Implant Dentistry Prosthetically Driven

Todays implant dentistry is prosthetically driven. A Board Certified Prosthodontist can determine and visualize, by the use of detailed radiographs, CT scanning, implant guides and diagnostic tooth positioning, exactly where the final tooth positions will be.  By doing so, all surgical procedures then become tailored to achieving the best esthetic and functional result possible. It is not enough to just put an implant into the bone and make an impression and try to make the tooth on top look good. The direct benefits of implant dentistry are bone preservation, maintenance of facial integrity, restoration of natural biting and chewing capacity and the self confidence that a secure smile can bring. Discover your dental implant options at www.drtupac.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

Nobel Active Implants

Just yesterday we placed a Nobel Active dental implant in a missing tooth site that had been gone for ten years. It only required local anesthesia, and in four months the partial denture will be history. The Active implant has bone condensing properties that allow minimally invasive bone preparation. A single suture covered the area.

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

A Nice Person Like You...

We have placed natural looking veneers on your four upper front teeth. As a satisfied patient, you are our best referral source.  "A nice person like you knows nice people, so send us your friends!"  Building a relationship with a patient is more than just doing clinical dentistry.  We want to restore the optimal function and appearance of a patient's smile AND get to know them to engage them in attaining a successful result.  That's because we are sincerely interested in them as human beings. Through our interaction with our patients they become friends, sharing what is new in their life. This creates energy in our interpersonal relationships and that energy leads to trust. Nice people DO know nice people, and we would like to know them too!

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 Sleep Well To Feel Good

Sleep is required for daily functions

Since humans spend about a third of their lives asleep, we can't underestimate its importance.  It is a required activity for normal body and brain functioning.

"Getting enough rest" ultimately means an average of about 6 to 8 hours per night, and making sure the cycle of REM (rapid eye movement) sleep, or dream phase, is achieved.  This is the period of deep, restful sleep. You only have to watch TV to see the commercial emphasis on creating comfortable sleep conditions beds that adjust to different sleep positions, mattress types, pillow shapes and sizes, etc.

The Mayo Clinic offers seven tips to make sleep a restful, rejuvenating experience:

• stick to a schedule--consistency helps reinforce your body's sleep-wake cycle and helps you fall asleep better
• eat light and right--a light dinner two hours before sleeping, with limited liquid
• regular exercise--at least three hours before bedtime
• create a sleep oasis--cool, dark, quiet and comfortable
• don't sleep the day away--no more than a half-hour in the mid-afternoon
• develop a bedtime routine--to transition your body toward sleep
• time it right--go to bed when tired and ready to fall asleep

For more information, go to www.MayoClinic.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 (map)

Fluoridated Water Good For Adults And Children

Fluoridated Water Prevents Tooth Decay 

The March, 2013, ADA News, references a study published online in the Journal of Dental Research, that showed that adults who spent more than 75% of their lifetime living in communities with fluoridated water had 30% less tooth decay compared to adults who had lived less than 25% of their lifetime there.  A new study, conducted by the Univ. of North Carolina and the Univ. of Adelaide, Australia, showed strong evidence that fluoridated water provides dental health benefits to adults, even if they didn't have access to it as children.

The study analyzed 3,779 adults aged 15 and older, between 2004 and 2006 and found reduced tooth decay with exposure to fluoridated water.

For more information, visit: ada.org/fluoride

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

American College of Gastroenterology: Stay Regular!

Risk Of Developing Colorectal Cancer

At the 2012 annual session of the AmericanCollege of Gastroenterology, a study of a retrospective claims database showed patients with chronic constipation had a significantly greater risk of developing colorectal cancer and benign neoplasms than those without chronic constipation.

The results were observed by comparing a group of 28,854 patients with at least two diagnoses of chronic constipation to a group of 86,562 patients without (people who had never been diagnosed for constipation and never had a prescription filled for a laxative during the observation period), and controlling for factors of age, sex and region of residence, over a time span from January, 1999 to September 2011.

