The NobleDentist Blog

This is an article by Kristi Gustafon that appeared recently in the Albany Times Union.

The anything-goes method of cleaning food from teeth might cause more harm than good, dental experts say.

You’re driving—or should we say creeping—down the highway during rush hour while enjoying your McDonald’s breakfast sandwich. Midmeal, a clump of sausage wedges itself between your teeth, up near your gums.

Your dental floss, of course, is home in your medicine cabinet, so you look around the car. The laces from your son’s soccer cleats? Not only are they dirty, but they’ll never fit up there. How about the air freshener string on the rearview mirror?

Hmmmm. A possibility.

While looking at the pine tree-shaped freshener, you catch a glimpse of yourself—and your diamond studs—in the mirror. An earring post. Perfect! You pop the earring out of your ear, poke it between your teeth, dislodge the offending meat . . . and cut your gums in the process. Sound crazy? Gross even? Believe it.

People are using whatever’s in reach to floss their chompers.

“When you’ve got half a meal stuck between your teeth, you’ve got to do something,” says Bill Winglosky, a mortgage banker from Clifton Park, N.Y. Don’t tell that to dentists and periodontists, who have been horrified to learn that poker decks, pencils, car keys and other such impromptu devices do double duty as floss. It’s just not good dental practice.

“Improper tools can actually contribute to, or accelerate recession or abrasion (to the gums). People actually chew off their fingernails and use them as floss,” says Dr. Gregg Liberatore, a dentist in private practice in Clifton Park, N.Y.

“Abrasion can also cause damage to the enamel or damage to the root surface.”

Winglosky broke teeth, pulled off caps and severed his gums with his improper flossing methods. In the past few weeks, he has spent nearly $900 for repairs, a result of his flossing methods and his delicate teeth. Now, he says he’ll carry floss in his pocket.

The British Dental Health Foundation found that more than 60 percent of people risk their oral health using whatever’s closest to remove food from between their teeth. American numbers are prob- ably lower, but not by much.

“People are determined to get things out, so they’ll use whatever’s accessible,” says Dr. Michael Breault, a Schenectady, N.Y.-based periodontist and a spokesman with the New York State Dental Association. “It’s like an eyelash in your eye. You know it’s there, it’s annoying and you’ve got to get it out.”

Hygiene and health issues are better reasons to reach for floss instead of your American Express card. Most people don’t neglect brushing their teeth, but they’ll pass on the flossing. Granted, it takes just four to five minutes to floss properly, but people see it as a chore.

“If you floss correctly,” Breault says. “You only need to do it once in a 24-hour period.”

And when he says do it once, he’s talking in the bathroom, during your morning or evening brush, and with nothing other than dental floss.

Experts suggest people carry floss in their purse, pocket, glove compartment or even their golf bag, since you never know when a pesky piece of food may find a resting place between your teeth.

“It’s ironic people will use something other than floss and it gets caught, and what do they use to get it out? They use floss,” says Dr. Charles H. Perle, spokesman with the Academy of General Dentistry.

This is an article by Diana Cozasinos that appeared recently in the Bay Post/Moruya Examiner

FOUR years ago, Moruya’s dental clinic was looking fragile. But thanks to a local initiative, our patients have a service that is the envy of rural health services everywhere.

The dental clinic’s secret to success is its rotation of dentists from the Westmead Centre for Oral Health. Every six weeks the recent graduates spend a fortnight at Moruya and Katungul Aboriginal Medical Service at Narooma.

That they’re still here is thanks in part to Dr Graham Thomas, a retired dentist and former Sydney University senior academic who has taken on a mentoring role in and out of the surgery.

“Having these dentists from Westmead has meant that the people of the Eurobodalla get public dentistry that they would (otherwise) have to travel to other centres for like Queanbeyan, Westmead or Bega,” he said.

It’s important not just for the region but for the dentists themselves, to gain rural experience and potentially be seduced by the country lifestyle.

The technique has worked, at least for Niranjan Thomas, a behavioural neuroscience graduate-turned recent dental graduate, who had already been considering rural practice before coming here.

“The pace of life and sense of community really appealed to me.”

The dental clinic has been an eye-opener for Amy Sacco, who has spent most of her life in Sydney, but she said having no back-up was a positive experience.

“You’ve got more responsibility as a dentist; it’s good in a sense, you have got a lot of freedom and you have to push yourself a little bit more than at Westmead.”

Dr Thomas conducts tutorials, often out on the lawn with the river glittering behind, and helps them through some tougher cases. And he takes them out onto his own farm for a taste of country living.

