Archive for July, 2009

Swine Flu Update

Friday, July 31st, 2009

Have you had your Swine Flu vaccination yet? Likely not. Although the vaccine is currently being produced, it takes time, and America just doesn’t have the facilities to meet our own demand. Only 20% of the flu vaccines used in this country are produced in the US, because the stringent government controls on medical research and development have made it economically unfeasible for private pharmaceutical companies to produce them. 70% of all the vaccines produced in the world come from Europe, and they may become hesitant to export them to the US, and may not want to deny them to their own citizens if this flu turns out to be as serious as some think.

So far the World Health Organization has reported 95,000 cases of Swine Flu, with 429 associated deaths. Other flu-related deaths total over half a million a year, so the Swine Flu deaths don’t appear that alarming. However, the percentage of deaths and the rate of spread of the disease are the cause of concern. Therefore, until these vaccines become more available, just take extra measures to be safe and protect your health and thus your resistance to viral attack.

The common things you are probably already aware of are prevention and lifestyle. Stay away from anyone with flu symptoms, use wipes on shopping cart handles, and if you develop severe symptoms, contact your doctor right away. On the lifestyle side, get plenty of rest and water, eat lots of raw fruits and vegetables, avoid sugar like the plague, and floss your teeth! Seriously! I’ve seen research that claims up to 90% of all other diseases stem from gum disease, the most critical of which is lung disease. The primary target of Swine Flu is the respiratory system and the main cause of respiratory weakness is gum disease. The premier concern for anyone wishing to protect their lungs should be periodontal health. This includes flossing and brushing of course, and regular cleanings, which have been called “the best bargain in dentistry”.

Dr. Moulton’s article was published in the Desert Valley Times, July 2009

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Don’t Swallow That Spider

Saturday, July 18th, 2009

Last week, we discussed the causes of osteoporosis, or low bone density, and mentioned how you can usually prevent it by eating whole natural foods, exercising, and avoiding drugs of any kind whenever possible. This week, we can focus on a special kind of bone in your jaws an around your teeth, called alveolar bone, and how bisphosphonates, a class of drugs used to treat osteoporosis, affects you.

In review, remember that bone is a living tissue which contains, among other things, osteoblasts, which are cells that deposit calcium from the blood into the bone structure, and osteoclasts, which are cells that remove the damaged structure and waste products and return them to the blood. In this way, the bone can be a vital tissue in your body that can stay healthy and respond to your environment. Constant exposure to things that increase blood acidity, such as drugs, sodas, and processed foods will induce excess osteoclastic activity in order to neutralize the blood. Over many years this results in a net deficit in bone density because more calcium is being removed than being restored by the osteoblasts. Unfortunately, life is never that simple. The process by which the osteoclasts and osteoblasts work is orchestrated by your endocrine (hormone) system in a way scientists don’t understand. Any condition or drug which affects your endocrine system will usually inhibit the osteoblastic activity, so that after the osteoclasts remove the unwanted tissue, little or no new bone is deposited in its place, resulting in a more rapid decrease in bone density and osteoporosis.

The most common condition that leads to hormone imbalance of course is menopause in women and impotency in men. After menopause, a decrease in blood estrogen is observed. In an attempt to restore the hormone balance and avert post-menopausal osteoporosis, doctors routinely prescribed artificial estrogen. Now, in spite of the fact that some research suggests it actually contributes to osteoporosis and estrogen therapy is proven to cause breast cancer, they stubbornly insist on continuing this practice.
The most common classification of drugs that affect the endocrine system is glucocorticoids, such as prednisone, prednisolone dexamethasone, and cortisone. These are usually used to control rheumatic diseases such as rheumatoid arthritis and systemic lupus erythematosis. These drugs have a devastating effect on your entire body because the endocrine system is so powerful yet fragile. But glucocorticoids affect bone density in several ways, so osteoporosis will follow swiftly and certainly. Because of that, physicians that prescribe these drugs routinely also prescribe bisphosphonates in hopes to counteract that inevitability.

That brings us to the focus of this article…finally. Different brands of bisphosphonate preparations constitute the hands down drug of choice for “treating” osteoporosis. The names you are most familiar with are Fosamax, Actonel, Boniva, Aredia, and Zometa. A drug called Forteo is occasionally used, but don’t go there. It is a synthetic parathyroid hormone which has among its nightmarish list of effects that it actually causes bone cancer.

