Thoughts of a caring dentist

More News on Oral Health and Heart Disease

I came across an article on MedScape, a news service for health professionals. It's authored by Sue Hughes from the UK. Bottom line, the healthier your mouth, the less likely you are to have heart problems. Brush your teeth less than once a day and you're twice as likely to have heart problems!

Ms Hughes' article cited a recent study published online in the British Medical Journal by Prof Richard Watt of University College London, UK. Prof Watt and his group noted that inflammation in the body (including mouth and gums) plays an important role in the buildup of atherosclerosis. The study investigated whether the number of times individuals brushes their teeth influences their risk for heart disease.

The article stated that researchers looked at over 11,000 adults. Individuals were asked about lifestyle choices such as smoking, physical activity, and their oral health habits. They were also asked how often they visited the dentist and how often they brushed their teeth. Medical history and family history of heart disease and blood pressure were then factored in. Blood samples were analyzed from some participants and levels of C-reactive protein (CRP) and fibrinogen were determined. The data gathered from the interviews was then linked to hospitalizations and death.

(C-reactive protein is an indirect measurement of inflammation in your body, and fibrinogen is a building block for blood clots. Levels of both chemicals rise with your degree of inflammation.)

The study found generally good oral hygiene habits, with 62% of participants visiting the dentist every six months and 71% reporting that they brushed their teeth twice a day. After risk factors were accounted for, participants who brushed their teeth less than twice a day were found to have an increased risk of heart disease. Those who had poor oral hygiene had increased levels of CRP and fibrinogen.

Here are some of the research findings:

Hazard Ratio for Cardiovascular Events (Fatal and Nonfatal) Relative to How Often Teeth Are Brushed Each Day

Frequency of tooth brushing      HR* (95% CI)

Twice a day 1.0

Once a day 1.3 (1.0–1.5)

Less than once a day 1.7 (1.3–2.3)

p for trend 0.001

*Adjusted for age, sex, socioeconomic group, smoking, physical activity, visits to dentist, body-mass index, family history of cardiovascular disease, hypertension, and diabetes

The researchers think that this is the first study linking toothbrushing and the rate of heart problems in adults who do not already have cardiovascular disease.

They feel this study suggests the role of poor oral hygiene in the risk of cardiovascular disease by raising systemic inflammation. Inflammation and clotting activity could be an underlying cause of periodontal disease and create an increased risk for heart disease.

More research is needed, but a body of evidence is pointing to oral health being a major factor in your overall health.

References

de Oliveira C, Watt R, and Hamer M. Toothbrushing, inflammation, and risk of cardiovascular disease: Results from Scottish Health Survey. BMJ 2010; DOI:10.1136/bmj.c2451. Available at: http://www.bmj.com.

Dr Sandlin | Sandlin DDS Lawrenceville, Ga

Oral Cancer on the Rise

While all other forms of cancer are becoming less frequent, the incidence of head and neck cancers is increasing. Some of these cancers, such as esophageal cancer, are both aggressive and usually fatal. Not only are head and neck cancers becoming more frequent, they are also affecting individuals who do not have classic risk factors for the disease (tobacco and/or alcohol consumption.) Most alarming, the group seeing the highest increase is men and women between the ages of 20-44.

Recent medical research has concluded that the rise in oropharyngeal squamous cell carcinoma is directly related to the spread of the Human Papilloma Virus (HPV). This finding suggests that many cancers of the head and neck are “sexually acquired”.

The Human Papilloma Virus is thought to spread both orally and genitally. It is a prevalent cause for Cervical Carcinoma and cancers around the tonsils. One strain of the virus, HPV-16, is the most aggressive form and is responsible for the majority of HPV positive cancers.

The good news is that HPV-associated oral cancers respond much more favorable to radiation therapy and chemotherapy. Also, HPV vaccines are being developed which should sharply decrease the rate of Cervical and HPV-associated Oral Cancer.

Another breakthrough in early detection of Oral Cancer is the development of better diagnostic tools. Pap Smears have long been the “gold standard” for detection of Cervical Cancers, but the equivalent method for detecting Oral Cancer is both complex and expensive. Recently, a new diagnostic tool has become available which reveals 98% of all early (Stage 1) Oral Cancers. Using a special rinse and light source, the test identifies suspicious areas. These areas are then stained with a dye to reveal any change in cellular structure. Questionable areas are then biopsied.