Link Between Constipation and Cancer

The prevalence of colorectal cancer was almost double (2.7% vs 1.7%) and more than double for benign neoplasms (24.8% vs 11.9%) in the chronic constipation groups.

Lead author Dr. Nicholas Talley said: "this study demonstrates an association, not causation, between chronic constipation and these diseases. This link between constipation and cancer risk is thought to be that longer transit times increase the duration of contact between the colonic mucosa and concentrated carcinogens in the lumen, such as bile. He suggested that patients who have their constipation well controlled may therefore be at lower risk.

Consultation with your physician is recommended if necessary.

Source:  Chemotherapy Advisor

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

HPV and Oropharyngeal Cancer: Risk Factors

Leslie Burgess, writing for Chemotherapy Advisor, continued her thorough and well researched article on the growing dilemma of HPV-Associated Oropharyngeal Cancer. She states: "An estimated 7,400 new cases are diagnosed annually in the U.S. Prevalence of oral infection is highest among adults in their late 20's and late 50's, and the disease is more common in men than women (almost 4:1) and in non-Hispanic populations. The presence of oral HPV infection is about 7% of the general population, but can be as high as 20% among those with a high number (20 or more) of lifetime sex (oral, anal, and/or vaginal) partners, early age (<17 years) at first intercourse and irregular or no condom use. Persistence of HPV infection increases cancer risk.

For more detail:  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

2012 Mouth Ulcerations and Lupus

Mouth Ulcerations Are A Common Symptom Of Lupus

Mouth ulcerations are estimated to affect 5 to 40% of lupus patients. They consist of white or red lesions, not necessarily painful, on the inside of the cheek, gums, palate and lips.  There is no evidence in the literature that lupus causes an increase in. However, two other factors may complicate the oral health of the lupus patient.

Lupus Symptoms:

First, many patients with lupus will also have secondary Sjogren's syndrome, which results in reduced saliva and tear production, and manifests in dryness affecting the mouth and eyes. Reduced salivary flow increases one's risk of a variety of oral maladies such as oral infection along with difficulty with speaking, eating, and swallowing.

Second, many of the medications prescribed to manage lupus have adverse affects that can affect the mouth. Prescribed steroids suppress the immune system and can increase one's risk of an oral fungal infection and poor wound healing. Drugs such as Plaquenil and methotrexate may themselves cause oral sores or ulcerations. Over 400 medications result in some degree of oral dryness, which worsens the Sjogren's syndrome.

Source:  Lupus Foundation of America

Diplomate, 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

HPV and Oropharyngeal Cancer: Vaccine

According to Chemotherapy Advisor, the available HPV vaccines are effective against the serotypes that are most commonly associated with oropharyngeal cancer.  The relationship previously established with this cancer and sexual behaviors and the disproportionate representation of men affected supports current recommendations to vaccinate both boys and girls to protect against HPV associated cancers.

Source: 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

Substance Use During Pregnancy

Effects Of Drug Use During Pregnancy 

Pregnancy complications and birth defects caused by alcohol, tobacco, or illicit drug use are completely preventable.

The US Surgeon General recommends complete abstinence from alcohol for all women who are pregnant or are planning to get pregnant.  Alcohol consumption during pregnancy increases the risk of premature birth, stillbirth, miscarriage, mental retardation, skeletal abnormalities, organ malformations. low birth weight, learning problems, and fetal alcohol syndrome.

Tobacco use during pregnancy is associated with ectopic pregnancy, spontaneous abortion, placental disruption, placenta previa, preterm delivery, stillbirth, low birth weight, cleft lip and palate, neonatal mortality and sudden infant death syndrome.

In the United States, approximately 4% of pregnant women use illicit drugs, including marijuana, heroin, cocaine and amphetamines.  This drug use can cause serious problems in the developing fetus and newborn, and the transmission of sexually transmitted diseases and hepatitis.