Bisphosphonates work by suppressing osteoclastic activity, so that the damaged bone and debris remains there, as new bone continues to be deposited. The result is that the bone becomes denser and less likely to fracture, for now. I’m reminded of Sally Field’s line in a Boniva commercial saying that it “makes your bones stronger and healthier.” Well, that’s a lie. Bisphosphonates also suppress the production of blood vessels, so that no nutrition is received, the cells all die, and the bone becomes dead – petrified. That doesn’t sound too healthy. If it stopped there, it wouldn’t be so bad, but eventually a process called necrosis occurs. The bone putrefies and turns to mush. I can just see all the lawyers licking their lips.

I know this because in the dental field we are seeing the tip of the iceberg. There’s even a name for it, Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ). This is becoming more prevalent each year and it is surfacing because this special kind if bone I’ve been talking about, alveolar bone, is a much more active bone because of the constant changes associated with the development, growth, infection, and loss of teeth. Because it is so active, the problems caused from bisphosphonate use are showing up earlier than in other bones, and it’s not pretty. Horrendous infections that are virtually untreatable because of the lack of circulation are destroying jaws. Drastic surgeries and drugs are used to counteract the effects of other drugs. It is like swallowing the cat to catch the bird that ate the spider. Just don’t swallow that first pill.

But before you jump out a window, let me tell you that it’s just a fraction of one percent of bisphosphonate users that are showing these signs in the jaws, although that fraction is increasing each year. And, admittedly, much suffering has been averted by the decrease in bone fractures from the use of bisphosphonates. The medical profession is playing a numbers game, betting that more people will benefit than suffer from these drugs. The drug industry is trying to sell more of them, and you’re caught in the middle. Just be sure you know the odds, and before you take bisphosphonates, make sure you correct and maintain your dental health. Also, remember what my mother told me as I went off to college, “Drugs are not the answer.” There are many alternative, natural methods of correcting and preventing osteoporosis that are just as effective, so take control of your own health and research and study these things so you can make the choice that is best for you.

Dr. Moulton’s article was published in the Desert Valley Times, December 2007

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Gum Recession

Friday, July 10th, 2009

One of the most frequent concerns I hear is about receding gums. Oral health is certainly important to those people, but actually their fears are usually about appearance. The margins of their crowns and the roots begin to show, making the teeth look longer than normal. And, as you know, being ‘long in the tooth’ is associated with age.

Actually, the real mechanism going on is bone resorption. The gums just follow along, except directly around the necks of the teeth, where the swelling from infection and inflammation keep them propped up around the teeth. That produces a false sense of security, sometimes swaying the decision to get them checked and treated.

Generally speaking, bone resorption can be triggered in two ways, internally and externally. Internally, acidic blood from eating acid-producing foods will dissolve the calcium out of the bone, causing bone degeneration throughout the whole body as well as around the teeth. Foods that produce acidity in the blood are, as you might have guessed, junk foods. Sugar, starches, sodas, diet sodas, processed foods, drugs (prescription or non-prescription), coffee, alcohol, and even tobacco are literally eating you alive! Fruits are great, however even though they are acidic, they produce just the opposite effect in the blood. Go figure. Vegetables are also great. They are your best chance to replenish the calcium in your bones.

The external causes of bone resorption are infection and irritation. You get both of those from the plaque and tartar that accumulate around the teeth and along the root surfaces destroying the supported bone, with the gums soon to follow, and then the teeth like a domino effect. Many people think that brushing and flossing is enough, but that’s just a good start. You need to see your dentist.

If I’ve scared you, then good. Gum disease is the number one disease in America. It is the main portal through which inflammation and bacteria can enter your bloodstream, attacking your heart and other organs. There’s more than just your appearance at stake.

Dr. Moulton’s article was published in the Desert Valley Times, February 2007

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Good News and Bad News

Friday, July 10th, 2009

The Center for Disease Control and The Center for Disease Prevention released a ten-year report April 30 of this year titled, ‘Trends in Oral Health Status’, which is based on data from the CDC National Center for Health Statistics. The report sounds good on the surface, but has some findings that have cause for serious concern to parents of infants.