“They like coming out here now because they have got the support. They make the difference between opening and closing this clinic.”

Dr Arnold Baume of Terrigal Medical Centre has recently become a participating dentist.

His dental practice is located at 9 Church Street, Terrigal, New South Wales.

Dr Arnold Baume and the team look forward to assisting members of NobleDentist.

Members wanting to make an appointment can simply click on Dentist Sydney for contact details.

Dr Arnold Baume of Terrigal is becoming a participating dentist.

This should take place by Wednesday, 20 September 2006. Contact details will be in Dentists in Sydney.

Dr Arnold Baume Dentist is located at 9 Church Street, Terrigal, New South Wales.

This is an article by Jan Jarvis that appeared recently in the Star Telegram.

Virginia Pritchett remembers getting her teeth filled when she was 7 years old.

Now, decades later, she cannot forget the health problems she suffered for years until the symptoms were linked to the mercury in her fillings.

“I was 43 when I was correctly diagnosed,” Pritchett said. “I was having severe neurological problems and going into seizures.”

In 1999, Pritchett had the five mercury fillings removed and replaced with composite materials.

“If those were not taken out, I would be dead now,” said Pritchett, who lives in Mineral Wells.

Pritchett, 49, plans to describe her years of gastrointestinal problems, concentration loss and immune system damage at a Food and Drug Administration hearing next week in Gaithersburg, Md. The hearing is to review the health hazards of mercury leaking from dental fillings. The meetings, Wednesday and Thursday, will mark the first time in 13 years that the government has held a public hearing to address the safety of mercury fillings. Pritchett said she hopes that her testimony will make a difference.

“My goal is, I want to see these things totally outlawed,” she said.

Critics of the fillings include the Florida-based International Academy of Oral Medicine and Toxicology, made up of dental, medical and research professionals who promote mercury-free dentistry. They say mercury amalgam fillings are linked to neurological damage, autism and other health problems. The mercury also harms the environment, they say.

Fort Worth dentist Michael Jackson said he stopped using amalgam fillings during the 1990s because of the risk to patients, his staff and himself. Studies have shown that the mercury is unstable and that it can come out of fillings, he said.

“Not everybody is going to be damaged by that, but there is a subset of people who do have problems,” he said.

Mercury is also an environmental hazard, he said.

“Mercury is the second-most-toxic naturally occurring element on the planet,” Jackson said. “I just think there are better substitutes that can be used.”

But others say the fillings have been studied and shown to be safe. Many dentists use amalgam fillings because they are well-suited for cavities below the gum line or deep cavities in back teeth, according to the American Dental Association. About 30 percent of dental fillings are amalgam and 70 percent are composite. The minute amount of mercury released by amalgams during eating and drinking does not affect health adversely, the ADA. maintains

Arlington dentist Robert Allen said amalgam has been around 150 years and has held up quite well under stress inside the mouth. There’s an outside chance that people allergic to mercury could have problems with the fillings, he said.

“But if they don’t, there’s not a lot of evidence that it hurts their health,” he said, adding that he switched to composite fillings because they match tooth color and are durable.

Charlie Brown, national counsel for Consumers for Dental Choice in Washington, D.C., said that the fact that mercury has been used for 150 years doesn’t make it safe.

“And what other part of pre-Civil War medicine are they endorsing?” he asked. “Some people smoke their whole life and nothing happens; in some people, it builds up and has a terrible effect. For some people, mercury has a terrible effect.”

Pritchett said she has no doubt that the mercury in her fillings harmed her health. Her problems started during the late 70s, when she was 23 years old. Her health deteriorated over the years and she saw dozens of doctors before one finally linked her symptoms to her fillings, she said. Since she had the fillings removed, her battered immune system has slowly improved, she said.

“I’m a lot better, but I still have problems;” she said. “It’s been a real nightmare.”

This is an article by Timoth Gower that appeared recently in The Ledger, Florida.

One fall day in 2004, Lea Anne Burke got a call from a neighbor. Had she heard that the city council was talking about adding fluoride to their water supply in Snohomish, Wash.? For years, the northern end of town had received fluoridated water from the nearby city of Everett. But nonfluoridated water from the Pilchuck River ran through pipes on the south side of Snohomish, where Burke, her husband, and their two little girls live.

Burke, 33, is a soccer mom and vice president of the local PTA. She studied environmental science in college and learned enough about fluoride to be convinced that she didn’t want it flowing from the taps in her home. She won’t even let her family brush with fluoride toothpaste. So Burke joined a small group of citizens who, last year, persuaded the city council to abandon its plan to fluoridate the water.