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

Lupus and Exercise

I'm so proud of my wife.  She was diagnosed with lupus quite a few years ago, and has severe joint issues as a result.  She's also had  knee replacement surgery.  Nevertheless, she gets out on the trails at Wildwood Park with me every weekend.

The basic benefit of exercise is that it stimulates the body to deliver more oxygen to the muscles that are contracting.  This oxygen rich blood increases the efficiency of your pumping heart, your expanding lungs, and those muscles that are creating movement.

For lupus patients, exercise is an overall stimulant that replenishes energy supplies and combats fatigue.  It improves muscle flexibility and strength and thereby protects joints.  It reduces inflammation, and, by stimulating endorphins, stimulates feelings of greater comfort, pleasure and confidence.

For suggestions on the best way to exercise with lupus, go to: www.lupus.org


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

Previous Cancer May Up Melanoma Risk

Cancer Survivors Have Higher Risk Of Melanoma

Almost four years after my first cancer surgery, and my six inch surgical scar has shrunk to half that length, I have to remember that the battle is not over. I still have fair skin tone, the kind of skin that burns and peels instead of tans.  In fact, I had another cancer removed less than a year ago, and I doubt whether the wound will ever fill in completely.

A new study finds that cancer survivors are at increased risk for cutaneous melanoma, one of the most aggressive forms of skin cancer.

Cutaneous melanoma is the 5th most diagnosed cancer in US men and 7th most commonly diagnosed in women. Overall incidence is increasing; death rates have decreased little, despite survival gains for other types of cancer.

Ultraviolet radiation exposure is the greatest risk factor for cutaneous melanoma.

Researchers analyzed data from US patients with melanoma as a first primary cancer and patients who were diagnosed with melanoma after surviving a previous cancer.

Among patients age 45 or older at first cancer diagnosis, the risk of developing cutaneous melanoma was much higher among those previously diagnosed with melanoma or other skin cancers, ocular melanoma, breast cancer or lymphoma.

Results suggest the need for continues skin surveillance in melanoma survivors as the risk remains elevated for over 15 years

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

HPV and Oropharyngeal Cancer: Increasing Rates

In a superb article in Chemotherapy Advisor, Leslie Burgess illustrates the increasing concern regarding HPV virus as the cause of more than 5% of all cancers, including all cervical cancers.  In addition, at current rates, by the year 2020 in the United States, oropharyngeal cancer will become the leading HPV associated cancer, surpassing the annual number of cervical cancers.

The incidence rates and types of HPV cancers are tabulated at www.chemothrapyadvisor.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

2012 Breast Cancer Decline with Reduced Hormone Therapy

In a new study of more than 2 million mammogram screenings performed on nearly 700,000 women in the United States, scientists show a direct link between reduced hormone therapy and declines in ductal carcinoma in situ (DCIS) as well as invasive breast cancer.

For nearly a decade, postmenopausal women have been strongly advised to refrain from long-term hormone therapy or to use lowest dose possible for the shortest time to relieve hot flashes and night sweats.  Numerous studies have suggested that women taking a combination of progestin and estrogen have a higher risk of breast cancer and other potential health hazards.

The study reviewed 2,071,814 mammograms performed between January 1997 and December 2008 on nearly 700,000 women between the ages of 40 and 79 as part of routine screening.

A clear pattern emerged:

Women 50 to 69 years old had the highest level of hormone usage--and showed the biggest reduction in invasive breast cancer when they stopped.

Rates of DCIS markedly dropped in the same age group after hormone therapy ended.  There was a parallel drop in cancer among women older than age 70.  Among women 40 to 49 years old, less likely to be on hormone therapy, had unchanged breast cancer rates over the course of the decade studied.

The results of this study corroborate previous reports and, to the authors, the statistics offer convincing evidence that hormone therapy cessation reduces breast cancer risk.

