Your Saliva Is A Fingerprint

New research shows that makeup of the bacteria found below the gumline in people's mouths is as powerful as a fingerprint in identifying ethnicity.  A Ohio State University study of 400 different species of bacteria, in the mouths of patients of different ethnic affiliations (non-Hispanic blacks, whites, Chinese and Latinos) found that only 2% of the species were found in all populations.  Thus, the different combination of species, in different concentrations, represented a "signature" of bacteria for each ethnic group.

Oral Bacteria

While it is well understood that that food and oral hygiene habits determine what bacteria survive in patient's mouths, and is affected by brushing and flossing, it turns out that genetics plays a similar role.  The most important part of the findings is that ethnicity-specific oral bacteria combinations in a person's saliva may predispose them to future disease.

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 Veneers Can Give You A Dramatic Change

For the patient who has bleached their teeth without desired results. For the patient with crooked teeth, spaces (diastemas), rotated teeth, or old unsightly fillings, porcelain veneers can provide dramatic cosmetic and esthetic changes in just two appointments. When orthodontics is not an option, correction of a smile can be a permanent benefit.

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

Health Alert: Hepatitis C Testing for Baby Boomers

The Centers for Disease Control and Prevention recommends adults born during 1945-1965 should receive one-time testing for the hepatitis C virus (HCV).  For these reasons:

• national data show this age group has a 5 times higher prevalence of the infection than other adults, and the age group makes up 75% of all those who have the disease
• HCV is the leading cause of liver transplants and liver cancer.
• a high proportion of those infected are not aware
• treatment can halt disease progression and provide a virologic cure in most infected persons.

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

Movember: Tips About Prostate Cancer

Movember is the movement during the month of November that brings awareness to prostate cancer and men's health.  Prostate cancer is the most common cancer in men and the second most common cause of death from cancer.

According to the Centers for Disease Control, in 2010 over 196,000 men in the United States were diagnosed with prostate cancer and 28,560 men in the US died from prostate cancer.  This positive approach can lower a man's risk for the disease:

• a diet high in soy products, vegetables, fish and nuts can help prevent the disease
• being active makes one healthier overall and boosts the immune system and also decreases chances of the disease
• regular, routine examinations by a physician lead to early detection and treatment and increases survival rate

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

What Do You Do If Your Tooth Is Knocked Out?

What do you do if your tooth gets knocked out?  DON'T rinse it with water!  Lick it clean and put it back in place and gently bite to hold it in position until it stabilizes.  If you need to transport it to the dentist, soak it in milk.  Tooth reimplantation does sometimes work, the sooner the better, if you're lucky.

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

Exercise Enhances Brain Power

Even for older people, physical exercise has been shown to actually increase activity in areas of the brain, and helps ward off a host of cognitive impairments and enhances brainpower all life long.  Michelle Voss, Assy. Prof. of Psychology, Univ. of Iowa, and her team examined more than 100 studies on the topic.  They found that aerobic exercise improves ability to coordinate multiple things, long term planning and the ability to stay on task for extended periods.  Resistance training, such as lifting weights, improves the ability to focus amid distracters.  MRIs of people in their 60s showed increases in gray and white matter just after six months of exercise.  This happens in the prefrontal and temporal lobes, sites that usually diminish with age.  With exercise, they grow.  Voss also explained that the hippocampus area of the brain, key for memory formation, shrinks 1% to 2% per year over the age of 60.  But if the same people begin fitness regimens, it grows by 1% to 2% instead.  Beyond growing one's brain, exercise improves the ability of different parts of the brain to work together.  Benefits can be had by simple brisk walking for 45 minutes three times per week.  

Source: Los Angeles Times  

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

Picture Perfect Smile With Veneers

Want your front teeth to be white and straight?  These four front teeth have porcelain veneers.

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

Does Taking Vitamins Prevent Cancer?

