Caroline Wallace DDS

Under Armour Performance Mouthware-Worth Looking at.....

2014-01-17T10:01:00.002-08:00

In the past 50 years, a considerable volume of research has concluded that clenching one’s teeth completes a neuro-physiological feedback loop responsible for a complex series of responses resulting in an increase in adrenaline and cortisol production as well as blood pressure and heart rate. That this “stress response” is invariably initiated during instances of physical exertion is undeniably counter-intuitive because of its detrimental effect on athletic performance. Cortisol in particular can, at high levels, cause the body to enter a state of constant muscle breakdown and suppressed immune function, thereby increasing the risk of illness and injury while at the same time reducing muscle.

The first research into the application of an oral appliance in athletic performance first began in 1958. Further research has continued over the years. A 2009 study involved an in depth comparison of muscular endurance with and without a mouthpiece and concluded a significant improvement in sporting performance resulting from the use of a specially designed oral appliance. Trial participants showed an increase of 1% in mean bench press repetitions and 17% in preacher curl repetitions when wearing a Bite Tech product. Perhaps more significantly, cortisol levels were found to be on average 49% lower.

Under Armour Performance Mouthwear (UAPM) Products are engineered using Bite Tech’s patented technology and clinical trials have shown that there is a definite improvement in the response to auditory clues and a potential improvement in response to visual clues when these products are used. The UAPM Products use ArmourBite Technology that is backed up by 15 years of research. It positions a patented, uniquely shaped Power Wedge between the molars to help maintain optimal spacing and reduce the effects of clenching by reducing cortisol production as well as reducing lactic acid build-up by up to 25%. Over 1,000 professional athletes wear Armour Bite; the appliance is a powerful tool in the quest to enhance athletic protection and performance.

UAPM has been engineered to unlock the body’s true potential and has a positive impact on an athlete’s ability to train harder and perform at a higher level by increasing strength and endurance and reducing the impact of the stress response that omits physical performance.

Dr. Caroline Wallace DDS

Complete Dental Care

103 South Colorado Street

Salem, Virginia, 24153

540-387-3844

Choosing a Toothbrush......

2013-06-18T11:01:00.001-07:00

Tooth brushing is the major behavior performed by patients to fulfill their needs to feel clean and fresh and to avoid dental problems. It is also considered by the dentist-dental hygienist team to be the major tool in the removal and control of dental biofilm and the prevention of periodontal diseases and dental caries.

Effective brushing is important but so is the design and selection of the brush. Not all brushes are the same. By using the appropriate brush and technique together, patients can maximize their daily oral hygiene efforts.

Why must plaque be removed? When the plaque matures, the microbial ecology changes and becomes pathogenic due to the different microorganisms, their by-products, and in the case of gum disease, the inflammatory response provoked by the host.

For gum health the plaque must be removed from:

*the healthy sulcus or shallow pocket, the ideal anaerobic breeding ground

*the gum tissue where maturing and growing supra gingival plaque deposits are in contact with the marginal gum tissue and can alter the sub gingival environment

*the interproximal areas-in between the teeth, which are hard to reach.

For cavity prevention:

Plaque must be removed from the the gum line, pits and grooves in the teeth and the interproximal areas.

Understanding the different elements of toothbrush design will help with making the correct selection.

Head and Bristles

The toothbrush head is an extension of the handle and is contoured to position the bristles. Bristles are typically round nylon filaments. The degree of hardness is determined by the diameter and the length of the bristles. Larger diameter bristles are stiffer and do not extend as easily into hard to reach areas. The shape of the end of the bristle has evolved over many years. The tapering of the bristle allows greater flexibility and slenderness to reach deep into the sulcus. A recently introduced bristle has a feathered tip, providing up to 70% more surface contact with the tooth. Positioning of the bristles is also important. Positioning tufts10 -20 degrees away from the vertical axis increases interproximal penetration. A dome-shaped head of bristles, where the bristles are raised in the center, has been shown to increase plaque removal.

Handle

The ideal handle grip should aid in holding the brush at the correct angle so the bristles are present at 45 degrees to the long-axis of the tooth. Is should be long enough to provide adequate grip to give full control, and the distance between the grip area and the head should enable easy access to the most posterior teeth.

Toothbrushes alone do not lead to adequate plaque removal. There is a clear need for between-the-teeth cleaning. This includes flossing and interproximal brushes. These are available in a wide variety of designs and a high level of customization is available.

Summary

*The bristles must be effective in cleaning the hard-to-teach areas-extremely tapered bristles have demonstrated superiority

*The handles should have a grip designed to automatically position the brush to achieve the correct angle

*The brush is only one element of a plaque removal system

*The brush should be readily available commercially

*The brush head should be compact to reach to the back of the mouth and have soft bristles to minimize soft and hard tissue trauma and sensitivity, while maximizing cleaning

*The brushes should be designed and manufactured by a long-established supplier of scientifically tested toothbrushes

Dr. Caroline Wallace DDS

Complete Dental Care

103 South Colorado Street

Salem, Virginia, 24153

540-387-3844

Losing Weight can help with TMJD

2013-05-16T10:41:00.000-07:00

Temporomandibular Joint Disorder- TMJD

* Chronic TMJD does not correlate w/ low socioeconomic status. This finding is in stark contrast to trends seen in other chronic pain conditions.

* Chronic TMJD seems to be associated w/ alterations in some parts of the nervous system that control pain perception.

* Genetic variability contributes to chronic TMJD. This includes several genes known to influence stress response, psychological well being and inflammation.

TMJD patients frequently experienced many more chronic pain conditions, such as lower back pain, headaches, and fibromyalgia. Evidence of abnormal jaw function associated with teeth grinding and clenching was also observed.

Losing weight improves the diabetic status and helps in the response to periodontal therapy. One theory is that excessive fat cells secrete more cytokines, which make insulin less functional and lead to hyperglycemia. Losing weight improves the diabetic status and helps in the response to periodontal therapy. A second theory pertains to leptin hormone, which regulates appetite. Leptin is involved in regulating metabolism and has been associated with C-reactive protein.

