Archive for October, 2009
More Than Everything You Wanted to Know About Root Canals
Wednesday, October 28th, 2009
Oh that term, Root Canal. It elicits a response somewhere in the neighborhood of colonoscopy. It’s wrapped in a shroud of forboding. It’s the standard against which all forms of discomfiture are measured. “I’d rather have a baby than a root canal.” “Well, that went over like a root canal.” “A root canal is like waterboarding.” No, I actually liked waterboarding. My brothers used to do that to me when I was a kid.
But you get the picture. In actuality, root canal therapy is usually no different than a filling (not that that’s a big thrill). In most cases, the nerve is so dead, it has no feeling left in it. The pain and sensitivity to touch is the pressure in the bone at the tip of the root where the infection is building. That’s very easy to get numb. So the apprehension surrounding root canals is exaggerated. Probably associated with the pain the person is already suffering when they come in to the office, or a throwback to the cowboy days when the barber used to give you a pint of whiskey and dust off the pliers they just used to shoe the horse.
It doesn’t just stop there, however. There are options to consider before you do the root canal and even after it’s done. The first thing you need to decide is if you even want the root canal therapy. Research has shown that no matter how well a root canal is done, bacteria continues to grow within the tooth. Whether that’s a health hazard or not depends on who you are talking to. An endodontist would just say, nonsense, but a homeopathic physician would have a fit.
There are other considerations, such as how much decay or gum disease is present, cracks in the root, and medical complications.
Then there is the decision about what to do with the tooth after the root canal is done. The standard recommendation is to put a crown or cap on the tooth. This idea is engendered by the fact that 83% of root canal failures come from teeth that haven’t been capped afterward, but that statistic is skewed. It’s also true that 83% of teeth that receive root canals are not followed up with a cap, so in actuality, doing a crown afterward has no bearing on the success of the endodontic therapy.
It can have a bearing on the success of the tooth, however. Endodontically treated teeth become more brittle than vital teeth. Also, according to a study by Dr. Jay H. Levy, nonvital teeth are less sensitive to pressure, so you may inadvertently chew harder on them than you would a normal tooth.
On the other hand, I put a lot of value on the health of the gums, and no crown margin can come near to the periodontal health that the natural tooth gives you. With that in mind, I like to compromise on the necessity of a crown when possible. If no more than 40% of the tooth is lost to decay, there are no cracks or mercury amalgam fillings in the tooth (they expand and are what causes the cracks), and if asthetics is not a concern, then I like to go with a bonded composite filling instead of a crown. It’s often a cleaner choice in my estimation, not to mention less expensive.
Next week, what are your options if you and or your dentist decide against a root canal.
Dr. Moulton’s article was published in the Desert Valley Times, October 27, 2009
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Zen and the Art of Tooth Maintenance
Wednesday, October 28th, 2009
Actually, the oldest and most common personal hygiene practice is the cleaning of the teeth. It comes in just ahead of bathing. There are prehistoric relics of brushes made out of shredded bamboo and pig bristles (sounds like a Chinese entrée).
But in spite of all that attention to tooth maintenance and our space-age technology, the incidence of decay and gum disease is still astronomically higher than it was in the dark ages, thanks to a corresponding increase in man’s ability to refine sugars. In this enlightened age we now have high fructose corn syrup. I don’t know why, because it doesn’t do anything for the flavor. It must be addictive or something, but I do know that it is highly destructive to the teeth, not to mention the blood sugar, just in case you don’t want to develop diabetes. You should avoid it as much as you can.
So here are seven tooth care tips to help you combat the modern diet:
1. Brush longer than you think you need to. When people try to estimate the recommended three minutes, they fall way short. Watch a clock or use an egg timer that your dentist can provide.
2. Work systematically. People often neglect the back teeth or the inside surfaces, or brush one side more than the other. Whatever system you use, try to cover every side of every tooth equally.
3. Use a brush with soft bristles of varying heights. The tendency is to think that hard bristles would clean better, but it’s just the opposite, and hard bristles can damage the enamel and gums.
4. Change your brush at least every three months, because the bristles will fray and bacteria will build up on them.
5. Manual brushes are just fine. Research indicates that sonic brushes are no better, but rotary brushes may be better depending on the type of bristles. The best of those is the Rotadent, which we get at wholesale as a service to our patients. The elderly may benefit the most from them because of dexterity issues.