“Until it’s proven safe, why do it?” asks Burke.

If you have only ever known fluoride as a champion cavity fighter that keeps your pearly whites strong, Burke’s concerns may sound off the wall. After all, two-thirds of U.S. cities and towns fluoridate water, and most U.S. dentists agree that it prevents tooth decay. In fact, in 1999, the CDC named the fluoridation of community water one of the top 10 public health achievements of the 20th century.

Yet, controversy and doubts about its safety have dogged fluoride ever since the first U.S. city, Grand Rapids, Mich., began adding it to its water supply in 1945. And now, several reports published earlier this year have tarnished fluoride’s brilliant veneer. In March, a panel of dentists, toxicologists, and epidemiologists assembled by the National Research Council (NRC) determined that the level of fluoride allowed in community drinking water in this country is too high. In a cruel irony, the panel found that children who consume water containing the highest level of fluoride permitted by the EPA might actually be damaging their teeth; there was even a hint that it might depress IQ. What’s more, the panel stated that consuming water with that amount of fluoride over a lifetime could weaken bones and increase the risk of fractures. And just 2 weeks after the NRC report made headlines, a Harvard study suggested that fluoridated water could cause a rare form of bone cancer in young boys.

The two reports have helped fuel the passions of fluoridation opponents, a group made up of scientists and concerned citizens. They claim that adding fluoride to drinking water may have made sense once but is unnecessary now because it is available in other forms, such as toothpaste. Drinking the stuff, they say, exposes millions of Americans to needless health risks.

“Fluoridation should be abandoned,” says dentist Hardy Limeback, Ph.D., DDS, head of preventive dentistry at the University of Toronto and a member of the panel that wrote the NRC’s fluoride report. “It could turn out to be one of the top 10 mistakes of the 21st century.”

If Limeback and other top-notch researchers at respected universities are now concerned that we’re getting too much fluoride, should you be worried, too?

For starters, read the label on a tube of toothpaste: Keep out of reach of children under 6 years of age. If more than is used for brushing is accidentally swallowed, get medical help or contact a Poison Control Center right away.

Poison? Indeed, some forms of fluoride are used in high concentrations to kill rats and crop-eating insects. Municipal employees who add fluoridation chemicals to public water systems must wear protective clothing and respirators. Industrial workers regularly exposed to fluorine, the gas form of fluoride, have suffered skin, lung, and gastrointestinal problems; it has even been fatal for some.

But at the doses most people get, fluoride behaves differently: About half of it exits quickly through the urine, while the remainder settles into the bones or teeth. The 1 milligram of fluoride per liter of water (1 mg/L) recommended by the government for water systems is equal to just 1 part per million (or 1 ppm). That scant dose of fluoride has been added to water since the 1940s to fight tooth decay, and early research suggests it did the job well. A 1962 study of Newburgh, NY, one of the first communities to fluoridate its water, found that cavity rates dropped by 70 percent over a span of 15 years.

That sort of success sounds impressive—but it’s no longer relevant, opponents say. When fluoridation began, scientists believed that fluoride needed to be ingested to fight cavities, so that it could be incorporated into the enamel of developing teeth before they erupted through a baby’s gums. However, most dental researchers today agree that throughout our lives, fluoride works best when it’s applied directly to the teeth, where it not only shores up dental enamel but also shields it from damaging acid produced by bacteria in the mouth. That means today’s fluoride toothpastes, rinses, tablets, and other dental products can do the job. At the very least, since most Americans today brush at least once a day, fluoride dental products have diluted some of the benefits of drinking fluoridated water.

In 1990, researchers at the National Institutes of Health compared the dental records of 16,000 children between ages 5 and 17. Half lived in fluoridated communities; the rest did not. They found that the kids who grew up drinking fluoridated water had just 18 percent less tooth decay than the other children.

Fluoride skeptics add that even this relatively unimpressive statistic loses much of its luster when you examine the numbers more closely. The study showed that children in fluoridated communities had 0.6 fewer decayed tooth surfaces—or about half of one cavity—than those who didn’t drink fluoridated water.

“That’s not much of a benefit,” says toxicologist Tim Kropp, Ph.D., of the Environmental Working Group, a Washington, DC-based nonprofit organization that opposes water fluoridation. Especially when you consider that too much fluoride can harm teeth.

Next, you’ll learn more about the possibly harmful effects of excess fluoride, and the 10 steps you can take to lessen your consumption of fluoride.

