Hi everyone,

An estimated 37 million Americans are edentulous–without teeth in one or both arches.  Despite this high number, however, many denture wearers can feel isolated and alone, suffering from self-consciousness and insecurity when socializing or eating due to fear of their dentures slipping out of place.

But now, we are offering denture patients in the metropolitan Detroit area a new treatment that can immediately increase denture stability in just 2-3 hours.  Recently, I have become certified by 3M^TM in the placement of Mini dental implants (MDIs) which provide an affordable and minimally invasive way for denture-wearers to anchor their dentures in their mouths so they can regain confidence and feel comfortable eating, talking and smiling.

In the past, denture wearers had few options for how to increase the stability of their dentures.  They could use adhesives, which were messy and not always effective or they could have a new denture made but that didn’t always work, especially if the dental ridges in their mouths were flat or difficult.  The other option was full-size dental implants, which, while effective, are often prohibitively expensive for many patients.  In addition, many patients are not good candidates for the procedure due to lack of adequate bone to support full sized implants.

Mini dental implants, however, are different from full -size implants.  Ranging in size form just 1.8 millimeters to 2.4 millimeters, these implants can be placed in the dental office in a very simple 2 hours procedure.  The patient’s existing denture can be adapted to snap on to the implants.  Unlike full-size implants, which require significant integration (fusing to the bone) time, MDIs can be immediately put to use keeping the patient’s denture in place, so the patient can walk out of the dental office transformed after just 2 hours.  Because the treatment is minimally invasive, mini dental implants can be an option for patients who are not good candidates for full-size implants.  Best of all, the treatment is much more affordable than full-size implant options.

I am now certified in the placement of 3M^TM MDI Mini Dental Implants, and I am always available to consult with you to discuss whether this treatment is right for you.  For more information, call our Southfield office at 248-356-8790 or visit 3M’s MDI website, http://mymdistory.com.

That’s all for now, until next time,

Mark W Langberg, DDS, FAGD

Hi everyone!

Today’s blog concerns new treatment for Obstructive Sleep Apnea, a growing health risk in the US, with dental appliances as an alternative to the more cumbersome CPAP, or “Continuous Positive Air Pressure” masks.

Obstructive Sleep Apnea

OSA is a debilitating sleep breathing disorder defined by a cessation of breathing for at least 10 seconds resulting in a lowering of your body’s blood oxygen (an “apnea”).  When this occurs the brain reacts by disrupting deep sleep and arousing you just enough to start breathing again.  OSA sufferers never get a “good night’s sleep” because the repeated apneas and arousals deprive them of REM and deep stage restorative sleep and lead to chronic daytime exhaustion, mood alteration and depression,  deteriorating work performance, as well as long term cardiovascular stress.  OSA is associated with high blood pressure (hypertension), irregular heart beat (arrhythmias), stroke, congestive heart failure, GERD (reflux disease) and diabetes.

If you have been diagnosed with OSA (Obstructive Sleep Apnea) by your physician, pulmonologist or sleep specialist, chances are you had an overnight sleep study (PSG or Polysomnograph) performed and have been given a “score” or AHI (Apnea-Hypopnea Index) or RDI (Respiratory Disturbance Index) which measures the number of breathing disruption episodes per hour.  If your index is greater than 30 per hour, then your OSA is severe and treatment with CPAP (Continuous Positive Air Pressure mask) is indicated.  If your indexes are less than 30, then your apnea is mild to moderate and your doctor will decide if an oral appliance is an appropriate alternative to CPAP.  For patients with mild to moderate OSA it has been shown that adjustable dental appliances made by a dentist who has been trained in sleep dentistry are an effective treatment and thus have been approved as an alternative to CPAP.  These appliances are custom made and are called Mandibular Advancement Splints or Appliances and they advance the lower jaw at night and thus keep the airway open during sleep.  They need to be individually fitted and then “titrated” (adjusted) by a dentist to find the right position to be effective yet comfortable.

Recently, the American Academy of Sleep Medicine has recommended oral appliances as an optional first line of treatment for snoring and mild to moderate sleep apnea. Non-compliant CPAP wearers, even those with severe apnea, could benefit from oral appliance therapy alone or with a combined CPAP/oral appliance treatment. This method of treatment allows for CPAP pressures to be lowered, giving superior comfort to patients.  We are familiar in fabricating and adjusting many types of OSA appliances, such as the SomnoDent ®, TAP,  EMA, SUAD, and the OASYS.