Risk Factors for Oral Cancer

Use of tobacco products.

This includes smoking cigarettes, cigars, and pipes, plus chewing,

and dipping snuff. Consumption of alcohol products. While the

amount of use varies in each study, more than one oz each day can

lead to many problems.

High risk sexual behavior.

Multiple lifetime partners and contact with HPV positive individuals.

HPV transmission can be both genital-oral and oral-oral.

Poor diet, lack of exercise, high stress.

Low resistance factors raise your risk for all cancers.

If it’s been a while, get checked today!

Dr Sandlin | Sandlin DDS Lawrenceville, Ga

Lifestyle Choices Control 50% of Your Health Prognosis!

“Patients carry their own doctor inside them. They come to us not knowing that truth. We are at our best when we give the physician who resides within each patient a chance to go to work.”

- Albert Schweitzer

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In 1975, Drs. John McCamy and James Priestly wrote a landmark book entitled, Human Life Styling. Though it’s been more than thirty years, the concepts promoted by these two MDs are the foundation of 21st Century Health care. Dr. McCamy wrote in his work about the “Four Horsemen of Health”:

Diet * Exercise * Stress Reduction * Your Environment (Ecology)

He expanded on the work of pioneers in the field of Health, Wellness, Longevity, and Life Style. People like Dr. Hans Selye, Dr. Linus Pauling, Dr. Emanuel Cheraskin, and Adele Davis.

Clinical disease is usually the last step of a decade or more of deterioration. Annual check-ups only lead to early detection of disease before it gets worse. This is not prevention. True prevention aims to prevent signs or symptoms of the disease from occurring in the first place.

“Every major disease is predictable and preventable in the first decade of its development.”

Human Life Styling focuses on changing lifestyle to achieve optimum health. The keys to Human Life Styling (HLS) are the following:

1. There is a difference between good health and average health. A truly healthy person has no physical or mental complaints. He should feel good all the time, have a great deal of energy and vitality, and have no recognizable symptoms.

2. Disease takes a long time to develop. Symptoms appear long before the clinical disease is manifested, sometimes decades before a precise diagnosis of disease. Invariably, the patient reveals a deficiency in all three areas of nutrition, exercise, and stress response.

3. Susceptibility (risk) factors increase the likelihood of disease. Resistance factors decrease the likelihood of disease. HLS means building up resistance and lowering susceptibility. All factors of resistance must be present to stay healthy. Miss one and resistance is lowered.

Increase All Your Resistance Factors while Decreasing Your Susceptibility Factors

• Heart disease, stroke, cancer, periodontal disease, and most chronic diseases have similar risk factors (though maybe not in the same sequence of importance.)

• Smoking, alcohol, overeating, poor diet, refined foods with white flour and high sugar content, lack of vigorous exercise, bottled up emotions, and high stress are significant risk factors.

Human Life Styling concerns itself with “Quality of Life” factors: Aging slowly and gracefully – living with energy and a positive orientation towards life.

Dr. Sandlin | Sandlin DDS Lawrenceville, Ga

Dr Sandlin Launches Health Initiative

I'm excited to announce that our office is san official Center for Dental Medicine. As of today, we can offer treatment for gum disease in a way that eliminates infection and creates health. You may have heard that gum disease increases the risk of heart disease, stroke, diabetes, and some types of cancer. In the past, the best we could do is accept this condition and try to manage its effect. Now, anyone suffering with periodontal infection can have healthy gums and also eliminate a lot of medical risk factors.

The Centers for Dental Medicine (CDM) protocol uses non-surgical laser decontamination of disease causing bacteria, non-surgical removal of bacterial debris, an advanced home care regimen including nutritional support, and state-of-the-art laboratory testing to establish your risk for systemic problems and to verify the success of your treatment.

All week we've been training to provide this advanced care. When we open after the holiday, we'll be outlining the possibilities for patients suffering with gum disease. If you have questions about ways to eliminate gum infection, or how this care might reduce your risk of medical complications, give us a call. If we've recommended that you see us every three or four months, just to slow down your gum disease, this may be a way to eliminate your disease and get back to a stable, healthy six month routine.

