December 31, 2012

It's Ski Season! How to Protect Your Skin



How your eyes can give you away


You can always tell when someone returns from a ski trip--they have that raccoon look, a sunburned face around the outline of ski goggles.

The high altitude sun exposure is especially dangerous, and there are ways of protecting your skin from UV rays and reduce your risk of melanoma:
  • wear a sunscreen with an SPF of 30 or higher
  • use waterproof sunscreen
  • reapply sunscreen often, usually every two hours
  • cover all exposed areas
  • "broad spectrum" protects against both UV-A and UV-B rays
  • wear wrap-around sunglasses to protect your eyes
  • apply sunscreen 30 minutes before going outside
Source:  CANCERCARE
Robert G. Tupac, DDS, FACP, Inc., 
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309

December 28, 2012

Health Habits: New Year's Resolutions




There is a fun and informative site at Hive Health Media.
A recent blog by Doug Robb detailed how adults who perform at least 150 minutes of moderate physical activity each week live longer than those who don't.

The details are available at www.healthhabits.ca/2012/12/18/how-to-live-longer-and-better/

Robert G. Tupac, DDS, FACP, Inc., 
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309

December 24, 2012

More Bad News About Sugar from the American Heart Association!

How sugar drinks and heart disease go together


A study published by the American Heart Association, circ.ahajournals.org, compared men who did and did not consume sugar-sweetened beverages and risk of coronary heart disease. Researchers followed 42,883 health professionals for a period of 22 years. They adjusted for age, smoking, physical activity, alcohol, multivitamins, family history, diet quality, energy intake, BMI, pre-enrollment weight change and dieting.

They found that intake of sugar-sweetened beverages (and not artificially sweetened beverages) was significantly associated with increased risk of coronary heart disease and adverse changes in lipids, inflammatory factors and leptin.

Robert G. Tupac, DDS, FACP, Inc., 
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309

How To Reduce Cholesterol by Diet Planning


 How to start reducing your cholesterol

In a previous blog about cholesterol, lowering cholesterol levels was demonstrated to lower the risk of heart disease.

A low cholesterol diet plan works by lowering the quantity of saturated fat to reduce LDL cholesterol as well as using more monounsaturated fats and soluble fiber to increase HDL cholesterol.



Start your diet plan


Cholesterol is found only in foods from animals, not in plant foods.  Reducing the amount of meat, replacing beef, pork or lamb with fish or chicken, and increasing the amount of whole grains and vegetables reduces the amount of saturated fat intake.
  • When eating meat, choose lean cuts and trim away all visible fat and skin before cooking.
  • USDA cuts marked Choice and Select are leaner than Prime.
  • Meat baked or broiled over a rack allows fat to drain; frying seals in the fat.
  • Stews and soups, when refrigerated, allow fat to be skimmed off.
  • Processed meats, usually high in saturated fat, are to be avoided.

Here are some tips to get more results


Saturated fat in dairy products (butter, milk, and cream) can be reduce by using low-fat milk or cheese.

Soluble fiber is found in oatmeal and oat bran, kidney beans, brussel sprouts, pears and apples.  Brown rice and whole grain pasta also lower cholesterol.

Trans fats act like saturated fats and are found in commercially baked and fried foods, like doughnuts, french fries, cookies, muffins, crackers pies and cakes. 

Cholesterol is found in egg yolk, but not in egg whites, which are protein rich.

Monounsaturated fats, which help reduce cholesterol levels, are found in canola oil, olive oil or peanut oil, rather than cooking with corn oil.

Robert G. Tupac, DDS, FACP, Inc.,
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309

December 21, 2012

Why Is Dental Care Important?

An attractive smile is a sign of happiness, confidence and 
self esteem. A healthy mouth is also an indicator of overall 
well-being.

What researchers have found about oral health


Scientific research has shown the relationship between oral health and heart disease, diabetes, premature birth, Alzheimer's disease, infertility and even erectile dysfunction. www.prevention.com has tips for oral care and protecting your teeth, as well as remedies for the prevention of gum disease, necessary vitamin intake, and foods that are best for protecting your healthy smile.


Robert G. Tupac, DDS, FACP, Inc.,
 Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309

December 20, 2012

Facts About Lost Teeth

Oral Health in America

The ADA Specialty Scan--Prosthodontics, just  published (Dec. 19, 2012), gives the following facts about lost teeth:

  • more than 35 million Americans have no teeth (are edentulous) and 178 million U.S. residents are missing at least one tooth
  • among seniors, the ratio of edentulous people is 2 to 1; about 23 million are edentulous and 12 million are edentulous in one arch
  • nine out of ten edentulous Americans have dentures
  • the number of partially edentulous Americans is expected to rise to more than 200 million over the next 15 years
  • about 15% of the edentulous population has dentures made each year
Source: American College of Prosthodontists
Robert G. Tupac, DDS, FACP, Inc., 
 Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309

December 19, 2012

What Is A Prosthodontist?



