December 30, 2013

Implant Options for Denture Patients

Bar structure

In the top radiograph, six upper implants (the ones on the sides tilted backwards) and their distribution allows them to be joined by a bar structure that has teeth attached to it and the hybrid bridge is permanently screwed in place.  It can only be removed in the prosthodontic office.  The prosthesis is more like a row of teeth, has minimal soft tissue coverage, and derives all of its support from the implants.  This prosthesis is most like having your natural teeth back again.

Tissue bar

In the bottom radiograph, four upper implants are joined by a tissue bar.  The resulting prosthesis is called a tissue bar overdenture--it is a removable prosthesis that attaches with clips or snaps to the bar for stability and retention when in place, but can be taken out to allow the implants to be brushed and cleaned.  The prosthesis is horseshoe shaped (open in the center of the palate) but does cover the ridge and adequate lateral tissue for additional support.  Sometimes, when there has been a lot of bone shrinkage, the removable prosthesis allows teeth to be better placed for lip and cheek support, esthetics and phonetics.

Implants options

You don't like your complete upper denture and would like to have some implants.  What are your options?  They depend on the amount of available bone you have remaining and the dimensions in your mouth (clearance for your bite, the sizes of the structural components of the prosthesis, and proper arrangement of teeth) that are required.

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 Infections in the Mouth


HPV can infect oral tissues.  A subgroup of oral cancer clearly is associated with HPV.  Oral HPV is transmitted sexually but also can be transmitted from mouth to mouth and vertically from an infected mother during delivery.  A detailed description of the mechanism by which an HPV lesion develops into oral cancer, with pictures, is found in JADA August 2011, 142(8), pp905, at www.jada.ada.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

December 27, 2013

A Healthy Smile




A healthy smile creates a positive impression whenever it emerges.  It conveys self-confidence, warmth and beauty.  It can also represent good general health.  Our mission is to help patient's mouths look good and feel good. This is what four porcelain veneers look like on this lady's four front 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

Lupus Treatment: Oral and Dental Complications


Syndrome of Lupus

All Lupus patients suffer from some sort of oral involvement, and these complications often come about as a side effect of medical treatment. Certain forms of organ involvement carry dental warnings: with kidney involvement, certain antibiotics (tetracycline) or analgesics (aspirin, NSAIDS) adversely affect kidney function. Antibiotics need to be given prior to treatment for those with Liebman-Sacks Endocarditis (a form of heart involvement) or mitral valve prolapse. Nitrous Oxide (laughing gas) is contraindicated for those with lung problems. Caution should be taken with patients with abnormal bleeding. Those with Sjogren's Syndrome usually have severe dry mouth that may result in massive decay, dental infections, yeast infections and gum disease.

Oral Health 

Medications: Anti-convulsants can cause gum atrophy and bleeding. Anti-malarials (plaquenil) can cause intraoral rashes. Immunosuppressive agents (methotrexate) suppress the immune system and may result in bacterial or fungal infections. NSAIDS (advil, motrin, feldene, daypro) can cause oral ulcers. Steroids--prednisone and other corticosteroids increase the likelihood of bacterial and oral fungal infections. Any medications which cause dry mouth put the patient at risk for tooth decay and gum disease.

Lupus patients require frequent dental checkups and periodontal maintenance to optimize their oral health.


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 23, 2013

Why Gum Health Can Worsen With Age


Gum Health

New Research from Queen Mary, University of London, in collaboration with research groups in the United States, may elucidate the reasons behind deteriorating gums as we age.  According to the study, published in Nature Immunology, the worsening of gum health, common with aging, is associated with a drop in the level of a chemical called Del-1.  In the study's abstract, authors wrote that aging is "linked to greater susceptibility to chronic inflammatory diseases, several of which, including periodontitis, involve neutrophil-mediated tissue injury."  The authors report finding "aging associated periodontitis was accompanied by a lower expression of Del-1, an endogenous inhibitor of neutrophil adhesion dependent on the integrin LFA-1."  

Prevent Gum Disease

According to a news release from the university, authors believe understanding more about Del-1 and its effects on the body's immune system could help in the treatment or prevention of serious gum disease.  The study compared gum disease in young and old mice and found that an increase in gum disease in the older animals was accompanied by a drop in the level of Del-1, a protein known to restrain the immune system by stopping white blood cells from sticking to and attacking mouth tissue.  Mice that had no Del-1 developed severe gum disease and elevated bone loss and researchers found unusually high levels of white blood cells in the gum tissue.  When they treated the gums of the mice with Del-1, the number of white blood cells dropped and gum disease and bone loss were reduced.

