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Hello and welcome to our community blog. My name is Dion Kramer and I am the managing director of NobleDentist.

This blog is designed to assist you with dental health issues. And to keep us in touch with members of NobleDentist.

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USC School Of Dentistry Teaches Hypnosis As An Alternative To Needles And Novocain

Posted in Dental Health News by Dion Kramer on October 3, 2008

This is an article that was recently published in Medical News Today – UK.

What if it was possible to undergo a root canal filling or tooth extraction without feeling the pinch of a needle or the after effects of general anesthesia? Hypnosis could uncover a new world for patients seeking dental care.

The soothing voice of your dentist could transport you into a state of mind that allows the dental professional to complete a procedure simple cleaning or a complex procedure that involves oral surgery slip into a state of relaxation.

“Now as I count from one to 10, I can feel myself sinking more and more deeply into the quiet, relaxed, enjoyable feeling. More relaxed with each count.”

Wendy J.N. Lee listens to the words uttered by associate professor Peter Stone, D.D.S., as her body slips into a more comfortable position during a recent visit to the USC School of Dentistry. Lee, a USC cinema graduate student, filmed Stone’s hypnosis techniques for Say Aah, a documentary about her fear of dentistry.

Hypnosis in dentistry was first reported in Egypt more than 3,000 years ago. The demise of its practice occurred with Horace Wells in the 19th century, who initiated the use of nitrous oxide and ether during procedures.

In the years that followed, chemicals and general anesthesia became common practice, and hypnosis became a sleepy alternative to sedation.

Today, the USC School of Dentistry is the only dental school in the United States that offers formal training for dental professionals in the use of hypnosis.

Stone, who works in the division of health promotion, disease prevention and epidemiology, teaches “Modern Hypnosis for the 21st Century Dentist.” He has taught the techniques and applications of hypnosis since 1981 for the Southern California Society of Clinical Hypnosis.

“The time spent learning hypnosis not only makes a visit to the dentist more pleasant for the patient, but it also enhances a practitioner’s productivity, providing a stress-free environment for all,” he says.

“Working with nervous patients makes it difficult to carry out our job,” Stone explains. “Dentists by nature, we don’t like to hurt people ¬ we’re trained to bring them relief from pain. When a patient is relaxed and calm, the procedure goes more smoothly and more quickly.”

Hypnosis could be a win-win for both patient and dentist. It’s a less expensive alternative to general or conscious sedation, which can cost hundreds of dollars.

“In the average patient, we can teach them to relax and control their fears 90 percent of the time. In a small group of patients, hypnosis allows them to control pain, bleeding or salivation during a procedure or speed up recovery time,” Stone says.

Stone shares his experience with one patient during oral surgery: “I remember telling my assistant, OIf only John would stop bleeding, I could finish this procedure quicker and remove the root tip causing his pain.’ Instantly my patient stopped bleeding.”

The technique is also used to control gagging, bruxism (teeth grinding and clenching) or breathing problems. In addition, hypnosis can enhance memory of a pleasant visit to the dentist.

Each year, dentists from across the country and Canada travel to Los Angeles for the two-day hypnosis course taught by Stone at the USC School of Dentistry. The workshop provides dentists with the tools and skills they need to use hypnosis comfortably in their dental practice.

By Monday morning, these dentists are equipped with the knowledge they need to put their patients at ease.

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Time for action about mouth cancer

Posted in Dental Health News by Dion Kramer on October 1, 2008

This is an article that recently appeared in Dudley News – UK.

‘Action speaks louder than words’ is the message as Britain’s leading oral health charity stages a November spotlight on a hidden killer disease.

Mouth Cancer Action Week takes place November 16 to 22, as the campaign organisers the British Dental Health Foundation takes a new, positive stance against the disease.

The new Action Week replaces the former Mouth Cancer Awareness Week name, as the Foundation and health professionals across the land take action a disease which kills more people than cervical and testicular cancer combined. Yet a fifth of the UK population remain unaware of mouth cancer.

Nearly 5,000 are diagnosed with mouth cancer in annually. Mortality figures have remained above 1,500 deaths per year for a decade. Mouth cancer kills one person every five hours in the UK.

The Foundation’s Blue Ribbon Badge campaign will continue to promote awareness by sending badges and collection boxes to dental practises, doctor’s surgeries, pharmacies and health centres across the country. Badges will then be sold to the public, raising funds and promoting the campaign.