The US Preventive Services Task Force (USPSTF) is tasked with the job of weighing the benefits and harms of multivitamins for the primary prevention of cardiovascular disease (CVD) or cancer (CA).  A draft of the recommendations was recently published online in the Annals of Internal Medicine.  The Kaiser Permanente Center for Health Research reviewed two large trials of 27,658 individuals followed over a ten year period. No clear evidence of risk or benefit was found in either men or women.  Based on their findings, the USPSTF does not recommend for or against taking vitamins or minerals alone, in pairs, or as a multivitamin to prevent cardiovascular disease or cancer.

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

Minimum Age For Dental Implant?

What is the minimum age for a dental implant?  This is especially important for boys and girls who have congenitally missing teeth.  

Dental implants should not be placed until after skeletal growth is complete.   Once placed, an implant and the bone which surrounds it do not change, so we don't want the jaws and teeth around the implants to continue to develop.  

In general, boys mature skeletally between the ages of 17 and 19, girls between 16 and 18.  

How do you really tell?  A "carpal index", or wrist film (X-ray), can be taken and evaluated by a radiologist.  The film will tell if the bones of the wrist (especially the adductor sesamoid) are completely formed (ossified), the growth (epiphyseal diaphyseal) centers of the fingers (proximal, middle and distal phalanges) are fused and the growth (epiphyseal diaphyseal) center of the radius is fused. These factors suggest completion of skeletal growth.

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

Health Alert: Flu and People with Diabetes

The Centers for Disease Control and Prevention has the following recommendations.  Both type 1 and 2 diabetic patients, even when well managed, are at increased risk of severe disease and complications, like hospitalization and even death, as a result of getting the flu.  This is because diabetes can make the immune system less able to fight severe influenza disease.  In addition, illness can raise blood sugar levels.

Therefore, the CDC recommends that people with either type 1 or type 2 diabetes, who are 6 months and older, get a flu shot.  Because these patients are at an increased risk of developing pneumonia from the flu, a pneumonia vaccine is also recommended.

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 Treat the Disease of Bone Loss

The bone around tooth roots is a special kind of bone:  alveolar bone.  It receives stimulation from the roots of the teeth it encloses.  Alveolar bone is healthy unless subject to inflammation from periodontal (gum) disease, which cause it to recede, or if the forces of chewing are greater than the capacity of the bone to withstand.  The full-mouth series of radiographs above clearly shows some teeth, and some segments of teeth, to have significantly reduced levels of bone.  The one universal truth about alveolar bone is that it resorbs (shrinks) when teeth are removed, because the bone loses its stimulation.  The best thing about dental implants is that they preserve bone.  Placed as soon as possible after tooth loss, the implants stimulate bone in the same way that natural tooth roots used to.  This means that possible dental implants  should ideally be included in treatment planning before teeth are removed.  A CT Scan can be used with dental imaging software to determine the exact location, size and number of implants.  By preserving bone, dental implants counteract the results of tooth loss and aging, and help control facial changes.  They give you the security of knowing things will stay in place when you eat, talk and smile.  They contribute to your comfort, quality of life, and self esteem.

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

Skin Suffer More 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.

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.

How To Prevent Dry Skin

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.

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

Porcelain Veneer Long Term Success

Development Of Resin-Porcelain Mixtures

One of the technological benefits of the "space race" in the 1960's was the development of light weight but highly durable composite (resin-porcelain mixtures) materials.  These composites rapidly expanded into different uses and found their way into all industries, including dental materials.  Hence, tooth-colored composite "bonding" materials became highly popular.  These resin based materials had some drawbacks--tendency to wear, chip and stain, and better techniques were sought.

Introduction of Veneers

In 1982, my in-house porcelain technician and I developed a technique for fabricating veneers for teeth out of porcelain, instead of composite, made on porcelain foil. The interior of the porcelain veneer could be acid-etched and then bonded to a tooth.  I described the technique in presentations to the Pacific Coast Society of Prosthodontics in 1983 and to the California Dental Association Annual Meeting yearly from 1983 to 1987.  In 1999, I presented a 15-year retrospective on porcelain veneers to the CDA meeting, and reported an overall 15 year success rate of 97%.