A prosthodontist is a dentist who has completed an additional three or four year American Dental Association accredited residency program after dental school.  It includes lectures and seminars, and intensive laboratory and clinical experience.

Prosthodontists are experts in diagnosis, treatment planning and restorative procedures.  They restore oral function and improve the esthetic appearance of smiles through:


  • replacement of broken, worn, or decayed teeth with crowns, veneers or inlays
  • placement of dental implants and implant crowns and prostheses
  • replacement of missing teeth with bridges
  • fabricating removable dentures
  • restoration of occlusion
  • management of TMJ disorders and bruxism

Source: American Board of Prosthodontics


Robert G. Tupac, DDS, FACP, Inc., 
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309

December 18, 2012

Why Gum Disease has Warning Signs

What's the number one bacteria source on your body?


Your mouth is full of bacteria--more than any other part of the body--because the digestive process starts there.  Brushing and flossing lowers the bacterial count, but harmful bacteria can still cause gum inflammation. Gum disease starts with surface inflammation, then spreads deeper, until it can even destroy the bone around your teeth.

What are the signs of gum disease?

  • red, swollen or tender gums or other pain in your mouth
  • bleeding while brushing, flossing, or eating hard food
  • gums that are receding, making the teeth look longer
  • loose or separating teeth
  • pus around the gumline
  • sores in your mouth
  • persistent bad breath
  • a change in the way your teeth fit together when you bite
Left untreated, gum disease leads to tooth loss.  If you have any of the problems listed above, and they persist, then it's time for a dental checkup!

Robert G. Tupac, DDS, FACP, Inc., 
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309

December 17, 2012

Childhood Obesity and Adult Metabolic Disorders




How Childhood Obesity and Adult Metabolic Disorders Relate

There is mounting evidence linking childhood obesity to an increasing risk of obesity, heart disease, type 2 diabetes, and other cardiovascular and metabolic disorders in adulthood. 

An extensive review article, quoted in Childhood Obesity, Oct 2010, 6(5):250-256, documents the rising prevalence of obesity in childhood and the importance of prevention and early intervention.

For more information, go to:  www.a-health-blog.com/evidence-links-childhood-obesity-to

Robert G. Tupac, DDS, FACP, Inc., 
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309

December 13, 2012

Do You Have Sleep Apnea?

What is Sleep Apnea?

Sleep apnea is a disorder which affects 18 million Americans.  It results in loud snoring and excessive daytime sleepiness and fatigue.

Types of Sleep Apnea

  • obstructive--the most common--occurs when soft tissue in the back of the throat collapses and obstructs the airway, causing breathing to stop
  • central--when the brain doesn't signal the muscles to breathe
  • mixed--a combination of the two

How Does Sleep Apnea Affect Rest?

During normal sleep, muscles that stiffen the airway behind the tongue and soft palate relax.  With a normal size airway, there is no problem.  However, if the airway is small (anatomically or because of excess weight), it can close.  Breathing continues against the closed airway and becomes increasingly strong (in response to diminished oxygen levels and increased carbon dioxide levels) until the greater effort causes awakening, which activates the muscles to reopen the airway.  The arousals are brief (and mostly unnoticed) but if they occur frequently enough during the night, sleep becomes fragmented and non-restorative, and daytime sleepiness and fatigue results.

With a proper diagnosis of sleep apnea, some dentists make appliances for patients to wear that are designed to keep the airway open.  Prevention.com has a listing of research studies regarding the health effects of untreated sleep apnea.

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

December 12, 2012

It's Time!



Smoking is responsible for 1 out of 3 of all cancer deaths. 




1/2 to 4/5 of cancer patients who smoke continue to do so after cancer 
diagnosis.

Why?  

Some of the answers can be found in a Dec. 5, 2012 article entitled "It's Time to Quit" at chemotherapyadvisor.com.  The article illustrates that smoking reduces the effectiveness of cancer treatment, increases the risk of cancer recurrence and secondary cancer, and shortens survival.  It also provides intervention techniques (ways to stop) in addition to resources regarding programs available to help with smoking cessation.

