News Year's Resolutions for a Healthy Smile

Top 10 tips for a healthy smile in 2011

1.       Brush and floss twice a day,( change your brush 4 times a year).

2.       Use a Fluoride toothpaste.

3.       Use a disinfectant mouthwash.

4.       Chew  a few pieces of Xylitol gum or mints throughout the day(freshens breath, protects teeth and tastes good).

5.       Never use your teeth for anything except chewing food . Biting your nails, pencils pens, thread, or any other foreign object damages your teeth.

6.       Don’t chew ice cubes.

7.       If you clench or grind your teeth, get fitted with a mouthguard/biteplane by your dentist.

8.       If you engage in any of the following activities listed below,  get fitted with a mouthguard *.

9.       Visit your dentist regularly.

10.   Avoid or minimize these foods listed below**.

*Activities where a mouthguard is recommended:

·         Football

·         Basketball

·         Soccer

·         Field hockey

·         Boxing

·         Lacrosse

·         Tennis

·         Racquetball

·         Wrestling

·         Boxing

·         Volleyball

·         Baseball

·         Softball

·         Cycling

·         Mountain biking

·         Skateboarding

·         Motocross

·         Off-roading of any type

·         BMX biking

·         Mountain biking

·         Horseback riding

·         Skiing

·         Snowboarding

·         Sledding

·         Hockey

·         Karate or other Martial Arts

·        Weight or Strength Training

** Foods to avoid or minimize:

·         Soda (any kind) but especially ones sweetened with sugar or high fructose corn syrup.

·         Any fruit drinks with added sugar (high fructose corn syrup etc) read the label and if sugar, high fructose corn syrup is one of the top 3 ingredients, watch out). Better to eat the fruit than drink the juice as the fruit has fiber and vitamins to help the body .

·         Raisins (have a high sugar content and stick to teeth)

·         Any sweet candy unless sweetened with Xylitol, Sorbitol or Mannitol. Sports drinks

·         Energy drinks unless there is no sugar or High fructose corn syrup in it.

·         Any starchy foods… foods with highly processed flour it , breads, pasta, etc..

·         Treats like fruit rollups, donuts, rice crispy treats, cookies, cake, pie, brownies, Craisins.

·         These are best eaten with a daily meal so the assault on your teeth is minimized

·          Avoid putting sugar in coffee and tea… use Xylitol , or Stevia if you must sweeten your drinks.

(Consider substituting sugar with cooking with Xylitol and Stevia when making foods at home.)

Warning signs that you should consult a dentist promptly about include:

·         Loose teeth.     

·         Teeth that are moving or shifting.

·         Bleeding gums.

·         Persistent bad breath.

·         Chipped and worn teeth.

·         Temperature and/or and biting sensitivity.

·         Swelling, sensitivity to sweets.

·         Receding gums.

·         A funny taste.

·         Sore jaws in the morning.

·         Headaches.

·         Dry mouth.

·         Sores in the mouth that last longer than 10 days.

·         Loose fillings or restorations.

Your comments are welcome.

Sincerely,

Phillip C. Neal DDS
Crystal Lake Dental Associates
280 B Memorial Court
Crystal Lake,  Illinois  60014
www.DrNeal.com

Sugar does more than ruin your teeth... It ruins your body!

Lately, I have been researching sugar and sugar substitutes for their health benefits and risks. My primary goal was to recommend healthy alternatives to table sugar (sucrose) and high fructose corn syrup (essentially sucrose). Sucrose and high fructose corn syrup are easily converted in your mouth into lactic, pyruvic, and formic acid, along with a sticky substance called dextran. These chemicals cause bacteria stick to your teeth and dissolve minerals leading to tooth decay.

 The extent of the potential toxic effect of the fructose molecule (one component of sucrose) on the body however was largely unknown to me until recently. 

I came across this video recently while doing my research. It is about 1 1/2 hours long, so make sure you can allow time to watch it in it's entirety. It will change the way you think about sugar, obesity, heart disease,  and diabetes.

The following video titled "Sugar: the bitter truth" is a presentation by Robert H. Lustig, MD, UCSF Professor of Pediatrics in the Division of Endocrinology.

Your comments are welcome.