Have a great day,

Dr Sandlin | Sandlin DDS Lawrenceville, Ga 

Health Care vs Disease Management

It was the famous physician, William Osler, MD who stated: “You can tell the health of a person by observing the health of their mouth! The health of the mouth is the window to the health of the body.”

One of my central goals for each person I serve is to bring the doctor inside of them to life. I believe I best serve each patient when I can help them prevent the causes of dental disease.

- Factors Contributing to Your Health –

20% - Heredity

10% - Medical Care System (Quality and Availability)

20% - Environment

50% - Lifestyle Choices

Based on figures from the National Center for Health Statistics, Centers for Disease Control, and National Institute of Health.

America is experiencing a disease-care crisis. This forces us to recognize several factors:

• People shift responsibility from themselves as agents of health, to the Medical Care System as agents to treat their disease. In reality, 50% of your own health status is a direct result of lifestyle choices.

• The Medical Care System contributes only 10% of the health care outcomes of individuals.

How does this translate to dentistry and dental health? Since we are dealing with all health, then certainly Oral Health must be included. Like the Medical Care System, the Dental Care System and insurance contribute to only 10% of the factors that determine if a person preserves their natural teeth for a lifetime or not.

Traditional medicine and traditional dentistry only react to disease. Consequently, disease treatment increases in cost every month, whereas preventing disease in the first place is the Proactive approach.

Because traditional dentistry is reactive, it focuses on repair and treating symptoms and effects of disease; but does not focus on prevention and true health, which is the absence of disease.

If you’re thinking how healthy can I be? How good can I feel? How much energy and vitality can I have in my life? Then, you’re thinking like I think and I want to become as healthy as I can become. I want the most out of the rest of the years in my life. What about you?

If you’re tired of being the object of cure and disease treatment, perhaps you are ready for a different approach; an approach where HEALTH IS FIRST!

Dr Sandlin | Sandlin DDS Lawrenceville, Ga

Federal Heath Care Legislation and Your Dental Health

Things are becoming clearer, now that the public has had a chance to study the Federal Health Care bill. Initially, no one was sure how the legislation would affect the average citizen, and there is still some doubt in areas of policy and Health and Human Services implementation, but what John Q Public can expect is slowly coming into focus.

As far as your oral health care, the legislation largely bypassed the practice of dentistry. Aside from a commission to study "the right to oral health", a requirement that all dental records be stored electronically by 2014, and a yet to be funded expansion of child dental services, only one significant change has been found. Tucked inside the bill is a provision to allow "Dental Health Technicians" to prepare (read drill) and restore (read fill) decayed teeth, and to perform simple extractions. This also allows anesthetic injection by the Technician.

This classification of health care providers has not existed before, and the training requirements, experience, and supervision of their care has not yet been outlined. HHS will provide that for us at some date.

The Dental Health Technician position comes out of a need to provide oral health care to indigenous populations in Alaska and Minnesota. It's now being promoted as a method of bringing oral health care to under-served populations throughout the US. These are mainly folks who live below the poverty line.

While I don't think anyone in our practice will be "dentally affected" by Obamacare, at least not directly, the economics of health care will likely have a profound effect on your wallet.

Many in the dental profession anticipate a vast change in medical health insurance coverage. Dental and Vision insurance have long been add-ons to employers' medical care contracts. With the potential impact Obamacare will have on the health insurance industry, look for dental insurance to become more restrictive (fewer benefits) and much more costly. Our front desk tells me that this is already occurring.

Also, expect that your medical insurance will cost more, and that will mean less discretionary spending for your family. Some analysts predict a 300% increase in your health insurance premium over the next 5 years.

Meanwhile, federal tax rates are scheduled to increase across the board in order to pay for this expansion in entitlement spending. Look for Uncle Sam to be asking for an additional 10% (according to some analysts.)

No matter your opinion on Health Care Reform, expect that things will be changing. As I heard one leader in our profession say, "They've changed the rules and nobody knows how things will be in 10 years."

Godspeed and have a great Memorial Day weekend.

Dr Sandlin | Sandlin DDS Lawrenceville, GA

Different Kinds of Dentistry

Could you help? I'd appreciate having your opinions and insights. (Please comment below, or email me at DrSandlin@SandlinSmiles.com.)

A short survey:

When you compare us with other dental offices, what's different?

Why do you come to see us, rather than anyone else?

What was the first thing you noticed when you entered our practice?