Dr. Caroline Wallace DDC

Complete Dental Care

103 South Carolina Street

Salem, Virginia, 24153

540-397-3844

Mussels can help with certain tooth pain

2013-04-25T10:19:00.001-07:00

From a recent Readers Digest article-

Some tooth pain develops when the hard outer enamel wears away and exposes the softer underlying dentin, which is sensitive to stimuli such as hot and cold. Pain-fighting toothpastes and chewing gums contain minerals that can augment enamel but don't adhere long enough to permanently rebuild it. For a solution, Chinese scientists turned to mussels, which secrete an adhesive to attach to underwater rocks, and they created a substance with similar sticky properties. When scientists coated worn-out teeth with the mussel-like adhesive and then soaked them in a bath of minerals, the teeth rebuilt a protective layer that simulates enamel. This discovery lead to better products for sensitive teeth.

Dr. Caroline Wallace DDS

Complete Dental Care

103 South Colorado Street

Salem , Virginia , 24153

540-387-3844

Preventing Infections

2013-04-16T11:11:00.000-07:00

In light of recent news reports concerning a Tulsa, Okla.-based oral surgeon, the American Dental Association (ADA) understands that there may be heightened interest in infection control procedures. Regulations for dental office inspections are determined on a state by state basis by the state dental board.

The ADA has long recommended that all practicing dentists, dental team members and dental laboratories use standard precautions as described in the Centers for Disease Control and Prevention's (CDC) Infection Control in Dental Health Care Settings guidelines. Studies show that following proper infection control procedures greatly reduces risk to patients to the point of an extremely remote possibility.

Infection control procedures are designed to protect patients and health care workers by preventing the spread of diseases like hepatitis and HIV. Examples of infection control in the dental office include the use of masks, gloves, surface disinfectants and sterilizing reusable dental devices. In addition, dental health care providers are expected to follow procedures as required by the Occupational Safety and Health Administration.

Before you enter the examining room, all surfaces, such as the dental chair, dental light, instrument tray, drawer handles and counter-tops have been cleaned and decontaminated. Some offices may cover this equipment with protective covers, which are replaced after each patient.

Non-disposable items like the dental instruments are cleaned and sterilized between patients. Disposable items like needles or gauze are placed in special bags or containers for monitored, proper disposal. Infection control precautions also require all dental staff involved in patient care to use appropriate protective garb such as gloves, masks, gowns and eye-wear. After each patient, disposable wear like the gloves and masks are discarded. Before seeing the next patient, the members of the treatment team scrub their hands and put on a new pair of gloves.

Patients who have questions about infection control in the dental setting should talk with their dentists, who will be glad to explain or demonstrate their procedures. More information on infection control in dental offices is available online athttp://www.ADA.org

Please be assured that we look at these guidelines as a minimum standard for our practice.We hold your safety and well being as paramount to how we work. We would welcome our patients to walk through with us on the various procedures we utilize in our practice.

Dr. Caroline Wallace DDS

Complete Dental Care

103 South Colorado Street

Salem, Virginia , 24153

540-387-3844

Chewing Gum Can be Healthy for Your Teeth

2013-03-15T09:47:00.000-07:00

There has been evidence of improved oral health associated with chewing gum containing xylitol, twice a day for 15 minutes. There is a a definite increase in saliva production and flow. This increase results in lower plaque and healthier gums. This is particularly significant for our aging population who typically experience decreased salivary production and flow. The resultant decrease leads to increased decay and gum disease. Chewing sugar-free gum can add to the quality of life for the aging population.

Dentistry Today-August 2012

Dr. Caroline Wallace DDS

Complete Dental Care

103 South Colorado Street

Salem, Virginia , 24153

540-387-3844

Don't forget to Floss

2013-02-26T11:16:00.000-08:00

Don't forget to floss by Dr. Patel

It's an activity almost no one enjoys, yet is so important when it comes to staying on top of your oral health.

Flossing: It can be awkward, difficult, time-consuming or maybe you just don't understand the importance of it, but it's an essential part of your daily cleaning routine.

Just the Facts: Floss at least once a day to achieve optimal oral health. Daily flossing helps remove plaque from the areas between your teeth where the toothbrush can't reach, which is important because plaque that is not removed by brushing and flossing can eventually harden into calculus or tartar. Flossing also helps prevent gum disease and cavities.

REMEMBER: NOTHING ELSE YOU CAN DO TAKES THE PLACE OF FLOSSING. NOT TOOTHPICKS, NOT CHEWING GUM, NOT EVEN MOUTHWASH.

Getting it done: Try to make flossing a priority in your daily life. It makes no difference when you floss--pick a time of day when you can devote an extra couple of minutes to your oral hygiene. And it's just not adults who need to floss--children should be having their teeth flossed by an adult as soon as they have 2 teeth that touch.

Flossing should not be painful with normal, healthy gums. You may feel discomfort when you first start flossing, but don't give up. That discomfort should ease within a week or two. If your pain persists, talk to your dentist.

If you find flossing difficult, consider a different flossing method. People who have difficulty handling dental floss may prefer to use another kind of device such as a wooden plaque remover, dental pick or pre-threaded flosser. Ask your dentist how to use them properly to avoid injuring your gums. You may simply need to try another type of dental floss--waxed, unwaxed, thick or comfort floss. Stick with it and you'll have adopted a health habit for life!

Dr. Caroline Wallace DDS

Complete Dental Care

103 South Colorado Street

Salem, Virginia , 24153

540-387-3844

Preparing Patients For Future Oral Healthcare Decline

2013-02-19T09:02:00.000-08:00

Elderly dental patients typically are challenging to treat due to their poor cognitive skills and manual dexterity. Older patients need treatment-planning strategies specific to their individual needs.

Prepare for the Future: Patient Education

The discussion needs to begin with the 50-60 year old patient regarding the need to prepare their mouths for the future assault that aging brings. Like their physicians do, a dental plan of action should be established.

There are a number of issues that pre-retirement patients should be aware of, such as dry mouth secondary to medications. The dental plan should address both the financial and treatment planning arrangements in anticipation of future challenges. This plan needs to protect the teeth from dry mouth and resultant root caries, maximizing the patient’s individual insurance benefit.