Fluoride has been tied to bone cancer, lower IQs, and osteoporosis. So why is it still being added to your water? Controversy and doubts about its safety have dogged fluoride ever since the first U.S. city, Grand Rapids, Mich., began adding it to its water supply in 1945. Several reports published earlier this year have tarnished fluoride’s brilliant veneer. In March, a panel of dentists, toxicologists, and epidemiologists assembled by the National Research Council (NRC) determined that the level of fluoride allowed in community drinking water in this country is too high. Learn more about the effects of flouride in Part II of our story.

Mottled Teeth and Lower IQs

The protective qualities of fluoride were first discovered in communities where the soil contained naturally high levels. What drew scientists’ attention: the locals’ stained or mottled teeth. Only later was it recognized that they also had fewer cavities. Both the strength and the unsightliness, it turned out, seemed to be due to fluoride exposure as their teeth were developing.

Many dentists consider the staining, called dental fluorosis, to be strictly a cosmetic concern because it’s usually mild—chalky streaks or splotches on one or more teeth. Still, the NRC panel determined that about 10 percent of kids living in communities where the drinking water is close to the EPA upper limit of safe exposure, 4 mg/L, develop severe dental fluorosis; that means not only yellow and brown stains on their teeth but also pits in their enamel, increasing the risk of cavities. Rates of dental fluorosis appear to be on the rise—the CDC says the percentage of Americans between ages 6 and 19 with fluorosis jumped from 23 percent in the late 1980s to 32 percent today. To prevent severe dental fluorosis, the NRC panel advised the EPA to lower the allowable amount of fluoride in drinking water.

“We have now said to the EPA that the level you guys think is OK could damage the enamel of children,” says University of Kansas Medical Center Professor Emeritus John Doull, Ph.D., a toxicologist and chairman of the NRC panel.

Concerns about relatively mild forms of fluorosis must be balanced against the benefits of the mineral, argues fluoride researcher Steven Levy, DDS, of the University of Iowa College of Dentistry. But it’s wrong to dismiss the streaks and splotches out of hand, he says, given how focused people are on the appearance of their teeth.

Levy questions a common practice among many pediatricians and pediatric dentists: prescribing fluoride supplements to children who live in nonfluoridated communities. The American Dental Association (ADA) still recommends daily supplements for such kids from the time they’re 6 months old to age 16. But 5 years ago, the CDC issued guidelines stating that even in communities without fluoridation, the only children who should get supplements are those with a high risk of cavities, such as kids with a family history of serious tooth decay. Levy says it may also be appropriate to follow the ADA’s guidelines on supplements if a dentist suspects that a child’s parents are not inclined to encourage healthy dental habits.

Some experts believe that giving fluoride pills and drops to any child is a mistake.

“It’s clearly demonstrated that they are a fluorosis risk,” says Brian Burt, Ph.D., a University of Michigan School of Public Health dental epidemiologist. “You’re getting more risk than benefit, so I don’t see any need for them.”

Burt’s reasoning seems particularly sound given another concern in the NRC report: Several studies from China have found a persistent link between high levels of fluoride and IQ deficits in children. In one study, children in a town with about 2.5 mg/L of fluoride in the water tested 8 points lower on average than children in a village whose water had just trace amounts of it. Some animal studies have suggested that fluoride can harm brain cells, though the chemical interaction isn’t yet completely clear. The report concluded that the “consistency of study results appears significant enough to warrant additional research.”

One problem in determining fluoride’s potential harm, if any, is that it’s not clear how much we get from other sources. Virtually all foods contain at least a trace: Fluoride is a component of soil, so it turns up in fruit, vegetables, and grains. But how much there is depends on where a crop was grown, because the fluoride content of soil varies from one region to another. Agricultural pesticides and irrigation water often contain fluoride, too, which is incorporated into plants. Water given to chickens, cattle, and other farm animals may also be fluoridated.

According to the CDC, the typical American gets 1 to 3 milligrams of fluoride per day, though experts say that is a very rough estimate.

“There’s a huge variation in levels of intake,” says Levy.

He leads a team that has been studying the diets of about 700 children in Iowa—roughly 70 percent of them in fluoridated communities—to get a more accurate picture of consumption of fluoride in this country. His research has already yielded some worrisome findings: About one-quarter of the children are swallowing twice as much fluoride each day as they should be.