If you suffer from chronic snoring or obstructive sleep apnea talk to your physician and let us know. We can be reached in Southfield, MI at 248-356-8790. We are well trained and equipped to help you.  Let us help you get a better night’s sleep!

That’s all for today so until next time,

Mark W Langberg, DDS

Thinking about whitening your teeth, but have questions?  Are you unsure what method gets the best results or which one is right for you?  Are you concerned about stories of tooth sensitivity during bleaching or worried about rumors that bleaching hurts your enamel?

Rest assured, modern bleaching does not hurt your enamel or strip your teeth.  It works by generating oxygen which bleaches out “lifestyle stains” (food, tea, wine, smoke), as well as certain congenital enamel discolorations.  All bleaching has the potential to cause some tooth sensitivity during the process, but WE ARE PROS at managing this. It’s never a problem and always goes away when you are done bleaching.  We’ve been doing this for years and can help you choose the whitening technique that is best suited to your lifestyle, budget, tooth type and coloration.  Bleaching your teeth allows you to have the white bright smile you’ve always dreamt of at a fraction of the cost of a single veneer for just one tooth.

Teeth Whitening Options

My Southfield Dental Office endorses four tooth whitening techniques:

• In-office ZOOM! brand whitening
• Professionally supervised at-home bleaching with custom made “Deep Bleaching” trays
• A combination of the two previously mentioned treatments:  ZOOM! followed by tray bleaching at home
• Some over-the-counter whitening products

We pair the ZOOM! whitening agent with an extremely bright light source that lightens the teeth to the desired shade. This isn’t a laser, but does the trick. We’re very careful to monitor application to avoid tooth and gum sensitivity in our patients. In-office whitening provides the quickest and most uniform results. It typically achieves 60-70 percent of each client’s potential dental whiteness by itself, but then when combined with home bleaching trays, it “jump starts” additional whitening.

Patients who choose our in-home bleaching option without ZOOM! may get similar results, but it takes much longer. This method incorporates highly active bleach gel, customized “Deep Bleaching” dental trays and weekly or biweekly in-office visits. We charge $450 for the trays, an unlimited number of interim coaching office visits, and enough bleach to get you to the point of satisfaction with results. Once you’re done with the initial bleaching you can purchase touch-up bleach as needed from us – at cost. You simply use it with your dental trays one to two times after each of your hygiene visits. This will help address new stains and slow the gradual relapse which inevitably occurs over the months and years that follow your primary bleaching session.

I find that the combination of in-office ZOOM! whitening, followed by custom tray bleaching at home for two to six weeks, works best. We charge $600 for this dual-level service, and like the in-home bleaching described above, it includes unlimited bleach and office visits until you are happy. Patients are generally blown away by the results of this combo. Be aware that the older you are, the longer it takes to whiten your teeth.  Folks with tetracycline staining take the longest.  We generally don’t bleach the teeth of teens younger than 16.

Any style of whitening may result in temporary mild tooth sensitivity or sore gums. These side effects can be minimized or eliminated with careful application of the whitening agent and the well-fitting dental trays we make. Analgesic gel – delivered through our trays – provides relief, too. The sensitivity is short term and always goes away once bleaching is completed. Many times it never even occurs. But if it does, we have all sorts of tricks to take care of this. So, no worries!

Drug-store teeth-whitening options include gels, trays, strips and paints. These products provide modest results, but will not be as dramatic as professionally assisted whitening. Some patients get moderate results, but some get very little change.  Be aware that the strips are only long enough to reach the six or eight teeth in front. I think the strips are generally the easiest to use. They minimize mess, and you are less likely to swallow the whitening agent or get it on your gums. The strips must be reapplied periodically to maintain whatever level of whiteness you were able to achieve.  They are somewhat unpredictable but relatively inexpensive.  My understanding is that Crest White Strips are the best ones.  They run $40 to $80 per box.