When someone else has a dental concern, what do you tell them about our office?

These questions have rattled around my head all week. A trip to the Center got me thinking about how we're different, and why we're different from other offices. If you could give me feedback, it'd help resolve my questions and concerns. Thanks in advance.

Form and Function

A lot has been said about shaping things for a purpose. You don't race the Indy 500 in a dump truck. You don't drive to a five star restaurant expecting a drive-thru window. Consider that dental offices are that way. All share a function (dump truck/race car - transportation; restaurants - food, dental offices - teeth, gums, and jaws), but how they function leads to different outcomes. Some practices are designed to react to disease. I've tried to create a practice that supports health. Let me explain.

I started my practice, fresh out of Emory, thinking that everyone wanted to be healthy (free from disease). I soon realized that most come to my office because they wanted to be free of a disease. There is a difference, though it's subtle. Health is the absence of breakdown. You have it by preventing deterioration. Our Medical Model is essentially Disease Care as it repairs deterioration already caused by disease.

It's also a fine line. With the Medical Model being what it is, it's rare for someone not to expect a relationship other than "Dr tells Patient bad news." Instead of helping someone become the strongest they can be, it's assumed that I all I do is repair damaged body parts.

When you enter a practice also differs according to your mindset. Depending on your previous dental experience (health-care vs disease-care), you might be at our door because:

You're feeling guilty - mom always told you to visit the dentist twice a year and you're overdue. Hope she doesn't find out!

You let me "do" things to you because, "He's the expert and he must know what's right."

You're afraid of pain more than you're afraid of me.

You're in pain and are willing to do anything to get rid of it.

You're feeling something different and you're afraid it's going to turn into pain.

You want something that only a trained professional can give you - cosmetic dentistry to improve your appearance.

(If that sounds cynical, I'm not griping. 95% of all dental offices operate on the disease-care model, and it can be very profitable. I practiced this way for almost 20 years, but found it impersonal and self-defeating. When all you do is treat damage caused by disease, it never goes away!)

Why am I saying all of this? I want my patients to experience something different. I want them to be healthy instead of not-yet-needing-treatment. I want to create health crazed dental missionaries who share their success with anyone who'll listen. I want to be a part of the reason your life will be better tomorrow than it is today. I want you to be whole.

50% of your health is related to personal choices. Only 10% is due to the availability and quality of your disease treatment (mislabeled as healthcare.) Let us help you choose to be healthy. Let us help you choose to be whole.

Now you know. Our office is designed to do things differently, and to do things you don't find in other offices. I realize that, at times, this can be frustrating. Some folks are so used to negotiating the Medical Model, that our way of practicing makes no sense. Please remember that we're working for a different outcome. Health vs Disease Recovery.

We try to educate and support. Ultimately, our goal is to put the decisions and responsibility for your health where they do the most good, with you. Only you can decide to be healthy. We'll work with you as you recover from pre-existing disease, and then we'll partner with you as you maintain your long term health.

That's the relationship I want to have, whole, healthy, and empowering.

Dr Sandlin |Sandlin DDS Lawrenceville, Ga

Brighter Smiles - Bleaching for Breast Cancer Research

Over the last ten years, the Brighter Smiiles program has raised hundreds of thousands of dollars for the Gwinnett Women's Pavilion. As a part of Breast Cancer Awareness Month, our office is again participating in this important effort.

If you have wanted to whiten your teeth, now's your chance!

For a contribution of $250 to the Gwinnett Hospital Foundation (tax deductible), and $67 to partially defray the cost of materials, we will provide you with a professional tooth bleaching tray system. What's more, if you keep the trays, you can "touch up" whenever you want in the future, and all you'll need is fresh bleaching gel. That's inexpensive.

The Brighter Smiles program continues until January 31, 2010. Let us know if you'd like to participate. It's just in time for the holidays.

Dr Sandlin and Staff | Sandlin DDS Lawrenceville, Ga

Bioesthetics Level 4 Complete!

After more than six years, and numerous trips to three cities (Denver, Louisville, and Boston), I've completed my training in Bioesthetic Dental Rehabilitation. Whew.

A lot of things came out of my experience. I've learned a great deal about managing facial and jaw joint (TMJ) pain. I've learned how to stabilize diseased and injured joint systems. And I've learned how to treat someone whose mouth is severely deteriorated. A lot more than they teach in dental school!