Routine care for the elderly is critical. Some even benefit from a 3-4 month cleaning schedule. Daily use of fluoride may also be recommended.

There are a number of common myths in our culture about aging teeth that should be discussed:

If there is no pain, there is no tooth problem
Teeth become softer with age and are more susceptible to decay
Tooth loss is a normal part of aging
If bleeding occus with brushing, stop immediately
Teeth are not as important for an older person since they prefer to eat soft foods
Dentures, just like real teeth, stay in the mouth 24/7
Dentures are a great alternative to real teeth—simpler to clean, more cost-effective, and easier to function

Dental treatment planning for the future decline should start in the 50’s, 60’s, and 70’s. Dental restorations should be designed to withstand the lack of oral care that commonly occurs as a result of the aging process. Fillings and crowns need to be easy to keep clean. Extraction and implant placement should be considered in situations where there is a guarded prognosis. Treatment planning should provide for implant retained lower dentures to allow proper nutrition and bone preservation and help prevent ill-fitting dentures from rubbing ulcers. This level of care needs to be completed when the patients are healthy and able to receive the care.

Focus on Prevention

Most of the dental care needed by the elderly is long-term care facilities (LTCFs) is not provided by a dentist. A recommended protocol is outlined below:

Daily Oral Care

Every resident should have a daily oral care plan
Supervised tooth-brushing should occur twice daily-after breakfast and before bedtime—with a regular toothbrush and fluoride toothpaste, not a toothette or sponge.
An accountability system with regular evaluation should be established.
Yearly oral health education of staff should be provided via inservicing

Daily Fluoride Application

A decay risk assessment should be performed to determine fluoride need.
An assessment of resident pharmacy formularies should be performed to determine fluoride prescription coverage and availability.
Appropriate fluoride application should be administered depending on the level of decay risk: fluoride toothpaste, fluoride rinse, and fluoride gel.
Staff training should occur annually for proper administration of fluoride toothpaste, fluoride rinse and fluoride gel.

Regular Professional Cleanings

The last cleaning and due date for the next cleaning should be documented in the resident’s medical record upon admission.
Assessment and identification of barriers to obtaining regular professional cleanings should be performed (id, funds, transportation, behavior challenges).
Confirmation and documentation that the facility dental provider offers regular professional cleanings (ie, every 3-6 months) for the residents should be secured.

Dentists need to play an active role in the oral healthcare of geriatric patients, including those residing in LTCF’s.

From Compendium Feb. 2013

Dr. Caroline Wallace DDS

Complete Dental Care

103 South Colorado Street

Salem , Virginia , 24153

540-387-3844

Death by Dentures ?

2013-02-13T09:24:00.000-08:00

Did George Washington's Famous Denture Do Him In?

Was the throat infection that took George Washington's life caused by colonies of bacteria that grew in his world-famous dentures? By all reports, he was a very athletic, strapping man who was taller, larger, and stronger than the average countryman of his time. So how is it that he became ill and died in only 3 days at the age of 67?

Washington suffered from both dental problems and various illnesses in his younger life. He lost his first adult tooth at 22 years old. By the time he became president in 1789, at the age of 57, he had only one tooth remaining despite daily brushing and the use of toothpaste and mouthwash. At his inauguration he was wearing a full set of dentures that were attached to his final tooth.

Washington was treated by no fewer than 9 prominent dentists who practiced in colonial America. The denture prepared for Washington had a base of hippopotamus ivory carved to fit his gums. The upper denture had ivory teeth, and the lower plate consisted of human teeth fastened by gold pivots that screwed into the base. The set was secured in Washington's mouth by spiral springs. The upper and lower gold plates were connected by springs that pushed the upper and lower plates against the upper and lower ridges of his mouth to hold them in place. Washington actually had to actively close his jaws tightly to make his teeth bite together.

Now we know much more about the connection between oral health and systemic health. We know that bacteria in dentures can cause upper respiratory infections, cardio-endocarditis, intestinal infections, open wounds and other things.

On Thursday, December 12, 1799, Washington spent the day outside in the snow and freezing rain inspecting his estate, Mt. Vernon. He ate his dinner that night in his wet clothing. The next morning he complained of a severe sore throat. Accounts now attribute the cause to quinsy, acute epiglottis, or possibly thrush. Quinsy is a bacterial infection causing severe inflammation of the tonsil area, often leading to the formation of an abscess that may require surgery in the tonsil area. Acute epiglottis is a bacterial infection around the epiglottis, which can cause severe air blockage, and thrush is a yeast infection that can develop in the throat or mouth.

Washington's condition worsened through the day until early Saturday morning, December 14, when he awoke Martha, his wife, telling her that he felt ill. Although several physicians were summoned to his bedside, Washington died at 10 pm.

Where did these infections come from? It is strongly suspected that the infection could have been harbored in Washington's dentures.

From Dentistry Today April 2012

Acupuncture can reduce Dental Anxiety

2013-01-09T11:58:00.002-08:00

New research concludes that acupuncture helps to reduce dental related anxiety. In a patient-blinded randomized controlled investigation, researchers compared 182 patients. One group received true acupuncture at auricular points. The second group received sham acupuncture (non-related acupoints) and a third group did not receive acupuncture or any medical procedures for the treatment of anxiety. The researchers measured anxiety levels prior to getting acupuncture and 20 minutes after receiving acupuncture which was immediately prior to the dental work. Anxiety levels in the true acupuncture group reduced significantly and slightly in the sham acupuncture group. In the non-intervention group, anxiety increased.
The researchers concluded that auricular acupuncture is both minimally invasive and “effectively reduces state anxiety before dental treatment.” The researchers suggest that acupuncture may provide an option to patients suffering from anxiety prior to dental care.

Dr. Caroline Wallace DDS
Complete Dental Care
103 South Colorado Street
Salem , Virginia , 24153
540-387-3844

Toothbrushes Saving Lives.........

