Antibiotics Aren't Always the Answer

Colds and many other upper respiratory infections, as well as some ear infections, are caused by viruses, not bacteria. If antibiotics are used too often for things they can't treat—like colds or other viral infections—they can stop working effectively against bacteria when you or your child really needs them. Antibiotic resistance—when antibiotics can no longer cure bacterial infections—has been a concern for years and is considered one of the world's most critical public health threats.

CDC efforts have resulted in fewer children receiving unnecessary antibiotics in recent years, but inappropriate use remains a problem. Widespread overuse and inappropriate use of antibiotics continues to fuel an increase in antibiotic-resistant bacteria.

Antibiotic resistance is also an economic burden on the entire healthcare system. Resistant infections cost more to treat and can prolong healthcare use. Read more

Source:  http://www.cdc.gov/Features/GetSmart/

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 Dentures Need Proper Placement

When teeth are removed, our jawbone begins a continuous, lifelong process of resorption, or shrinkage.  The pressure from dentures on gum tissues also cause shrinkage, since gum tissues were never intended to withstand chewing forces.  Dentures that don't fit properly cause even greater and more rapid shrinkage.  How do you know when it is time to get a new set of dentures?

New Set of Denture

If you're like most people, you'll find high quality, well-fitting dentures restores your youthful appearance, allows you to eat most of the foods that you love, helps you feel better about yourself, eliminates embarrassment, enables you to speak more clearly and may even help with digestion!

A set of dentures is not meant to last forever because your denture was made to fit the original shape of your oral anatomy and that shape changes as the bone and gums underneath recede.  Often you don't notice the gradual shrinkage that causes them to loosen and become unstable, affecting you in a number of different ways.  If your denture slips and moves, if words are difficult to form, if you can't chew as easily as before, or if lack of facial support has given you the collapsed "denture look",  then it's time to get your smile back with a new set of dentures.  The new set will make you look better and feel younger, speak more clearly and enhance your chewing ability.

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

Do You Have Sleep Apnea

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

Types of Sleep Apnea

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

How Does Sleep Apnea Affect Rest?

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

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

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

Why Gum Disease has Warning Signs

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

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

What are the signs of gum disease?

• red, swollen or tender gums or other pain in your mouth
• bleeding while brushing, flossing, or eating hard food
• gums that are receding, making the teeth look longer
• loose or separating teeth
• pus around the gumline
• sores in your mouth
• persistent bad breath
• a change in the way your teeth fit together when you bite

Left untreated, gum disease leads to tooth loss.  If you have any of the problems listed above, and they persist, then it's time for a dental checkup!

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

Decrease Colorectal Cancer Risk With Regular Doctor Visits

A study published in the Annals of Internal Medicine measured colorectal rates for over 200,000 people between the ages of 67 and 85 and showed, over a ten year period (1994-2005), that higher utilization of primary care among Medicare beneficiaries reduces both cancer incidence and mortality.

Regular Checkup

Primary care visits in the 4- to 27- month period before colorectal cancer diagnosis was assessed.  Patients with five to ten primary care visits had lower incidence and mortality rates compared with patients with no more than a single primary care visit.

This study adds to the significant amount of evidence that regular medical checkups can result in a healthier and longer life.

Source: Ann Intern Med. 2013;159(7):437-44


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

More Than Normal Wear and Tear: Bite Disease

Prosthodontists are interested in your bite, the way your teeth come together and mesh together--and that is known as your "occlusion".  Jose-Luis Ruiz, DDS, FAGD, in Inside Dentistry, noted in an excellent monograph that "occlusal disease" impairs normal function:

• masticatory: chewing difficulty due to muscle pain, tooth pain, missing teeth, and jaw joint problems
• phonetic: tooth fractures, tooth mobility and bone loss lead to missing teeth
• esthetic: disfiguring tooth wear and tooth loss caused by fractured teeth
• periodontal and endodontic problems

Signs and symptoms include pathological wear, tooth sensitivity, tooth mobility, cracked teeth, bite sensitivities, vertical bone loss, pain and tired chewing muscles, and jaw joint pain.  Dr. Ruiz states that Occlusal Disease cannot be cured but can be managed with proper therapy.

For the entire article: www.dentalaegis.com/id/2014/01

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 Survival Best with Surgery First--Study

ChemotherapyAdvisor continues to be a superb source of cancer-related news.  A study reported by JAMA Otolaryngology-Head and Neck Surgery, under the direction of Dr. Steven Chinn of the University of Michigan, retrospectively evaluated 19 patients who had surgically treated advanced oral cavity squamous cell carcinoma.  The study groups were divided according to chemoradiotherapy first and then surgery and surgery first and radiotherapy.  Statistical analysis showed a significantly greater five year survival rate for those patients who were treated with resection surgery first.