Source:  American Society of Clinical Oncology 

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

Heart Health and Food Choices

Dietary choices can protect your heart from disease as you age.
The Mediterranean Diet offers suggestions for food substitutions to improve your heart health:

• eat meals based on plants: fruits and vegetables, whole grains, beans and nuts
• substitute herbs and spices for flavor instead of salt
• restrict meat intake to a couple of times per month, and eat chicken or fish twice a week
• substitute olive or canola oil for butter
• choose low-fat/fat-free options for dairy

Source:  Mayo Clinic, Mediterranean Diet

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

Porcelain Crowns

Three upper front teeth instead of four.  The three have been restored with all-porcelain crowns made in our in-office laboratory.  It's the Tom Cruise look.

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

Dentistry During Pregnancy

Recently, the California Dental Association Foundation published guidelines for providing dental care during pregnancy.  Its report stated: "Prevention, diagnosis, and treatment of oral diseases, including needed dental radiographs and the use of local anesthesia, are highly beneficial and can be undertaken during pregnancy with no additional fetal or maternal risk when compared to the risk of not providing care.  Good oral health and control of oral disease protects a woman's health and quality of life; and has the potential to reduce the transmission of pathogenic bacteria from mothers to their children."
Local anesthetic (lidocaine with epinephrine), analgesics such as ibuprophen, and antibioitics (penicillin and cephalosporin) are commonly considered safe for use during pregnancy.  Shorter appointments are recommended.  Strict oral hygiene therapy can prevent pregnancy gingivitis and other oral manifestations of changed hormone levels.  Sedative agents, centrally acting analgesics (opiates) and nitrous oxide are not recommended.

From:  Re-evaluating Therapeutic Drugs for Pregnant Dental Patients, Inside Dentistry, March, 2013

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

Implants Are The Treatment For The Disease Of Bone Loss

Denture Become Loose After Years Of Wear

I saw a new patient today, a healthy woman in her middle 50's. She got her first upper denture about three years ago and hasn't had any treatment since. Now, due to the continued shrinkage of her upper ridge, the denture is loose. Her lower teeth are healthy and can be maintained for many years, but they can put excessive pressure on her upper ridge. She was just switching over to my office and I'm glad I saw her at this stage of her dental history. Here's why:

The bone loss that occurs after tooth removal is the greatest in the first few years. Usually denture patients go a couple of years or more in between adjustments. The dentures eventually get loose, maybe get relined, maybe get remade and then one day their ridge has shrunk so much that satisfactory function is limited and speech, facial and esthetics are severely compromised.

Then patients ask: Why didn't anyone ever tell me about this bone loss? Why didn't anyone ever tell me this would happen? They have the right to know! They don't have to learn the hard way!

Today's new patient, three years post-extraction, has already lost half of her ridge height and volume. Her upper ridge was never meant to withstand the pressure generated by lower natural teeth. In five years, she'll almost be a dental cripple. In five years, her upper jaw will have shrunk to the extent that reconstructing it would be a complicated.

Dental implants preserve bone because bone responds to the stimulation it receives from them. Our new patient still has adequate bone for some upper implants and even permanent teeth fixed in her mouth! Her ridge would be preserved and she would do away with the removable denture. The implants are the treatment for the disease of bone loss. Our patient deserves to understand that now is the right time to put some implants in to maintain her bone levels. We can ensure a long term quality of life for her that's better than what she is experiencing now and far better than the future of her mouth without dental implants.

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

Teeth In A Day Guided Surgery

 

These are pictures of a patient we treated five years ago, successful both then and now.  After a CAT-Scan using a duplicate of this patient's full upper denture with radiographic markers was used to designate potential implant positions, the Nobel scanning software was used to do a "virtual surgery" on the computer.  This allowed us to create a template that was fixed in his mouth at surgery that had holes to guide implant placement without having to lay the tissue back and expose the bone.  The software also created a virtual model that facilitated our making a temporary fixed bridge in advance, to fit the implants.  The implants and bridge were placed at the same appointment.  The procedure is called "Teeth In A Day".