6. Don’t knock success. Once my Uncle Jerry was leading a golf tournament, so before the final round he took a lesson from his golf instructor. Needless to say, he played miserably the next day and lost the tournament. If you’re not getting cavities and your gums are nice and healthy, then just keep doing what you’re doing.
7. Don’t forget to floss! This is EQUALLY as important as brushing, yet it is the most neglected part of tooth care. Did you know that people that floss live TEN years longer than people that don’t? That’s because eliminating bacterial plaque improves your overall health. If you have trouble wrapping the floss around your fingers, then see your dentist for instructions, or try those disposable floss holders like Eez-Thru by Butler GUM (which we carry). They are not quite as effective as the manual method, but they are better than nothing. As Nike says, “Just do it”.
Dr. Moulton’s article was published in the Desert Valley Times, July 2008
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Salivary Diagnostics
Friday, October 23rd, 2009
The appearance of the saliva has always been a tool that dentists have used to help with their diagnosis. Too much, or thick saliva can indicate the presence of irritants, such as metals or toothpastes. The lack of saliva can indicate disease or drugs, and its consistency gives a clue to dietary concerns.
I just have to tell you about a young man whose family had been coming to us since he was a child. The summer after his first year in college, he came in for a check-up and as I was working, I jokingly chided, “Well, I see you discovered alcohol.” His eyes got wide and he gave a half-hearted little laugh, but I never saw him again even though the rest if his family continued to come in.
Research continues to uncover more definitive information about saliva however, and noninvasive tests are becoming available for the detection of such diseases as HIV and cancer. Dr. Daniel Malamud, PHD at the New York University College of Dentistry, specializes in the development of anti-HIV agents and oral-based diagnostics. Dr. David Wong, the director of the UCLA Dental Research Institute, is known for his research in using saliva tests for the early detection if oral cancer. Other kinds if cancer can also be detected by saliva tests. Dr. Charles Streckfus at the University of Texas Houston Dental Branch is working on a saliva test that could indicate whether a person will develop breast cancer, and Dr. Joseph Califano, MD, is developing a test to detect the presence of certain cancers of the head and neck based on compounds found in the saliva.
I’m sure this is just the tip of the iceberg in salivary diagnostics, because the American Dental Association has made this its 2008 mega issue, considering it among the most significant developments in disease screening and diagnosis in decades. For more information on the tests, call my office at 346-3371.
Dr. Moulton’s article was published in the Desert Valley Times, July 2008
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A New Kind of “Dentist” is the Writing on the Wall
Friday, October 23rd, 2009
As it is in medicine, the dental care in the US is by far the highest quality in the world. I’ve had the opportunity to do emergency treatment for patients from many countries. They’re usually tourists that have had a dental mishap during their vacation. This has given me a chance to observe the quality of their dental work, and from Europe to the Orient, there is absolutely no comparison to ours. Keep in mind that these are the more affluent ones that can travel and afford the best dental care available in their country. These visitors are always surprised and pleased at their care, and we have even had a few of them make a special trip back to the US so we could finish their work. How many of you have flown over to Italy so you could get some bridge work done?
Why is it that the dental and medical care here is so superior to anywhere else? Are we just naturally more talented? No, it is the same freedom and independence that has made us great in so many other ways. We can research and innovate and modernize and economize so we can compete in the market. And you are the one who benefits. The highest quality and lowest cost are the factors that drive the producers to act in favor of the consumer. Those producers that are substandard will just naturally fall by the wayside through public preference, leaving the best ones to serve you, and for proof, just look in any mouth “made in the U.S.A.”
What about the underprivileged? That’s a good question. Approximately 20% of my production is charitable. Not that it’s such a big deal, but every health care provider donates a large portion of their time to voluntarily serve the underprivileged. That’s humanitarianism on a human level – face to face, where it belongs. That’s not the type of thing you can legislate.
But it seems our “leaders” want to “fix” this system for good, and humanitarianism has nothing to do with it. Where is the incentive to serve your fellow man when you can only do what you’re told? Economics has nothing to do with it. Instead of being able to tax the health care providers, the government will have to increase your taxes to pay those providers, and their overhead, and the hospitals, and the zillions of government administrators, and pay off their special interest buddies.