Source:  nature.com/ni/journal/v13/n5/full/ni2260.html

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

It's Never Too Late To Quit



After having celebrated the annual Great American Smokeout last month, and looking forward to New Year's resolutions, smokers may be thinking of quitting.  It's never too late!

More than any lifestyle choice a person can make, quitting cigarettes will have the most positive impact on general health status.  This is what happens after quitting:
  • 20 minutes after stopping smoking, the heart rate becomes normal
  • 12 hours after stopping, the carbon monoxide level in the blood drops to normal
  • 2 to 3 weeks after stopping, coughing and shortness of breath decrease
  • 1 year after stopping, the added risk of coronary heart disease is half that of a smoker's
  • 5 to 15 years after stopping, the risk of having a stroke is reduced to that of a nonsmoker
  • 10 years after stopping, the chance of death by lung cancer is reduced to half of what it was when smoking
The National Cancer Institute's website at www.smokefree.gov provides science-driven tools, information, and support for those who quit.  It has state and national resources, free materials, and quitting advice from NCI.

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, 2013

Preschoolers Need Tooth Brushing



The number of preschoolers requiring extensive dental work suggests that many parents are not enforcing daily teeth brushing.  The Centers for Disease Control and Prevention noted an increase, the first in 40 years, in the number of preschoolers with cavities.  Dentists nationwide are seeing, at all income levels, sometimes six to ten cavities or more.  The level of decay, they added, is so severe that they recommended using general anesthesia because young children are unlikely to sit through such extensive procedures while they are awake.  The growing problem is due to a combination of reasons:  endless snacking, juice or sweet drinks before bedtime, leaving a bottle of milk in the crib, parents who choose bottled water instead of fluoridated tap water, and lack of awareness that infants should, according to pediatric experts, visit a dentist by age 1 to be assessed for future cavity risk, even though they may have only a few teeth.  Lax parenting when it comes to brushing or pacifying kids by giving them a sippy cup all day are important causes.

Reported in the New York 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

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

December 18, 2013

Smoking Still Popular in Middle and High School



The latest statistics released from the Centers for Disease Control, analyzed from data from the 2012 National Youth Tobacco Survey, address the prevalence of current tobacco product use in the youth population.  They show:
  • 6.7% of middle school aged youths smoke
  • 23.3% of high school youths smoke
  • cigars were the second most commonly used tobacco product, behind cigarettes
  • electronic cigarette use increased significantly from 2011 to 2012 among both groups
  • hookah use increased in high schoolers
These statistics emphasize the need to continue monitoring and prevention of youth tobacco use.

Source: CDC Morbidity and Mortality Weekly Report, 11/15/2013

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

FDA Approves Breakthrough Hepatitis C Drug



For most of the last 20 years, the standard treatment for hepatitis C involved a grueling year-long program of oral and intravenous medications that caused nausea, fever, headaches and cured fewer than half of patients.  Then, in 2011, two new drugs were approved that raised the cure rate to about 65-75%, when combined with the older treatments.

Hepatitis C Symptoms

Between 3 million and 4 million Americans are estimated to carry the blood-borne virus, though most do not even know they are infected.  Others have tested positive but are waiting for more effective treatments to become available.  Hepatitis C symptoms may not appear until two or three decades after infection, though the virus can cause liver failure, cirrhosis and cancer if left untreated.  An estimated 15,000 people in the U.S. die each year from the disease.

The federal government is urging all baby boomers (those born between 1945 and 1965) to be tested.

Treatments for Hepatitis C

The newly approved medication is taken orally once a day for twelve weeks in combination with the older oral and injectable treatment.  Studies have shown this new medication increases the cure to as high as 90%.

As found in HUFFPOST HEALTHY LIVING.

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, 2013

Seniors: Exercise To Think More Clearly



Regular exercise can help people with dementia think more clearly and care for themselves better.

A study analyzed 16 trials, of over 1000 patients, from Canada to Los Angeles.  The trials differed in terms of types of exercise programs, level of dementia of the participants, and care settings.

There was universal agreement that exercise is not only beneficial for older adults in general, but also for persons with dementia, in terms of delaying memory problems, improved cognitive functioning and ability to perform activities of daily living.