First the good news. Let’s work from the top down. In the 65 and older category, edentulism (loss of teeth), is down 7% from 1997, which is most likely because periodontal (gum) disease, the leading cause of tooth loss, is down 10%. Let’s hear it for the seniors! Public awareness and motivation toward disease prevention is getting them flossing and having cleanings like never before, but don’t let up, because gum disease still remains their primary threat to oral health.

The adults from 20 to 64 have 5% less periodontal disease, a mild improvement. As you look at younger groups, the focus shifts from periodontal disease to decay being the main concern. In children from 12 to 19, decay is down a whopping 9% over the last 10 years. I’m sure that this is due to the increase in the use of sealants in that group, which is up 20%. Similarly, the use of sealants in children from 6 to 11 is up 8%, resulting in a 4% decrease in decay. Not a lot, but any positive trend is good.

The CDC report revealed additional information which is beneficial in understanding causative factors in dental disease. An obvious example is the fact that 12% of children from 6 to 11 that are from families which are below the poverty level have untreated decay, versus 4% of those in families above the poverty level. Well, of course you would expect that. Another trend I found interesting however, was the fact that 31% of Mexican American children from 6 to 11 years of age have had decay in permanent teeth, versus 19% of white non-Hispanics. On the surface, one might suspect some socio-economic reason, but in my experience I have seen that it is simply hereditary. Mexican-Americans have fissures, or grooves, in their teeth that are much deeper on the average than other nationalities. It’s unfortunate, but in light of that statistic, now they are armed with the knowledge that they need to be more diligent than average in having their children’s teeth checked and having sealants done to prevent that type of decay.

Well, I’ve put off the bad news as long as possible, but here it is. The decay rate in children from 2 to 5 years is up 4% from 24% to 28%. It may seem like a small thing, but there is something going on that has decreased these children’s resistance to dental disease and possibly other diseases. This trend will produce a ripple effect through all the previously mentioned categories as the children get older, unless our society makes some major changes in our approach to disease prevention.

Like any other endeavor, it must start with a good foundation, the diet. The first thought is to pick on sugar, but there are a lot worse things. Of course, limiting your sugar is important, but totally avoid high fructose sugars usually found in sodas and candy. Also keep your children away from processed foods and artificial sweeteners such as sucralose and aspartame. These are killers. Good substitutes are pure maple syrup, stevia, splenda, and xylitol, a natural sugar that actually prevents decay. If you need any help finding these products, call our office. Baby bottles and sipper cups, outside of meal times, should only contain water.

Then good hygiene habits must be developed. If flossing and brushing is started before walking, you’ll never need to remind your children when they get older. Just stay away from fluoride toothpastes such as Crest and Colgate. If you will read the fine print on those products, it says if you accidentally swallow any more than is necessary to brush your teeth, then call the poison control center! Well, you know your kid is going to swallow anything that goes in his mouth, and fluoride is especially toxic to young children. Find good fluoride-free toothpaste, such as Spry, Neways, Tom’s, or Oxyfresh at the health food store or our office.

Finally, the American Association of Pediatric Dentistry recommends getting your child’s first dental exam before their first birthday. Of course, you will rarely find anything, but at that age they are relatively fearless, and having a fun experience riding in the chair and getting a toy and some kudos will reinforce their confidence and desire to see the dentist in the future. The CDC, ADA, and AAPD consider the rise in children’s decay cause for national concern and have coordinated their efforts to mobilize a program to reach infants, especially in poverty-level families, to educate the parents in effective preventive measures and to provide treatment. To contribute to this cause, our office is providing free exams and cleanings to any child 3 years and younger. Also, I would like to remind you that we have always provided free dental treatment to children that qualify through Virgin Valley Family Services. I urge you to take advantage of these services for the sake of your children.

Dr. Moulton’s article was published in the Desert Valley Times,
June 2007

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Frequent Failures: Diagnosis and Treatment Planning

Friday, July 10th, 2009

The dental experience is very often and hopefully a routine visit involving your periodic cleaning, some x-rays, a checkup, and maybe a minor correction, such as a filling. However, about every three to five years it is recommended by the American Dental Association that you have a full mouth evaluation with x-rays of all the roots. It’s very tempting to put that off, but I can attest to the fact that this is where we find most of the serious problems. Nobody likes to go looking for trouble, but it will surely gather some buddies and come looking for you otherwise.