A key message is retained from previous campaigns – ‘if in doubt, get checked out’.

Easily recognisable symptoms and regular check ups can boost survival rates to 90 per cent with early detection. Survival rates once mouth cancer has spread are as low as 50 per cent.

Foundation chief executive Dr Nigel Carter BDS LDS (RCS) said: “Our slogan, ‘if in doubt, get checked out’ reinforces our call to action. We are encouraging the public and the health profession to wear their Blue Ribbons with pride, and not only talk about the mouth cancer but take positive steps.”

He continued: “Action can be as simple as visiting the dentist regularly to making lifestyle choices such as quitting smoking or drinking in moderation.”

Early detection of mouth cancer can save lives, so people should look out for non-healing ulcers, red and white patches in the mouth, or unusual changes in the mouth.

Common causes are smoking, chewing tobacco, drinking to excess and poor diets.

Links have now been found between oral sex and mouth cancer.

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Dental health reform urgent for the bush

Posted in Dental Health News by Dion Kramer on September 29, 2008

This is an article that appeared recently in ABC Online News – Australia.

The Rural Dental Association is calling for a fair go for the average Australian mouth.

Dr Bruce Simmons says an Oral Health Reform Commission should be set up to ensure basic dental care for half the population who can’t afford to see a private dentist.

He says it comes after Australia was found to have the second worst adult oral health in the OECD, with 650,000 people waiting more than two years to see a public dentist.

“And so you’ve got basically two halves of society, ” he says.

“Fifty per cent roughly are doing pretty well keeping their teeth, The other fifty per cent are having a lot of trouble losing their teeth early because they can’t get in and get the small work, the sort of early intervention work that might make a difference.”

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Seal of Acceptance granted to Natural Dentist Anticavity Fluoride Rinse

Posted in Dental Health News by Dion Kramer on September 26, 2008

This article was recently published in Dental Office Magazines – Tulsa, OK, USA.

MEDFORD, Massachusetts—The Natural Dentist has announced that the American Dental Association has granted its Seal of Acceptance to The Natural Dentist Healthy Teeth Anticavity Fluoride Rinse.

The seal was awarded based on the ADA Council on Scientific Affairs’ finding that the product is effective in helping to prevent or reduce tooth decay, when used as directed.

The Natural Dentist Anticavity Fluoride Rinse strengthens tooth enamel to help minimize the risk of cavities. It is designed as part of a healthy oral care regimen that includes brushing and flossing.

The Natural Dentist Anticavity Fluoride Rinse is all-natural, with no alcohol, artificial sweeteners, dyes or preservatives. It preserves mouth moisture with vegetable glycerin and aloe vera gel. It kills bad breath germs and has a minty flavor with cool, menthol freshening, but none of the “burn” or staining of other brands.

The ADA-accepted The Natural Dentist Anticavity Fluoride Rinse is available at leading drugstore, grocery and mass retail locations nationwide, and is part of an all-natural product family. This includes The Natural Dentist Healthy Gums Mouth Rinse, and The Natural Dentist Healthy Teeth & Gums toothpaste.

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Dental Implants: The Best Option for Aging Bridges

Posted in Dental Health News by Dion Kramer on September 24, 2008

This is an article that was recently published in Best Syndication – Pinon Hills, CA, USA.

The American Association of Oral and Maxillofacial Surgeons has reported that approximately 69% of adults have lost one or more teeth because of tooth decay, gum disease, or accident. Many of these people have bridges to replace these missing teeth; however, as these bridges age, dental implants are becoming a more feasible, attractive, and durable options for patients.

What Are Bridges?

In order to have a bridge, you must have teeth on either side of a missing tooth. To build bridges, dentists reduce the size of these surrounding teeth before creating a prosthetic that fits over these teeth and fills the gap with a false tooth. The bridge is then bonded on either side to the existing teeth.

Because bridges need to be replaced or repaired every 7 to 15 years, many people are presented with new prosthetic options for missing teeth. Among the top options are dental implants.

What Are Dental Implants?

In contrast to bridges, dental implants do not use surrounding teeth to anchor a prosthetic tooth. Instead, dental implants (which are sometimes called single-tooth implants) are standalone. To receive a dental implant, your dentist will create an implant post using a process called osseointegration, which allows the dentist to fuse titanium metal to your jawbone. After that process is complete, he or she will attach a crown to the implant post. Ultimately, dental crowns rely on the jawbone rather than on surrounding teeth for strength and support.