One last note: Cavities or gum disease must be treated before undergoing teeth whitening.  To set up an appointment for a free consultation, call my Southfield dentist office at (248) 356-8790. We’d love to help you achieve the smile of your dreams. For more information and to view before-and-after pictures, visit www.drlangberg.com.

So until next time,

Mark W. Langberg, DDS, FAGD

Hey everyone!

We’re a population on the go. We hit the door with our car keys and water bottle in one hand and our BlackBerry or iPhone in the other. Wheels, water and Wi-Fi access – the American way of life.

As a healthcare provider, I can’t help but filter everything – even this common scenario – through the lens of health and wellbeing. Getting in the car? Buckle up! Going to use your phone? Use a hands-free headset, so your phone is kept at an optimal distance from your head. Both hands should be on the wheel, and never – EVER – text while driving.  As for the bottle wedged in your car’s cup holder? Well, I have a few things to say about that.

If your bottle is full of water, that’s a step in the right direction. Sugar-laden beverages do your teeth and waistline no favors. Whether you are sipping herb-infused designer water or a 20-ounce bottle of Dasani, the nutrition is the same. They’ll both wet your whistle without adding calories. Bottled water will, however, shrink your wallet!

The Environmental Protection Agency (EPA) estimates that community-sourced water costs less than a penny a gallon. Bottled water runs about $3.80 per gallon, according to consumer watchdog Environmental Working Group, and adds about 2 million tons of plastic to our landfills annually. Even worse, some bottled waters may expose us to trace amounts of pharmaceuticals, heavy metals, ammonia, nitrates, caffeine, arsenic and radioactive isotopes, according to a study by the University of Iowa Hygienic Laboratory.

While bottled water is portable and some is perfectly clean, it may be shortchanging your teeth if it’s your primary source of fluid, according to the American Dental Association (ADA). Sure it keeps your mouth moist – which is great for gums and teeth – but those who drink primarily bottled water may be missing out on the proven dental protection supplied by optimally fluoridated municipal water.

Water from underground sources, mountain reservoirs, wells and springs can have varying amounts of natural fluoride, but it’s often filtered before processing. If the bottled water comes from a municipal water source (and much does), it may have been heavily filtered to remove odor and the taste of chlorine. The fluoride gets flushed too.

People with home filtration systems may inadvertently remove fluoride from their main water source as well, negating this compound’s ability to inhibit the formation of cavities. Water treatment systems are installed under the sinks in many new homes or exist as built-in components in refrigerators. Many people opt for pitcher-filter setups.

There is no significant research regarding the use of these filtration systems and their impact on dental caries. Manufacturers report that regular carbon and charcoal-based filters do not typically remove fluoride from the water, but the ADA reports that activated charcoal filters with alumina can remove up to 80 percent of fluoride in treated water. Reverse osmosis filtration removes the majority of water fluoridation, while steam distillation systems remove 100 percent of fluoride, says the ADA.

Basically, consumers don’t know what they are getting when they twist the lids off their water bottles or stick a glass under the filter tap – unless they’ve done some painstaking research. That’s why the ADA would like to see more consumer-friendly information available regarding home filtration systems and fluoride levels. The ADA also supports labels on water bottles, detailing fluoride concentration and other components, as well as bottlers’ phone numbers and addresses so consumers and their dentists can make informed decisions about fluoride treatment.

Adding fluoride to public water sources became a health policy in the 1940s. Since then, fluoride has been included in toothpaste, mouth rinses, prescribed supplements and dental office treatment protocol to minimize dental decay.  The record speaks for itself.  Dental decay is nothing like the scourge it was when I first started practicing in the mid-1970s.

Tap water is highly regulated for safety by the Environmental Protection Agency (EPA) and has been since the 1977 Clean Water Act. Anyone can obtain water profile reports from local water providers or through the state health department. Bottled water falls under the Food and Drug Administration’s (FDA) jurisdiction. Currently, the FDA does not require bottlers to post water source, treatment method or purity.

People love the convenience of bottled water. I get that! But, between the high cost, the loss of fluoride protection, and the undeniable impact that plastic bottles have on the environment, a reusable stainless steel thermos or Nalgene bottle and some clean cold tap water are sounding better and better!

Questions about fluoride treatment? Please call my Southfield dentist office at (248) 356-8790.

Until next time,

Mark W. Langberg, DDS, FAGD

Hi everyone!

