Thursday, April 29, 2010

Dental Did You Know: Dental Infections Part 4...The Three Stages of Infection (Abscess)

Having an abscess is the third stage of dental infection and it usually happens between days 4-10. It is characterized by:
  1. mild, localized discomfort 
  2. usually fluctuant and tender to touch
  3. pus is present
  4. skin is usually red in the periphery
The bacteria species involved are generally anaerobic (oxygen hating)

Source: Gregoire C, How are Odontogenic Infections Best Managed?, JCDA, April 2010, Vol 76, No 2, pg 114-116

Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)
(905) 273-7100

Wednesday, April 28, 2010

Dental Did You Know: Dental Infections Part 3...The Three Stages of Infection (Cellulitis)

Cellulitis is the second stage of infection. It is usually occurs in days 2 -5 of an infection and is characterized by severe and diffuse discomfort, areas that are firm and indurated to touch, no sign of pus, red skin and is the stage with the highest risk to the health of the patient. The bacterial species involved are mixed, both aerobic and anerobic (oxygen loving and hating bacteria)

Source: Gregoire C, How are Odontogenic Infections Best Managed?, JCDA, April 2010, Vol 76, No 2, pg 114-116


Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)
(905) 273-7100

Tuesday, April 27, 2010

Dental Did You Know: Dental Infections Part 2...The Three Stages of Infection (Inoculation)

Inoculation is the first stage of a dental infection. Typically 0-3 days in duration, with mild discomfort, no pus, but a soft and doughy feel from the tissues involved. The bacterial species involved are usually aerobic (oxygen loving) and the skin displays as normal.

Source: Gregoire C, How are Odontogenic Infections Best Managed?, JCDA, April 2010, Vol 76, No 2, pg 114-116


Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building) (905) 273-7100

Tuesday, April 13, 2010

Dental Did You Know: Dental Infections Part I

Most dental infections are caused by more than one type of bacteria. About 50% are caused by anaerobic bacteria alone, 44% by a combination of aerobic and anaerobic bacteria, and 6% by aerobic bacteria alone.

The first line of defence is a prescription for Penicillin V, 600mg every six hours, supplemented with 500mg of Metronidazole twice a day for advanced cases.

Source: Gregoire C, How are Odontogenic Infections Best Managed?, JCDA, April 2010, Vol 76, No 2, pg 114-116

Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)
(905) 273-7100

Sunday, April 11, 2010

Dental Did You Know: Tooth Whitening in the Past

Dental researchers as early as 1877 noticed that oxalic acid could be used to whiten vital teeth.

Source: Alford A, Clinical Report: The use of 10%, 16%, 22% Carbamide Peroxide and 3%, 7.5%, 9.5% Hydrogen Peroxide Materials for at-home Vital Tooth Bleaching in Combination with Active and Passive Treatment Modalities for Control of Tooth Sensitivity and Gingival Irritation, Oral Health, March 2010, Vol 100, No 3, pg 90-101.

Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)
(905) 273-7100

Saturday, April 03, 2010

Practice Philosophy

Hi everyone, I thought that posting our practice philosophy would help our new and existing patients better understand my clinic:

Dear Patient,

We understand that choosing a new dentist and dental health team can be a challenge, leaving you feeling somewhat uncertain. Let us welcome you and share some insights about what we do for our patients. The philosophy guiding our practice is as follows:

"Our purpose is to help people achieve the highest level of dental well-being and in so doing, to enhance the quality of their lives."
In other words, we help you be or become as healthy as you choose. Instead of just telling you how healthy you ought to be, we will try to help you understand your choices about dental health and then let you make a free and informed decision. Your first choice in this regard is how you would like to begin with us. There are five levels on which people may choose to be seen in our practice:

  • Level 1...URGENT CARE: People in crisis or with an emergency problem such as pain, swelling, or bleeding that need our immediate help are at this level. We see urgencies immediately, whenever possible.
  • Level 2...REMEDIAL CARE: People who choose this level of care desire treatment only when something breaks or becomes uncomfortable. Generally people at this level expect a limited type of examination, focusing on obvious problems. They usually want to correct immediate problems with as little effort and cost as possible.
  • Level 3...SELF-CARE: Patients who choose this level of care want a thorough examination and take an active part in the treatment and prevention of present and future disease problems. However, they usually choose repair solutions that are short range in nature.
  • Level 4...COMPLETE DENTISTRY: Patients at this level are similar to people described in level 3. They choose to have a thorough examination. However, they decide on a MASTER PLAN to formulate a long-term treatment plan for health and repair. These patients are very concerned about treating the causes of dental disease, not simply the effects. These patients want all dental treatment provided to be completed in the most lasting fashion possible.
  • Level 5... LOOK YOUR BEST: People in this group are in level 4 as far as dental health is concerned, but also want to look their best at all times. They know that their smile is one of the first things others notice about them and want to put their best foot (face) forward.