Which Option Is Right for Me?

Today, the choice is clear for most patients. Although bridges are the more traditional option for replacing missing teeth, they are problematic to maintain. It is difficult to clean and floss areas around the bridge, and tooth decay can result. Some patients even require longer bridges as the anchoring teeth deteriorate or become damaged.

Additionally, most believe that implants look more natural than bridges, implants better align with your natural jaw line, and they are easy to care for.

Ultimately, implants over both cosmetic and health benefits over bridges. Although implants may initially seem expensive, most patients experience long-term savings, as implants rarely need to be replaced or repaired. Even those patients who currently have bridges can take advantage of implants by having those old bridges replaced.

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Osteoporosis-treating Bisphosphonates Linked to Jawbone Damage

Posted in Dental Health News by Dion Kramer on September 22, 2008

This is an article bu Susan Brink that was recently published in the Los Angeles Times – CA, USA.

Patients taking the drugs may develop small patches of dead bone in their mouths. And, extra care is called for when dental procedures are needed.

Drugs to treat osteoporosis are not without possible side effects, most notably a widely publicized condition in which jawbone tissue dies.

Pun absolutely intended, Dr. Thomas B. Dodson explains, ” ‘Bisphosphonate-related osteonecrosis of the jaw’ is a mouthful.” His expertise is another mouthful—oral and maxillofacial surgery at Massachusetts General Hospital. He’s an expert on . . . let’s just call it BRONJ.

The problem has been linked to drugs called bisphosphonates, ranked 10th in U.S. sales among all drug categories, according to IMS Health, which analyzes pharmaceutical and healthcare markets. Most cases come after someone has been treated for cancer with potent, intravenous forms of the drugs. About 1 in 10 cancer patients treated with IV bisphosphonate develops the jaw problem.

But a handful of cases have shown up in women taking much smaller doses of the drugs for treatment of osteoporosis.

Bisphosphonates, marketed as Actonel, Actonel+Ca, Aredia, Boniva, Didronel, Fosamax, Fosamax Plus D, Reclast, Skelid and Zometa, are meant to increase bone density in the short run by reducing the bone-loss part of the bone life cycle. But some scientists think the drugs may eventually hurt the jaw’s ability to heal after, say, a tooth extraction or a dental implant.

The estimates on the number of people who might experience the jaw problem range from 1 in 2,000 to as many as 1 in 300 people who take the drugs for osteoporosis.

In the U.S., 55 million prescriptions for bisphosphonates are written annually, according to a 2007 report in the journal Osteoporosis International. Even if not all of those prescriptions are filled, and even if many of the women who start taking the drugs stop, the number of women who might have trouble in dentists’ chairs is sure to rise.

Most commonly, those people will see or feel some exposed bone in the mouth, as the dead bone works its way through gum or tissue, but without pain. In those cases, people are simply told to use an antibacterial mouthwash. If there’s pain or discomfort, and the area of exposed bone is small, a dentist will try to smooth down the exposed area.

In rare cases, the area of dead bone is large. “Then people run the risk of breaking the jaw, because the area is so large,” Dodson says.

So why would a medicine that circulates through the entire body result in a pharmaceutical punch to the jaw? Researchers have only theories.

It could be, Dodson says, that bone in the jaw metabolizes at a speedier rate than in other parts of the body so more of the drug is getting deposited there. And because there is more bacteria in the teeth and mouth area, that could add to inflammation, worsening the problem.

Or it could be, he says, that the mechanism of the drug is at work. Bisphosphonates inhibit cells that dissolve bone. “But dissolving bone is part of a healthy life cycle,” he says. The natural balance between dissolving bone and making new bone is disrupted and bone-producing cells now dominate. But when they die off, there are fewer cells to clean them out, and they remain, a dead mass.

Dental procedures—tooth extraction, dental implants, oral surgery—can increase the risk of a problem because of trauma to the jaw. That’s why the American Assn. of Oral and Maxillofacial Surgeons recommends that if a woman is going to begin taking a drug for osteoporosis, she have dental work done before she starts.

If she’s been taking the drug for three years or more, the association recommends a three-month drug holiday before having non-emergency oral surgery.