Bone Troubles

Adults could face other troubling consequences. A report last year in the American Journal of Medicine described a woman who developed a rare condition that is known to be caused by overexposure to fluoride: skeletal fluorosis, which produces stiff, painful bones and joints and can be crippling in its later stages. The woman’s doctors were puzzled by her symptoms until they discovered the cause. Everyday for much of her adult life, she drank 1 to 2 gallons of double-strength instant iced tea. Tea leaves, it turns out, absorb a great deal of fluoride from soil, though levels vary depending on the region where they are grown and the season in which they are harvested.

It takes a lot of fluoride to begin developing skeletal fluorosis—at least 10 milligrams a day for 10 years. But endocrinologist Michael P. Whyte, MD, of the Washington University School of Medicine, the lead author of the report, says a person can get into the danger zone without quaffing gallons of tea everyday. Whyte and his colleagues analyzed 10 types of instant tea for fluoride content. They found a range: Two brands contained only about 1 milligram/Liter—Lipton Instant Diet Iced Tea Mix (Decaffeinated Lemon) and Schnucks Instant. However, most of the teas had at least twice that amount of fluoride, and one popular brand, Lipton Instant, had 6.5 milligrams/Liter. Likewise, brewed tea can contain anywhere from 1 to 6 milligrams/L of fluoride, depending on the variety used, the water, and the brewing time.

Picture a lifelong iced tea lover who guzzles a liter—about 1 quart—of a high-fluoride brand made with fluoridated water everyday. Whyte suspects the scenario may not be so unusual in hot climates.

“That’s 7.5 milligrams. That’s getting close to 10 milligrams a day,” he says. “That could start to be associated with symptoms of skeletal fluorosis.”

Even lower amounts of fluoride, consumed over enough time, can be problematic. Doull’s NRC panel determined that a lifetime of drinking water at the EPA’s 4 milligrams/Liter upper limit seems to increase the risk of bone fractures. Just 200,000 Americans live in communities where the water supply naturally contains that much fluoride—mostly areas located in South Carolina, Texas, Oklahoma and Virginia. But an additional 1.4 million live in communities where concentrations naturally range from 2 to 3.9 milligrams/Liter. Even the CDC’s recommended target of 1 milligram/Liter of fluoride may increase the danger of bone ills: In 1992, researchers from the University of Utah reported in the Journal of the American Medical Association that elderly men were 41 percent more likely to fracture a hip if they lived in a community where the water contained that amount than if they lived in areas with lower levels; women’s risk increased by 27 percent. Although the authors didn’t ask specifically how long the residents had lived in the towns studied, all were settled communities with little migration in or out.

Joseph L. Lyon, MD, a University of Utah professor of family and preventive medicine and lead author of the study, says findings like his are why adding fluoride to drinking water makes no sense, especially because its benefits can be obtained with toothpaste and other fluoride dental products.

“You are imposing risk on all individuals who use a public water system,” says Lyon.

The Harvard fluoride study from earlier this year provides yet another reason to question the safety of the 1 milligram/Liter standard. Researchers compared 103 people who were diagnosed before age 20 with a rare kind of bone cancer called osteosarcoma with a similar group of people who did not have the disease. They discovered that young boys who grew up drinking water containing at least 0.7 milligrams/Liter of fluoride were up to 5 1/2 times more likely to develop osteosarcoma than boys whose drinking water contained less. The cancer is more common in boys—risk didn’t seem to increase in girls. Even water with a moderate concentration of fluoride—0.3 to 0.69 milligrams/Liter—appeared to boost risk in boys more than threefold.

The Good That Fluoride Does

The Harvard bone cancer study made a big splash, coming 2 weeks after the NRC report. And that drives fluoride advocates crazy, because they feel it didn’t tell the whole story. The authors of the NRC report had looked at the study results prepublication and stated that there is still no way to confirm or refute the link between fluoride and bone cancer. Two studies in the early 1990s had suggested a connection, while several others found none. Likewise, lab research designed to determine if—and how—fluoride might promote bone cancer has produced mixed results.

That’s true of all the worrisome findings on fluoride, say proponents. Although individual studies have linked exposure to high levels of fluoride with certain medical conditions, several large scientific reviews have failed to conclusively link any major disease to drinking water that contains the government’s recommended concentration of 1 milligram/Liter of fluoride, notes dentist and epidemiologist Jayanth V. Kumar, DDS, director of oral health surveillance and research for the New York State Department of Health.

What’s more, opponents understate the true value of fluoridated water in fighting cavities, says dentist and epidemiologist John Stamm, DDS, a professor of dentistry at the University of North Carolina at Chapel Hill and a spokesman for the ADA. Stamm asserts that the primary finding of the 1990 NIH study mentioned earlier—in which fluoridated water appeared to reduce tooth decay rates by only about a half cavity, on average—is misleading. The youngest children in the study were just 5 years old, suggesting that their permanent teeth had not been in place long enough to develop serious tooth decay. With so few cavities to count, there were only tiny differences between younger children in the fluoridated and nonfluoridated communities, making the overall difference look small.