Each year as summer activities gear up in southeastern Michigan, I inevitably get more questions from parents about mouthguards for their children. Sometimes the questions are in response to sports league rules or summer camp packing lists. Unfortunately, other queries come after an emergency room visit.

Mouthguards for Children

Thousands of kids get their teeth knocked out or damage their jaws, lips and tongues each year while involved in recreational sports. It happens at school, in parks and in the driveway. All it takes is a wild pitch, a stray elbow, or hitting a rut in the pavement while skateboarding. The pavement always wins.

The majority of dental recreational injuries could be prevented by wearing protective gear. Soccer shin guards and football helmets are standard athletic equipment. A customized mouthguard is just as important!  Mouthguards are made of soft plastic and fit over the teeth. They are designed to absorb and transfer shock away from the teeth and protect soft tissues in the mouth. And although I am mostly addressing parents here, let me be clear that I advocate mouthguards for everyone, young or old alike. It is important to note that a large percentage of concussions are caused not by blows to the skull, but by impact to the jaws. Mouthguards play a key role in preventing concussions and potential brain injury, as well as protect your one and only smile.

Football, kickboxing, basketball, field hockey, soccer and lacrosse are among the obvious contact sports in which well-fitting mouthguards are necessary. Skateboarding, racquetball, water polo, mountain biking, waterskiing and equestrian pursuits are other activities in which a fall or blow to the mouth or head could be disastrous. Cheerleading and gymnastics can be just as risky. Even jetskiing can be hazardous to your teeth. Check out this recent blog.

According to the American Dental Association, “An athlete is 60 times more likely to suffer harm to the teeth when not wearing a mouthguard. Mouthguards help buffer an impact or blow that otherwise could cause broken teeth, jaw injuries or cuts to the lip, tongue or face. Mouthguards also may reduce the rate and severity of concussions.”

Parents have the option of three types of mouthguards:

1. A store bought, readymade, “one-size-fits-all” mouthguard
2. A store bought “boil-and-bite” mouthguard
3. A custom-made and fitted mouthguard fabricated to fit just you by your dentist

Of course, I recommend that you visit my office to get a custom-made mouthguard since it is individually fitted to your specific teeth and bite, and I will make sure it fits perfectly.  A custom-fitted mouthguard is much more effective and comfortable and thus you are way more likely to wear it. Sports-related oral injuries can cost thousands of dollars to treat – not to mention your child’s discomfort – so I feel pretty strongly about this. But, one way or the other, please protect your child’s mouth. Mouth injuries are not pretty, are very painful, and can result in permanent consequences!

A sports mouthguard should:

• Be sturdy
• Be comfortable to wear
• Be customized for the sport
• Be easy to clean
• Not restrict breathing or speech
• Have a ventilated carrying case
• Have a helmet strap if needed

Once you have gotten your child a mouthguard, he or she should be taught how to care for it properly. To clean it, brush with toothpaste and rinse in cool water. Store it in a sturdy carrying case. Avoid contact with hot water or leaving it in the car or in direct sunlight, where it can be warped. Have your dentist periodically check it.  Replace the device as it gets worn and when the child outgrows the fit.  And never ever wrap it in a Kleenex or napkin! They are way too easily thrown out by accident!

Young athletes should wear their mouthguards consistently, whether in practice or during competition – just like the NBA players and Olympic athletes.  If your child wears braces, a single or double mouthguard can protect not only the teeth, but also the wires and brackets. It will help shield the lips, gums and cheeks from getting cut by brackets during a knock to the head.

The American Dental Association estimates that mouthguards prevent 200,000 injuries among high school and college athletes annually. It’s a small investment, but it offers huge rewards and peace of mind.  To make an appointment for yourself or your young athlete, call our office in Southfield at (248) 356-8790.

So until next time,

Mark W Langberg, DDS, FAGD

Hey everyone!

Global warming, tornadoes, royal weddings and overthrown governments compete for our attention these days. Sometimes it’s hard to know what deserves our notice and consideration and whom to believe.

Bisphenol A – or BPA

The media is notorious for using health topics as news teasers to grow their audiences. Bisphenol A, an organic component in many plastic consumer products, is one of the current controversies. You might know this as “BPA,” a material used in the manufacture of plastic water bottles.