We hope these levels of care make sense to you. It is not uncommon for people to begin at one level and progress to another over time. We are here to help you discover and decide at what level you are most comfortable. Thank you for the opportunity to serve you and provide you with the best dentistry appropriate for you.  

To YOUR health,

Dr. Hans Skariah, Jodie and Gloria


Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)
(905) 273-7100

Tuesday, March 30, 2010

Baby's Death Linked to Pregnancy-Related Gingivitis

Hi everyone,

In a landmark case, researchers were contacted by a 35 year old woman who had recently delivered a still-born baby at 39 weeks and 5 days gestation: full term. Postmortem microbial studies found the presence of F. nucleatum in the lungs and stomach. The baby died from a septic infection and inflammation caused by bacteria.

Researchers used DNA-cloning technologies found a match between the oral bacteria of the mother and the bacteria in the baby's lungs. Bleeding associated with gingivitis allowed the bacteria to enter the bloodstream and work its way to the placenta. The mothers immune system usually takes care of this situation, but she also experienced a upper respiratory infection which may have weakened her immunity enough to allow the bacteria to colonize the uterus.

Source:  Han Y et al, Term Stillbirth Caused by Oral Fusobacterium nucleatum, Obstetrics and Gynecology, Feb 2010, Vol 115, Issue 2, Part 2, pp 442-445.

Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)
(905) 273-7100

Thursday, March 25, 2010

Article: How a family reduced its toxic footprint

Hi everyone,

I saw this interesting article in the Toronto Star Online Edition, about reducing/eliminating toxic products in everyday hygiene items. Here's the teaser quote:

I stick my nose deep into Marika Goode's armpit and inhale. She's right. She doesn't stink. Not bad for a woman who hasn't purchased deodorant for a year. Her breath smells minty. And her hair is voluminous and shiny. She hasn't bought toothpaste or shampoo for a year either.

How does she do it?

"I'm going to make you some toothpaste," says Goode, 47, setting a white mixing bowl on her kitchen counter. "Do you like spearmint or peppermint?"

Although, I like what she is doing, a warning needs to be let out on the toothpaste side, especially concerning people with sensitive teeth. Baking soda is an abrasive that might make sensitive teeth even more sensitive after use.

As always, when using a particular item we all have to weigh the pros and cons and come up with a decision on whether there is a net benefit. (By the way, the greatest impact in cleaning your teeth is not your toothpaste or toothbrush but the time spent brushing...2 minutes/twice day is great)

Source: Porter C, Porter: How a Family Reduced its Toxic Footprint, Toronto Star Online, March 24, 2010, Read on March 24, 2010,  http://www.healthzone.ca/health/newsfeatures/article/784935--porter-how-a-family-reduced-its-toxic-footprint?bn=1

Take care

Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)
(905) 273-7100

Friday, March 19, 2010

Dental Did You Know: Dental Personnel and TB

The current guidelines by the Royal College of Dental Surgeons of Ontario (RCDSO) instruct that all new employees should be screened for latent TB (tuberculosis) infection and TB disease.

Source: Cleveland J et al, Tuberculosis Epidemiology, Diagnosis and Infection Control Recommendations for Dental Settings, Peak Dispatch, Feb/Mar 2010, Royal College of Dental Surgeons of Ontario.

Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)
(905) 273-7100

Wednesday, March 17, 2010

PepsiCo Pulls its Sugary Drinks from Schools (finally!)

I've been waiting for this day for a long time. Finally, as reported in the Toronto Star article below, sugary drinks are been removed from schools worldwide. Here's the teaser quote:
The world's No. 2 soft drink maker, PepsiCo Inc., has pledged to pull high sugar soda from schools around the world by 2012. The company said Tuesday it is "voluntarily adopting" the global policy following discussions with the World Heart Federation in Geneva. The decision to pull the calorie-laded mainstay of the company's product line from every school marks the first such move by a major soft drink producer. 
It comes after years of campaigning by public health agencies to limit children's access to foods linked to the rising tide of childhood obesity.
You can read the rest of the article here: PepsiCo Will Pull Sugary Drinks

Source: Toronto Star Online,  PepsiCo Will Pull Sugary Drinks, March 17 2010,  Read March 17, 2010, http://www.thestar.com/business/article/780921--pepsico-will-pull-sugary-drinks


Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)
(905) 273-7100

Tuesday, March 09, 2010

New Ad: (Proposed) Final Edition

Hi everyone,

Here's the (proposed) final edition of the advertisement. Thanks to friends, family and patients for their feedback (wow!). This will be posted in the elevators in the buildings surrounding our practice.



Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)
(905) 273-7100

Tuesday, February 23, 2010

Glaxo Removing Zinc from Denture Creams: Part 2

Hi everyone,

I received this email blast from the Ontario Dental Association regarding the removal of zinc from denture adhesive pastes. Here's the quote:

GlaxoSmithKline (GSK) warns about a potential health risk associated with long-term, excessive use of zinc-containing denture adhesives Poli-Grip "Advanced Care," "Extra Strength" and "Ultra Fresh."

Media Releases from Glaxo Smith Kline:

GSK will stop manufacturing these zinc-containing denture adhesive and plans to replace them with zinc free products.

While zinc is an essential part of the diet, recent publications suggest that an excessive intake of zinc-containing denture adhesives over several years may lead to the development of neurological symptoms such as numbness, tingling or weakness in the arms and legs, difficulties with walking and balance, and blood problems such as anemia.

Poli-Grip is safe to use as directed in the product label. However, some consumers apply more adhesive than directed and use it more than once a day. Therefore, as a precautionary measure to minimize any potential risks to these consumers, GSK has voluntarily stopped the manufacture, distribution and advertising of these products.

Health Canada has not to date issued a recall of the product. These measures are being taken by GSK.

ODA Members may wish to advise patients who use denture adhesives to:

  • follow package instructions
  • use zinc-free alternative such as Poli-Grip "Original," "Comfort Strips" or "Powder" and
  • arrange a consultation with you to assess ill-fitting dentures.

Consumers with questions may call GSK at 1-888-521-8033.

Source: ODA Advantage Email Sent Feb 22, 2010, Read on Feb 23, 2010.


Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)
(905) 273-7100

Saturday, February 20, 2010

Glaxo Removing Zinc from Denture Creams

Hi everyone,

I saw this article on Zinc and denture creams and the link with neurological problems. Here's the teaser quote from the Globe and Mail:

After being hit with dozens of lawsuits and growing questions about product safety, GlaxoSmithKline Consumer Healthcare Inc. announced yesterday it will stop selling denture creams that contain zinc.

Excessive zinc intake can cause serious neurological problems and lead to numbness, tingling or weakness in the limbs as well as difficulty walking and balancing or anemia and other blood problems, the company said.

The company said it’s a precautionary move designed to prevent any potential long-term health problems in people who use zinc-containing Poli-Grip in excess of the amount indicated on the label.

And they’re also warning consumers who are using too much of the product to immediately stop and see their doctor if they have any concerns.

You can read the rest of the article here: Zinc to be removed from some denture creams

Source: Globe and Mail Online, Feb 19, 2010, http://www.theglobeandmail.com/life/health/zinc-to-be-removed-from-some-denture-creams/article1474174/ Read Feb 20/2010

Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)
(905) 273-7100

Thursday, February 18, 2010

I'm wanting feedback on this potential advertisement


Hi everyone,

I'm thinking this will be the template for advertising in the buildings around us. Any comments/suggestions?

Hans.

Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)
(905) 273-7100

Tuesday, February 09, 2010

Dental Did You Know: What's in your Toothpaste Part 2

Surfactants (detergents) such as sodium lauryl sulfate, ammonium lauryl sulfate and lauryl sarcosinate are used to produce a foam that helps clean teeth. The first two have significant antibacterial properties but can irritate oral tissues. To minimize this, lauryl sarcosinate is used in part or in whole as a replacement.

Source: Field S, Why There's Antifreeze in Your Toothpaste: The Chemistry of Household Ingredients, Chicago Review Press, 2008, pg 239-241.

Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)
(905) 273-7100

Sunday, February 07, 2010

Dental Did You Know: What's in your Toothpaste Part 1

Hydrated Silica: also known as Silicic Acid, Silica Gel, and Amorphous Silicon Dioxide
Chemical Formula: SiO2.nH20
Description: Transparent Gel
Use: It is the abrasive used in gel toothpaste or as a secondary abrasive in opaque toothpastes

Source: Field S, Why There's Antifreeze in Your Toothpaste: The Chemistry of Household Ingredients, Chicago Review Press, 2008, pg 239-240.

Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)
(905) 273-7100

Wednesday, February 03, 2010

Dental Did You Know: Dental Radiation and Airport Scanners?

Hi everyone,

Ok, it seems that everyone is worked up about the potential for damage from these new airport backscatter radiation scanners. (Which also brings up the topic of radiation doses from dental radiographs). On occasion, certain patients will decline radiographs because they think the doses they are receiving are large.

To clear the record, this chart from the Health Physics Society (http://www.hps.org) gives us the basis of where a dental radiograph is compared to other medical xray procedures:

(Dosage in millirem (mrem))

Skull (lateral): 1
Chest (PA): 2
Skull (PA or AP): 3
Chest (lateral): 4
Chest (PA and lateral): 6
Limbs and joints: 6
Thoracic spine (AP): 40
Thoracic spine (lateral): 30
Lumbar spine (AP): 70
Lumbar spine (lateral): 30
Abdomen (AP): 70
Abdomen: 53
Pelvis (AP): 70
Pelvis or hips: 83
Bitewing dental film: 0.4

As you can see, dental films are *way* down the scale in terms of dosage and provide information that is beneficial to the patient in term of detecting potentially large cavities in between teeth and other pathological conditions.

As another basis of comparison, most people don't know they are getting a dose of radiation from the environment: house, lawn, park, work, airplane, office etc. This dose is in the range of 300 millirem per year. The new airport scanners are 5-10 microrem (not millirem), therefore going through these scanners are about 1/50th of a dental radiograph and 1/30000 background radiation.

Now, any radiation dose is not good for you, but we as health practitioners have to balance out the consequences of not taking a picture vs. taking the pictures. The odds ratios almost always favour taking a radiograph in order to help the patient overall.

As for the airport scanners, I would personally be more worried about crossing the street in traffic.

Cheers,

Hans

Source: Stabin M, Doses from Medical Radiation Sources, Health Physics Society, Dec 18, 2009, Read on Feb 3/10, http://www.hps.org/hpspublications/articles/dosesfrommedicalradiation.html

Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)
(905) 273-7100

Monday, February 01, 2010

Dental Records for Canadians Missing in Haiti

Hi everyone,

One of the sad aspects of being a dentist is being asked by authorities for chart records to identify victims of disasters such as those in the Haitian earthquake zone. Quoted below is the (edited for brevity) text of an electronic bulletin from the Canadian Dental Association (CDA) with respect to the relief efforts in Haiti:

The massive earthquake that recently struck Haiti has affected an estimated 3 million people according to the Canadian Red Cross, resulting in extreme injuries and significant loss of life. As of January 22, over 300 Canadians are still unaccounted for in Haiti.

Canada is responding to the disaster in several ways including providing troops and personnel for humanitarian aid, search and rescue, and disaster victim identification (DVI). Dental records are one of the most important sources of identification for all DVI efforts. Since Canada has such a high standard of dental care, dental records will form the basis of the positive identification of missing Canadian citizens. Using dental records is a highly accurate and inexpensive method of identifying a person during a disaster.

Original dental records and radiographs of all types are needed to help identify missing citizens. Chief coroners, chief medical examiners and/or police departments in each province will develop a list of missing and presumed deceased persons. They will then attempt to acquire antemortem records for these people, including dental records from treating dentists and data from other sources such as medical records, fingerprints or DNA.

As always your generosity to the people of Haiti is needed at this time...please give generously.

Source: (email) CDA Alert, Jan 22, 2010, Dental Records for Canadian Missing in Haiti, Canadian Dental Association, http://www.cda-adc.ca

Take Care

Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)
(905) 273-7100

Sunday, January 31, 2010

Dental Did You Know: Early Childhood Caries and Body Weight

Studies have shown that children with early childhood caries (cavities-ECC) are at risk of weighing less than 80% of their ideal weight, fitting into the criteria of failure to thrive.

Source: Ezer M et al, Early Childhood Caries: The Dental Disease of Infants, Oral Health, Jan 2010, Vol 100, No 1, pg 8-12.

Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)
(905) 273-7100

Saturday, January 30, 2010

Dental Did You Know: Early Childhood Caries (Cavities)

Dental caries (cavities) is a chronic disease that in children is five times more common than asthma and seven times more common than hay fever.

Source: Ezer M et al, Early Childhood Caries: The Dental Disease of Infants, Oral Health, Jan 2010, Vol 100, No 1, pg 8-12.

Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)
(905) 273-7100