For greater detail, go to: The Cochrane Library

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

Neonatal Abstinence Sydrome



In this country, almost 14,000, or one infant each hour is born having signs of drug withdrawal.  Neonatal abstinence syndrome is characterized by a range of symptoms and signs, including irritability, feeding intolerance, hypertonia (heightened muscle tone), tremors, respiratory distress and seizures.

Neonatal Syndrome

From 2000 to 2009 in the U. S., the yearly rate of maternal opiate use grew almost 5 times, while diagnosis of neonatal abstinence syndrome in infants grew nearly 3 times.  Research revealed that 16.2% of pregnant teenagers and 7.4% of pregnant women between the ages of 18 and 25 years make use of illegal drugs. 

Compared to all other hospital births, neonatal syndrome babies had a 31% greater incidence of respiratory distress, a 20% greater incidence of low birth weight, a 19% greater incidence of feeding difficulties and a 2.3% greater rate of seizures.

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 16, 2013

Mammography Screening Increases Breast Cancer Treatment Success



At the 2013 San Antonio Breast Cancer Symposium, the American Cancer Society presented an analysis of a broad range of studies regarding the absolute benefit of mammography screening and breast cancer mortality.

Researchers considered national and international reviews of the subject.  After standardizing the analysis of the studies, which included screenings from the age of 50 years and breast cancer death rates from the ages of 55 to 79 years, regarding the same exposure to screening, similar target population, period of screening and duration of follow-up, the conclusions were definite.

All of the reviews indicate a substantial reduction in breast cancer mortality with screening.

Source: Robert Smith, PhD, senior director of cancer screening, American Cancer Society

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

Obesity Treatment Resources



The Obesity Action Coalition and the American College of Physicians have a new free resource.  Information from the Center for Nutrition and Weight Management at the Geisinger Obesity Institute and the Washington Center for Weight Management and Research is also available.

Visit: www.obesityaction.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

December 12, 2013

Pinning Down Prostate Cancer Risk



The British Medical Journal has recently published a controlled study of over 21,000 men between the ages of 40 and 55, to determine the association of PSA scores during that age range and subsequent risk of prostate cancer metastasis and mortality.  They found that PSA concentration can be used to predict long term (up to 25 or 30 years) risk of metastasis or death from prostate cancer.   They found that testing before the age of 45 was not diagnostic.  They found that, for those with below average PSA scores before age 55, screening was necessary only every 10 years.  They found that the group with the highest scores before age 55 required closer and more frequent screening to enable the disease to be treated as soon as possible.

Source:  www.bmj.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

Your Appearance and Getting a Job



In America, most people--including employers--make instant judgments based on appearance, including someone's smile and teeth.  We associate how one presents their oral health with all kinds of biases that reflect some of the social biases we have.  Those views can prevent potential employers from recognizing potential assets.  If a job requires social interaction with the public, a customer service job or good entry-level job may only be available to those who can smile, function or chew properly.

The problem is partly based on appearance, but also on the health effects of poor dental care, which have been linked to heart disease, diabetes and stroke.  Employers do not like those working for them to miss work, and when employees don't feel good, their performance suffers also. The problem is also embarrassing.  Studies show that when people have good dental health, chances of employment increase.  Your local Board Certified Prosthodontist is best able to offer you the alternatives you need to have a 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 11, 2013

Breast Cancer Prevention: Recommendations



The United States Preventive Services Task Force (USPSTF) has published draft recommendations for preventive therapy in women with high risk of breast cancer.  Risk assessment is based on the National Cancer Institute (NCI) Breast Cancer Risk Assessment Tool, which predicts 5-year cancer risk based on an individual's age, family history, ethnicity, age at first menstruation, age at first live childbirth, and personal history of ductal carcinoma, lobular carcinoma, or breast biopsies.

The recommendations are for women between the ages of 40 and 70, who have no prior diagnosis of invasive breast cancer, ductal cancer, lobular cancer, and no history of blood clots or stroke.  Preventive therapy using tamoxifen or raloxifene in this group was shown to reduce the risk of invasive breast cancer by 30-56%.

For greater detail, go to: 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

Are You Having A Stroke? Signs, Types & Symptoms


What is a Stroke?

Can you tell if you're having a stroke?  A stroke occurs when the blood supply to part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and food.  Within minutes, brain cells begin to die.  A stroke is a medical emergency and therefore prompt treatment is crucial.  Early action can minimize damage and complications.  The good news is that they can be treated and prevented.

