents but low enough to avoid serious side effects. Fluoridation is the adjustment of the natural fluoride concentrations to achieve this optimal level about one part of fluoride to one million parts of water. Reliable scientific data have consistently indicated that water fluoridation is a costeffective, safe and practical means for reducing the incidence of dental caries.

How does fluoride prevent cavities?

Fluoride researchers originally thought that fluoride changed the tooth surface and inhibited cavities only when incorporated in dental enamel as the tooth was developing, before the tooth erupted into the mouth. More recent research indicates that fluoride works primarily after teeth have erupted, especially when small amounts are maintained constantly in the mouth, specifically in dental plaque and saliva. Thus, adults also benefits from fluoride, rather than only children, as was previously assumed. Studies have shown that optimal water fluoridation reduces the amount of decay in children by as much as 4060% and nearly 35% in adults. Maximum decay reduction is realized when fluoride is available in the right amount, in the right place at the right time. Water fluoridation helps maintain an appropriate concentration of fluoride in the mouth.

Why is fluoridation being considered by some Utah communities?

Fiftyfive percent of Utah children six through eight years of age have at least one filling or untreated cavity. These rates are higher than in many other areas of the country. Utah adults also have dental restorations and decay at a rate that is above the national average. Utah community water supplies already contain some fluoride but at suboptimal levels. Only 51% of Utah citizens have drinking water with fluoride levels that are adequate to prevent cavities.

Why is community water fluoridation necessary rather than just giving children fluoride drops or tablets?

The need for taking fluoride drops or tablets daily over an extended period of time is a major disadvantage of fluoride prescription programs, one that makes them much less practical and effective than community water fluoridation. In addition to these challenges, the overall cost of prescription supplements per child is much greater than the per capita cost of community water fluoridation. Community water fluoridation also provides decay prevention benefits for the entire population regardless of age, socioeconomic status, educational attainment or other social variables. This is particularly important for families who do not have access to regular dental services. The nationwide goal to prevent cavities through community water fluoridation is similar to previous public health efforts to prevent other common health problems. These include adding iodide to salt to prevent thyroid problems, adding iron to infant formula to prevent anemia, adding Vitamin D to milk to prevent rickets, adding niacin to flour and other foods to prevent pellagra, and adding folic acid to cereal grains products to prevent birth defects. Each of these public health efforts represent situations where a nutritional additive is provided to everyone or to large target populations since it is impossible to individually identify and effectively treat the significant number of people who are at risk. As a result of these programs thousands of cases of illness, disability, and death are prevented each year with no harm to the rest of the population.

How much experience is there with fluoridation in the United States?

In 1945, Grand Rapids, Michigan, began fluoridating its water supply, and several other cities implemented water fluoridation shortly thereafter. The studies in these cities demonstrated the oral health benefits of fluoridated water in communities and established water fluoridation as a safe, practical, effective public health measure that would prevent cavities. Of the 50 largest cities in the United States, 43 have community water fluoridation. Currently, more than 162 million Americans (65% of the population served by public water systems) live in areas where the fluoride level is adjusted in the water supply to bring it to the level considered best for dental health. Since 1945, many studies have demonstrated the dental health benefits of fluorides and fluoridation. In Utah, Brigham City and Helper have been fluoridating their water systems for more than 40 years.

Is fluoride safe?

 A few small research projects have questioned whether increased rates of certain health problems were associated with community water fluoridation but these theories have not been confirmed by larger, welldesigned studies. Despite the decades of experience with water fluoridation in communities with large populations, no legitimate largescale epidemiological, laboratory, or clinical study has demonstrated that longterm ingestion of fluoride at optimal levels in water causes disease or illness. Community water fluoridation has served the American public extremely well as the cornerstone of dental decay prevention activities for more than 60 years. The preponderance of research continues to confirm the safety, effectiveness, efficiency, costeffectiveness, and environmental compatibility of community water fluoridation. UDOH/CFHS 01/2007

What is enamel fluorosis and the possible increased risk when fluoridated water is added to infant formula?