BPA, a polycarbonate, has been used in consumer products for more than 50 years. It’s found in eyeglass lenses, baby bottles, compact discs, reusable food containers, toys, dinnerware and the paper receipts you get at the checkout counter. It’s also used in the epoxy resin that lines the inside of cans of baked beans and chicken noodle soup. It’s everywhere – even in trace amounts in dental sealants and composites. And, that’s why I’m writing this blog. I want to address the concerns that some of you might have.

The truth is that opinions vary widely among experts. Some studies on rodents and aquatic organisms suggest that BPA could possibly mimic the behavior of the female hormone estrogen. Similar claims have been made about soy products. Other studies have possibly linked BPA exposure to developmental problems in animal fetuses. BPA can be inhaled, eaten or absorbed. Because there is inconsistent evidence some entities have banned baby bottles and other children’s products containing BPA, while others are not convinced the cited studies have a strong correlation to human health.

The American Dental Association (ADA) says, “These effects have not been observed in humans and are questionable at the exposure levels resulting from consumer products.” Experts consulted by the World Health Organization and the Food and Agriculture Organization of the United Nations say that BPA does not accumulate in the body because it is excreted quickly. “Initiation of public health measures would be premature,” the organizations stated in November 2010.  Even Consumers Reports still recommends dental sealants and composites to the public.

The ADA thinks that worries about the extremely small and limited BPA exposure from dental products in particular are unwarranted at this time, and I’d have to agree. According to the ADA, “the amount of BPA to which people are exposed is estimated to be much lower than the amount of BPA exposure considered safe by government agencies.” …But, that’s not to say I’m not concerned about this topic. I most definitely want what’s best for my patients, and I’ll be one of the first to yank these products if I find out they are a problem at the extremely low levels currently present in dental plastics.  Ideally, dental materials manufacturers will soon come up with replacement products that perform the same but contain no BPA, and then this debate will be moot.

Presently, there is no low-cost alternative available to mercury-containing, silver amalgam fillings other than composites.  Gold and porcelain restorations are prohibitively expensive for some patients, so composites are these patients’ only affordable option to these mercury-silver fillings.

I also will continue to use sealants – along with fluoride and diet and hygiene recommendations – to ensure the dental health of our youngest patients. It’s our goal to get them to age 18 without any fillings in their permanent teeth, and for the most part we are succeeding. An amazingly high percentage of our child and teen patients have no decay and no fillings, something unheard of a generation ago!  Statistics indicate that children with no fillings by the time they turn 18 are unlikely to need any restorative dentistry when they are adults. That means no crowns or bridges, and that means better overall health and huge financial benefits!

This topic is complicated, and I will continue to monitor this debate and the research findings concerning BPA.  If you would like to discuss this further, please give my Southfield dentist office a call at (248) 356-8790.

So until next time,

Mark W. Langberg, DDS, FAGD

Hi everyone!

If eyes are the windows to the soul, it would be fair to conclude that the mouth is the doorway to the lungs. The oxygen that passes through this gateway is good stuff when it’s clean and unadulterated from cigarette smoke or toxic pollutants. …Other foreign material in the lungs? Not so good.

Most people know that if you inhale a big mouthful of water, you are going to choke. If you fail to cough it out, you may end up with pneumonia or worse. But, few people think about what oral bacteria can do to the pulmonary system if it gets inhaled into the lungs. Let me tell you, it’s not good news.

A Downward Spiral

Left unchecked, the sticky gunk called “dental plaque” builds up on your teeth, and it’s the perfect breeding ground for dangerous bacteria. Infected gums get red, irritated, swollen, may start to bleed, and can even form pus. Tissues recede and teeth loosen. Tooth loss and decay follow. Unfortunately, the story doesn’t stop there. Bacteria from diseased gums may be inhaled into the lungs or enter the blood stream, launching a flood of pathogens and toxins throughout the body.

While researchers are hesitant to be specific about cause and effect, many speculate that oral bacteria also wreak havoc on the immune system. Some pretty solid studies have found a correlation between periodontitis (gum disease) and diabetes, cardiovascular disease (including heart attacks and strokes), rheumatoid arthritis and even pancreatic cancer. More recently, these same oral bacteria have been chief suspects in cases of bronchitis, pneumonia, chronic obstructive pulmonary disease (COPD) and lung cancer. It has been implicated in pregnancy complications including premature birth and low birth weight, and Case Western University even reported a stillborn birth associated with a mother’s infected gums in early 2010.