It’s good to have an edge, so I thought it might be helpful to be armed with the knowledge of some common pitfalls when faced with the possibility of more involved treatment. These are the most frequent causes of failures based on my experience and a report by a very popular and wise prosthodontist, Dr. Gordon Christensen. This will be a six-part series that we hope might help you avoid any failures.

The first consideration is, of course, the first step in your journey: the exam. Be sure to be very thorough in your approach to making decisions that could mean the difference between a happy or sad outcome. Have your dentist take full mouth x-rays, pictures, study models, periodontal charts, and a current health history. It shouldn’t be too expensive, because most of this work can be done by the assistants, and when the dentist does the exam and makes recommendations, he will be dealing from a full deck. Ask questions, find out about alternatives, and request additional educational materials to familiarize yourself with the situation.

Take an active role in planning your treatment, and when you and your dentist make your plans, remember these hints: Use specialists for the more complicated root canals, extractions, gum surgery, and so forth. Don’t get too heroic in trying to save problem teeth, such as trying to save just one of the roots, or redoing root canals that have failed once or twice. Use posts liberally to strengthen the teeth that have had root canals – especially in areas of stress, such as bridge supports. If you are trying to improve the appearance of teeth with fluoride staining (flourosis) or very dark or striped teeth, you will get a far more aesthetic result with opaque porcelain crowns rather than bleaching or veneers. That will also give you a better success rate because of other factors in badly stained teeth such as bonding problems and weakness from cracking. Speaking of weakness, if you’re planning a filling that is too wide, it would be a much wiser choice to do a crown or an onlay, but not a fired ceramic inlay that has become so popular recently. They break too easily. Use cast porcelain. Finally, if you’re using any metals, stay away from the most allergenic metals, such as nickel, chromium, copper, palladium, and mercury, which by some strange coincidence happen to be the most commonly used metals in dentistry.

Dr. Moulton’s article was published in the Desert Valley Times, March 2007

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Digitize Me

Friday, July 10th, 2009

Digital x-rays have gone from a novelty to a luxury to a necessity now. The old systems were actually inferior to photographic film mainly because of the lack of definition. The pixel density was very low and the sensors were crude. The computer software was also pretty deficient.

However today, factors such as increased speed and memory, more advanced hardware and user-friendly operating systems have made digital systems almost a must. It’s only recently that the picture quality has approached that of film, but now that it has, the other features make digital imaging practically indispensable.

Basically, they are the same advantages that have revolutionized photography. You can manipulate the images: enlarge or enhance them. They’re easier to store, print and transport electronically by e-mail. One feature that’s interesting about dental imaging is that the program can actually analyze the picture and tell you where the cavities are. There are additional advantages of the software that can even show you what you might look like after your work is completed!
One of the greatest advantages of digital x-rays over photographic film however, is one that may not have ever been intended. It uses only about one fourth the radiation that the film needs, which wasn’t much to begin with. In the past, we would address patient’s fears about the radiation used for dental films by explaining how insignificant an amount it was. It used to take about two thousand dental x-rays to equal one chest x-ray. Well now it’s eight thousand. It’s so slight, the FDA doesn’t even require the use of a lead apron on the patient when taking digital dental x-rays, however we still use it just to be extra safe.

Dr. Moulton’s article was published in the Desert Valley Times, January 2007

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PLAN FOR SUCCESS: CROWNS AND BRIDGES