Combining Veneers With Crowns

As with any technique, success leads the procedure to be used in more demanding situations.  One of these often advertised is the use of veneers in combination with crown lengthening, to create longer teeth and eliminate a "gummy smile."  These veneers inevitably have margins (edges of the veneers) on root surfaces or dentin, instead of enamel.  A recent report in the JADA Specialty Scan quotes a scientific study which shows failure rates of veneers bonded to dentin to be 10.3 times higher than those bonded to enamel, and also a high increased risk of failure associated with crown lengthening, with the most frequent failure type being fracture.

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 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.

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

We Perform Oral Cancer Screenings

Oral Cancer 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.  

More Oral Cancer 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

Osteoporosis Medications and Your Dental Health

Bone Density

As we grow older, our bones begin to lose their density and strength, especially after the age of 50. Many factors affect bone density, including diet, physical activity, family history, hormones, lifestyle and certain conditions and medications.

Bone Disease

Osteoporosis--porous bone--is a disease that weakens bones, especially hip, spine and wrist, and makes them more likely to break. It affects about 10 million Americans, 8 million of whom are women. The disease affects more women than cancer, heart disease and stroke combined. An additional 34 million Americans have osteopenia, or low bone density, and are at risk for developing osteoporosis.

Treatment

Broken bones, as a result of osteoporosis, will affect 50% of women and 25% of men over the age of 50, according to the National Osteoporosis Foundation. To prevent broken bones, many people with low bone density or osteoporosis take drugs called bisphosphonates (fosomax, boniva, actonel, reclast, etc.). Studies indicate that, in many people, these medications help reduce the chance of breaking bones by reducing bone loss and increasing bone density.

In rare cases, a condition known as osteonecrosis of the jaw (ONJ) has been reported in patients taking these medications. This rare but serious condition can cause severe damage to the jawbone. 94% of those diagnosed with ONJ are patients with cancer who are receiving or have received repeated high doses of medication through an intravenous infusion.

The benefits of these medications greatly outweigh the very low risk of developing ONJ. You should not stop taking these medications without consulting your health care provider. There is no known prevention for ONJ. However, regular dental visits and excellent oral hygiene practices may be the best way to reduce your risk.

Source: American Dental Association, JADA, vol. 142, #11, 1320, Nov. 1, 2011

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 Take Charge of Your Health Care

The more you play an active role in your health care, the better quality of care you will receive.  Most people depend upon different doctors, nurses, pharmacists and insurance programs for their health care.  It's a team effort, and you (the consumer-patient) are the most important member of the team.

To take charge, follow these steps:

1. Keep track of important health information, kept in one place.  Include: name, birth date, blood type, emergency names and phone numbers, list of medical providers, dates of checkups and tests, list of shots received, health conditions, allergies and current medications.
2. Know your family health history.
3. Keep regular checkups, because early detection means easier treatment.
4. Make the most of your doctor visits:  take a list of questions to ask, take notes on your doctor's answers, talk about changes wince your last visit, and possibly bring a relative or friend with you.

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

Chronic Obstructive Pulmonary Disease (COPD) Can Be Treated

After years of fighting chronic respiratory problems, my dear mother in law succumbed to lungs so severely depleted by infection that they no longer could sustain her.  Chronic obstructive pulmonary disease (COPD) refers to lung diseases that block airflow as you exhale and make it increasingly difficult to breathe.

