Tuesday, February 21, 2017

The Littlest Patients

Congratulations on the new addition to your family!
     When you bring your new baby home from the hospital, you AND your baby will have plenty of new routines to get used to. One of them should be wiping his/her gums with a soft, wet washcloth at bath time. You could also use a little wet gauze for this purpose, but  I prefer the wash cloth.  You do not need to use any toothpaste yet. Simply wrap the cloth or gauze around your index finger and rub it gently over the gums.  Not only will you be cleaning the food residue away, you will also be getting your child accustomed to having their mouth cleaned. This way, when you need to begin brushing the teeth (around 6 months, when teeth  start erupting into the mouth) there will be no surprises and fewer objections.

     If your child still hasn't gotten her first tooth by her first birthday,  relax – some children don't start getting teeth until 15 to 18 months.  Don’t worry.
     For now, you don't have to worry about flossing. (I know.. I can’t believe I’m saying that)   I recommend starting to floss only when the spaces between the teeth close,  and you can't clean them with a toothbrush.
The American Academy of Pediatrics and the American Academy of Pediatric Dentistry do recommend that you take your child to the dentist by her first birthday, but my own practice, I think any time before the age of two is just fine. Of course, if the pediatrician notes any oral/dental abnormalities during their routine visit, you should bring your child to the dentist as soon as possible.
      In the meantime, at every well-baby visit, your baby's primary healthcare provider should take a look at your baby's teeth (if she has any) and apply fluoride varnish every three to six months, depending on your baby's risk of cavities. (Some kids don’t need this at all)  As with all types of medical care, prevention is the best way to go !

Tuesday, June 14, 2016

Do you or someone you love SNORE?

Do you or someone you love snore?  It could be more than just an annoyance. It could be a warning sign of obstructive sleep apnea (OSA), a chronic obstructive breathing disorder with long term health consequences.
     We've all heard people snoring loudly (just ask my long suffering wife). It is a loud and penetrating sound. It can be amazing that the snorer himself (or herself) can actually sleep through it. Approximately 45 percent of adults snore and around half that number are habitual snorers. A quarter of those habitual snorers suffer from some degree of Obstructive Sleep Apnea.
      Obstructive sleep apnea happens when the tongue falls back and partly or completely blocks the trachea during sleep. This forces your diaphragm and chest muscles work harder to open the obstructed airway and pull air into the lungs. After a short pause,  breathing often resumes with a loud gasp, snort, or cough. This can happen many times each hour you sleep. You may not sleep well, but you probably won't be aware that this is happening. It can affect your blood pressure or neurological functioning, and can increase your risk for heart attack or stroke.

      If you think you or your partner might be suffering from OSA, please discuss it with your physician or dentist. There are several types of treatment that can be effective depending on the individual.  Continuous Positive Airway Pressure machines (CPAP) are like little oxygen masks that apply just enough pressure to open the blocked airway. They are the most effective treatment, but not everyone can get comfortable sleeping with them. For other people, oral appliances or surgery may solve the problem.
DON'T suffer in silence. Talk to your doctor and get a sleep study done so the condition can be properly diagnosed, and if necessary, treated.

Monday, November 23, 2015

Dr. Rubinstein appointed to faculty at University of Rochester's Eastman Dental Institute


     We're proud to announce that our practice has been designated a research site by the National Practice Based Research Network. This allows our practice to participate in active research efforts to improve treatment outcomes in oral and general health.
      Under a grant from the National Institute of Dental Research and the N.I.H., the network allows us to combine forces with other dental practices to create powerful and efficient research programs. The opportunity for patients to participate is, of course, completely voluntary and the information collected is kept strictly confidential.
     The D.P.B.R.N. network studies create a valuable opportunity for us to not only remain at the cutting edge of oral health treatment, but to give our patients the advantages of the most current and studied treatments in the practice of Dentistry.

Monday, August 17, 2015

Fluoride is not just for kids !

           Did you think fluoride treatments were just for  kids?  Should you consider supplemental fluoride treatments? The answer is "maybe". After all, most dental insurance only covers in-office fluoride treatments for children under the age of 18.
Unfortunately, just because we're adults, that does not mean we've become magically immune to tooth decay (Caries). And just because your insurance plan doesn't pay for it, that doesn't mean it wouldn't be a benefit to you.  Adults who have an elevated risk for caries should have that risk assessed, and additional fluoride can be a very effective preventive intervention.

There are several reasons an adult might require extra fluoride. Many of the prescription medications we take can reduce saliva flow or otherwise create dry mouth.  Patients who have undergone radiation treatment for cancer also have significantly decreased salivary flow, because radiation damages the salivary glands. Saliva neutralizes acids in the mouth, and also contains antibodies and other immune system factors, so any reduction in saliva increases the risk of tooth decay.

Adults often experience gum recession, which exposes part of the root surface of teeth. These areas are softer than the hard enamel at the top of the tooth, which makes them more susceptible to decay.

Today many people opt for orthodontic treatment (braces) as adults. Braces make it more challenging for patients to maintain good oral hygiene. Just ask your kids! Fluoride can keep the teeth strong and cavity-free even with the obstacle of orthodontic appliances.
Have you had a restoration done within the last year due to new decay? If you have, that puts you at a higher risk for cavities. Fluoride treatments are a great way to prevent more cavities in patients who are already prone to them.

Fluoride can also help with the growing problem of sensitive teeth. Diets high in acidic foods and beverages, general gum recession, and increased use of whitening products all tend to produce tooth sensitivity. Fluoride treatments re-mineralize tooth enamel and reduce that sensitivity.

If one or more of these conditions applies to you, consider requesting a topical fluoride treatment.

Some Helpful Informatiuon from the American Dental Association about Fluoride Supplementation.

Tuesday, July 7, 2015

Practice Based Research : The Future of Dentistry

     There are some big changes happening in the world of dental and medical research. Technology affords our patients new and better ways to access the information they can use to improve their health. One of the most significant is "practice based research". This is a model in which hundreds of doctors in private practices throughout the country participate in a research project together, under the guidance and support of a national organization (in our case, the National Dental Practice Based Research Network).
     In my practice, we have been participating in this type of research for several years now. We want the dental care we provide to be "evidence based". That seems obvious. But how do we decide what kinds of evidence we should be using, and how we should be collecting and evaluating it? What does it mean when we say a treatment or a cure is based on "research"? 
     Historically, basic dental research in this country was conducted in teaching hospitals and academic medical centers, and a much of it still is. But full time academics often conduct their studies far from the realities of private practice, and this can hinder their vision of the ultimate goal of research: improving dental practice and patient outcomes.

"Practice based" research is a welcome and growing trend in the profession of dentistry.