But for women who’ve been on the drug, an urgent problem—such as a throbbing toothache—should be dealt with immediately, even though there may be a 1 in 300 chance that she has BRONJ.

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Don’t Drink Fruit Smoothies Made with Added Sugar, Warn Dentists

Posted in Dental Health News by Dion Kramer on September 19, 2008

This is an article by David Gutierrez that was recenty published in Natural News.com – Phoenix, AZ, USA.

The head of the British Dental Health Foundation has warned that the high sugar content of some fruit smoothies, combined with acid from the fruits, can lead to serious tooth damage.

According to a survey conducted by Oral B and the British Dental Health Foundation, 30 percent of the population believes that drinking fruit smoothies is good for the teeth. But British Dental Health Foundation Chief Executive Nigel Carter warned that while fruit consumption is healthy for the body in general, certain smoothie ingredients are actually bad for your teeth.

“Fruit smoothies are becoming increasingly popular and the fruit content can make them seem like a good idea,” Carter said. “However, they contain very high levels of sugar and acid and so can do a lot of damage to the teeth.”

Many commercially available fruit smoothies contain added sugar – sometimes in the form of seemingly natural ingredients such as grape juice – or other additives, such as ascorbic acid. Smoothies made without these additives contain much lower levels of sugar and acid. It is these ingredients that Carter warned of.

“While fruit smoothies can be a good way to get people to consume more fruit, the high concentration of sugar and acids means that they can do real damage to the teeth if sipped throughout the day,” Carter said. “Every time you sip on a fruit smoothie, your teeth are placed under acid attack for up to an hour, so constantly sipping on these drinks can cause the protective enamel to erode, causing pain and sensitivity. It can also lead to decay.”

Dentists advise people who consume fruit drinks to brush their teeth before drinking them, rather than immediately afterward. The acid content of fruit juices can weaken enamel, and brushing teeth in this weakened state may cause permanent damage.

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Waiting Lists Grow While Senate Delays

Posted in Dental Health News by Dion Kramer on September 17, 2008

This is an article by Alison Mills that was recently published in the Parramatta Sun – New South Wales, Australia.

A stalemate in the Senate over public dental funding will bring little relief to the estimated 650,000 people nationwide waiting to see a dentist.

On the eve of the 2007 federal election, the Howard Government expanded the Medicare dental scheme but the Rudd Government stopped funding the scheme in June 2008.

Attempts to replace that scheme with a new Commonwealth Dental Health Program are stuck in the Senate with coalition senators threatening to refuse to pass the necessary legislation.

Parramatta MP Julie Owens said the previous government’s “failed’’ scheme was “poorly targeted’‘.

“If the Commonwealth Dental Program doesn’t go ahead and people in my electorate miss out on vital treatment, it will be because the Liberal and National parties are refusing to support dental care for those most in need,’’ Ms Owens said.

However Liberal Senator Marise Payne argued the coalition’s scheme was “highly successful and in high demand, providing more than 300,000 dental services in the first three months’‘.

Ms Owens said dental care was consistently raised by her constituents during the election campaign and the government had committed to spend $290million on the program and provide 327,2000 dental services in NSW.

The Westmead Centre for Oral Health, the largest dental teaching facility in the southern hemisphere, treated more than 170,000 patients in 2007.

A Sydney West Area Health Service spokeswoman said the centre was “waiting for additional funding … to reduce the dental waiting list’‘.

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Senate to Save Dental Extraction

Posted in Dental Health News by Dion Kramer on September 15, 2008

This is an article by Mark Metherell that was recently published in the Sydney Morning Herald – Sydney, Australia.

CHRONICALLY ill patients who are desperate to get expensive dental care under a popular Medicare scheme before it is shut down may get a reprieve.

The scheme, introduced last November, provides up to $4250 in benefits for operations and dentures and has financed more than 100,000 services a month.

Patients and dentists had been advised against beginning treatment after this week because the Federal Government wanted to close it and replace it with a less lavish scheme covering more people.

However, those with chronic disease needing urgent dental work may be saved by the Senate. The move to axe the program was blocked by the former Coalition-controlled Senate and there is doubt if the new Senate will ditch it.

Dentists and the Opposition say the looming closure of the scheme has created confusion and anxiety among patients hoping to get treatment they could not previously afford.

The Department of Health’s website warns patients and dentists that, subject to Parliament, the Government “intends to close this scheme to all patients at the earliest opportunity once Parliament resumes on August 26”.