Gum Disease and COPD (Chronic Obstructive Pulmonary Disease)

COPD, a disease marked by the gradual loss of lung function, caused more than 126,000 deaths in people age 26 and older, according to statistics reported by the Centers for Disease Control (CDC) in 2005. This figure was an 8 percent increase in COPD fatalities over those recorded in 2000. Today, COPD is the fourth-leading cause of death in the United States. Pneumonia and influenza, two other pulmonary diseases, caused 52,717 deaths in the United States in 2007. Lung cancer, a leading cause of death worldwide, costs Americans about $10 billion annually.

A recent study, cited in the January 2011 issue of Journal of Periodontology, correlated many of these lung diseases with the presence of gum disease. Researchers in India took a look at 200 human subjects – half of whom had been hospitalized for respiratory disease. The other 50 percent had no history of lung disease. Each participant was given an oral evaluation to determine periodontal health. (Only people with a minimum of 20 natural teeth were assessed.) Study statistics showed subjects with the respiratory diseases had more gingivitis and gum disease. The researchers in that study believe that oral pathogens either increased the patients’ disease risk or triggered an existing propensity for the lung illnesses.

Periodontitis and Cancer Rates

In another study by London’s Imperial College and Harvard University, the health records of 50,000 men were assessed. Subjects with a history of gum disease had a 33 percent higher incidence of lung cancer. A history of smoking made the risk climb even more. Gum disease also was linked to a 50 percent rise in pancreatic and kidney cancer risk and a 30 percent increase in blood cell cancers.

I hope these statistics got your attention. I know they got mine. I think it’s really important that dental professionals and others in the health community keep their eyes on this type of research and support ongoing studies to confirm this possible link. More importantly, the general public needs to be aware that an unhealthy mouth may contribute to serious and possibly fatal systemic disease.

‘Live Your Best Life’

My intention is not to scare you, but to help you “Live your best life,” as Oprah says. While creating and restoring beautiful smiles is a favorite part of my profession, my deepest desire is to see modern dentistry really impact the overall health and quality of life of my patients. Overall, if health advocates can influence people to get into the office for regular cleanings and dental care, I believe we will see pulmonary disease rates fall and maybe even a reduction in cancer statistics.

Health Insurance

Everyone can take an active role in disease prevention by eating a healthful diet, exercising, seeing a general practice doctor at least once a year, and seeing one’s dentist and hygienist twice a year. Brushing teeth twice a day and flossing at least once per day are an integral part of a healthy lifestyle. It takes two to three minutes to brush and floss thoroughly; however, most folks spend only 30-40 seconds. Many only brush only once per day, if that. Changing human behavior is difficult, but knowing that proper oral hygiene may extend and improve life may serve as a strong incentive.

Now, if it’s been a while since you’ve paid us a visit, please call (248) 356-8790 to set up your general or cosmetic dentistry appointment. We run a safe, non-judgmental office, so don’t let guilt or dental fears get in the way of your optimal health! Your gums, teeth and whole body will thank you!

So until next time,

Mark W. Langberg, DDS, FAGD

Hi everyone!
It’s been one month since the magnitude 9 earthquake hit Japan, triggering a devastating tsunami that set the stage for the worst nuclear disaster since Chernobyl’s meltdown in Ukraine in 1986. The seriousness of the Fukushima Daiichi crisis has raised questions about nuclear power, radiation and safety.  Understandably, worries about radiation and its impact on human health have been in the forefront of everyone’s mind. We all are trying to grasp the gravity of the situation – trying to separate fact from fiction. Unfortunately, misinformation is prevalent. It’s even raising questions in my dental office about dental X-ray safety.