2012-12-19T13:27:00.004-08:00

Toothbrushes Trump Seat Belts

Yes, you read this correctly. As important as seat belts are as a preventive measure, toothbrushes have a far greater impact on the health and longevity of the American public. According to the National Highway and Safety Administration (NHTSA), seat belts save about 13,000 lives a year, nationwide. That is no small number: more than 1,000 Americans each month owe their lives to the 5 seconds it took them to "buckle up". NHTSA points out that seat-belts reduce a person's chances of dying in a crash by 45% and being injured by 50%. However seat belts probably will not play a role in saving your life, because chances are you will not be in a serious car crash, most Americans never are.

On the other hand, most Americans have gum disease. Estimates are that up to 80% of American adults suffer either from gingivitis or periodontal disease. The most common cause of tooth loss among adults is periodontal disease. What you may not know is that tooth loss is one of the least important consequences of periodontal disease. Periodontal disease is a significant risk factor for heart attack, stroke, low-birth-weight infants, and some forms of cancer. While very few of you will die from a car crash, many of you will die from a heart attack or cancer. And, believe it or not, using a toothbrush and eliminating periodontal disease reduces the chances of dying from either of these causes.

Dr. Caroline Wallace DDS

Complete Dental Care

103 South Colorado Street

Salem, Virginia , 24153

540-387 - 3844

Pediatric Dental Disease and the Domino Effect

2012-12-10T09:46:00.001-08:00

First Tooth Pain, Then School Absence, Then Lower Grades, Then Parental Concern, Then Lost Work Days . . .

Poor oral health, dental disease, and tooth pain can put children at a serious disadvantage in school. Researchers had previously documented that 73% of disadvantaged children in Los Angeles have cavities. This study illuminates the specific connection between oral health and performance in school for this population. Children who reported having recent tooth pain were 4 times more likely to have a low grade point average (GPA)--below the median GPA of 2.8--when compared to children without oral pain. Poor oral health doesn't just appear to be connected to lower grades. Dental problems also seem to cause more absences from school for children and more missed work for parents.
On average, elementary children missed a total of 6 days per year, and high school children missed 2.6 days. For elementary students, 2.1 days of missed school were due to dental problems, and high school students missed 2.3 days due to dental issues. In addition, parents missed an average of 2.5 days of work per year to care for children with dental problems.
A factor determining whether children miss school due to dental health issues was the accessibility of dental care. 11% of children who had limited access to dental care--whether due to lack of insurance, lack of transportation or other barriers--missed school due to their poor oral health as opposed to only 4% who had easier access to dental care.
The date indicated there is an impact on students' academic performance due to dental problems.

Info from Ostrow School of Dentistry of USC, "American Journal fo Public Health"-The Impact of Oral Health on teh Academic Performance of Disadvantaged Children, Dr. Roseann Mulligan.

Dr. Caroline Wallace DDS
Complete Dental Care
103 South Colorado Street
Salem, Virginia, 24153
54-387-3844

Can parents contribute to a childs fear of the Dentist

2012-11-27T08:27:00.001-08:00

Fear of visiting the dentist is a frequent problem in pediatric dentistry. A new study confirms the emotional transmission of dentist fear among family members and analyses the different roles that mothers and fathers might play.

A new study conducted by scientists at the Rey Juan Carlos University of Madrid highlights the important role that parents play in the transmission of dentist fear in their family.

Previous studies had already identified the association between the fear levels of parents and their children, but they never explored the different roles that the father and the mother play in this phenomenon.

América Lara Sacido, one of the authors of the study explains that "along with the presence of emotional transmission of dentist fear amongst family members, we have identified the relevant role that fathers play in transmission of this phobia in comparison to the mother."

Published in the International Journal of Pediatric Dentistry, the study analyzed 183 children between 7 and 12 years and their parents in the Autonomous Community of Madrid. The results were in line with previous studies which found that fear levels amongst fathers, mothers and children are interlinked.

A key factor: the father

The authors confirmed that the higher the level of dentist fear or anxiety in one family member, the higher the level in the rest of the family. The study also reveals that fathers play a key role in the transmission of dentist fear from mothers to their children as they act as a mediating variable.

"Although the results should be interpreted with due caution, children seem to mainly pay attention to the emotional reactions of the fathers when deciding if situations at the dentist are potentially stressful," states Lara Sacido.

Consequently, transmission of fear from the mother to the child, whether it be an increase or reduction of anxiety, could be influenced by the reactions that the father displays in the dentist.

Positive emotional contagion

Amongst the possible implications of these results, the authors outline the two most salient: the need to involve mothers and especially fathers in dentist fear prevention campaigns; and to make fathers to attend the dentist and display no signs of fear or anxiety.

"With regard to assistance in the dental clinic, the work with parents is key. They should appear relaxed as a way of directly ensuring that the child is relaxed too," notes the author.

"Through the positive emotional contagion route in the family, the right attitude can be achieved in the child so that attending the dentist is not a problem," she concludes.

Dr. Caroline Wallace DDS

Complete Dental Care

103 South Colorado Street

Salem, Virginia, 24153

540-387-3844

Understanding Antioxidants

2012-11-13T10:25:00.001-08:00

Antioxidants are prolific in our diets, being present in spices, herbs, fruits, vegetables, nuts, legumes, grains, and certain beverages. At a cellular level the body also produces natural antioxidants and there are many supplements that either contain antioxidants or enhance the body's ability to produce antioxidants. Studies have revealed a correlation between measurably low antioxidant levels with many inflammatory oral soft-tissue conditions and diseases. Recently, antioxidant products have been introduced in the marketplace that allow for immediate absorption into the oral cavity.

Dental patients who have an antioxidant/oxidant imbalance favoring the production of oxidative stress and low antioxidant capacity are at higher risk for the development and progression of many oral inflammatory conditions and diseases. The same antioxidant imbalance can predispose individuals to numerous chronic illnesses, cancer and accelerated aging processes.

New antioxidant products are emerging onto the marketplace almost daily. Novel therapies exist to increase antioxidant absorption directly into the oral tissue and improve clinical outcomes, and adjunctive dietary supplements have the potential to improve periodontal parameters. Supplements are available that will activate the body's antioxidant productions within the cells, and turn down the pro-inflammatory genes. There has never been a better time to increase your understanding of antioxidants.

Dr. Caroline Wallace DDS

Complete Dental Care

103 South Colorado Street

Salem, Virginia, 24153

540-387-3844

Kids Get It ......

