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Posts for: March, 2015

By Edward Joseph, D.D.S.
March 26, 2015
Category: Oral Health
Tags: oral health   nutrition  
TheSweetandLowdownonSugarSubstitutes

We’ve all heard about potentially negative health effects from the sugar that’s added to many of our favorite foods. So these days, lots of us are trying to cut down on our consumption of sugar — not only to lose weight, but also to help prevent maladies like diabetes and heart disease. We can’t help noticing those pastel-colored packets — pink, yellow and blue — on the rack of our favorite coffee shop. But now we’re wondering: Are those sugar substitutes a good alternative to natural sugar? And which one should we choose?

Artificial sweeteners have been around for decades. Six different types (including the ones in the colorful packets) are currently approved as safe by the Food and Drug Administration; a couple of older ones (notably cyclamates) have been banned for many years. In addition to those zero-calorie sugar substitutes, low-calorie sweeteners called sugar alcohols (for example, mannitol and xylitol) are often used as food ingredients. So what’s the difference between them — and which one is best?

That’s not so easy to answer. If you have a rare genetic condition called phenylketonuria, you should avoid aspartame (the blue packet), because your body can’t process the substance. Otherwise, the choice may come down to a matter of taste. Even though they are FDA-approved, some controversy (both fact-based and far-fetched) remains about the long-term safety of sugar substitutes, and their usefulness in preventing obesity and other diseases.

Yet it’s clear that for some people, the consequences of consuming too much sugar could be much worse. So if you’re at risk for diabetes or certain other diseases, sugar substitutes can be an important tool in maintaining a healthier diet. They also have another health benefit: sugar substitutes don’t cause cavities. Further, some sugar alcohols (xylitol in particular) have the property of stimulating saliva flow, and have been shown to actually impede the formation of cavities. Oral health is an important (if sometimes overlooked) component of your general well-being, and several studies have pointed to a link between oral and systemic diseases — for example, diabetes and heart disease.

As with so many aspects of our health, there seems to be no “magic bullet” to cure all our diet-related problems. But used in moderation, artificial sweeteners can be a valuable part of the effort to improve our overall health and well-being. For more information on this topic, see the Dear Doctor article “Artificial Sweeteners.”


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By Edward Joseph, D.D.S.
March 18, 2015
Category: Oral Health
UnderstandingThe4StagesOfGumDisease

Since the dawn of man, periodontal (gum) disease has impacted humans. And while dental health has dramatically improved over the generations, the facts are still clear — millions of Americans are suffering from gum disease and probably do not even know that they have a problem. This is because periodontal disease most often starts without any symptoms or ones that most people tend to discount or ignore.

Stage 1: Gingivitis. The first stage of gum disease is inflammation of the gingiva (gums) without bone loss. While nearly all people will develop gingivitis in the absence of good oral hygiene, only 10 to 15% of them will go on to develop more advanced stages of the disease.

Stage 2: Early periodontitis. With this stage, gingivitis progresses into the deeper periodontal structures — the tissues that attach the teeth to the bone resulting in early or beginning bone loss. About 10% of the population develops full-blown periodontitis with progressive bone loss.

Stage 3: Moderate periodontitis. The third stage of gum disease results in moderate bone loss (20 to 50%) of root surfaces of the teeth due to continued destruction of the surrounding tissues and bone. Periodontal disease is “cyclical” — it goes in cycles with bursts of activity, followed by a period in which the body tries to recover. This is called chronic inflammation, or frustrated healing.

Stage 4: Advanced periodontitis. With the final stage of gum disease, there is severe bone loss (50 to 85%) from the tooth's root. This stage includes looseness of teeth, moving teeth, abscess formation with red, swollen and painful gums. The end results — eating and even smiling is difficult and uncomfortable, and you could lose all your teeth.

You can learn more about gum disease in the Dear Doctor article, “Understanding Gum Disease.”

Have We Described Your Mouth?

If any of the above stages sounds like we are talking about your mouth, contact us today to schedule a consultation, discuss your questions and receive a thorough exam. If addressed promptly and with commitment to following your treatment plan, your mouth can return to good oral health.