People know the radiation coming from the damaged reactors in Fukushima is harmful. From there, many jump to the conclusion that all radiation is “bad.” This is apparent when you tune into the online chatter on social networking sites or read one of the cautionary emails that get forwarded into your Inbox each week.  Fueled by references to the recent Japan disaster and an episode of  “The Dr. Oz Show” which aired on television in September 2010, concern about thyroid cancer and X-rays has spiked. The resulting Internet chatter is an unfortunate mix of fact, fiction and fear mongering about radiation. I personally received a email that is circulating around the internet warning people to avoid all dental X-rays and mammograms.  And recently we’ve been getting more questions about the safety of routine dental X-rays at our Southfield dental office.

I understand these concerns and I know the thought of battling cancer can be terrifying. However, let me assure you that the diagnostic X-rays we use are safe – we are currently using the newest digital technology that decreases patient exposure by up to 75%! I consistently follow the American Dental Association (ADA) guidelines and drape my patients with leaded thyroid collars and leaded aprons during X-rays. It’s nothing new. We’ve been routinely using thyroid collars for well over 25 years now!  We also go out of our way to take the absolute minimum number of films we can in order to additionally decrease exposure (and cost!).

The episode of “The Dr. Oz Show” cited in the email I received focused on thyroid cancer.  Cardiothoracic surgeon and TV host Mehmet Oz encouraged the use of thyroid collars and leaded aprons during medical procedures to reduce radiation exposure.  This is standard medical protocol. The ADA and the U.S. Food and Drug Administration have outlined guidelines for this practice in “The Selection of Patients for Dental Radiographic Examinations.”  Dr. Oz did not advise patients not to have any dental X-rays or mammograms, only to use the same recommended protection we have always used.

There’s no doubt that there are more cases of diagnosed thyroid cancer being reported in the United States in recent years. It’s about 17 cases out of 100,000 women annually and about 5.8 cases for men. This endocrine cancer is very treatable and 97 percent of patients do well, according to Dr. Otis Brawley, the chief medical officer with the American Cancer Society.

“It is not so much that there are more thyroid cancers, as that more thyroid cancers are being discovered or diagnosed,” explained Dr. Brawley, who is also a health correspondent for CNN. “Use of CAT scans, MRI scans and thyroid ultrasound has dramatically increased over the past 30 years. These tests can detect very small thyroid nodules that several decades ago would not have been found.”

The radiation level in everyday dental X-rays is very low compared to other medical exposure sources, such as a full-body CT scan (0.005 millisieverts for dental X-rays vs. 10 mSv for a Cat Scan).  However, we still take every precaution in my office – particularly with children who have a heightened sensitivity to exposure.

Simply put, radiation is energy. It comes from natural and manmade sources. We all are exposed to small amounts every day from the sun’s cosmic rays, elements in the soil, your TV, medical diagnostic tools, the microwave, and so forth. While a nuclear plant meltdown warrants concern, an annual dental X-ray does not.  According to the U.S. Centers for Disease Control, “about 80 percent of human exposure comes from natural sources, and the remaining 20 percent comes from man-made radiation sources.”

Dental X-rays are a valuable tool that helps me identify bone loss, hidden cavities, gum disease and hidden dental infections. Radiography shows me things that are out of view and allows me to address oral health issues which will worsen if neglected. I always consider my patients’ medical history, age, cavity risk and oral health to minimize the number of films, and our new digital X-rays significantly decrease patients’ exposure times.

I hope this discussion has reassured you about the safety of dental X-rays, but if you have further questions, please call my cosmetic and general dentistry office at (248) 356-8790 to set up a consultation. Together, we’ll discuss what’s right for you.

So until next time,

Mark W Langberg, DDS, FAGD

Hi everyone!

Although Ol’ Man Winter is still stomping his feet in Michigan, spring weather is on its way to Southfield. Warmer temperatures mean lighter jackets, blooming flowers and, unfortunately, pollen – one of the many triggers of allergies and asthma.

Pollen, smog, dust mites, tobacco smoke, cold air, exercise, mold and viral infections act as irritants to the lungs and nasal passages. The airways react and become more sensitive. Lungs get congested and sinuses swell, making it harder to breath through the nose. Mouth breathing is the only option – and sometimes even that is a struggle if you have asthma.

According to the Centers for Disease Control and Prevention (CDC), more than 7 million children in the United States have asthma. Studies in Sweden also have linked asthma with dental problems in children, teens and young adults.