Sincerely,

Phillip C. Neal DDS
Crystal Lake Dental Associates
280 B Memorial Court
Crystal Lake,  Illinois  60014
www.DrNeal.com

Phil's soon to be "World Famous" fajitas

(the marinade comes from "Lisa's Favorite Carne Asada recipe)

Ingredients for marinade

3/4 cup orange juice

1/2 cup lemon juice

1/3 cup lime juice

4 cloves garlic, minced

1/2 cup soy sauce

1 teaspoon finely chopped canned chipotle pepper

1 tablespoon chili powder

1 tablespoon ground cumin

1 tablespoon paprika

1 teaspoon dried oregano

1 tablespoon black pepper

1 bunch fresh cilantro, chopped

1/2 cup olive oil

3 pounds flank steak

Feeds 4-6

Directions

Combine the orange, lemon, and lime juice in a large glass or ceramic bowl along with the garlic, soy sauce, chipotle pepper, chili powder, ground cumin, paprika, dried oregano, black pepper, and cilantro. Slowly whisk in the olive oil until marinade is well combined.

Place the flank steak between two sheets of heavy plastic (resealable freezer bags work well) on a solid, level surface. Firmly pound the steak with the smooth side of a meat mallet to a thickness of 1/4 inch. After pounding, poke steak all over with a fork. Add the meat to the marinade in the large bowl, cover, and allow to marinate in the refrigerator for 24 hours.

Heat skillet on high and sear each piece on each side to caramelize. Cut into 1 inch strips (kitchen scissors work great for this).  (The searing is optional but I believe it enhances the flavor). Place cooked meat, any liquid drippings, and marinate in a Crockpot. Add water till meat is covered. Heat on high for 2 hours then low or medium till ready to serve (the Crockpot is what makes the meat melt in your mouth).

Serve with refried beans, rice (I use a rice pilaf), sautéed onions and peppers, tortillas, and toppings of your choice (cheese, sour cream, salsa, picante, avocado, etc.)

Tortillas

1 package (10) flour tortillas ( I prefer multigrain)

Directions

Place 3 tortillas between damp paper towels and heat on high in microwave for 30 seconds. Serve.

Refried beans

1 large can of refried beans. (any brand)

Directions

Just warm up. (You can get creative and add some cheddar cheese, hot sauce, and sour cream, to spice them up a bit to your taste)

Onions and peppers

Ingredients

1 large white onion

1 green bell pepper

1 red bell pepper

1 yellow bell pepper

2 tablespoons olive oil

Directions

Chop up one large onion into slices, and 1 each red, yellow and green pepper into strips.

Place a couple of table spoons of olive oil in a pan and heat to medium high, add onions and sauté half way stirring. Add peppers and turn down heat to medium low. stir occasionally till done. drain off excess liquid. Serve.

Rice ( any rice recipe you want to use) or try mine below.

This is my rice pilaf recipe

Ingredients

1 cup white or brown rice

1 1/2 cups water

6 oz Italian dressing

Directions

Add rice to water in a sauce pan cover and heat on high till boiling, add 1/2 the dressing, and turn heat down  to simmer for about 20 min. Add remaining dressing and some of the finely chopped peppers and onions from the above sautéed mixture. Gently stir and serve.

Do silver fillings release mercury? Are they Safe

The short answers are yes and maybe. 
The most highly controversial issues in dentistry are the safety of Mercury and Fluoride, both of which can be toxic. 
The Mercury in silver fillings is in the news again as the FDA is reviewing it's position on safety of silver fillings.

What is clear is that mercury is most dangerous to the fetus and young children as it is highly toxic to the nervous system. The nervous system is undergoing it's greatest growth in the early developmental years.  What is unclear is that Mercury seems to be highly toxic to some people for either genetic or other environmental reasons. Perhaps diet or other factors are present giving some individuals less resistance to the toxic effects, or the inability to eliminate mercury naturally.

In any case the most dangerous forms of Mercury to the general population are Mercury vapor from elemental (silver fillings), and and methyl Mercury from seafood.

When it comes to silver  fillings, the current FDA position is that they are safe for all except pregnant women and children under age 6.