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By Edward Joseph, D.D.S.
March 10, 2015
Category: Dental Procedures
Tags: crowns   veneers  
Life-likeDentalPorcelainHelpsRestoreSmilesMarredbyUnattractiveTeeth

With its life-like color and texture, dental porcelain can restore a smile marred by decayed or damaged teeth. This durable ceramic material not only matches the varieties of individual tooth colors and hues, its translucence mimics the appearance of natural teeth. But perhaps its greatest benefit is its adaptability for use in a number of different applications, particularly veneers and crowns.

Veneers are thin layers of dental porcelain laminated together and permanently bonded to cover the visible outer side of a tooth to improve its appearance. Crowns, on the other hand, are “caps” of dental porcelain designed to completely cover a defective tooth.

Veneers and crowns share a number of similarities. Both can alter the color and shape of teeth, although crowns are used when more extensive tooth structure has been damaged. They’re also “irreversible,” meaning the tooth must be altered in such a way that it will always require a veneer or crown, though on some occasions a veneer can require no removal of tooth structure and can be reversible.

They do, however, have some differences as to the type of situation they address. Veneers are generally used where the affected teeth have a poor appearance (chipped, malformed or stained, for example) but are still structurally healthy. And although they do generally require some removal of tooth enamel to accommodate them (to minimize a “bulky” appearance), the reduction is much less than for a crown.

Crowns, on the other hand, restore teeth that have lost significant structure from disease, injury, stress-related grinding habits or the wearing effects of aging. Since they must contain enough mass to stand up to the normal biting forces a tooth must endure, a significant amount of the original tooth structure must be removed to accommodate them.

Which application we use will depend upon a thorough examination of your teeth. Once we’ve determined their condition and what you need, we can then recommend the best application for your situation. But regardless of whether we install a veneer or crown, using dental porcelain can help achieve an end result that’s truly life-changing — a new, younger-looking smile.

If you would like more information on dental porcelain restorations, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Porcelain Crowns & Veneers.”


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By Edward Joseph, D.D.S.
March 02, 2015
Category: Oral Health
Tags: oral health  
HaveTeethorJawProblemsCheckedBeforeYourNextFlightorDive

Among the “to-do” items on your pre-dive checklist like “Pack wetsuit” or “Fill scuba tanks,” be sure to add one other: “Check my dental health status.”

While that may seem like an odd concern, the changes in atmospheric pressure you encounter while diving (or flying, for that matter) could amplify oral sensitivity and intensify pain if you have pre-existing teeth or jaw problems.

The reason for this is the effect of basic physics on the body. All anatomical structures, including organs, bones and muscles, equalize external pressures the body encounters. We don’t notice this at normal atmospheric pressure, but when we encounter an extreme — either lower pressure during air flight or higher pressure during a scuba dive — we may feel the effects of the pressure on any structure with a rigid-walled surface filled with either air or fluid. These structures can’t equalize the pressure as fast as other areas, resulting in pain or discomfort. This is known medically as “barotrauma,” or more commonly as a “squeeze.”

One structure in particular could have an effect on your upper teeth and jaws: the sinus cavities of the skull, particularly the maxillary sinuses just below the eyes. Their lower walls are right next to the back teeth of the upper jaw and, more importantly, share the same nerve pathways. It’s quite possible, then, for pain from one area to be felt in the other, commonly known as “referred pain.” A toothache could then be felt in the sinus region, and vice-versa.

During a squeeze, then, pain levels from existing problems in the teeth and jaws that were previously tolerable (or even unnoticed) may well become amplified as the pressure from the sinus cavity impinges upon the jaw. That dull toothache you’ve been having may suddenly become excruciating at 30,000 feet — or 30 meters under the surface.

That’s why it’s important to see us if you’ve experienced any signs of tooth decay, gum disease or TMD, including pain, before your next dive or air flight. And, if you encounter any significant pain while flying or diving, be sure you consult with us as soon as possible when you return. Taking action now could help you avoid a miserable, and potentially dangerous, flying or diving experience in the future.

If you would like more information on pressure changes and dental health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Pressure Changes can Cause Tooth and Sinus Pain.”


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Burbank, CA Dentist
Edward C. Joseph, D.D.S.
2701 West Alameda Ave, Suite #503
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(818) 842-7628

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