For details: 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

Pancreatic Cancer Biomarkers Found in Saliva

The Journal of the American Dental Association this month reports a study at UCLA that identified salivary biomarkers for pancreatic cancer.  Dr. David Wong, previously featured in this blog, in the Journal of Biological Chemistry, conducted a study on mice which showed that pancreatic tumor derived molecules are transported from the source of the tumor into saliva as biomarkers.  The importance of the study is that systemic disease can be detected in saliva, which represents a significantly less invasive diagnostic test than previous methods.

Source:  JADA, Jan 1, 2014, vol. 145, p. 20


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

Dentures:: How Would You Like Your Teeth To Be?

When a prosthodontist makes a new set of dentures for a patient, there are several things that can be changed in order to recapture the look you want as a patient.  If you've worn the same set of dentures for a long time, your ridges have shrunk.  As a result, your bite has become closed down and getting back the height of your bite will give you a more normal dimension in the lower third of your face.  In addition, your old teeth seem to have receded and putting the new teeth back where your natural teeth used to be results in better lip and facial support.

You will be a partner in the process.  By seeing your teeth before they are finished, you can be sure they aren't too big or too small, they're straight or irregular, your midline is correct, and they are the color you desire.


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 Would Change In Your Life If You Fixed Your Teeth?

As a board certified prosthodontist, our entire office is interested in you as a person.  We are all husbands or wives, siblings, sons or daughters.  Our job is to do not what's best for us, but what's best for you!  We care about what you do, your family, hobbies and past dental experiences.  We'd like to eliminate any obstacles to starting treatment.  We're happy to share stories of how dental work has transformed other patients' lives.  If we did it for them, we can do it for 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

Baby Boomers And Cancer

According to the Journal of the American Medical Association, ten thousand baby boomers reach the age of 65 each day in the United States.  It is estimated that the incidence of cancer in this group will increase 67% between 2010 and 2030.

The geriatric population is complicated by age-related physical and psychological changes.  As a result of living longer, they have more involved medical histories.  This population of cancer patients is bound to put a strain on the medical delivery system.

To read an article on possible solutions, see: www.chemotherapyadvisor.com on the care of geriatric cancer patients.


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

Do You Have Sleep Apnea?

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

Types of Sleep Apnea

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

Normal Sleep 

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

Diagnosis of Sleep Apnea

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


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

Burning Mouth Syndrome

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

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

Treatment  involves behavioral strategies, topical therapies and systemic approaches.

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

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

Cancer Survival Rates Increasing

The current report in Cancer reports that death rates from cancer continue to decline in the United States.  Researchers from the National Cancer Institute found an annual 0.4% per person decrease in cancer incidence rates between 2001 and 2010.  Rates were stable among women, but declined by 0.8% per year among children and 0.6% per year among men.

Details of the decrease rates, by population group and type of cancer, can be found in Cancer, 2013,doi:10:1002/cncr.28509 

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 Diet to Fight Type 2 Diabetes

Mediterranean Diet

Researchers studied more than 22,000 participants over an eleven year time period.  They then took those who had developed type 2 diabetes and monitored their dietary habits.  The researchers constructed a 10-point "Mediterranean diet score" (MDS) and a similar scale to measure the available carbohydrate (or glycemic load{GL}) of the diet.

A Mediterranean diet features the use of extra virgin olive oil, which leads to a high ratio of monounsaturated fats to saturated fatty acids.  The diet recommends fish and lean meats, whole grains, legumes, fruits and vegetables, and nuts.

MDS Score vs GL Score

People with an MDS score of over 6 were 12% less likely to develop diabetes than those with a score of 3 or below.  Those with the highest available carbohydrate in their diet were 21% more likely to develop diabetes than those with the lowest.  Those people with both high MDS and low GL had a 20% less chance of developing type 2 diabetes.  In addition, they found that it was the dietary characteristics, according to these two measures, rather than gross weight (or overweight) that was significant.

Further information may be found in: Health Blog, Mediterranean Diet Protects Against Type 2 Diabetes


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 Year's Resolution: Lose Weight and Lower Cancer Risk!

Pancreatic Cancer

Two recent studies significantly correlate weight loss and cancer risk:

The Journal of Clinical Oncology, reported (online 10-21-2013) data from the Brigham and Women's Hospital in Boston, from 902 patients, and the association of pancreatic cancer survival and prediagnostic BMI.

Researchers found a significantly higher risk of death from pancreatic cancer for patients with BMI>35 kg/m (obesity) than those with a BMI of less than 25.  It is theorized that chronic alterations in systemic metabolism, associated with obesity, are the reason.

Belly Fat

A study from the Mayo Clinic, reported in Clinical Gastroenterology and Hepatology systematically reviewed and (meta) analyzed the association between belly fat (central adiposity) and esophageal inflammation, metaplasia and adenocarcinoma.