Quality has nothing to do with it either. Where is the desire to be service-oriented, or innovate, or even do a good job when all it means is more work, and cannot affect your job security or income? As if in preparation for this take over, less expensive laymen have been put in place rather than doctors, to make medical decisions and even treat people. Up to now, dentistry has been safe from such a threat, however, on May 16, in spite of strong opposition, the Minnesota legislature passed a bill to create “midlevel providers” of dental care. They decided to call them dental therapists and prescribed a short training period to certify them to give patients education, and do fillings, crowns, bridges, and dentures. They are not allowed to do gum therapy or surgery – yet.
That’s the writing on the wall. Right now it is just a little crack in the dam, but that’s what starts the flood. Dentistry rose up out of the barber’s chair, but it looks like we’re reverting right back. Minimally trained “dental therapists” could be doing your grandkids’ nationalized dental work, just like in good old Russia (if they don’t mind waiting six months for an appointment).
Since anyone with half a grain of common sense can see that a successful national medical system is unattainable, as demonstrated by countless other countries, why then are the liberals so hot to push it through? Power. They want to get their hands on one seventh of the gross national income so they can reign forever.
My greatest disappointment in this whole affair however, is the American Dental Association. You know that once the government takes away your medical rights, they will come after your dental rights. Now the ADA can’t wait to join the Obama administration in the destruction of their own profession. They just wrote him a letter to get in on the action, asking for only three “small” things. They want him to fix Medicaid (gee, I wonder what’s wrong with Medicaid), and establish a dental public health department (probably another Czar). Oh yah, the third thing is that they want the government to dump lots more of that extra toxic silicofluoride into our drinking water. Probably so we won’t care so much about the destruction of our nation. Das Vadanya,
Comrade.
Dr. Moulton’s article was published in the Desert Valley Times, June 2009
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H1N1 Vaccine Finally Hits Nevada
Tuesday, October 13th, 2009
Nevada seems to be low on the food chain as it is one of the last states to be allotted Swine Flu vaccine by the Center for Disease Control. Just this week, the Southern Nevada Health District received the first 20,000 doses, which it will distribute this month to public health clinics, hospitals and registered physicians to be used according to guidelines recommended by the CDC. The recipients with the highest priority are health care employees, children and pregnant women.
Nevada is slated to receive 400,000 doses by the end of this year, as the production of the vaccines gets into full swing. That may seem like a lot, but it’s only about one seventh of our population. However, this might not be such a shortfall because about two thirds of the parents in America have decided to delay or skip their family H1N1 vaccinations.
Why is there such an unprecedented aversion to such a seemingly urgent public healthcare mandate? The internet. Now we are able to see all sides of the issue and make a more informed decision. We find that as rosy and safe and necessary as these vaccinations are portrayed by public health organizations, there are qualified and reputable physicians that warn that the vaccinations could be more harmful to you than the Swine Flu. We can learn that the symptoms are more mild than originally thought, and public health advocates like Dr. Marc Sigel, Professor of Medicine at New York University, admit that they believe that the hospitalizations are more from panic and secondary bacterial infections and that the need for the vaccinations is more for economic considerations because of loss of time at work.
On the internet, we can discover that back in 1976, the Swine Flu epidemic ended up killing fewer people than the vaccinations did. All they had was the government to trust back then. We can also find out who is making the vaccine and what they are putting in it.
In the US, we are using vaccines produced from seven companies around the world. Sanofi Pasteur in France provides about 45% of the vaccine used here, and in the US, Baxter Healthcare makes about 20%. The rest is made by Galaxo Smith Kline in England, Novartis in Switzerland, Astra Zeneca, Merck and a manufacturer in China that I couldn’t even find the name of, much less a list of ingredients. These are the people that gave us poison toothpaste, poison dog food, lead paint on the toys and viruses in their computer chips!
When you get your vaccination, it’s just potluck as to where it came from. All the vaccines I checked contained a list of adjuvants as long as your arm, and I hate to think what’s in the one from China.
An adjuvant is a substance added to the vaccine to stimulate a stronger immune response. They are usually toxic, because that’s what elicits the strongest response. Adjuvants are usually used in vaccines, but since the virus products used to make N1H1 vaccine have been spread so thin in order to make more doses, adjuvants that have been discontinued and even outlawed because of extreme toxicity, have been reinstated under the Emergency Use Authorization so they can shock your immune system into responding to the weak viral component. This is all somewhat theoretical and they’re not positive it will really work, but I’m sure you have been warned of that, haven’t you?