I believe there are safer and better restorative materials, and have not placed silver fillings since 1998.

I am currently researching the latest on Mercury release from silver fillings, as well as other sources of Mercury exposure along with its potential effects on the body.

 I will provide much more detailed  information in the near future.

Your comments are welcome.

Phillip C. Neal DDS
Crystal Lake Dental Associates
280 b Memorial Court
Crystal Lake, Illinois  60014
815 459 2202
www.DrNeal.com

Whoopi Goldberg --Gum disease can Kill you!

Watch this video if you want to see how gum disease can affect your health.

Your Comments are welcome.

Phillip C. Neal DDS

280 B Memorial Court

Crystal Lake, Illinois  60014

815 459 2202

www.DrNeal.com

Snap-onSmile

Below is a  video one of our patients made of her Snap-on Smile.

Follow the link below to our Snap-onSmile web page for more information.

Snap-onSmile web page

The YouTube link is posted below if you would like to see her comments,questions and answers.

YouTube link

Your comments are welcome.

Phillip C. Neal DDS
Crystal Lake Dental Associates
280 B Memorial Court
Crystal Lake, Illinois  60014
815 459 2202
www.DrNeal.com

Is Your toothbrush Making You Sick?

Answer.... Maybe

I will list some guidelines and recommended products at the bottom of this post, but first let's look at what we know:

·         Your mouth is a perfect breeding ground for bacteria, and so is your toothbrush.

·         6 billion microbes live in your mouth. reprint

·         6 hundred species of microbes live in your mouth. reprint

·         60 million bacteria live on the average toothbrush.

·         Most people keep their toothbrush in their bathroom.

·         Your bathroom is one of the filthiest rooms in your house.

·         Fecal plumes from flushing your toilet can stay in the air for 2 hours and can travel more than 6 feet.

·         Fecal bacteria however  are everywhere in your house, and will find your toothbrush. Mythbusters video

·         Toothbrushes are not required to be sterile, and when you open a new package, it will likely already be infected with bacteria.

·         Some bacteria will  enter  the bloodstream from tooth brushing and flossing.

·         Toothbrush bristles fray after as little as 2 weeks and can begin to cause micro tears in the gum allowing more bacteria to penetrate your bloodstream.

·         Many more bacteria enter the bloodstream when people do not regularly brush and floss.

·         85% of adults have some gum disease. AAP

·         People with gum disease are at greater risk of diabetes, coronary heart disease and stroke. reprint

·         Sonic toothbrushes break down Biofilm and result in healthier gums and teeth. reprint

·         It is virtually impossible to sterilize a toothbrush regularly without ruining it.

·         Ultraviolet units kill 99.99% of germs, while steam units claim to kill 99.9999% of germs, but their effect on the longevity of a toothbrush is in question.

·         Rinsing a brush with tap water and leaving it to air dry kills most of the germs but exposes it to more germs from the air.

·         Keeping a wet toothbrush in a sealed container allows bacteria to multiply.

·         Bacteria can live up to 6 weeks on a toothbrush, and viruses can live longer.

·         Most of the claims for the need to sterilize a toothbrush come from the manufacturers of disinfecting products.

·         Mouthwash can kill 99.99% of germs

·         Hand washing and sanitizers can kill 99.99% of germs

·         The American Dental Association and The Centers for Disease Control do not advocate the use of sanitizers for the average healthy person.

·         Cross contamination from toothpaste ,and toothbrushes  touching  each other or another contaminated  surface does spread diseases.

Many people that may benefit from added precautions include:

• People with compromised immune system
• HIV
• Young children
• Elderly and debilitated
• Cancer victims
• Anyone undergoing treatment for immune diseases and taking medication that lowers resistance
• People with recent joint replacement or surgery
• People with general poor health
• People with poor nutrition
• Diabetics
• People with poor circulation
• People with heart disease or, strokes
• Pregnant women.
• Anyone concerned about germs

 Recommendations:

1.       Disinfect your floss container and toothpaste tube daily , and give each person their own.

2.       Wash and/or disinfect your hands before brushing and flossing.

3.       Rinse your mouth with a disinfecting mouthwash for 30 seconds before brushing or flossing.

4.       Brush (2 minutes) and floss according to your dentists recommendations.

5.       Rinse your brush off in hot tap water, then immerse your toothbrush in a disinfecting mouthwash for 30 seconds.

6.       Place in an ultraviolet or steam disinfection device and activate.

7.       Replace your toothbrush  often...every 3 months or sooner.

Products to consider

Mouthwash:

• Listerine or generic equivalent
•  Scope mouthwash or generic equivalent
• Crest Pro Health Multi Protection Rinse (alcohol free) or generic equivalent

Toothbrush:

·         Powered 

•        Sonicare Flex Care+ (has built in UV sanitizing)* this is my favorite

·         Standard

•         any                        

Toothpaste fluoride:

•    any

Toothpaste fluoride free:

•  Carifree tooth gel

Floss:

• waxed any

Sanitizers:

•  Germ Terminator
• Purebrush

Sanitizers or toothbrush containers should not put the brush in a solution with other brushes, or seal in where the brush cannot dry out. Any device that places the brush bristles down is not recommended.

Discalimer. Though I do sell Sonicare brushes directly to my patients, I do not make any royalties from of any products listed.

Your comments are welcome.

Phillip C. Neal DDS
Crystal Lake Dental Associates
280 B Memorial Court
Crystal Lake Illinois,  60014
815 459 2202
www.DrNeal.com

Oral Injuries in Children

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Injury Prevention

Injuries to the head, face, and mouth are common among infants and young children. Estimates indicate that up to 30 percent of young children may experience injuries to the primary teeth. Injuries to the primary teeth occur most often in children ages 18 through 30 months. Because children in this age group are unsteady on their feet, as they begin to walk, run, and climb, accidents occur that result in oral injuries.

Types of Injuries

In infants and young children, the teeth most often affected by oral injury are the upper front primary teeth. The most common type of injury is a displacement (tooth is pushed out of position) injury with gingival (gum) bleeding. Intrusion injuries, in which a primary tooth is driven into the bone, are also common. Avulsion (tooth knocked completely out of the mouth) of the tooth can also occur.

Oral soft tissues — including the lips, tongue, palate, and gingiva can also be injured. Impalement injuries can occur when an infant or young child falls with an object in the mouth and the object penetrates the oral soft tissues.

Jaw fractures, while uncommon among infants and young children, can occur, especially with a significant blow to the face or the chin. Jaw fractures result in difficulty opening and closing the mouth, facial asymmetry, and/or paresthesia (a sensation of pricking, tingling, or creeping).

Infants and children who experience an oral burn as a result of chewing on electrical cords should be referred to a burn specialist for assessment and possible intervention. Early referral is crucial to reduce the risk of scarring and fusion of the corners of the mouth. The risk increases with delayed care.

Managing Injuries

The roots of the primary teeth are close to the crowns of the permanent teeth; therefore the force of the impact to a primary tooth can be easily transmitted to the underlying developing tooth. Infection caused by primary tooth damage may harm the permanent teeth as well. The intervention strategy for injured primary teeth is dictated by a concern for the permanent teeth.

Bleeding should be controlled with direct pressure.

ice

Swelling can be reduced by placing ice in a zip-lock bag or a bag of frozen veggies like peas will work also. Popsicles and other frozen food items can help also. 

For pain Acetaminophen (Tylenol etc) or Ibuprofen (Advil etc) may be used. Follow label directions for dosage. (Note Ibuprofen has been linked to a rare but possibly fatal condition called Steven Johnsons Syndrome.)

All oral injuries should be assessed as soon as possible. If unable to see a dentist, an emergency health facility or family doctor may be the next best starting point.

Avulsed Tooth

Because of the danger of damaging the underlying permanent teeth, no attempt should be made to reinsert an avulsed (tooth completely knocked out) primary tooth. It is impossible to relocate the tooth accurately, and there is danger of pushing it too far into the soft alveolar bone.

However, an avulsed permanent tooth should be reinserted immediately or as soon as possible, with appropriate splinting and follow-up by a dentist. If you are not sure if a tooth is permanent or not, treat it as one. 