Higher than recommended levels of fluoride (either naturally occurring of adjusted) in water may lead to enamel fluorosis. Enamel fluorosis is not a disease but rather affects the way teeth look. In the vast majority of cases, enamel fluorosis appears as barely noticeable faint white lines or streaks on tooth enamel and does not affect the function of the teeth. Recent studies suggests that mixing powdered or liquid infant formula concentrate with fluoridated water on a regular basis may contribute some risk to a child developing the faint white markings of very mild or mild enamel fluorosis. It is important to understand that some fluoride exposure to developing teeth also plays a longterm role in preventing tooth decay. For more information on infant formula and fluorosis go to: http://www.cdc.gov/fluoridation/safety/infant_formula.htm

Is fluoride a toxic substance?

Like many common substances essential to life and good health salt, iron, vitamins A and D, chlorine, oxygen and even water itself – fluoride can be toxic in excessive quantities. Fluoride in the much lower concentrations (0.7 to 1.2 parts per million) used in water fluoridation is not harmful or toxic. “Fluorine” is the thirteenth most abundant chemical element found in earth’s crust but in nature it is always found in combination with other elements such as sodium and these are called fluoride compounds.

What fluoride compounds are used in water fluoridation?

Nearly all of the fluoride compounds used in water fluoridation are obtained as a byproduct of the phosphate fertilizer industry. The three most common compounds used in the United States for adjustment of community water fluoridation to optimal levels are sodium fluoride, sodium fluorosilicate, and hydrofluorosilicic acid. The production and use of these fluoride compounds meet all of the standards of American Water Works Association (AWWA), American National Standards Institute (ANSI) and National Sanitation Foundation (NSF) to ensure they are safe for human consumption. There is no evidence that any impurities in the fluoride chemicals used in water fluoridation have failed to meet any of these safety standards. More than 90% of U.S. public water suppliers use hydrofluorsilicic acid or sodium fluorosilicate chemicals for the purposes of community water fluoridation. These chemicals are less expensive than sodium fluoride, readily available, fully dissociate when they are diluted in water at the optimum level, meet safe drinking water standards and are equally effective in preventing tooth decay.

How much does water fluoridation cost?

There are three components to the costs that may be reported related to fluoridation: 1) Start up costs of purchasing fluoridation equipment. These costs will vary depending on the type of equipment purchased. 2) Ongoing costs of adding and monitoring fluoride and maintaining the equipment. It has been calculated by the Centers for Disease Control and Prevention that the annual cost of water fluoridation in the United States is $0.72 per person, with a range between $0.17 and $7.62 per person, depending mostly on the size of a community, labor cost, and the type of fluoride compounds utilized. 3) Other improvements to water systems that occur at the same time. When initiating fluoridation, water companies may use the opportunity to upgrade other aspects of their equipment and facilities but these costs should not be considered part of fluoridation expenses. Data from generally accepted scientific studies continue to confirm that fluoridation has substantial lifelong decay preventive effects and is a highly cost effective means of preventing tooth decay in the United States regardless of socioeconomic status. Should fluoride compounds used in public water systems be FDA approved? The U. S. Food and Drug Administration (FDA) has jurisdiction over pharmaceutical grade fluoride compounds, which are used in the formulation of prescription drugs. The FDA does not regulate chemicals added to public water systems. It has no expertise, experience, nor statutory authority from Congress to oversee public drinking water. The Centers for Disease Control and Prevention (CDC) sets the optimal fluoride level in community water supplies for dental disease prevention. The U.S. Environmental Protection Agency (EPA) sets the maximum fluoride levels used in public water systems. The National Sanitation Foundation (NSF) International, the American National Standards Institute (ANSI) and the American Water Works Association (AWWA) set the quality standards of fluoride chemicals used in water fluoridation to ensure they are safe. Where can I get additional, reliable information about fluoridation? The internet can be a good source of information but there are many internet sites that contain inaccurate or incomplete information about fluoride. Those that provide scientifically accurate information include: The Centers for Disease Control and Prevention: http://www.cdc.gov/OralHealth/factsheets/index.htm U.S. Public Health Service: http://www.cda.org/public/pubhsrvc.html American Dental Association: http://www.ada.org/public/topics/fluoride/index.asp