Wednesday, July 8th, 2009

Here’s some inside information on how to increase the chance of success of dental procedures, based on research by Dr. Gordon Christensen. Our last category is concerning crowns and bridges. A crown covers the entire tooth and is used mainly when the tooth is weakened too much by decay or cracking. The decay is removed, and also the enamel surface of the tooth, so it can be replaced by a custom-made form which is bonded permanently onto the remaining tooth. This holds the tooth together, and it can be made of porcelain, metal, or a combination of the two.
If you’re a tooth grinder, the old school of thought was to make any crowns with a metal biting surface, but now the new, nonabrasive low-fusing porcelain is better. However, it is still a good idea to find out why you’re grinding your teeth and correct that.
So here is your first hint. Whether it’s in preparation for a crown, or just to replace an old filling, have your dentist remove all of the old filling material first. The failure of that filling is the reason you are replacing it or crowning it, and the likelihood that there is further leakage and decay is very high. It is one of the basic lessons we learn in dental school, and yet, more than half the crowns I see, and practically all the failed ones have old filling material underneath them. And when we remove that old filling material it is just loaded with decay which had continued to grow underneath the crown.
Now let’s move on to what is known as the fixed bridge. It is used to replace missing teeth by preparing the surrounding teeth for crowns, and when the crowns are made, the missing teeth are fused in between them and the whole thing is cemented permanently to the remaining teeth. The fixed bridge used to be the gold standard in tooth replacement, but the new implant systems have surpassed them in success rate and they are much more conservative. However, there are still many situations which would favor the use of a bridge, and these tips might help you plan them more successfully.
The chance of failure grows exponentially with the size if the bridge. The bigger the bridge, the more complicated the stresses and the chewing patterns become. The more teeth involved, the more chances you have of one of them failing for an inaccurate fit, recurrent decay, gum disease or fracture, and often one such problem can destroy the whole bridge. Try to keep it down to three to five units per bridge (that includes crowns as well as missing teeth).
Avoid the use if cantilevers. Those are bridges that have one or more missing teeth that are not supported on both sides by natural teeth. They have an extremely high failure rate.
Never splint two teeth together in order to hold one of the crowns in place. That crown will still come loose just as easily, except then you may not realize it until after the tooth has been destroyed by decay and infection because that crown won’t fall off since it is being held in place by the other one.
Finally, be diligent in your evaluation of your treatment options, and in the proper maintenance afterward. There are usually more than one way to treat a particular problem, so if your dentist only gives you one choice, ask a lot of questions to find out what the other options are and what are their expenses, success rates, limitations and aesthetic considerations. For instance, when a nerve becomes infected, you might assume that your only choice is root canal therapy, but if your main concern is longevity, replacing it with an implant could be a much better choice. And when the treatment is completed, many people think that they’re good to go for a long time without any further care, but in actuality, the more involved the treatment has been, the more maintenance is necessary. So protect your investment with regular check-ups and cleanings.

Dr. Moulton’s article was published in the Desert Valley Times, May 2007

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Cover Up

Wednesday, July 8th, 2009

You’ve heard of it before, but maybe you don’t quite know exactly what it is. It could be a filling, or it might be a crown. It’s a veneer. In the dictionary, a veneer is a covering over the outside of something, usually to enhance its aesthetic or physical characteristics, and that’s just what it is in the mouth.

A veneer is a thin coat if porcelain or resin bonded to the face of a front tooth to make it look better and to strengthen it. If the tooth is cracked or weakened by too many fillings, a veneer may be necessary to protect it from breaking, or if the tooth or teeth are discolored or crooked, veneers are a nice, conservative and quick way to correct that. In fact, they have been called “instant orthodontics”. Although you don’t actually move the teeth with braces, they can be reshaped to instantly straighten them.

I’d like to stress the conservative aspect of doing veneers. When planning treatment, my motto is always, “if it ain’t broke, don’t fix it”, but a broken smile is every bit an injury as a broken tooth. And when doing a veneer, less tooth tissue is removed than most other types of restorations. It’s like the front half of a crown, but since there is no metal, it can be made super thin, and it looks more natural because it’s translucent like your own enamel.

There are basically two kinds of materials you can use to make veneers, plastic resin and a hybrid porcelain which is non-abrasive. The plastic is less expensive, but usually isn’t as durable. Its average life expectancy is 5 years, whereas, the porcelain is about twice that, and it is more translucent and natural-looking. These are all considerations your dentist can discuss with you based on your particular circumstances.

Dr. Moulton’s article was published in the Desert Valley Times, March 2007

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Choose Success: Implants

Wednesday, July 8th, 2009

In Dr. Gordon Christensen’s report on how to avoid the most frequent causes of failures in dental procedures, he offers assistance to dentists by pointing out statistics gathered by one of the most unique research organizations in the world. His creation, the Clinical Research Associates (CRA) in Utah, is entirely self-funded. Any profits are either given to charity or reinvested in further research for the benefit if dentists and patients everywhere. Since no manufacturers donate to CRA, they can be totally objective without deference to any company or product. The manufacturers of these products hate the CRA with a passion.