The additives of most concern are Squaline and Thimerosal. Squaline has been outlawed for human use because it causes autoimmune disease such as rheumatoid arthritis. It’s used to induce diseases in laboratory animals for scientific study. The Thimerosal in one injection contains 25,000 times the amount of mercury in a can of tuna. Mercury causes neurological disorders such as autism, ADHD, chronic fatigue syndrome and fibromyalgia. Dr. Kent Holtorf, an endocrinologist, recommends that the nasal mist vaccination may be slightly safer, because it usually doesn’t contain Thimerosal.
I could name a hundred other allergens contained in most brands of H1N1 vaccines, such as monkey serum, aluminum salts, egg proteins and bacteria, but I think I’ve made my point.
I’m certainly not going to recommend whether you and your family get the H1N1 vaccinations, but I strongly urge you to do your homework first and research the subject so you can make an informed decision.
In the meantime, the same health precautions you take for other types of flu are just as effective as for Swine Flu. Be cautious about touching your face in public places. Plenty of rest, water and exercise will build up your natural immunities. Supplements such as vitamin C (oranges are best), vitamin D3 (5000 I U per day), d-elenolate and lots of systemic enzymes between meals will give your immune system a real boost. Finally, stay away from sugar, especially the concentrated kinds in candy and soda just until this blows over.
Dr. Moulton’s article was published in the Desert Valley Times October 13, 2009
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A Drug is Finally Available to Reverse the Effects of Dental Anesthesia
Tuesday, October 13th, 2009
I don’t know how many times patients have commented that they wished there was something that could reverse the effects of the anesthesia as they were leaving the office. They were not looking forward to a day of drooling and lisping. At last, Novalar Pharmaceuticals is coming out with a product called Ora Verse in October. It’s not exactly a panacea, but it’s something.
According to Novalar president, Donna Janson, “the primary benefits seen by dental professionals include reduced risk of injury during the period while the patients are anesthetized and increased patient satisfaction.” As the patient is finished with the dental appointment, the Ora Verse is injected into the same site as the anesthetic was. The numbness doesn’t disappear immediately; however, it only goes away a little quicker, about 85 minutes sooner than the average. So you can see that it’s not quite as effective as it appears on the surface.
Also, there are some drawbacks. Ora Verse can cause post-operative pain at the injection site, it can occasionally cause allergic reactions, tachycardia and cardiac arrhythmia, and it’s not recommended for children under 7. That seems to contradict Ms. Janson’s point that it could reduce the risk of injury because of the possible side effects, and because it is the children who are at the most risk for injury by inadvertently chewing on their lip, cheek, or tongue while they are numb. I’m always suspicious of drugs that are not recommended for children, and you have to take into account that the generic name is the alpha-adrenergic blocking agent phentolamine mesylate. I have a personal theory that a drug’s toxicity is multiplied by the number of syllables in its name!
Besides, there are alternatives. Most dental anesthetics contain epinephrine, or adrenalin, to prolong their effects, so whenever possible, I like to use anesthetics that don’t contain epinephrine, so they will wear off much faster. I won’t be trying Ora Verse for a couple of years because I don’t want to experiment on my patients. We will just wait and see if any unforeseen side-effects surface.
Dr. Moulton’s article was published in the Desert Valley Times, June 2008
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Now’s the Time for Invisalign
Wednesday, October 7th, 2009
I don’t know if you’ve noticed, but all around the country you can find some outrageous deals on Invisalign braces as the year comes to a close. That is because Align Technology Inc., the producer of the Invisalign system has set yearly quotas on all of their certified providers, effective immediately.
This controversial move has forced many providers to offer the clear braces at, or even below the dentist’s cost to meet their quotas by December. Aligntech holds the patent on the technology, and the providers have no other knock-offs to turn to, so the company has come under fire by major dental associations for this new requirement. The legality and ethics of such a move have been questioned, but it has been determined that Aligntech is acting within their rights.
The consequences of not meeting your quota are not severe, but highly inconvenient. The dentist needs to pay $3000 and go through another certification course, so most would rather just offer those last cases at a large discount in addition to loss leaders such as free exams, x-rays, and diagnostics. We are bound to be more prepared by this time next year, but if any youth or adults alike were ever contemplating braces, this would be a pretty good time.