Instructions:

• Find the avulsed tooth.
• Hold it by the (top part) only, not the root.
• Rinse it under cold water; do not scrub.
• Reinsert it into the socket quickly, making sure that the front of the tooth is facing you. If this is not possible, place the tooth in cold milk or cold water and take the child and the tooth to a dentist immediately.

Chipped/Cracked Tooth

If you can locate the chipped portion, treat it the same as the avulsed tooth and bring the pieces to the dentist as he/she may be able to reattach the chipped portion with bonding.

Follow up

The dentist may x-ray the area to see if there is root damage or a fracture of the underlying bone. He/she may splint the teeth until they stabilize. If the tooth/teeth injured have damage to the Pulp (nerve), the dentist may recommend  tooth canal treatment on either the permanent or primary teeth. If there is significant laceration of tissue, a few stitches may be placed.

Long Term Complications

The gingiva (gums) ad other oral soft tissues are remarkable in their healing ability. Teeth however can be quite unpredictable. The dentist will advise you that even though healing looks good initially, there could be several problems that occur in the future including: 

• A primary or permanent tooth turning dark.
• an abscess requiring extraction or root canal therapy.
• A fracture to a permanent tooth root complicating any orthodontic movement.
• Failure of a reattachment of a tooth chip and bonding.
• The need for a crown.

 Mouthguards

Wearing a mouthguard during any activity where oral injury can occur will greatly reduce these types of injuries. Furthermore, after an injury occurs, wearing a mouthguard will greatly improve prognosis and prevent re-injury.

Your comments and questions are welcome.

Phillip C. Neal DDS

Crystal Lake Dental Associates

280 B Memorial Court

Crystal Lake IL  60014

815 459 2202

www.drneal.com

Bruxzir™ and Emax™ the Highest Strength Metal Free Crown

One of the great dilemmas facing dentists is to create esthetic smiles for patients with severe wear, or destructive habits like habitual clenching and grinding (Bruxism). 

severe wear

Historically, the material of choice for patients who have these conditions has been the use of cast metal. The metal used was usually gold alloy, semiprecious, or non precious alloy in  crowns and bridges. These metals gave restorations great strength and wear  resistance. Unfortunately, metal has horrible esthetics.

metal bridge

We still measure the longevity of all other restorative materials against metal alloy.  A gold crown can function  more than 50 years in the mouth.

In the early to mid 20th century, acrylic and porcelain were used to hide the metal and improve the esthetics of dental crowns and bridges. The problem with these esthetic restorations is the weaker porcelain can fracture off revealing the metal below. 

porcelain fractured off porcelain/metal bridge

 Since then not much has changed in the fabrication of restorations until the use of Dilithium Silicate marketed as Eris™  and Zirconium marketed as Lava™, and Procera® and others. These materials utilize the Dilithium Silicate or Zirconium as a base layer (core)  and overlay with porcelain. Dilithium Silicate is 3 times as strong as porcelain, while Zirconium is 10 times as strong as porcelain. These were the first strong  "Metal Free" restorations that were used for crowns and bridges. Since their introduction, fracturing of porcelain is still reported in bruxers as the porcelain is still weak, so we kept looking for stronger materials with good esthetics.

porcelain fracture off porcelain/zirconium bridge

 Through experimentation, newer shades of Dilithium Silicate and Zirconium have been developed which have acceptable esthetics.  These materials are E-Max™ and Bruxzir™. Both of these materials can be milled out of a solid block of material. E-Max™can be used with the CEREC™ in office milling system,which can be placed in a single visit for single crowns and onlays. Bruxzir™ must be made in a lab and will require 2 visits. Bruxzir™ has enough strength to be used in a full arch bridge.

 We have been placing E-Max™ crowns in one visit for over 2 years with no breakage. 

E-Max™ before

E-Max™ after

We  have been using the Lava™ system for several years for crowns and bridges and now will be able to offer the Bruxzir™ system as well for our more severe cases.

Bruxzir™ bridge before

Bruxzir™ bridge after

If you have any questions you can contact us at:

phone                   815 458 2202 

or Email us at     info@drneal.com

You comments are welcome

Sincerely,

Phillip C. Neal 

Crystal Lake Dental Associates

280 B Memorial Court

Crystal Lake IL 60015

www.DrNeal.com