The results were more striking among older children, Stamm notes. For example, kids who were 17 at the time of the study had 1.6 fewer cavities if they had grown up drinking fluoridated water. Is that enough to make fluoridation worthwhile?

“Sure, absolutely,” says Stamm, who—like most other dentists—argues that constantly bathing the teeth with fluoridated water complements the cavity-fighting work of fluoride dental products.

But for skeptics like Hardy Limeback and Tim Kropp, 1 1/2 fewer cavities seems like a very questionable reward given the potential risk. And they point out that an important British report often used to defend fluoridation actually casts doubts on its safety and benefits. In 2000, what’s come to be known as the York Review examined 214 studies probing the effectiveness and safety of water fluoridation. Though the review found that adding fluoride to drinking water helps fight cavities, University of York research fellow Paul Wilson called the overall quality of studies his group analyzed “really poor.” Many were biased or used outdated scientific methods, he says, so it’s impossible to say whether fluoride is safe or a threat.

“There is currently a lack of reliable evidence to make a definitive judgment either way,” Wilson says.

That review was published 55 years after fluoride was first added to U.S. water systems. The NRC report released earlier this year finds essentially the same thing—there’s a troubling lack of evidence proving or disproving fluoride’s safety. Even knowing that fluoride fights tooth decay, you may find it unsettling to hear scientists express uncertainty about the possible dangers of something you swallow everyday.

Beyond the issues surrounding water fluoridation, however, there is some reassurance: The Environmental Working Group says using fluoride-based dental products make sense, and even Limeback uses fluoride—topically—in his dental practice. Given lingering concerns about the omnipresent compound, a reasonable person may simply decide that she doesn’t want herself or her family to swallow fluoride, but instead apply it directly to her and her kids’ teeth, where it matters most. For those who eat right and brush regularly, that may be plenty to keep teeth healthy.

If you live in a community with fluoridated water, such a decision will mean filtering your taps or drinking nonfluoridated bottled water. We’re probably years away from a serious reappraisal of fluoridation. Dental epidemiologist Burt, who has suggested reducing the concentration of fluoride added to water systems, says dentists greeted his suggestion with little enthusiasm. The 1 milligram/Liter standard, he says, “has become enshrined, given almost the status of divine revelation in some quarters. There’s a feeling that we can’t monkey with this.”

Lea Anne Burke might be considered a heretic, then. “I’m always suspicious when people tell me, ‘You have to do this.’ Tell me why and show me some good science. With my children’s health at stake, you have to give me some really good reasons.”

Burke has plenty of company: In 2005, cities in nine states—California, Colorado, Iowa, Missouri, New York, Ohio, Oregon, Utah, and Washington—voted to reject, abandon, or prohibit water fluoridation.

10 STEPS TO CUTTING BACK ON FLUORIDE

Whether you’re in favor of fluoridated water or not, it makes sense to know how much fluoride you’re getting from all sources—and consider limiting your exposure. These steps can help:

1. Find out the fluoride level of your community’s drinking water. Call your local water department or visit www.prevention.com/water to look up the CDC’s tally of fluoride levels in your town.

2. If the fluoride concentration in your community water is more than 2 ppm, the CDC recommends finding an alternative source of drinking water for children ages 8 or younger to reduce their risk of dental fluorosis. The best alternative: bottled water to which no fluoride has been added—it will say on the label. However, to be doubly sure, you’ll have to contact the bottler. Or visit www.prevention.com/water for a list of the top brands with low—or no—fluoride.

3. Use a filtration system to reduce levels of fluoride, but don’t count on those pitchers with charcoal filters to do the trick. Most experts recommend putting reverse-osmosis filters on your tap; manufacturers claim they remove 80 to 90 percent of fluoride from water. Cost: several hundred dollars.

4. Monitor small children when they brush their teeth with fluoride toothpaste until you are confident that they only use a pea-size amount and don’t swallow it.

5. Has your pediatrician or dentist prescribed fluoride supplements for your kids? Ask why—and then ask whether a fluoride rinse would work just as well.

6. Curb your kids’—and your own—thirst for soda pop because it’s generally made with fluoridated water. Fruit juice, beer, and wine also give you lots of it. At www.prevention.com/water you’ll find a USDA listing of the fluoride content in hundreds of foods and drinks.