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

Five Important Medical Tests You Need To Take

Julie Chen, MD, in the March, 2013, To Your Health,  suggests these top five tests to see if you are generally healthy:

• comprehensive metabolic panel--a blood test to asses electrolyte and mineral levels, and liver and kidney function
• complete blood count--checks platelets, red and white blood cells
• lipid panel--checks cholesterol and triglyceride levels
• fasting glucose level--checks sugar levels
• thyroid panel--TSH levels for thyroid function, sometimes T3 and T4 also

These tests monitor your health status, and if you are taking any vitamins or medications are recommended on a yearly basis.
For greater detail, go to: www.toyourhealth.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

Breast Cancer Symptoms

The purpose of this blog is to illuminate both medical and dental issues of interest.

Thanks to screening, breast cancer often is found before a woman has any physical symptoms. Yet a woman should know how her breasts normally look and feel so that she can report any unusual changes to her doctor. Reasons to call your doctor include:

• A lump in or near your breast or under your arm
• Thick or firm tissue in or near your breast or under your arm
• A change in the size or shape of your breast
• Nipple  discharge (fluid that is not breast milk)
• Nipple changes, such as a nipple that turns inward (inverted) into the breast
• Changes to your breast skin, areola, or nipple, such as itching, redness, scaling, dimpling, or puckering

Keep in mind that most breast changes are not cancer. For instance, nipple discharge can be caused by birth control pills, some medicines, and infections. Or, a breast lump could be a cyst, which is a fluid-filled lump that is not cancer. Early breast cancer usually does not cause pain. Still, if you notice a change in your breast or pain, call your doctor and schedule a visit. Don't wait until your next 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

Dental Disease At A Young Age

Medical Conditions Can Ravage Teeth

Sometimes, medical conditions ravage teeth--as in this patient who is not yet 30 years old.
While continued retreatment of the dental decay seems to always result in failure, dental implants are not susceptible to the bacteria that cause decay.
An overall treatment plan is necessary to assess what the health of this patient's mouth will be in the future, with the goal of preserving her jawbone and creating a disease-free environment with dental implants.

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

Oral Cancer Symptoms and Appearance

Oral Cancer has Many Symptoms

Oral cancer can present with many different symptoms. Often, a non-healing ulcer (wound), whether or not it is painful, is the first presenting symptom.  A recent study suggests that the onset of orofacial pain that worsens during function may be an important predictor for the transition from oral pre-cancer to cancer. Screening patients who have new-onset orofacial pain may lead to a diagnosis of early resectable head and neck cancer, and may improve quality of life and survival rates for patients.

Various Symptoms 

Other symptoms that should raise suspicion include: white or red spots, bleeding mouth sores, increased mouth pain, loose teeth, poor fitting dentures, non-healing extraction socket, ear pain, lip or tongue numbness, difficult or painful swallowing, change in speech or a lump in the neck.

It is very important to remember that any white/red lesion or ulcer in the mouth that has not healed within three weeks should be evaluated.

Oral Cancer Screening 

Dr. Tupac provides oral cancer screening as part of new patient and patient recall examinations. He also works with Dr. Tung Trang, Chief of Head and Neck Oncology, of Kern Medical Center with the prosthetic treatment of cancer patients both in the operating room and after tumor surgery for patients recovering with surgical defects. Dr. Tupac had almost 40 years of experience in the prosthetic reconstruction of oral cancer patients to reestablish near normal function as it relates to speaking  and eating in addition to maintaining facial appearance.

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

Oral Health and Parkinson's Disease

Understanding Parkinson's Disease is Critical in our Approach to Oral Health

A prosthodontic practice has a large senior citizen contingent, and those patients have many of the diseases and conditions common with late adulthood. Understanding them is critical to our approach to dental treatment and the ability of patients to maintain their oral health.  One of those diseases is Parkinson's disease.

Severity and Symptoms Vary

The type and severity of symptoms experienced by a person with Parkinson's disease vary with each individual and the stage of the disease.