Yesterday the Government refused to say when it would end the scheme. Sources in non-government parties said the move was looking doubtful.

The Health Minister, Nicola Roxon, said the replacement scheme, the Commonwealth Dental Health Program, would be more accessible and better targeted than the current “failed” scheme that enabled millionaires to get treatment while pensioners could not have a toothache treated.

The Opposition health spokesman, Joe Hockey, accused Ms Roxon of trying “to con dentists and patients into walking away from a very successful program.

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Baby Wants a Toothbrush! Baby Wants a Toothbrush!

Posted in Dental Health News by Dion Kramer on September 11, 2008

This is an article by Paige Parker that was recently published in The Oregonian – OregonLive.com – Portland, OR, USA.

The baby’s now a year old, and you say you’ve got this parenting gig down cold.

The diapers don’t scare you. You’ve kept up with all those pediatrician appointments.

But has the baby seen the dentist yet?

The American Dental Association recommends that children see a dentist within six months of cutting their first tooth, and no later than their first birthday. The American Academy of Family Physicians advises parents to start caring for a baby’s gums, then teeth, at birth, wiping them with a soft, wet cloth after each feeding.

Though these oral health advisories have been around for a few years, parents have been slow to get the word. Meantime, national rates of decay in baby teeth continue to creep up, the national Centers for Disease Control and Prevention reports, and Oregon ranks near the bottom among states when it comes to untreated tooth decay.

A 2007 survey by the Oregon Department of Human Services found that one in four of the state’s children hadn’t seen a dentist in the previous year. More than one in three Oregon children need treatment for tooth decay.

“It’s heartbreaking to see kids here, in a developed country . . . and they have a lot of decay,” says Dr. Prashant Gagneja, chairman of Oregon Health & Science University’s department of pediatric dentistry. “It’s happened that we’ve had to pull all 20 baby teeth.”

Gagneja says health care practitioners of all stripes should promote early preventative care to their patients and think of a decay-free mouth as critical to overall health.

“We need to give health care providers simple encouragement to consider oral health,” he says.

Obstetricians, Gagneja says, should recommend that women see a dentist during pregnancy because mothers with high levels of oral bacteria can pass them along to their children. Lactation consultants have the perfect opening to dispense oral health education along with breast-feeding advice.

Still, health practitioners say that although they understand the importance of good dental care, that doesn’t mean they’re able to promote it to their patients—or that their patients can find a dentist willing to treat infants, toddlers and pregnant women.

“This is not something that comes up every day,” says Margi Munson, an international board-certified lactation consultant and supervisor of Legacy Health System’s lactation services. “When the mom comes in four days postpartum and the baby’s not pooping or peeing, we don’t talk about dental health. I do think it’s something that should be covered, but I see it as more of in the pediatric domain.”

Dr. Megan Newman, a pediatrician at Emanuel Children’s Hospital, said she follows the American Academy of Pediatrics’ guidelines, which recommend only infants at higher risk of dental caries see a dentist before they turn 1.

“Short of being in the dentist’s chair, I think there’s lots of dental care that’s being initiated at those well-child checks,” Newman says.

Dr. Karen Muchowski always peers inside her young patients’ mouths and looks for problems. The pediatrician for Providence strongly promotes fluoride, and she covers brushing basics. But unless the child seems at risk of early cavities—they’re sucking down lots of juice, they were born premature or their mom has cavities—Muchowski tells parents to make the first dentist appointment when the child reaches age 3.

Many doctors mistakenly think a child can’t sit still for a dental exam before age 3, says Dr. Samer Hakimeh, a pediatric dentist at Kaiser Permanente.

“We would like to see them before then to talk about risks and what they can do to prevent cavities,” Hakimeh says. “By age 3 it’s generally too late—too late as in they already have a bunch of cavities.”

Toddlers are squirmy, true enough, but unlike general dentists, pediatric dentists are specifically trained to treat them. Hakimeh, for example, has parents hold their children while he looks in their mouths; he perches toddlers in a pint-sized seat rather than an adult exam chair.

Hakimeh asks parents about their child’s diet, discouraging sugar consumption, night feedings and putting babies to bed with bottles. He uses a tooth model to demonstrate proper brushing technique.

“Usually,” he says, “the ones that come my way by age 1 are saved from cavities.”
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