 

UDOH/CFHS 01/2007 UTAH DEPARTMENT OF HEALTH Statement on Community Water Fluoridation January 2007

The Dangers of Meth

Posted in Uncategorized on February 23, 2009 by dukeslc

The American Dental Association shares this with us:

Methamphetamine Use and Oral Health (Meth Mouth)

Dental health care professionals should be aware that methamphetamine use is on the rise in the U.S. The allure of this drug is that it is cheap, easy to make and the high lasts much longer than crack cocaine (12 hours versus one hour for cocaine). As well as being a potent central nervous system stimulant that can cause permanent brain damage, methamphetamine use has also been associated with severe oral health effects. Dental professionals should be aware of methamphetamine’s oral health effects and the treatment considerations for users of this drug.

Street names for Methamphetamine
Meth, Speed, Ice, Chalk, Crank, Fire, Glass, and Crystal

Drug description
Methamphetamine can be smoked, snorted, injected or taken orally. Typically, it is a bitter tasting powder that readily dissolves in beverages. Another common form of the drug is a clear, chunky crystal. This is the form known as “ice” or “crystal meth” and it is smoked in a manner similar to crack cocaine. Methamphetamine can also be in the form of small, brightly colored tablets. The pills are often called by their Thai name, yaba.

Mechanism of action
Methamphetamine stimulates release and blocks re-uptake of neurotransmitters called monoamines (dopamine, norepinephrine and serotonin) in the brain. Several areas of the brain are affected: the nucleus accumbens, prefrontal cortex, and striatum.1

Cerebral effects
By altering the levels of neurotransmitters in the brain, methamphetamine causes feelings of pleasure and euphoria. Methamphetamine is a neurotoxin and potent stimulant, which can also cause cerebral edema and hemorrhage, paranoia and hallucinations. Short-term effects include insomnia, hyperactivity, decreased appetite, increased respiration and tremors. Long term effects can include psychological addiction, stroke, violent behavior, anxiety, confusion, paranoia, auditory hallucination, mood disturbances, and delusions1. Methamphetamine use can eventually cause depletion of monoamines in the brain, which can have an effect on learning. 2,3

Systemic effects
With high doses there may be an increase in both systolic and diastolic blood pressure due to cardiac stimulation. In addition, methamphetamine may produce arrythmias. Other systemic effects include: shortness of breath, hyperthermia, nausea, vomiting and diarrhea.

Oral effects
The oral effects of methamphetamine use can be devastating. Reports have described rampant caries that resembles early childhood caries and is being referred to as “meth mouth”.4,5,6 A distinct and often severe pattern of decay can often be seen on the buccal smooth surface of the teeth and the interproximal surfaces of the anterior teeth.4 

The rampant caries associated with methamphetamine use is probably caused by a combination of drug-induced psychological and physiological changes resulting in xerostomia (dry mouth), extended periods of poor oral hygiene, frequent consumption of high calorie, carbonated beverages and tooth grinding and clenching. Some reports have also speculated that the acidic nature of the drug is a contributing factor.4,5,6

Methamphetamine user profile
Traditionally, methamphetamine use has been most pronounced among males between the ages of 19 and 40.7 According to the 2003 National Survey on Drug Use and Health8, 12.3 million Americans age 12 and older had tried methamphetamine at least once in their lifetimes (5.2 percent of the population), with the majority of past-year users between 18 and 34 years of age. Research funded by the National Institute on Drug Abuse (NIDA) found 2.8 percent of young adults (ages 18–26) reported the use of crystal methamphetamine in the past year during 2001–2002.9 These users were disproportionately white and male and live in the West. The study found Native Americans were 4.2 times more likely than whites to use the drug.