Symptoms typically begin appearing between the ages of 50 and 60. They develop slowly and often go unnoticed by family, friends, and even the person who has them.

The most common symptoms include: Tremor or shaking, in a hand, arm or leg. It occurs when awake and sitting or standing still (resting tremor) and subsides when the body part is moved.

Common Early Signs

Rigidity stiff or aching muscles. One of the most common early signs is a reduced arm swing on one side when walking that is caused by rigid muscles. Bradykinesia--slow, limited movement, especially when moving from a resting position, like getting out of a chair or turning over in bed.

Weakness of face or throat muscles affecting the ability to talk or swallow, causing choking, coughing or drooling, softer speech with a monotone. Loss of movement of facial muscles causes a vacant facial expression, called "Parkinson's mask."

Difficulty with Walking and Balance 

Gait disturbance and postural instability--difficulty with walking and balance. This causes small steps, shuffling with feet close together, a stooped posture (bent forward slightly at the waist) and difficulty turning around. Balance and posture problems may result infrequent falls. Emotional and physical stress tend to make tremors more noticeable, whereas sleep, complete relaxation, and intentional action or movement usually reduce or stop the tremor.

There are other physical and psychological symptoms that become more pronounced as the disease progresses.

Consult your Physician 

Armed with this basic information, you can approach your physician for diagnosis, advice and treatment of these symptoms occur

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

Tooth Position and Lip Support

Bone Support versus Tissue Support

When this patient was wearing removable dentures, her upper lip was flat and the corners of her mouth were wrinkled.
With All-on-4 implant bridges her teeth are now bone supported instead of tissue supported.  As a result, the teeth can be positioned to give her the same lip support she enjoyed with her natural teeth--fully contoured lips with sharply defined edges.  The sunken in "denture look" no longer exists.

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

New All-on-4 Success Rates

In this month's Journal of Prosthetic Dentistry (JPD), Parel and Phillips report on a study of implant survival rates for 558 jaws treated with 4 implants per jaw in a patient population between 2008 and 2010.  A total of 2,132 implants were placed, with only 48 failures, giving a 97.8% success rate.  Of the few failures, they were 5 times more likely in the upper jaw and more often associated with male patients, poor bone density, opposing natural teeth and the location of the most posterior implant.  Smoking, bone volume, systemic factors, addictive drug use and pathology, including the existence of periapical infections did not appear to be related to failure in this population.

Dr. Tupac has enjoyed universal success with All-0n-4 treatment.

When patients with greater risk had additional implants placed, there were no failures.

Dr. Tupac, Bakersfield's only full time Board Certified Prosthodontist, specializes in taking patients from failing teeth to implant supported fixed bridges and has been successfully treating patients in this manner for many years. 

All treatment, from diagnosis and treatment planning, to extractions and implant insertion, to fabrication and placement of the fixed bridges is accomplished in his office.

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

You Know What it's Like to Have the "Winter Blues"?

A Seasonal Funk

A seasonal funk that seems like something you have to just tough out? I remember when I was a freshman at the University of Chicago, the sun didn't come out between October and April of the next year! Everything was gray. Seasonal affective disorder is a type of depression that occurs at the same time every year. For most people with SAD, symptoms start in the fall and may continue into the winter months, sapping energy and causing moodiness. Then the symptoms go away during the sunnier days of spring and summer.

Symptoms include: hopelessness, anxiety loss of energy, heavy feeling in arms and legs, social withdrawal, oversleeping, loss of interest in activities once enjoyed, appetite changes, carbohydrate craving, weight gain and difficulty concentrating.

The Specific Causes are Still Unknown

While the specific cause is unknown, genetics, age, and the body's natural chemical makeup all play a role in developing the condition. Specific factors include the body's circadium rhythm (sleep/wake cycle), reduced serotonin levels due to reduced sunlight, and changed melatonin levels. All these factors may lead to feelings of depression.