Stroke Signs

How do you know if you or someone else may be having a stroke?  You may have trouble walking, stumble, feel dizzy or lose balance or coordination.  You may have trouble with speaking and understanding, slurring or an inability to find the right words to explain what you feel.  You may experience sudden paralysis or numbness on one side of your body or face.  See if you can raise and hold both arms above your head.  You may have sudden blurred or blackened vision or may see double.  You may have a sudden very severe headache.  

Types of Strokes

The most common (90%) type of stroke is the ischemic stroke--caused by blockage in an artery.  A ministroke--a transient ischemic attack (TIA)--is a brief episode of symptoms caused by a temporary blockage, and requires medical attention also.  Strokes are more prevalent with a personal or family history of heart disease, being age 55 or older, high blood pressure, high cholesterol, smoking, diabetes, being overweight or obese, binge drinking or cocaine and methamphetamine use.  Emergency treatment is directed at restoring blood flow to the brain.  Further measures can be undertaken to reduce the risk of further strokes.  After that, care focuses on helping you regain your strength, recover as much function as possible and return to independent living.  

Knowing your stroke risk factors, following your doctor's recommendations and adopting a healthy lifestyle are the best steps you can take to prevent a stroke. 


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, 2013

Board Certified Prosthodontics: Comprehensive



Treatment Options

Sometimes people are desperate, but are not willing to do what they need to do, even when they are able.  As a Board Certified Prosthodontist, while we very much enjoy "single tooth" dentistry--crownsveneerssingle implants, etc. (and do these things with the most current technologies available)--we see many patients who have been told they are at the end of the line.  These patients have multiple problems: missing teeth, broken down teeth, gum disease and bone loss.  As difficulties increase, people can feel overwhelmed.

At any stage of dental disease, however, there are always options!  The beauty of a comprehensive examination and evaluation is that it includes discussion about needs, wants and priorities.  In this manner, treatment options are considered in terms of benefits and expectations.  

Today there are more ways to achieve a great smile and have function, too.  We can find a worthwhile solution that fits! 


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 Care For Dentures



Careful daily removal of the bacterial and fungal biofilm present in the mouth and on complete dentures is important to minimize denture inflammation (stomatitis) and to help contribute to good oral and general health.  The latest evidence in the literature recommends that patients who wear dentures should do the following:
  1. daily cleansing by soaking is superior to denture creams and pastes and less abrasive
  2. denture cleansers should only be used outside the mouth
  3. dentures should be thoroughly rinsed after cleaning before reinsertion into the mouth
  4. dentures should never be placed in boiling water, because they will warp
  5. dentures can be soaked in diluted bleach solutions but only for 10 minutes or less
Your local Board Certified Prosthodontist (denture specialist) can help you with your dentures.

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 09, 2013

The Size of Your Smile




Remaking this patient's smile was accomplished with 10 porcelain veneers on her upper teeth and 10 on her lower.

What the size of your smile says about you is explored in today's social media and healthy living literature. There is even a study of the Baseball Register in the British Medical Journal that showed people with big grins lived longer!

We all know how smiles are contagious!  :)

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

Cigar Smoking and Cancer


Cigarettes vs Cigars

Cigarette smoking causes cancer.  Is it the same for cigar smoking?  Cigars are composed usually of a single type of tobacco, rather than a blend, which is air-cured and fermented.  While a cigarette contains less than one gram of tobacco, a cigar can have up to 20 grams of tobacco.  The National Cancer Institute has established that cigars:
  • have a higher level of cancer-causing substances (nitrosamines) than cigarettes
  • have more tar, for every gram of tobacco smoked
  • have a higher level of toxins, because the wrapper is nonporous and the burning of the tobacco is less complete, resulting in higher concentrations of toxins


Cigars Causes Cancer

Cigars cause cancer of the oral cavity, larynx, esophagus and lung.  It may also cause cancer of the pancreas.  Daily smokers, particularly those who inhale, are at increased risk for developing heart disease.
Even if smoke is not inhaled, high levels of nicotine are absorbed through the lining of the mouth.  Since a single cigar can potentially provide as much nicotine as a pack of cigarettes, cigars are addictive.