Robert G. Tupac, DDS, FACP, Inc., 
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309

December 11, 2012

How Cancer Risk and Obesity are Linked














What are the numbers?

  • A body mass index (BMI) between 25 and 30 kg/m2 defines overweight
  • A BMI greater than 30 kg/m2 defines obesity
  • The number of overweight and obese individuals in the U.S. has consistently increased over the past 50 years
  • The latest data shows 75% of adults and 33% of children are considered overweight or obese
  • SEER Epidemiology data suggest that each 5-point increase in BMI results in an increased risk of developing cancer that ranges from 13% to 60% depending on cancer type

 What cancer type and what may be the mechanism?

  • Esophageal, colorectal, pancreatic, kidney cell, postmenopausal breast and endometrial cancers
  • weight-associated changes in the synthesis and action of sex hormones, insulin, insulin-like growth factor and other cellular growth factors
  • systematic inflammation, oxidative stress and altered immune response
Moderation in both diet and exercise can be cancer preventing. More information can be found at www.chemotherapyadvisor.com

Robert G. Tupac, DDS, FACP, Inc., 
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309

December 10, 2012

Burning Mouth Syndrome

Symptoms of Burning Mouth Syndrome


The just released December issue of the American Dental Association Journal features an article on a problem often seen in a specialist's office such as ours--burning mouth syndrome. (BMS).
BMS is classified as either primary, a burning sensation of the tissues of the mouth or around the mouth, usually on both sides and distributed symmetrically, or secondary, occurring as a result of clinical abnormalities such as oral lesions, systemic disease, certain psychological conditions, or side effects of medications.

How BMS has boundries


Diagnosis is challenging.  BMS is most common in women, with symptoms beginning during the period between three years before menopause and twelve years after menopause.  The most frequent location is the surface or side of the front two-thirds of the tongue.  Symptoms can develop spontaneously, or have been reported to follow respiratory infections, dental work, prescribed medications, or traumatic life events.  The symptoms can last months or years, and be worse at different times of the day or exacerbated by certain foods.

Treatment  involves behavioral strategies, topical therapies and systemic approaches.

For greater detail, and information regarding clinical implications, see the JADA, December 1, 2012, vol. 143, no. 12, 1317-1319


 Robert G. Tupac, DDS, FACP, Inc.,
 Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309

December 07, 2012

Do Mouthwashes Work?


How Do Other Mouthwashes Compare to Listerine?

A recent study compared the effects of certain commercially available mouthwashes on the bacteria that cause decay and the (bio)films they develop on teeth.

Mouthwash Study

Four mouthwashes were studied, one of which contained chlorhexidine gluconate, and another was Listerine. The mouthwashes were applied to the bacteria biofilms and then the viability of biofilms investigated.

Listerine Prevents Tooth Decay

It was found that the bactericidal potency of Listerine was significant, and could be used to prevent decay.
Source:  Oped Dent J., 2012;6:23-30


Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

December 06, 2012

Guidelines for Treatment Planning Therapy

Guidelines for Treatment Planning Therapy 

Cone-Beam
Dr. Lyndon Cooper's popular dental implant guidelines for treatment planning therapy in the edentulous mandible are designed to improve the success of both the implants and the prosthesis.  The "rules" govern the biology and amount of bone necessary for implants sufficient to support chewing forces.  The "rules" also specify the distribution of the implants to control the forces they must withstand and the amount of space necessary to fabricate a prosthesis with enough structural integrity to withstand these forces.

Implant tissue bar/overdenture and implant supported/fixed (hybrid) prostheses

The rules apply to both implant tissue bar/overdenture and implant supported/fixed (hybrid) prostheses.
The first rule is that the lower jaw must allow for implants at least 10mm in length--that the mandible's inferior/superior dimension be a minimum of 10mm.  Evidence in the literature supports the conclusion that 10mm implants in the anterior mandible have an equally high survival rate than longer implants.

Second Rule

The second rule is that the vertical (restorative) dimension must be at least 10mm from ridge crest to occlusal plane. Using a "top down" approach, the average height of mandibular anterior teeth is 10mm, and there must be room for acrylic attachment, a rigid framework, abutment height and biologic width.  This allows for a prosthesis with structural integrity and permits establishment of proper contours in support of comfort, mastication and speech.

Third Rule

The third rule is that the anterior/posterior distribution of implants be at least 10mm for the hybrid.  This allows the lever arm from the anterior implants to the posterior implants to be sufficient for the counter leverage necessary to support 15mm of cantilevered teeth back to the first molar.