2012-10-30T09:42:00.001-07:00

As Halloween approaches, children's views and perceptions were measured by experts and revealed that kids agree that they eat too much candy and would actually prefer to receive a gift like a video game, instead.

A new questionnaire, conducted by the American Dental Association and PopCap Games, targeted trick-or-treating aged children (5 to 13 years) in the U.S., inquiring about their views on Halloween.

The researchers found that around 94 percent of all American children participate in trick-or-treating, and 65 percent of them think Halloween is the best holiday of the year. However, the survey also found that a vast majority of kids are ready for changes regarding the holiday.

Other top findings included: Two-thirds of kids questioned agreed that they eat too much candy during Halloween, while 89 percent reported that they would still like the holiday if it was not candy focused, but rather, aimed towards other types of fun. Ninety-three percent of children surveyed would prefer to receive a video game instead of candy while trick-or-treating.

Youths' Favorite Holiday

The most-liked Halloween activities are "trick-or treating" (75 percent), "Dressing up in a costume" (71 percent), and "Getting lots of candy"(66 percent).

Health-Conscious Kids

Over three quarters of children surveyed (78 percent) agreed with the statement "too much candy is bad for me", and two-thirds (67 percent) report they eat too much candy near Halloween. Out of the chidlren who were questioned, girls (82 percent) were slightly more likely to respond favorably than boys (74 percent) to the statement: "too much candy is bad for me".

Dr. Caroline Wallace DDS

Complete Dental Care

103 South Colorado Street

Salem, Virginia, 24153

540-387-3844

Healthy Mouth...Healthy Body

2012-10-11T10:49:00.001-07:00

There are an overwhelming number of studies showing that your oral health is related to your body's overall health. If you mouth isn't healthy, you may be twice as likely to die from a heart attack, 3 times more likely to die from a stroke and evn 4-7 times more likely to die if you have diabetes. Additionally, you may be 63% more likely to develop pancreatic cancer, one of the deadliest forms of cancer. Clearly, oral health (or lack thereof) has life and death consequences.

Here's some good news, times are drastically changing for the better with the addition of new medical tests available in dental offices and used to communicate with physicians in a language they understand. These test can help bridge the gap between the two professions.

Dr. Caroline Wallace DDS

Complete Dental Care

103 South Colorado Street

Salem, Virginia, 24153

540-387-3844

Take the Quiz for better Dental Health

2012-09-24T08:03:00.001-07:00

Americans need a serious brush-up when it comes to their oral health. On average, Americans scored a "D" on a series of questions such as how often to brush, what age a child should first visit a dentist and what causes cavities.

Take the dental quiz

Q: How often should you brush your teeth?
A: Although 90% of survey respondents believe they should brush after every meal, the ADA recommends brushing only twice a day.

Q: How often should you replace your toothbrush?
A: 65% of respondents believe they should replace their toothbrush twice a year. The ADA recommends replacing your toothbrush every 3 - 4 months or sooner if the bristles become frayed.

Q: When should you take your child to the dentist for the first time?
A: 75% of respondents don't know that a child's first trip to the dentist should be within 6 months after their first tooth appears, usually by the children's first birthday

Q: Are the germs that cause cavities contagious?
A: Yes! 59% of respondents don't realize that cavity-causing germs can be passed from person to person. Parents and caregivers can pass bacteria that cause cavities to their children by pre-chewing food or sharing utensils.

Q: How often should you floss your teeth?
A: 53% of respondents think you should floss twice a week. The ADA recommends flossing every day. When you skip flossing, you miss cleaning more than 40% of the tooth surface.

Q: Are refined sugars more harmful to teeth than natural sugars?
A: 67% of respondents think refined sugars are more harmful than natural sugar. The truth is that all sugar can promote tooth decay. Frequency of exposure increases risk.

Facts:
9 out of 10 adults ages 20-64 have had cavities in their permanent teeth.
Dental disease is the most common chronic disease suffered by children.
Nearly 1/2 of children ages 2-11 years old have had cavities in their baby teeth.

Check out www.MouthHealthy.org for more information. The new website is organized by life stages and includes information on the top 10 dental symptoms, how to handle emergencies and A-Z oral health topics.

Dr. Caroline Wallace DDS
Complete Dental Care
Salem, Virginia

Men Are More Likely to Have Oral HPV than Women

2012-09-11T09:32:00.003-07:00

A rise in oral sex may be pushing up HPV infection rates in men, along with head and neck

Oral infections of human papillomavirus, or HPV, affect nearly 7% of Americans and are significantly more common in men than in women, according to a new Centers for Disease Control and Prevention study.

The study, which is the first to examine the prevalence of oral HPV in the U.S., found that three times as many men (10%) as women (3.6%) have HPV infections. The data may help to explain why the incidence of head and neck cancers has been increasing, particularly in males, even as smoking rates are on the decline.

For the study, CDC researchers plumbed data on 5,579 people aged 14 to 69 who participated in the National Health and Nutrition Examination Survey in 2009 and 2010. The participants answered extensive questionnaires about their sexual behavior and gave oral cell samples for analysis for HPV.

The researchers found that the risk of oral HPV infection increased with the number of sexual partners a person had: it was eight times higher in people who had ever had sex versus not, and as high as 20% in people who had had more than 20 sexual partners in their lifetime. The data indicate that “oral HPV infection is predominantly sexually transmitted,” through oral sex, not passed through casual contact like kissing, the authors concluded.

The CDC researchers also found that HPV infections peaked in two age groups: 30-to-34-year-olds, who had a 7.3% chance of infection, and 60-to-64-year-olds, who were 11.4% likely to be infected. It’s not clear why older people had higher rates of oral HPV, but the authors offered some possible theories: perhaps it’s because older people came of age at a time when there were fewer concerns about sexually transmitted infections, or perhaps latent HPV infections are becoming reactivated as the immune system weakens with age.

HPV is the most commonly sexually transmitted virus in the U.S. At least half of all sexually active people will acquire an infection at some point in their lives. Most will clear the virus on their own, but persistent infections can cause cancer, including cervical, vulvar, vaginal, anal and penile cancers. Oral infection with a high-risk strain of HPV can cause oropharyngeal cancers — cancers of the tonsils, upper throat and base of the tongue.