7. Don’t let fear of fluoride spoil your taste for tea—iced or regular—but brew it at regular strength, consider using nonfluoridated water, and limit yourself to a serving or two per day.

8. Choose organic fruits and vegetables: The U.S. National Organic Program does not allow the use of the pesticides that leave high fluoride residues.

9. Avoid or limit your consumption of mechanically deboned chicken in any form—nuggets, baby food, canned. These may contain high amounts of fluoride. The deboning process often leaves traces of fluoride-containing bone in the final product.

10. If you have a baby on powdered formula, mix the formula with unfluoridated water. And go easy on baby food made with chicken.

This is an article by Dr Jim Arnold that appeared recently in the Northwest Indiana Times.

Q: “Dr. Arnold, my son is 18, and he began smoking this year. I understand the health risks, but can you explain the dental problems associated with smoking?”

A: We all know the well-documented effects that smoking can have on one’s overall health. Just a few of these include increased risk for cardiovascular (heart) problems, lung cancer, and low birth-weight babies. In fact, research estimates that smokers live an average of 14 years less than non-smokers.

Unfortunately, smoking can also have a profound impact on one’s oral health, too. The use of tobacco products greatly increases the risk for and can elevate the severity of periodontal (gum and bone) disease, which is one of the leading causes of tooth loss.

It can also exacerbate gum recession, which leads to exposure of the root surfaces of teeth. These root surfaces are often very sensitive to temperature changes, sweets, and any type of abrasion (such as brushing one’s teeth).

These exposed areas are also more prone to decay (cavities).

Oral cancer is another common sequela of tobacco use. Cancer of the mouth sometimes goes undetected until it is too late. It often grows rapidly and can be fatal if not diagnosed and treated quickly. A good dental team will screen for oral cancer at each visit, so please make sure that your son sees his dentist regularly.

Smoking after a tooth is extracted (removed) can lead to what is known as a dry socket. This is an infection that can develop in an extraction site and can be very painful. Tobacco use must be discontinued for at least 72 hours after tooth removal to decrease the likelihood of a dry socket.

Other potential problems include increased staining and tartar buildup, bad breath, and the possibility of diminished senses of taste and smell.

The longer (and more) that one smokes, the more likely they are to have the aforementioned oral health problems. I would encourage you to help your son stop smoking as soon as possible to decrease the risk factors associated with this obviously unhealthy habit.

This is an article by Harry Jackson that appeared recently in the Times Leader, Pennsylvania.

Yes, those fillings contain mercury. But studies just don’t support the naysayers’ concerns.

For 150 years, dentists have used “silver fillings” in tooth cavities.

Surprise: The major component of silver fillings is mercury.

That has a lot of people concerned. Mercury in its many forms is poisonous, especially to children and pregnant women. The most heinous problems are neurological ones, which can hurt children’s ability to learn, even before they’re born.

Still, many dentists and all of the associations that back them say the fillings are safe. But some medical practitioners, holistic adherents and even the World Health Organization say mercury shouldn’t be considered totally safe under any conditions.

The answer as to whether you should fear your silver fillings falls to your own comfort level, dentists say.

Reputable studies say silver fillings pose no danger; others, including some dentists, say that if they hurt one person, that’s one too many.

The studies

Silver fillings in teeth are called amalgams. They’re about 50 percent mercury, plus a powder composed of silver, zinc, copper and tin. When those ingredients are mixed, the substance hardens and seals a cavity virtually forever.

The mercury used in amalgam is elemental mercury. Its primary danger is the vapor it gives off over time. Tests show it’s tiny — about 0.03 to 0.27 micrograms a day, depending on the number of fillings in your mouth and what you’ve been chewing. The amount of mercury vapors needed to cause sickness — neurological problems, kidney problems and other illnesses — is about 1,000 times more than that, experts say.

Studies, including a big one as recent as April, say that years of research in Europe and the United States has found no ill effects in adults or children linked to mercury-based dental fillings.

As a result, federal agencies have given mercury-based fillings a clean bill of health. Those agencies include the Food and Drug Administration, which approves medical applications such as mercury-based fillings, and the U.S. Centers for Disease Control and Prevention and the National Institutes of Health, which monitor medical research and applications.

Scientists consider the form of mercury found in some large fish a more immediate concern, especially to children and pregnant women. Go to www.epa.gov/ waterscience/fishadvice/advice.html for the Environmental Protection Agency’s guidelines on eating fish.

The doubts

Some people don’t trust the government or the studies to be that precise.