Cone-Beam Technology Required

Applying these rules requires using cone-beam computed technology for a volumetric assessment of the mandible.  It means determining final anterior and posterior tooth position prior to planning and executing implant placement and presurgical correlation of the anatomy of the mandible with the location of the planned prosthetic teeth.

Robert G. Tupac, DDS, FACP, Inc., 
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309

December 05, 2012

The All-on-4


Implant Treatment Plan

When people lose their back teeth, the jawbone quickly shrinks.  In the upper jaw, half of the residual bone can be lost in as little as one year, and with the way the sinus cavity enlarges at the same time, the amount of bone remaining is often not enough to hold implants.  In the lower jaw, the posterior ridge shrinks just as quickly.  Bone grafting to recapture this lost volume is unpredictable, costly and takes a long time.

All-On-4

For these reasons, a solution to the problem, called All-0n-4,  was developed by Dr. Paulo Malo.
He determined that the use of long, well-angled posterior implants (as pictured above) both avoided vulnerable anatomical structures (upper sinuses and lower nerves) and offered improved support for the prosthesis by reducing cantilevers.  Together with straight anterior implants, from a bio-mechanical point of view, this arrangement was suitable to support an arch of 12 teeth.

Why only 4?

The use of four implants in an arch reduces treatment complexity, facilitates oral hygiene and allows for a more durable prosthesis.  By using NobelBiocare NobelSpeedy Groovy implants, the greatest variety of implant components is available to ensure a highly esthetic outcome. In our office, we have found this solution to be favored by our patients.  It is a well proven, scientifically validated, bone anchored alternative to the social, emotional and nutritional disappointments caused by removable dentures.

As Per-Ingvar Branemark, dental implant pioneer, says:  
"No one should have to die with their teeth in a glass of water beside their bed."


Robert G. Tupac, DDS, FACP, Inc., 
 Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309

December 04, 2012

Steroid-Related Risk of Heart Disease in Lupus Patients

Heart Disease Risk is Increased for Those with Lupus

A study reported in the American Journal of Epidemiology, (2012. Sept 27. doi:10.1093/aje;kws130, Epub ahead of print) investigated the reasons that individuals with lupus are at increased risk for heart disease.

Lupus Study at Hopkins Lupus Cohort

1800 individuals who were enrolled in the Hopkins Lupus Cohort from April 1987 to June 2010 were included.  Patients with previous heart disease related events were excluded. Patients were tested quarterly with a battery of physical and laboratory tests to determine lupus disease activity and antibody markers.

Researcher found that among this population, the number of heart-disease related events was substantially higher than in the general population.

Heart Disease Linked

Researchers then separated out a multitude of factors specifically relating to lupus--duration of disease, age at diagnosis, average lupus disease activity, history of the disease as indicated by antibody levels. Even after accounting for the increased risk due to increased lupus disease activity, and increased blood pressure and cholesterol, patients who were currently taking steroids at a dose of 20 mg/day or more had significantly more heart disease events.
More detailed information regarding this research can be found at the above reference.

 Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

December 03, 2012

How Implant-Based Solutions Lead to Improved Quality of Life!



















How to Improve Quality of Life  

There is no need to be edentulous.  With conventional dentures severe bone resorption may occur.  Because they may fall out at any time, patients lose more than confidence, avoiding certain foods can lead to nutritional deficiencies, and an altered self-image causes an avoidance of social situations.  Dentures restore only 10% of chewing function.  Poorly fitting dentures can cause sore spots and painful blisters.  They often offer only limited lip and cheek support.

Dental implants provide the following functional benefits:
  • greater chewing capability
  • improved esthetics
  • improved speech
  • greater comfort
  • less bone resorption
and the following emotional benefits:
  • improved self image and self-confidence
  • improved social life
The above before and after pictures illustrate this difference.

 Robert G. Tupac, DDS, FACP, Inc.,
 Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com 
5060 California Ave., #170, Bakersfield, CA 93309

How Shift Work and Sleep Deprivation are Linked

Increased Cancer Risk


Many of my previous blogs have mentioned the importance of six to eight hours of sleep per night in maintaining good general health.  Our lives nowadays can be active 24/7, it seems, with the communication tools of emails, twitter, facebook and the never ending news cycle.

It turns out that there is evidence in the medical literature regarding the risks for many chronic conditions due to insufficient sleep and here is a link to a great article in Chemotherapy Advisor about circadian rhythms, melatonin, and cancer risk:  www.chemotherapyadvisor.com/association-of-shift-work-and-sleep-deprivation-with-increased-cancer-risk.

Robert G. Tupac, DDS, FACP, Inc.,
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309