Warning Signs of Lung Diseases

Emphysema and chronic asthmatic bronchitis are the two main conditions in which damage to the airways eventually interferes with the exchange of oxygen and carbon dioxide in the lungs. Signs and symptoms:  shortness of breath, wheezing, chest tightness and chronic cough.  Causes:  Chronic asthmatic bronchitis causes inflammation and narrowing of the airways that lead to the lungs and increases mucus production, which further blocks the airway.  Emphysema damages the air sacs (alveoli) in the lungs to reduce the amount of surface area available for oxygen/carbon dioxide exchange and makes the alveolar walls weaker so they collapse with exhalation and trap air.  Shortness of breath results because the chest wall muscles have to work harder to expel the air.  Risks:  Long-term exposure to irritants in tobacco smoke, dust, chemical fumes, or air pollution are typical factors.  COPD develops slowly over years, so most people are at least 40 years old when symptoms begin.  Complications:  More frequent respiratory infections that can produce further irreversible damage to the lung tissue.  High blood pressure in the arteries that bring blood to the lungs (pulmonary hypertension) and heart disease.  Tests and Diagnosis:  There are imaging (X-ray and CT Scan) tests, lab tests of blood gas analysis or sputum, or pulmonary function tests to determine the existence and progression of the disease.  If present, patients need to be treated by a pulmonologist.  There is no cure for COPD, and lung damage cannot be undone.  But COPD treatments can control symptoms, reduced the risk of complications and exacerbations and improve your ability to lead an active life.  Unlike some diseases, COPD usually has a clear cause and a clear path of prevention.  Prevention  involves reducing or eliminating exposure to risk factors.   

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 Veneers for Fractured Teeth

Veneers can Restore Your Smile 

Fall and break your teeth and they need to be protected!  Porcelain veneers are a conservative method of covering and sealing cracks and fissures while restoring teeth in a beautiful manner.

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

Experts Agree: Standard of Care for a Lower Denture is Two Implants for Retention

The standard of care for an edentulous mandible (no lower teeth) should be the two implant -retained mandibular overdenture (IRMOD).  The authors conducted a 2011 survey of U.S. academic prosthodontic experts to determine their opinions.  Methods:  a Delphi method survey was used in which consensus was defined as a 70% agreement level among panelists.  Results: Consensus favored the IRMOD for 9 of the 10 parameters assessed--retention, stability, speech, masticatory efficiency, comfort while eating soft foods and hard foods, confidence in intimate situations, satisfaction and self esteem.  The exception was aesthetics for which the majority favored the IRMOD but the number was below consensus ranking.  Conclusions:  The panelists reached consensus that they would recommend an implant retained mandibular overdenture instead of a complete denture only as the first choice of care when restoring an edentulous mandible of a healthy patient or a patient with mild systemic disease but not for patients with severe systemic disease.  

Source:  JADA,August, 2012

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

Reduce 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.

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

Are You Prepared for an Emergency?

Ask about planning at your workplace and your child's school or daycare center.  The US Department of Education gives guidelines for school preparedness.  Workers at small, medium, and large businesses should practice for emergencies of all kinds.  See Ready Business for more information.  Being prepared means staying informed.  Check all types of media "Web sites, newspapers, radio, TV, mobile and land phones" for global, national and local information.  During an emergency, your local Emergency Management or Emergency Services office will give you information on such things as open shelters and evacuation orders.
  
Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

US Periodontal Health Assessment Update

The American Academy of Peridontology (AAP) was recently invited to provide testimony to the Centers for Disease Control and Prevention's Division of Oral Health (CDCDOH) as part of the strategic planning process for 2011 through 2014. The goal is to develop a surveillance program to determine the incidence and prevalence of periodontal disease in the US population.  An initial study indicates that the incidence of periodontal disease may be two to three times higher than previous estimates.  This is important because of the growing body of research that links periodontal disease to other disease states, such as cardiovascular disease and diabetes. The testimony recommends promoting public awareness of periodontal disease prevalence in the US and the importance of periodontal health in achieving overall health. 

Source: www.jiacd.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

All-on-4: Implant-Retained Fiixed Bridge Succes for Denture Patients

Dr. Robert Tupac participated in an All-on-4 presentation at the NobelBiocare headquarters in Yorba Linda, California given by Dr. Ken Parrish.  This technique has been developed to maximize the use of available bone and to allow for immediate function.  Tilted posterior implants are placed to optimize anterior-posterior spread to provide a fixed prosthesis that has enough posterior teeth for bite support and effective chewing.  Dr. Tupac has personally performed this treatment, with great success, on more patients, over the last several years, than any other prosthodontist in the Central Valley.  This technique also allows the patient to go from wearing a removable complete denture to having implants and a temporary fixed bridge in a single appointment.  For more information, visit Dr. Tupac's website www.drtupac.com or call the office at 661-325-1275.

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