Rates of oral HPV infection are substantially lower than genital infections — which can be as high as 42% in women in their 20s, for example — but they are becoming increasingly troublesome. While HPV is best known as the virus that causes cervical cancer in women, because of better screening, the rate of such cancers has declined. Meanwhile, the rate of oral cancers is on the rise: a study published in October in the Journal of Clinical Oncology found that HPV-related oropharyngeal cancers increased 225% between 1984-89 and 2000-04. In 1984-89, about 16% of oropharyngeal cancers tested HPV-positive; by 2000-04, the proportion of HPV-positive cancers had risen to 72%, accounting for more oral cancer than smoking.

Overall, the risk was greatest and rising in men, the study found, possibly because of increasing rates of oral sex. The data indicate that the burden of HPV-related cancer may shift from women to men, with the number of HPV-positive oral cancers potentially eclipsing that of invasive cervical cancers within 10 years.

That supports efforts to boost HPV vaccination, suggest the authors of the current CDC study, published online by the Journal of the American Medical Association. Public health officials recommend that girls aged 11 or 12 be immunized with either of two approved HPV vaccines, Gardasil or Cervarix, which both protect against HPV 16 and 18, the strains that cause most cervical cancers. (Gardasil also protects against HPV strains 6 and 11, which cause 90% of genital warts cases.) Girls aged 13 to 26 should also be immunized if they haven’t been already.

The advice extends to boys as well, but only one of the shots, Gardasil, has been tested and approved for males to protect against warts and anal cancer. Boys are advised to receive the vaccine at age 11 or 12, or between ages 13 and 21 if they haven’t already been immunized. The primary reason for the advice is to protect adolescents and young adults from infection with the high-risk strains of cancer-causing HPV before they become sexually active.

It’s not clear whether the vaccines can also protect against oral cancers. More research is needed to figure that out. But researchers speculate that if the vaccine reduces rates of HPV in women, it can in turn help reduce the risk of infection in men.

Dr. Caroline Wallace DDS

Complete Dental Care

Salem, Virginia

Using Teeth to Restore Hearing

2012-08-06T10:48:00.000-07:00

One day in 2006, stuck in bumper-to-bumper Bay Area traffic, Amir Abolfathi had a eureka moment. Formerly vice president of R&D for Invisalign, a company known for transparent dental braces, he had recently been chatting with a friend who was working on hearing aids. Abolfathi knew that bone was a good sound conductor. What if he could somehow make a removable oral hearing aid—one that could channel sound from wearers’ teeth to their ear through the bones in their head?

That moment of freeway inspiration gave rise to the SoundBite, a device designed for sufferers of single-sided deafness, which strikes about 50,000 people every year in the U.S. After his friend, Michael Benninger, an otolaryngologist at the Cleveland Clinic in Ohio, told him it could really help to solve the problem, Abolfathi set about turning his idea into reality. The biggest challenge was miniaturization, so he opted for a piezoelectric actuator, which needs very little power to generate the vibrations that travel through bone. That allowed him to use a much smaller battery, making the entire insert compact enough to fit comfortably in the mouth.

Invention: SoundBite
Inventor: Amir Abolfathi
Cost: $19 million
Time: 4 years
Is It Ready Yet? 1 2 3 4 5

Made of acrylic, SoundBite snaps onto a user’s molars. A tiny microphone worn in the deaf ear wirelessly beams incoming sound to an electronic receiver in the molar insert, which transmits sound waves from the teeth through the bones in the jaw to the cochlea, the part of the ear that processes sound. (Traditional hearing aids only amplify sound, so they don’t work for people with non-functioning cochlea.) The battery lasts for six to eight hours at a time and can be recharged in a wall outlet.

How SoundBite Works: A microphone in the deaf ear beams incoming sound to a receiver on the acrylic tooth insert (placed on either side), which transmits it through the jaw to the cochlea. Paul Wootton

The best remedy for single-sided deafness currently on the market is a bone-anchored hearing aid (BAHA), which, like the SoundBite, uses direct bone conduction to deliver sound to the cochlea. But BAHA installation involves surgically implanting a titanium post into the base of the skull. Other noninvasive tooth-based systems have been attempted, but none was ever fully developed and brought to market.
The SoundBite restores hearing just as effectively as a BAHA but requires no surgery. Instead it can be popped in and out of the mouth like a retainer. In clinical trials that wrapped up in February, patients typically reported that it restored from 80 to 100 percent of their hearing in the deaf ear and that they scarcely noticed they were wearing it. Lawrence Lustig, the director of the University of California at San Francisco Cochlear Implant Center, is so impressed with the SoundBite that he says he’ll recommend it to people who would otherwise have to undergo surgery.

If the device secures FDA approval as anticipated, it will hit the market this summer for around $6,000. (Surgery for a BAHA can run well over $10,000.) Abolfathi’s company, Sonitus Medical, plans to negotiate with insurance providers to reimburse patients for at least part of the cost. Abolfathi is also investigating other applications for the technology, including wireless, water-safe MP3 players and stealth communication for intelligence personnel. But even if those don’t pan out, he’s satisfied to know that he’s already improved people’s lives. “One patient just e-mailed and told me, ‘I saw Avatar, and it was great. I hadn’t been to a movie in years.’”

Dr. Caroline Wallace DDS

Complete Dental Care

Salem , Virginia

Aspirin may prevent throat cancer .....

2012-08-01T08:45:00.000-07:00

BOSTON, Mass., USA: U.S. researchers have found evidence that taking anti-inflammatory drugs and aspirin in particular reduces the risk of Barrett's esophagus (BE), a medical condition that is the largest known risk factor for esophageal cancer. In a recently published study, they found that aspirin users were 44 percent less likely to have BE compared with nonusers.
Researchers from the Massachusetts General Hospital Institute for Technology Assessment analyzed 434 patients diagnosed with BE between 1997 and 2010 for factors that might be used in the screening and management of the condition, including age, sex, body mass index, medical and social history, as well as medications.

Among other findings, the study revealed that current aspirin users had a lower risk for developing BE than nonusers and that men were more than three times more likely to develop BE than women.