Researchers found that, compared with patients with normal physique, those with increased belly fat (the amount of belly fat was independent from the patient's BMI and also from the existence of gastroesophageal reflux disease {GERD}),  had significantly increased risk of esophageal inflammation, erosion and cancer.

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 Risk of Heart Disease and Stroke

A systematic review of 28 different studies by researchers from Harvard Medical School assessed two things:  the risk of heart disease and stroke among patients with lupus compared to those without the disease, and which factors can increase the risk of heart disease and stroke for those with lupus.

The findings:

• those with lupus had at lease a two to threefold increased risk of heart disease and stroke compared to those without lupus
• if those with lupus had added risk factors (smoking, increased age, high blood pressure and high cholesterol) there was even a higher risk

For those with lupus, the above facts underscore the importance of prevention:  regular exercise, not smoking, eating a healthy dies to control cholesterol, and controlling blood pressure.  Those with lupus must work with their physicians to monitor their health status and potential 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

Prediabetes and the Risk of Diabetes

The Centers for Disease Control estimates that 1/3 of adults in the United States has prediabetes: 79 million Americans, half of all Americans aged 65 years or older, and that 15% to 30% of people with prediabetes will develop type 2 diabetes within 5 years.

If these risk factors apply to you, seek medical attention:

• age 45 or older
• overweight
• family history of diabetes parent or sibling
• background--African-American, Hispanic/Latino, American-Indian, Asian-American or Pacific-Islander
• history of diabetes during pregnancy (gestational diabetes) or giving birth to a baby weighing 9 pounds or more
• physical activity less than three times per week

Early diagnosis and treatment and lifestyle changes can prevent serious medical consequences!

Source: www.cdc.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

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

Missing Teeth and Diabetes

A study of 2,508 participants in a diabetes database compared to patients without diabetes shows some remarkable statistics:

• Among adults with natural teeth, those with diabetes have, on average, lost 50% greater numbers of teeth than those without the disease
• Among adults with no teeth (edentulous),  those with diabetes are twice as likely to have no teeth that those without the disease

One in every five cases of edentulism in the United States is linked to diabetes. 

JADA, vol. 144, no. 5, 478-485

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.

Source:  evidence-based guidelines from the AmericanCollege of Prosthodontists as commissioned by the American Dental Association

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 is Peri-implantitis?

Risk Factors in Implants Failure

Peri-implantitis is a more serious disease distinguishable from the condition of peri-implant mucositis.  It is characterized by an inflammatory process around an implant, which includes both soft tissue inflammation and progressive loss of supporting bone beyond biological bone remodeling.  It is present when there is bleeding on probing and/or suppuration and detectable bone loss.  Since after all dental implants are placed, the bone undergoes a process of remodeling that results in the loss of an average of 1mm of bone height, the only way to document further bone loss is by comparison to a baseline radiograph obtained at the time of suprastructure placement, or by (if no baseline radiograph is present) using a threshold vertical distance of 2mm from the expected marginal bone level following remodeling post implant placement.  Risk factors include:

• previous periodontal disease--does not affect implant survival rate, but is a more frequent finding in patients with a history of periodontitis
• poor plaque control or difficulty cleaning due to prosthesis design dictated by esthetics, phonetics and function
• residual cement that provides a positive environment for bacterial attachment
• smoking--a 3.6 to 4.6 times greater risk of inflammation
• genetic factors that contribute to patient susceptibility
• diabetes--which affects tissue repair ability and defense against inflammation
• possible bite overload

Diagnosis of Peri-implantitis

The presence of bone loss and probing depth alone is not enough to make the diagnosis.  Only in the presence of bacterial inflammation, is bone loss, seen over time, definitive for peri-implantitis.  Non-surgical therapy has not been shown to be effective in the treatment of peri-implantitis, therefore surgical intervention is necessary, and there are several ways to do it.  An understanding of peri-implant mucositis and peri-implantitis underscores the importance of regular monitoring and professional care for dental implants as well as natural 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

Protect Your Baby's Teeth From Your Cavities!

The American Dental Association points out that cavity-causing bacteria can be transmitted to babies by parents licking their pacifiers or by sharing eating utensils.

The ADA and the American Academy of Pediatrics agree that breast feeding is both the most complete form of nutrition for infants and an immunity builder.  The ADA recommends that parents train their children by brushing their teeth and wiping their gums from the time that their teeth begin to erupt into their mouth.
The ADA also recommends that children receive their first dental visit within six months from the time or the eruption of the first tooth in their mouth and no later than their first birthday.