Gum inflammation and cavities were the two main correlations identified in asthma studies by dental researchers from the Department of Cariology at Sahlgrenska Academy in Gothenburg, Sweden. Test subjects with healthy respiratory systems, however, showed a lesser degree of dental caries and gingivitis.

Researchers examined asthmatics – ages 3, 6, 12-16, and 18-24 – and a control group of healthy youths of similar age and geographical background. The results were telling.

• Only 5% of tested asthmatic teens were cavity-free, compared to 65% of “healthy teens.”
• Teens with “long-time moderate or severe asthma” had more gum inflammation than the control group.
• The 3-year-old asthmatics showed more dental caries than 3-year-olds in the “healthy” control group. This trend still existed in a follow-up exam three years later, when the kids were 6 years old.
• Adolescents with asthma had lower plaque pH than the control group, meaning their mouths were more acidic, making their teeth prone to decay and their gums vulnerable to inflammation.
• Cariogram data showed 55% of the control subjects had a “high chance of avoiding caries.” Only 10% in the asthma group showed a similar prognosis.

Researchers think low saliva levels contributed to the gum irritation and tooth decay. Saliva washes food particles from teeth and minimizes the growth of bacteria that contributes to decay.

When an asthmatic child exercises or sleeps, he often will breathe through the mouth to get enough air. Subsequently, the mouth dries out. Medication used to control asthma dries the mouth even more. While optimally a thirsty child reaches for water, statistics from the study indicate that asthmatics reported a higher consumption of sugary beverages than non-asthmatics. A dry mouth and sugary drinks invite tooth decay if good oral hygiene is not established.

If you live in Bloomfield Hills, Southfield or Farmington Hills and you have a child who has asthma, please call my cosmetic and general dentistry office at (248) 356-8790 and schedule your child for an evaluation and caries exam. Routine checkups, topical fluorides, sealants and learning the ABCs of daily dental care are important tools in guarding the health of those you love who have asthma.

So until next time,

Mark W Langberg, DDS, FAGD

Hi everyone!

When you see me as a new patient for an initial examination or when you visit our hygienists to get your teeth cleaned you will have the health of your gums evaluated by using a simple and relatively painless test called a periodontal chart or periochart. Most likely you will hear either me or your hygienist calling out a series of 6 numbers per tooth. What we are doing is measuring, in millimeters (mm), the depth of the cuff of gum tissue around each tooth. This depth is the difference in height between the level of your gumline and the point at which the gum actually attaches to your tooth. 2-3 mm is considered healthy and physiologic and anything over 5 mm usually indicates that the bone that supports your tooth has begun to be destroyed by disease. To give you something to compare with, a pencil eraser is typically about 5 mm in diameter. The diagram at the bottom of the blog explains it better, but here is a little more detail on what measuring the “pockets” mean:

0 to 3 mm without bleeding: Congratulations! No issues!

1 to 3 mm with bleeding: This is gingivitis which is the mildest form of gum disease. Usually a good cleaning coupled with improved oral self-care is all that is needed.

3 to 5 mm with no bleeding: There is a strong potential of gum disease. Routine cleanings cannot reliably go deeper than 3 mm. Three to four visits a year may be recommended to improve the situation.

3 to 5 mm with bleeding: Early to moderate gum disease (beginning Periodontitis) which may require some additional treatment as well as better home care and three to four visits per year.

5 to 7 mm with bleeding: Bone loss is likely as is soft and hard tissue damage. Almost always requires definitive treatment, possibly over several visits, as well as greatly improved home care and three to four hygiene visits per year to prevent tooth loss.

7mm and above with bleeding: Advanced periodontal disease which means aggressive treatment to save your teeth. Additionally, surgery is almost always required to repair the damage done. Periodontal maintenance visits are also required every 3-4 months thereafter.

As noted, the presence of bleeding or pus when you are being periocharted is a strong indicator of disease. Healthy gums do not bleed! The presence of gum disease leads to tooth loss and a greatly diminished quality of life. Gum disease is also implicated in serious health issues such as heart disease and strokes, diabetes, and respiratory problems.

So, don’t put it off! Contact me or my excellent staff at 248-356-8790 for a periodontal (gum) evaluation. The earlier these problems are detected, the easier and more predictable the treatment is.

Until Next Time-

Dr. Mark Langberg