The fact is, mercury is harmful even when it doesn’t hurt enough people to sway a double-blind, controlled study.

So it’s the right of anyone who wants to avoid being the statistically insignificant person who might get hurt, said Dr. Ron Schoolman, who practices dentistry with Cherry Hills Dental Group in Wildwood, Mo. He and his partner haven’t used silver fillings for more than 15 years.

“The possible toxicity of mercury has been an issue,” he said. Despite the American Dental Association’s endorsement, “... a mercury vapor analyzer can be placed in people’s mouths and you can see the mercury vapors coming off of these (fillings).”

Also, he cited the International Association of Oral Medicine and Toxicology as saying that mercury vapors come from a tooth when rubbed with an eraser — something that might simulate chewing, he said.

Despite the reports of overall safety, and despite how small the amounts of mercury vapors might be, he said, “We don’t know who is (sensitive) to mercury and who is not. It has to do with your genetics. Only people who can detox their bodies naturally can handle these fillings and other people may not. These mercury fillings could be a problem for their general health.”

Proponents of using amalgam fillings — or more precisely, people who don’t fear them — point to the latest study that was printed in the Journal of the American Medical Association in April. The studies were sponsored by the National Institute of Dental and Craniofacial Research and agency of the National Institutes of Health.

Both studies watched children from 8 to 10 years old, a total of more than 1,000 — half getting amalgam fillings and half getting composite fillings made from plastic.

The studies found no medical problems that could be linked to mercury poisoning. Scientists checked for neurological, digestive, kidney and mental problems. They even watched for drops in IQ as small as 3 points.

They found that children with amalgams excreted slightly higher amounts of mercury in the urine: about 1.5 micrograms per liter at the most. “However, these numbers fall within the so-called ‘background’ level of 0-4 micrograms per liter for an average person not exposed to industrial or other known sources of mercury,” the researchers wrote.

Alternatives

This is where the proponents and opponents agree. Amalgam fillings are about to hit the end of their shelf life.

Dr. Jeffrey Dalin, who practices dentistry in Creve Coeur, Mo., and is a spokesman for the Greater St. Louis Dental Society, says he finds amalgams safe, but that because of the alternatives he hardly uses them any more.

Plastic composite looks like real tooth material and these fillings are as dependable as amalgam fillings.

“I like the composite plastics — tooth-colored materials. They look nice, they bond to the tooth and there’s no post-operative sensitivity — patients can eat right away without being on the ‘dental diet,’ ” Dalin said. “It’s not that I’m negative on silver or that I’m worried about it, I’m just more positive on the plastic.”

The only problem is small, he said. The tooth surface must be perfectly dry when it’s placed. If not, it won’t hold. If that becomes a problem, the amalgams are the next option, he said.

Still, he said he honors patients’ wishes. So the alternatives include gold fillings or other means of repairing a tooth that’s falling apart.

Dentists said that the silver fillings can be removed, but no dentist questioned had seen a rush to have amalgam fillings removed.

Nevertheless, removing them could cause more problems than they cure. Drilling, even accompanied by instruments that reduce the smoke and vapors, could produce more toxic vapors in a short time than someone would get for a long time simply by letting the tooth sit. Also, removing a filling could remove more of the tooth, and the only alternative after that is a cap, dentists said, a more expensive option.

Still, dentists say they’ll remove amalgam fillings upon request.

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This breaking news appeared on News.com at 3.32am this morning.

The government-owned health insurer, Medibank Private, could be sold in a public float, with Treasurer Peter Costello backing the move.

Federal Cabinet is expected to decide within a few weeks whether to offload the health fund, which could add as much as $2 billion to government coffers.

Mr Costello said floating the fund on the stock exchange would have benefits for both Medibank members and the industry.

“I think this could be an area where we could achieve some other policy goals and I would actually like to see us very carefully examine the possibility of offering Medibank to the public, particularly to policyholders,” he told the Nine Network.

“Policyholders who might like to have an interest in the health fund who are therefore on both sides of the equation; they are insured and they are getting benefits and they could well be owners in getting any growth.”

On Friday, the federal parliamentary library released a research note which concluded that while the commonwealth was the legal owner of the fund, it was not the owner of Medibank’s assets.

The report also questioned the point of the sale, saying there was little evidence privatisation would make the insurer more competitive.

Labor seized on the research as another reason why the Government could not proceed with the sale but the Government dismissed the report, saying it had legal advice it could sell the fund.

Labor said it remained opposed to the sale of Medibank Private in any form, suggesting it would put upward pressure on premiums.

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