When to see a doctor: while it's normal to have "down days", if the feeling persists for days at a time, getting motivated is difficult, sleep or eating patterns change, there are feelings of hopelessness, or you find yourself turning to alcohol for comfort or relaxation, see your doctor.

A thorough evaluation will rule out underlying physical conditions. Light therapy phototherapy is one of the first line treatments for SAD.  By sitting a few feet from and being exposed to a specialized bright light that mimics outdoor light, there is a change in brain chemicals linked to mood.  It generally starts working in two to four days and causes few side effects, and is effective for most people in relieving seasonal effective disorder symptoms.

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

Winter Relief from Dry skin

Chances are your Skin is Suffering in the Winter

Whether you're outdoors or indoors during the winter, chances are that your skin is suffering during the coldest months of the year.

In winter, the atmosphere loses moisture, and the climate strips our skin of the layer of oils, cells and lipids that normally shield us. Outside we face low humidity and wind, inside dry heat doesn't help.

Certain Products can Contribute to Dry Skin

Even products we use can aggravate existing problems. Antibacterial cleansers, fragrances and even some sunscreens can dry skin. The trick, then, is to preserve and boost your skin's natural moisture without sacrificing sun protection.

Even if you have oily skin, liquid and antibacterial soap can be replaced with a mild soap with skin cream (like Dove), or glycerin soaps like Neutrogena.

A lukewarm shower causes less lost skin moisture than a hot one.  The moisture can be replaced with a thick body lotion, applied when your skin is still damp.  Some dermatologists recommend a "shielding" lotion, like SkinCareMD, which creates a barrier between your skin and the elements.  A cream formula with mineral oil, coconut oil or other emolient also works.

Because most sunscreens are inherently drying, find a winter moisturizer that contains an SPF of at least 15.

Drink Plenty of Water

Finally, don't forget to drink!  Water, that is.  At least eight glasses of water per day keeps cells hydrated and helps skin regenerate, resulting in happy, healthy winter skin, inside and out.

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

Men Over Age 50 and Skin Cancer

Battled Skin Cancer, Twice

I have had skin cancer twice.  The first time was very serious and resulted in a six hour surgery and a resultant scar more than four inches long.  I wasn't going for regular checkups, and I had just watched the thing enlarge, for too long, not wanting to think it needed attention.  The second time, I was more proactive, and pointed it out to my dermatologist, and the removal was achieved in an office visit.  At least the scar is smaller because earlier treatment kept it from being more invasive.

The American Academy of Dermatology reports that older men should screen themselves for skin cancer.
Two studies presented at the Academy's Annual Meeting showed men aged 50 years or older are more likely to be diagnosed with invasive melanoma by a dermatologist than to detect it themselves, and they are less likely to seek a skin cancer screening due to a suspicious lesion.

Since delayed diagnosis has greater consequences, even sometimes death, my personal experience makes me encourage men over 50 to have their skin checked regularly.

For more information, check out HealthDay News.

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

Smoking and Tooth Loss

The just published Journal of the American Dental Association (JADA), March 1, 2013, cites the Buffalo OsteoPerio Study, which followed 1,106 postmenopausal women, comparing tooth loss and smoking status.
After adjusting for age, education, income, body mass index, history of diabetes diagnosis, calcium supplement use and dental visit frequency, the authors found that heavy smokers (packs smoked per day, years of smoking, pack-years and years since quitting smoking) were significantly associated with tooth loss due to periodontal disease, but not with tooth loss due to tooth decay.
Source: JADA, 3/1/2013, Vol. 144, No. 3, 252-265




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

Dry Mouth

Dry mouth (xerostomia) can be caused by prescription or over-the-counter medications. More than 500 medications contribute to oral dryness: antihistamines (for allergy or asthma), antihypertensives (for blood pressure), decongestants, pain medications, diuretics and antidepressants.

In the most severe form, dry mouth can lead to tooth decay, mouth sores and oral infections.  Half of all Americans take at least one prescription medication daily and more than 90% of adults over the age of 65 do the same. Therefore, older adults are at significantly higher risk.