According to the Journal of Dental Research, 75% of Americans are in need of orthodontic treatment, and of that 75%, only 1% actually receive it. Another interesting statistic is that in over half the cases that need orthodontics, Invisalign is the treatment of choice. So at the present, if you want to go with the invisible braces, Invisalign is your only choice.
Fortunately, it is a great system. Each participating dentist must go through certification training and then take five to ten continuing education courses per year. We work with a panel of orthodontic specialists to determine where each tooth is going to end up, then a series of non-plastic, biocompatible trays is designed and constructed by computers to systematically go from where the teeth are now, to the desired position. The result is that you have a more esthetic and comfortable method of straightening your teeth, it’s usually faster, and the nicest part is that you can take them out to eat and clean your teeth properly.
Dr. Moulton’s article was published in the Desert Valley Times, October 6th, 2009
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Scientific reasons why you should insist on Mercury-Free fillings
Wednesday, October 7th, 2009
Mercury is in the news lately. The Neuro Toxicology Journal last year in July published a study titled, “Glutathione Modulation Influences Methyl Mercury Induced Neurotoxicity in Primary Cell Cultures of Neurons and Astrocytes”. Here, the toxic effects of mercury on nerve cell cultures are discussed. Another purpose of the study was to explore the body’s natural defense against mercury contamination.
These are some of the conclusions drawn by the authors: The three main sources of mercury exposure are contaminated fish, vaccinations, and mercury amalgam dental fillings (also known as silver fillings). “Methyl mercury is a potent neurotoxicant that affects both the developing and mature central nervous system.”
“The CNS damage caused by methyl mercury is irreparable.” “Severe neurological disturbances, such as paresthesia (numbness), ataxia (loss of coordination), sensory and speech impairment, and constriction of the visual field are caused by methyl mercury poisoning.” The mechanism by which the mercury damages neurons is through the generation of very high levels of oxygen free radicals during its oxidative metabolism. And finally, “Antioxidants provide cellular defense against reactive oxygen species, with glutathione constituting the most important and abundant component.”
So there you have it in a nutshell. Whenever you eat fish, get a vaccination, or if you have silver amalgam fillings, it wouldn’t hurt to boost your glutathione levels, which were shown to become depleted during mercury exposure. You do that by supplying your body with the building blocks it needs to produce its own glutathione. The complete ingredients you need are, Complete Omega-3 Co-Factors (2 capsules a day) and Complete Whey-G (1-2 tablespoons a day). These can be obtained from Nutri-West at 800-443-3333.
Now let’s hear from the other side. In response to this type of study and to the movement in Congress to ban the use of mercury fillings, the American Dental Association is trying to defend its support for the use if mercury amalgams. In the September 2007 Journal of the ADA, they published a Report on the New England Children’s Amalgam Trial, not a court trial, but a 5 year study comparing neuropsychological changes and urinary mercury in children receiving mercury amalgam versus those receiving composite fillings. Their bottom line is that they find “no significant associations between neuropsychological outcomes” of the two groups. They glossed over the fact that there was an average of almost 1% decrease in the mercury group in every NP index: IQ score, General Memory Index and Visual Motor Composite. Plus the urinary mercury levels were almost double in the amalgam group! To me, those findings are very significant. Maybe they didn’t exactly cook their stats, but they might have warmed them up a bit.
Well, the point is that there is no argument concerning the proven fact that mercury is constantly being absorbed by the body from amalgam fillings. The difference of opinion is the significance of the effects that extra mercury has on the central nervous system. Personally, I won’t use it, but it’s an informed decision that each dentist and patient must make for themselves. And when an amalgam filling has to be removed, be sure to do it with a rubber dam, high speed vacuum, and low speed drill under water to minimize the exposure to the mercury vapors produced.
It’s ironic that the people most exposed to the mercury contamination are the very proponents of its use, the dentists and their staffs. The production of mercury vapor is greatest when the material is mixed and condensed into the tooth; it permeates the entire office, and those masks only serve to trap and concentrate the vapor as you breathe. I just wonder how much of a coincidence it is that dentists have the highest divorce and suicide rates of any profession.
Dr. Moulton’s article was published in the Desert Valley Times, May 2008
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