What I've learned most is the importance of diagnosing problems early. Dr Robert Lee, the founder of Bioesthetics, used to say, "Save the children!" I've come to appreciate his plea. Identifying developmental problems early can allow intervention and relatively easy correction. Once facial growth is completed (ages 17-20), solutions become limited and complex (as in expensive and involved.)

So many of the problems I've seen: painful jaws; headaches/neck pain; worn teeth; and even advanced bone deterioration, are directly related to growth patterns gone wrong. Sometimes one of the jaws doesn't develop in a way to coordinate with the opposing arch. Sometimes the teeth don't erupt to coordinate with other teeth. Sometimes the chewing system deteriorates until every other element is adversely affected - tooth form (worn down teeth), shape of the teeth in either or both arches (crowded, drifted, or rotated teeth), deterioration of the jaw joint(s) (TMJ), and overused and strained muscles (headaches and neck aches.) It's a complex system that deserves a lot of respect.

During my training, I've had the opportunity to treat patients who presented with a variety of symptoms. While their underlying problems were different, and ultimately the solutions were unique to each case, everyone had the same bottom line cause: their jaws and teeth didn't fit within their chewing system. Their treatment sequence all started with stabilizing the jaw joints and muscles (with a mouth splint), determining how their chewing systems operated outside of the stable model, and designing solutions to their functional challenges. Our treatment goals sought to achieve a stable chewing complex with attractive, comfortable, and stress free function.

I want to thank our staff for being supportive during my training. It's been tough for them as well, extra work, learning new techniques, and being able to discuss new treatment options with our patients. Thanks also to the specialists who have supported my class cases. Dr Turner (root canals), Dr Fussel (orthodontist), and Dr McIntosh (surgery and implants.) I want to especially thank Jay, our lab technician, who traveled with me to class and who's accepted the challenge of working at a demanding level of accuracy. Without them all, I could never have accomplished my dream of providing the highest level in dental care.

Dr Sandlin | Sandlin DDS Lawrenceville, Ga

Reflections On Health

“The excellence of the body is health; that is, a condition which allows us, while keeping free from disease, to have the use of our bodies; for many people are 'healthy' as we are told Herodicus was; and these no one can congratulate on their 'health', for they have to abstain from everything or nearly everything that men do.” - Aristotle

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Allow me to share the words of two doctors who I greatly admire. Dr. Harold Wirth was a visionary in the middle part of the 20th century. Dr. Michael Schuster is one of my mentors and writes extensively on practice and philosophy in health care.

Reflections

Healthy, attractive mouths are found in all walks of life, rich and poor, highly educated and not. These mouths are seen in people who think well of themselves and have come to appreciate the deep physical and psychological roles their mouths play in their life. They know that teeth can make or break careers or inter-personal relationships.

The mouth, in its entirety, is an important and even wondrous part of our anatomy, our emotions, our life; it is the site of our very being. When an animal loses its teeth, it cannot survive unless it is domesticated; its very existence is terminated, it dies.

In the human, the mouth is the means of speaking, of expressing love, happiness and joy, anger, ill temper, or sorrow! It is the primary sex contact; hence it is of initial importance to our regeneration and survival by food and propagation. It deserves the greatest care it can receive at any sacrifice.

Psychiatrists have found that the improvement of unhealthy or unattractive mouths produces a profound emotional response in oneself and when others observe unattractive or unhealthy mouths. On the other hand, they are often baffled by the occasional person who becomes emotionally disturbed as a result of the loss of teeth. This emotional castration is not easily treated by the psychiatrist. And it is not easily undone by an accomplished dentist.

A sensible approach seems to be learning about one’s mouth and overall health. Thus, preventing disease and creating a customized plan for optimum health, function, beauty and longevity. Intelligent action consistent with personal values for health, function, beauty and a long healthy life will follow.

- Drs. F. Harold Wirth and Michael Schuster

As our nation continues to wrestle with issues of Health Care delivery and Cost Management, I'm inclined to ask what we, the patients and consumers of treatment, are asking of ourselves. If "personal values for health, function, beauty, and a long life" are truly deciding factors, I suspect the answer to our national conundrum lies closer to home than Washington DC.

Dr. Sandlin | Sandlin DDS Lawrenceville, Ga