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, 2013

Dental Implants The Secure Solution



Just yesterday, we had two new patients who were wearing upper removable partials replacing some missing front teeth.  Their stories were similar:  every few years their gums change and the partials had to be remade. The partials moved around and they were self-conscious that people could tell the teeth were loose.  The movement made them guarded with their smiles and speech, because they had to hold the partials in place as they talked.  There were some foods that were best avoided.

Implant The Quality In Your Life

Fortunately, as long as you are healthy, it's never too late for dental implants.  Teeth on implants are secure and comfortable.  By allowing you to smile, speak and eat with confidence, they improve your quality of life.

If you are missing teeth and are interested in this solution, give us a call!

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 Fluoride Works To Prevent Tooth Decay


A  report in the journal Langumirof the American Chemical Society, gives evidence of how fluoride in drinking water, toothpastes, mouthrinses, and other oral care products prevents tooth decay.  Fluoride penetrates a thin layer to harden the enamel on the tooth surface.  In addition, it also works by impacting the adhesion force of bacteria that stick to the teeth and produce the acid that causes cavities.  By reducing the ability of decay-causing bacteria to stick on teeth, it is easier to wash away the bacteria by saliva, brushing and other activities.

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, 2013

Walk It Off


Benefits of Exercise for Cancer Patients 

The benefits of exercise for cancer patients are well known:  in both younger and older patients, physical activity improves quality of life, reduces fatigue and shortness of breath, and speeds recovery after surgery.

More than just a feel-good remedy, moderate physical activity, such as walking 3-5 hours per week,  reduces the risk of cancer recurrence and significantly improves survival after treatment.

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

Sealants Prevent Decay At All Ages


Causes of Tooth Decay 

In the United States, approximately 41% of children have decay in their baby teeth, and 42% ages 6-19 have decay in permanent teeth.  Decay on the chewing surfaces of molars (primary and permanent) represent the vast majority of cavities and chewing surfaces of teeth are the place where pit and fissure sealants are the easiest to apply and the most effective.

Sealants Reduce Tooth Decay

Decay reductions of up to 90% have been reported with the use of pit and fissure sealants when recall appointments and maintenance were included.  Sealants are more effective than just the application of topical fluoride.  They can halt the progression of incipient decay lesions. Pit and fissure sealants can be placed on permanent teeth of patients at-risk for decay, independent of the age of the patient.

Source: Dr. Fiona Collins, www.dentallearning.net

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, 2013

Smokeless Tobacco and Cancer

Smokeless tobacco is tobacco that is not burned.  It is available in different forms: chewing tobacco is loose leaves or bricks, and snuff is finely cut or powdered and either loose or in pouches.

Risk of Cancer

Smokeless tobacco contains at least 28 chemicals that have been found to cause cancer.  The level of tobacco-specific nitrosamines, formed during the growing, curing, fermenting and aging of the tobacco, is directly related to the risk of cancer.

The International Agency for Research on Cancer has reported that smokeless tobacco causes oral cancer, esophageal cancer and pancreatic cancer.  Furthermore, it is associated with and may cause heart disease, gum disease and oral lesions other than cancer.

Smokeless Tobacco Is Additive

Smokeless tobacco is also considered addictive because of the amount of nicotine absorbed by the lining of the mouth.  When absorbed through mouth tissues, the nicotine goes directly into the bloodstream and is transported to the brain.

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 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.  


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

December 02, 2013

Oral Health--Osteoporosis Connection

What is Osteoporosis

Osteoporosis is a disease characterized by reduced density of bones, and subsequent tendency to fracture, caused by aging, menopause, and lack of vitamin D and calcium.  More women than men are affected by the condition.

Osteoporosis Affects Teeth

For those people with teeth, studies have shown that osteoporosis affects the bone surrounding the roots of the teeth, resulting in loss of bone height or causing tooth mobility.  Gingivitis refers to inflammation of the gum tissues.  When that inflammation spreads deeper, below the gumline, to the tissues that attach to the root or are close to the bone around the roots, then the condition has become periodontitis.  Therefore, for the patient with osteoporosis, who also has gum inflammation, there is a greater risk for that inflammation to progress to periodontitis and cause tooth loss.

For the patient who has no teeth and wears complete dentures, osteoporosis causes more rapid loss of the bone that forms the ridges upon which the dentures rest.  Less bone means a denture with less retention and stability, with concomitant discomfort and lack of function.  This bone loss also requires the dentures to be relined or replaced more frequently.

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