I would like to share this information with you because I believe it’s in the interest of your safety and success. The second of our six-part series deals with dental implants. To me, this is one of the most exciting developments in dentistry. You can get your teeth back! And the prognosis is, on the average, every bit as good as natural teeth. The success rate is higher than any prosthesis in dentistry or medical science for that matter.

Usually, the first question we get is how soon can they be finished? The answer is anywhere from immediately to up to six months, but your success rate drops significantly the sooner you put a tooth on the implant, or “load” it. The bone needs about four to six months to fuse to the special coating on the implant body or root. Depending on its position, type, size, and environment, the success rate after that amount of time is from 95% to 99%, however if it is immediately loaded that figure goes down to 90% to 95%. Dr. Christensen advises against that. Your chance of failure could go up to one in ten if you rush it.

When I started practicing dentistry, the success rate of implants was estimated at an optimistic 80%. That’s one failure in five. I refused to do them and advised my patients against them. If they insisted, I sent them to another dentist. So you can guess how I stand on immediate implants.

Well, if the Supreme Court has their way, I could be guilty of pollution, so let me wrap this up with a few hints. I must be brief but technical, so write these down and discuss them with your dentist. Be sure you have adequate antibiotic coverage when placing the implant body. The direction of the implant should be in the direction of the biting forces. There should be no gum disease around any other natural teeth. Use custom abutments for single implants. Don’t connect implants to natural teeth. Attach the tooth or crown with cement rather than a screw, and make sure the bite isn’t too high. Finally, when doing implant-supported partial dentures and dentures, avoid long cantilevers, rigid retainers, and high noble framework.

Dr. Moulton’s article was published in the Desert Valley Times, April 2007

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Be Dentally Prepared for Joint and Heart Surgery

Wednesday, July 8th, 2009

When certain kinds of surgeries are done, those areas can be especially compromised by the presence of bacteria. Of course, your doctor is going to make every effort to provide a sterile operating environment, but the bloodstream could be a potential source of hidden bacteria.

In most cases, this is not a critical factor, however in some areas such as around artificial joints or heart valves, the circulation is a little restricted, leaving them more susceptible to bacterial attack than other tissues in the body. Some common measures taken to avoid any occult bacteria in the blood include premedication with an antibiotic just before surgery, and preventing any other source of infection that may arise. Watch out for cuts and scrapes of course, but the most obvious place to find lots if serious bacteria is in the mouth.

Even though decay is produced by bacteria, it doesn’t get into the blood until it infects the nerve. That’s certainly a potential for bacteremia. I found one of those in a patient scheduled for surgery the next week and the doctor had to reschedule it until we were able to resolve the infection.

However, it is much more likely to find problems in the gums. Depending on the study, the prevalence of gingivitis or periodontitis ranges from 65% to 75% in America. If you haven’t been keeping up with your dental cleanings, you might be one of those statistics. In view of the health issues associated with periodontitis, it is always a good idea to prevent that bacterial plaque from working its way under your gums, but if you’re planning on surgery, it’s especially important to get your mouth in order.

I’ve heard of an eleventh-hour approach by surgeons who tell their patients a week before the surgery to not brush their teeth very hard so they don’t stir up any bacteria that could be present in their gums. While this might be good advice at such a late hour, a much better approach would be to try to eliminate any oral infections well in advance of the surgery. If it is an emergency, you have no choice of course, but most surgeries are at least planned if not scheduled months ahead of time. Plenty of time to resolve any urgent dental problems, and just because nothing hurts, don’t be lulled into thinking everything is okay. Most dental infections are not painful.

Here is a strategy I recommend. As soon as you decide on a surgery, inform your doctor that you are planning to get a complete dental check-up, if you have not done so recently. Have full mouth x-rays taken and a periodontal examination. At this time it is not necessary to concern yourself with any elective procedures or minor problems. You’re just looking for potential sources of infection. Get those taken care of along with adequate gum therapy which could be just a simple cleaning or more. Then brush and floss thoroughly every day right up to the day of your surgery. That will prevent a buildup of bacterial plaque.

If the surgery is just a week or two away, skip the gum therapy but have the teeth x-rayed. I’m sure your doctor would like to know if you have an active abscess going on. Dentures can also create hidden infection occasionally, so it is good to get those checked. Needless to say, the best approach is to stay current on your exams and cleanings, floss every day, and don’t smoke!

Dr. Moulton’s article was published in the Desert Valley Times, February 2007

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