"The protective effect of aspirin use appears robust because the analyses suggests a dose–response relationship in which high-dose aspirin was significantly associated with decreased BE risk," said Dr. Chin Hur, assistant professor of medicine at Harvard Medical School and director of GI Health Outcomes Research at the Massachusetts General Hospital Gastrointestinal Unit.

Although previous research has analyzed nonsteroidal anti-inflammatory drugs and aspirin chemoprevention for esophageal cancer or BE progression, the current study is one of the few to explore whether the drugs can prevent BE.

Hur warned however that it would not be advisable at this stage to start taking aspirin at higher doses if preventing BE is the only goal. "If additional data confirms our findings and an individual at higher risk for development of BE and esophageal cancer also could derive additional benefits, most notably cardiovascular, aspirin could be a consideration," he added.

According to the World Health Organization, esophageal cancer is the eighth most common cancer worldwide, with 481,000 new cases estimated in 2008, and the sixth most common cause of death from cancer, with 406,000 deaths. This type of cancer is two to four times more common among men than women, and more than 80 percent of the cases and of the deaths have occurred in developing countries, the organization stated.

The study was published in the July issue of the Clinical Gastroenterology and Hepatology journal.

Dr. Caroline Wallace DDS
Complete Dental Care
Salem, Virginia

Family Life could effect Childrens Oral Health

2012-06-14T07:18:00.000-07:00

NEW YORK, N.Y., USA: The interaction between parents could have an impact on the oral health of their children, researchers from the New York University College of Dentistry have found. A greater incidence of verbal or physical aggression between partners correlated with increased oral health problems in children. The researchers are now developing an intervention for couples whose relationship discord may impact the oral health of their infants.

Mental health has much to do with dental health, according to Professors Richard Heyman and Amy Smith Slep, psychologists and co-directors of the Family Translational Research Group within the Department of Cariology and Comprehensive Care at NYUCD. Heyman and Smith Slep aim at understanding how psychological factors affect oral health, especially in relation to the causes of early childhood caries.

For the study, the researchers collected data on nearly 150 families. They took blood and saliva samples, conducted physical exams, and administered questionnaires. The researchers found that children whose parents were verbally or physically aggressive towards each other were more likely to suffer from oral health problems.

"There are two hypotheses about how oral health is affected by parental discord," Heyman said. "First, lax supervision of children, as an outgrowth of discord, directly impacts children in that they eat sugary cereals and beverages, and do not brush. The second is a biological response. There is strong research showing that family conflict and stress affect the immune system."

"Lax parenting may be an even stronger influence on tooth decay than violent behavior," said Dr. Mark Wolff, professor and chair of the Department of Cariology and Comprehensive Care and associate dean for Predoctoral Clinical Education at the NYUCD, who was also involved in the study. "Allowing children to eat sugary food is something seen even among well-educated people. We have to understand the psychological causation of tooth decay to prevent it. A simple lecture on brushing isn't going to improve things. You have to change parenting behaviors."

Heyman, Smith Slep and Wolff have now teamed up with Dr. Ananda Dasanayake, professor of Epidemiology and Health Promotion, to adapt and test an intervention, developed in Australia, for couples whose relationship discord may impact the oral health of their very young children.

This project is the first to intervene with new parents at multiple levels to prevent childhood caries. It is hoped that, by improving noxious family environments, instilling daily oral health-promoting behaviors in children, and encouraging parents to bring the child to regular dental checkups, the children's early oral health will be demonstrably better than is typical.

For the testing currently being conducted, up to 30 families are being recruited from maternity wards at Bellevue Hospital Center and Stony Brook University Hospital in New York. The researchers are seeking families whose newborn children are already considered at high risk for poor oral health owing to low family incomes, parents who have no more than a high school education, and at least one non-European American parent. Couples who participate will watch DVD segments on conflict resolution and healthy parenting. They will also be assigned a coach, who will check in and help them improve their conflict-resolution and parenting skills. Additionally, they will complete a workbook that reinforces those messages with exercises.

The couples' intervention takes place over eight sessions, timed to intersect with the developmental stages of their infant, from three to 12 months. This timing covers the period of tooth eruption and transition to recommended dental visits. It also covers both the newborn and toddler periods, and allows families breaks between sessions and time to review material and solidify their skills. To examine the impact on oral health, dental exams will be performed on the children at 15 months.

The researchers will look for early childhood caries and contributing factors, such as bacteria and salivary hormones related to stress.

Dr. Caroline Wallace DDS

103 South Colorado Street

Salem , Virginia, 24153

540-387-3844

Untreated Periodontitis may Complicate Pregnancy

2012-06-05T09:06:00.000-07:00

CLEVELAND, Ohio, USA: A recent study has investigated the association between periodontitis and women's health issues. The researchers focused on adverse pregnancy outcomes in particular and found that periodontitis, depending on the severity, may be linked to preeclampsia, preterm birth and low birth weight of the child, among others.

By reviewing 61 journals and about 100 articles, Charlene Krejci, associate professor at the Case Western Reserve University School of Dental Medicine found that a considerable body of periodontal literature generally associates hormonal changes in women with the inflammatory disease.

In the early 1980s already, a study of 54 pregnant and 23 nonpregnant women revealed levels of Bacteroides species 55 times higher in the pregnant group. In addition, women who received contraceptive therapy were found to have a sixteenfold higher level of the same bacteria compared with the control group.

More recently, in a study of 366 pregnant women, researchers found various oral bacteria in the amniotic fluid of women whose pregnancies were complicated by preterm birth. A subsequent pilot study suggested that nonsurgical periodontal therapy could lower the rate of preterm birth.

Moreover, a study of 124 women revealed that periodontitis was significantly more prevalent in women who had preterm low birth weight (PLBW) infants than in women whose infants had a normal birth weight. The subjects diagnosed with periodontitis were 7.5 times more likely to have PLBW infants.

Krejci found that hormonal changes during puberty, menstruation, pregnancy and menopause, and those accompanying the use of hormone supplements cause an increase in the number of oral bacteria, which enter the blood and negatively impact on certain female health issues.