"Each day, a healthy adult normally produces one and a half liters of saliva, making it easier to talk, swallow, taste, digest food, and perform other important functions that often go unnoticed," notes Dr. Fares Elias, past president of the AGD.

Treatment options are available at: 661-325-1275, 5060 California Ave #170, Bakersfield, CA 93309

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

Cleft Palate? See A Prosthodontist!

A cleft palate presents itself in a number of different ways.
Mindy had a cleft palate, with no bone and no tooth in her upper left lateral incisor location.  The adjacent teeth had shifted towards the defect, even after orthodontic therapy.  Without bone for an implant, and knowing that surgical reconstruction of the defect with a bone graft wasn't a sure thing, she chose to have a fixed bridge to replace the missing tooth and straighten her front teeth.  You can see how it worked out.


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

Why a Prosthodontist Should Place Your Dental Implant

The Prosthetically Driven Implant Industry 

Todays implant dentistry is prosthetically driven.  A Board Certified Prosthodontist can determine and visualize, by the use of detailed radiographs, CT scanning, implant guides and diagnostic tooth positioning, exactly where the final tooth positions will be.  By doing so, all surgical procedures then become tailored to achieving the best esthetic and functional result possible.  It is not enough to just put an implant into the bone and make an impression and try to make the tooth on top look good.  The direct benefits of implant dentistry are bone preservation, maintenance of facial integrity, restoration of natural biting and chewing capacity and the self confidence that a secure smile can bring. Dr. Tupac is trained in five different implant systems, and can explain which is best for your needs.  Discover your dental implant options at www.drtupac.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 (map)

How Bulimia Damages Teeth

Bulimia is an eating disorder characterized by compulsive overeating followed by self-induced vomiting or laxative or diuretic abuse.The frequent purging results in a prolonged acidic environment in the mouth, and damages tooth enamel.  This damage usually starts on tooth surfaces facing the inside of the mouth.  A prosthodontist recognizes the problem by identifying eroded enamel on chewing surfaces of back teeth, and stripping of enamel on the back of front teeth.  The overall thickness of the protective enamel is reduced, and edges of front teeth begin to wear and chip. Fortunately, these teeth can be restored, even when the damage is severe, and the patient returned to healthy function  and an attractive 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

March Focus on Colorectal Cancer Screening

Colorectal cancer is one of the cancers that is curable, if discovered and treated early.

Therefore, it is important for both men and women over the age of 50 to get screened.  The month of March is dedicated to this screening.
More information is available at:  www.healthfinder.gov

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

Custom Mouthguards Are Best

Mouthguards prevent injuries.

Over-the-counter boil-and-bite mouthguards are fitted and formed by heat, finger, tongue and biting pressure.  They have been shown to have limited protective capacity, because of poor fit, poor durability, and interference with speech and breathing.
Custom-made mouthguards, on the other hand, made on dental models of a person's teeth, are accurately adapted to the teeth, retentive, do not deform, and can be fabricated at the proper thickness to absorb and spread impact energy.
To find out more, go to:  www.dentalaegis.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

The Effects of Exercise

A preliminary study presented at the American Physiological Society suggests exercise effects the immune system. 16 cancer survivors were recruited for a 12-week whole-body exercise training program which included moderate aerobic exercise and resistance exercise.  Blood samples drawn before and after the program showed an increase in T-cells (responsible for the body's immune response) that had been quieted by chemotherapy. This suggests that the exercise stimulates the ability of the immune system to recognize cancer cells. Other Methods that Counter Cancer Other recent research has pointed to additional avenues by which exercise may reduce cancer occurrence or recurrence: one, from China, showing tai chi stimulates T-cells in lung cancer patients, and another, from the University of Colorado, involving exercise and breast cancer genes. A German study of breast cancer patients found a decline in physical activity during and one year after treatment. This may be the time when patients need to exercise the most!



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