Traffickers have aggressively targeted rural areas in an effort to escape law enforcement, and most use is found in the western, southwestern, and midwestern U.S.

What the dentist should be on the look out for:

  • Unaccounted for and accelerated decay in teenagers and young adults.
  • Distinctive pattern of decay on the buccal smooth surface of the teeth and the interproximal surfaces of the anterior teeth.
  • Malnourished appearance in heavy users, because methamphetamine acts as an appetite suppressant.”

What dental health-care providers can do when they suspect methamphetamine use:

  • Complete a comprehensive oral examination that includes taking a thorough dental and medical history.
  • Express concern regarding the dental findings.10
  • If the patient is receptive to a medical consult, have the phone number of a local physician, clinic or substance abuse rehabilitation facility available and be familiar with their protocol, so that the patient can be told what to expect.10
  • Use preventive measures such as topical fluorides.
  • Encourage consumption of water rather than sugar-containing carbonated beverages.
  • Be cautious when administering local anesthetics, sedatives or general anesthesia, nitrous oxide, or prescribing narcotics.
  • Take opportunities to educate your patients about the risks associated with methamphetamine or any illicit drug use.11,12

New Years Goals – Don’t let anyone tell you that you can’t do it!

Posted in Uncategorized on January 26, 2009 by dukeslc

Toothpaste Abrasion Ratings

Posted in Uncategorized on November 20, 2008 by dukeslc

Toothpaste can be good and bad.  Unfortunately the better it is at removing stain, the better it is at removing enamel also.  Stay away from the high abrasive toothpastes as they can remove the luster and polish of porcelain veneers and crowns and dull that beautiful smile.

The RDA value is also known as radioactive dentin abrasion or relative dentin abrasivity. For a toothpaste to be approved by the FDA, it has to have a RDA value…but often this is not included in the marketing or promotion of the product, since a few of them are quite abrasive…
 
The ADA has adopted a standardized test. Basically, extracted human are irradiated with mild neutrons, mounted and stripped of enamel. The teeth are then inserted into a brushing machine and brushed at a constant pressure and stroke speed. The rinsewater is then measured for its radioactivity and recorded. Thus after a few calculations, a score or index is given to the toothpaste. Any value over 100 is considered to be abrasive. The ADA recommended limit is 250, whereas the FDA limit is 200. Other factors that are taken into consideration is the size, quantity, and surface structure of the abrasive itself.
 
The RDA table:
0-70 = low abrasive
70-100 = medium abrasive
10-150 – highly abrasive
150-250 = regarded as harmful limit

  RDA Value
Toothpastes
Straight Baking Soda 7
Arm & Hammer Tooth Powder 8
Arm & Hammer Dental Care 35
Oxyfresh 45
Tom’s of Maine Sensitive 49
Arm & Hammer Peroxicare 49
Rembrandt Original 53
CloSYS 53
Tom’s of Maine Children’s  57
Colgate Regular 68
Colgate Total 70
Sensodyne 79
Aim 80
Colgate Sensitive Max Strength 83
Aquafresh Sensitive 91
Tom’s of Maine Regular 93
Crest Regular 95
Mentadent 103
Sensodyne Extra Whitening 104
Colgate Platinum 106
Crest Sensitivity 107
Colgate Herbal 110
Aquafresh Whitening 113
Arm & Hammer Tarter Control 117
Arm & Hammer Advance White Gel 117
Close-up with Baking Soda 120
Colgate Whitening 124
Crest Extra Whitening 130
Ultra Brite 133
Crest MultiCare Whitening 144
Colgate Baking Soda Whitening 145
Pepsodent 150
Colgate Tarter Control 165
Colgate 2-in-1 Tarter Control/White 200
FDA Recommended Limit 200
ADA Recommended Limit 250