Source:  www.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

What To Do With A Cold Sore

Cold sores usually clear up without treatment.  In the meantime, the following steps may provide relief:  

Topical ointments:  lidocaine, or benzocaine (Zilactin) can help ease discomfort.  Benzocaine should not be used in children younger than 2 without a doctor's orders.  For adults, never use more than the recommended dose.  

Oral antiviral medications:  these may modestly shorten the duration of cold sores and decrease pain, if started very early.  They include: acyclovir (Zovirax), Famciclovir (Famvir), and Valacyclovir (Valtrex).  These may also be prescribed to prevent a recurrence of cold sores if you have frequent bouts of them, experience significant related illness during an outbreak or have an identifiable trigger of cold sore recurrences--such as intense sunlight--and you anticipate exposure to that trigger.  Over-the-counter pain relievers (aspirin, tylenol, advil) may also help.  Applying ice or warm compresses to the blisters may ease the pain.  

Most important:  let it heal without squeezing, pinching or picking at any blister.  

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

Successful Long-Term Removable Partial Treatment

A study of clasp-retained removable partial dentures covering a period of 25 years showed a survival rate of about 90% (89.8) after 10 years.  Published in the March/April 2012 issue of the International Journal of Prosthodontics, investigators in the Regensburg, Germany, University Medical Center, explored the survival rate of 174 partials made in the Department of Prosthodontics between 1984 and 2009.  They analyzed the frequency of and time to fracture of clasps, connectors or bases, the occurrence of decay or gum infections, loss of critical teeth and the need for maintenance procedures such as relines or adjustments.  The survival rates for all partials was 96.4% after five years and 89.8% after ten years.  Clasp fractures were the most common problem, occurring in one in five partials in five years and one in four partials in ten years.  New decay rates and periodontal problems were mostly manageable at normal recall visits during the ten year period.  According to these statistics, a removable partial denture can be considered a durable and long lasting prosthesis.

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

Drug Addiction and Statistics Infographic

Alcohol is the most commonly used and abused drug among youth in the US. More than half of American over the age of 12 consume alcohol. And another 30 million use or abuse recreational drugs and prescription medications. See the infographic for more drugs facts.

Source: Aboutaddictionfacts.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

How Shift Work and Sleep Deprivation are Linked

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

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

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

Get a Bone Density Test

How to check your bones

A bone density test measures your bone strength and if you are at risk for osteoporosis. The test is painless and is like an x-ray scan of your body and takes about 15 minutes.

If you are a woman age 65 or older, schedule a bone density test.  If you are a woman between 50 and 64, ask your doctor if you need one.  If you are a man over 65, discuss it with your doctor.

Osteoporosis is a bone disease that has no signs or symptoms.  It weakens bones and makes them more likely to break, especially bones in the hip, spine and wrist.  It is most common in older women.  One in two women and one in four men over age 50 will break a bone in their lifetime because of osteoporosis.

To protect your bone health, get enough calcium and vitamin D.  The calcium shopping list includes low fat or fat free milk, cheese and yogurt, almonds, broccoli and greens, orange juice with added calcium, and calcium supplements.Get enough vitamin D from salmon or tuna, fat free or low fat milk with vitamin D, some cereals and juices and yogurt with added vitamin D, and vitamin D supplements.

Stay active!  Physical activity slows bone loss.  Moderate aerobic activity and strengthening exercises can make a big difference.

Source:  National Health Information Center

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

Understanding Lupus

Lupus is a chronic inflammatory disease that can affect various parts of the body, especially the skin, joints, blood and kidneys.  It is of special interest to me because my wife has the disease, and so do many of my patients.  Here are some facts to help understand the disease:

• it is an autoimmune disease that causes inflammation and tissue damage
• it is chronic and last a lifetime
• it is not contagious--it can't be caught or given away
• it is not like or related to cancer
• it is not like or related to HIV or AIDS
• it can cause a mild skin rash or achy joints, or can effect internal organs
• it is unpredictable, as symptoms can appear, disappear or change
• it can be mild or life-threatening and requires treatment by a physician
• with appropriate medical care, most people with non-organ threatening lupus lead a full life

Source: Lupus Foundation of America

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

Take The Edge Off With Nitrous Oxide

Nitrous Oxide (laughing gas) is used in dentistry as an adjunct to anesthesia.  It is a gas you can breathe through a mask, colorless, with a slight smell, and works quickly and leaves the body just as quickly.  It is not an anesthetic--it is an analgesic, because it raises your pain threshold in addition to creating relaxation or a pleasurable feeling.  The device in our office is a fail-safe device, allowing a gas mixture that is always at lease 70% oxygen. It is very safe and has no ill effects on the heart, lungs, liver, kidneys or brain.  Usually nitrous oxide delivery is titrated--gradually increased until a comfortable level is reached, so that oversedation is not a problem.  It can be just enough to "take the edge off" and make your dental experience more manageable.

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