In addition to regular brushing and flossing, Krejci recommends visiting the dentists at least twice a year, and more often if women are pregnant, suffer from bone loss or gum problems.

The study was published in the first 2012 issue of the Oral Health and Preventive Dentistry journal.

Dr. Caroline Wallace DDS

Complete Dental Care

103 South Colorado Street

Salem, Virginia , 24153

540-387-3844

What is the uvula and what purpose does it serve?

2012-05-30T08:19:00.000-07:00

The uvula is the structure seen hanging down from the soft palate in the middle of the throat at the back of the mouth. It gets blamed for causing snoring, and is sometimes removed to treat snoring. Unfortunately, other structures can often contribute to snoring or more severe conditions, such as obstructive sleep apnea, can fail to respond to removing the uvula. It is also painful to remove. Why is it there in the first place? The palate and uvula serve to help direct airflow through the nose down to the voicebox and lungs. These structures serve as a valve to close off the airway when speaking or swallowing, so that things do not go up the nose. My kids can still have this happen if they laugh too hard while drinking. While we do not use the uvula much with speaking English, other languages, such as Spanish, French and Hebrew, use "uvular consonants". "Drilling your r's" in Spanish is a typical use. The uvula is also active in yodeling. The uvula can occasionally swell up, most commonly from being sucked down the throat while snoring, or stretched during upper endoscopies.

Dr. Caroline Wallace DDS

Complete Dental Care

103 South Colorado Street

Salem, Virginia, 24153

540-387-3844

Pacifiers could harm your childs dental health.....

2012-05-23T08:36:00.000-07:00

COLUMBUS, Ohio, USA: Researchers have found that children who are learning to walk are at the highest risk of injury from baby bottles, sippy cups and pacifiers. For the first time, they analyzed nationwide statistical data from the last 20 years and found that, on average, 2,270 injuries related to these products are treated in U.S. emergency rooms every year.

The study conducted by researchers at the Research Institute at Nationwide Children's Hospital in Columbus, Ohio suggests that between January 1991 and December 2010 an estimated 45,398 children under three required treatment in an emergency room owing to baby bottles, pacifiers and sippy cups.

According to the study, approximately two-thirds of injuries occurred among children aged one, a period of development associated with unsteady walking. The researchers found that 86 percent of the injuries were the result of falls while using the product. More than 70 percent of the injuries caused by falls affected the mouth and teeth of the toddlers, followed by lacerations of the head, face or neck (20 percent).

Baby bottles were involved in about 66 percent of the injuries. Pacifiers accounted for 20 percent of the injuries and sippy cups for 14 percent. Pacifiers were associated with soft-tissue and dental injuries, in particular.

"The permanent front teeth begin to develop in an infant's jaws soon after birth and the crown of the permanent tooth does not complete development until a child is three or four years old. If the toddler falls and injures a baby tooth, that tooth can get pushed up into the jaw and disrupt the development of the permanent tooth to follow. The risk is greatest when a baby tooth is injured before the child is three years of age and if the baby tooth is pushed up into the gums or completely knocked out," said Dr. Dennis McTigue, pediatric dentist at Nationwide Children's Hospital.

The researchers said that, currently, there are few formal recommendations regarding the ages at which children should discontinue using these products. Although the American Academy of Pediatric Dentistry and the American Academy of Pediatrics recommend using lidless cups by 12 months of age to prevent dental caries, and limiting pacifier use after six months to prevent infections, the products tend to be used at least until the age of two, the researchers said.

"Educating parents and caregivers about the importance of transitioning their children away from these products at the ages recommended by the AAP and AAPD could prevent up to 80 percent of the injuries related to baby bottles, pacifiers and sippy cups," study co-author Dr. Laura McKenzie suggested.

There is a need for further research into the nature of these injuries and prevention strategies, the researchers concluded.

Statistics were obtained from the National Electronic Injury Surveillance System operated by the U.S. Consumer Product Safety Commission.

Dr. Caroline Wallace DDS
Complete Dental Care
103 South Colorado Street
Salem, Virginia, 24153
540-387-3844

Oral Bacteria can cause Artificial Joint Failure

2012-05-15T09:23:00.000-07:00

CLEVELAND, Ohio, USA: Study results have suggested that periodontal bacteria can migrate from the mouth to the synovial cavity, which might be the reason for the failure of artificial joints. In recent DNA tests, researchers detected the same bacterial DNA in synovial fluid and dental plaque in 14 percent of patients with arthritis and periodontitis.

The study was conducted by researchers at the Case Western Reserve University's School of Dental Medicine and the University Hospitals Case Medical Center.

"For a long time, we have suspected that these bacteria were causing problems in arthritis patients, but never had the scientific evidence to support it," said Prof. Nabil Bissada, chair of the Department of Periodontics at the dental school.

In order to prove their bacterial translocation hypothesis, the researchers investigated the presence of bacterial DNA in synovial fluid and periodontal tissue samples from 36 patients with periodontal disease and arthritis. Five of the subjects showed a direct DNA link between the bacteria in the fluid and plaque. The researchers detected identical bacterial DNA in two patients with rheumatoid arthritis and three patients with osteoarthritis who were also diagnosed with periodontitis.

"The oral–synovium translocation could be due to the periodontal disease the patients had. In the presence of periodontal disease, the quantity of oral bacteria increases dramatically. This, in combination with inflamed gums, increases the chance of oral bacteria entering the circulation, leading to systemic dissemination," the researchers said.

"On the basis of our present and previous studies, we suggest that patients with arthritis or failed prosthetic joints be examined for the presence of periodontal disease and be treated accordingly," the researchers concluded.

According to the researchers, this data is the first genetically proven evidence that oral bacteria can migrate to the synovium in humans. Nevertheless, Bissada admitted that larger studies, with control groups, are required to corroborate the findings.

The case study group consisted of nine men and 27 women, aged between 45 and 84, with a mean age of 61.6 years. Eleven of the patients were diagnosed with rheumatoid arthritis and 25 with osteoarthritis.

The study was published in the April issue of the Journal of Clinical Rheumatology.

Dr. Caroline Wallace DDS
Complete Dental Care
103 South Colorado Street
Salem, Virginia, 24153
540-387-3844