"Good Running Condition"

This is what an appreciative patient wrote in a letter to me: 

"When I was an automotive technician, I used to preach to my customers about how important preventative maintenance is in keeping their vehicle in top running condition, which in turn would extend the useful life of their vehicle. Regular maintenance, or "attention to" most everything in our lives leads to a healthier lifestyle and increased fulfillment.  As we age we are faced with new challenges in keeping ourselves healthy and in "good running condition".  Maintenance is even more crucial as we advance through this life. Starting today, I have a new preventative regimen to follow to help protect my roots from decay.  I will add my new tools to my ever growing collection and will use them dutifully to ensure that "long of tooth" will not get the best of me!"

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

Oral Health and Parkinson's Disease

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

The type and severity of symptoms vary with each individual and the stage of the disease.  They usually begin appearing between the ages of 50 and 60.  They develop slowly and often go unnoticed by family, friends, and even the person who has them.  The most common symptoms include: tremor or shaking, in a hand, arm or leg.  It occurs when awake and sitting or standing still (resting tremor) and subsides when the body part is moved.

One of the most common early signs is a reduced arm swing on one side when walking that is caused by rigid, stiff or aching muscles.  Bradykinesia--slow, limited movement--is another, especially when moving from a resting position, like getting out of a chair or rolling over in bed.  Weakness of facial or throat muscles affecting the ability to talk or swallow, causing choking, coughing or drooling, is seen, often with softer speech and a monotone.  Loss of movement of facial muscles causes a vacant facial expression, called "Parkinson's mask".

Gait disturbance and postural instability, exhibited as difficulty with walking and balance, causes small steps, shuffling with feet close together, a stooped posture (bent forward slightly at the waist) and difficulty turning around.  Balance and posture problems may result in frequent falls.  Emotional and physical stress tend to make tremors more noticeable, whereas sleep, complete relaxation, and intentional action or movement usually stop the tremor.  There are other physical and psychological symptoms that become more pronounced as the disease progresses.

From a prosthodontic standpoint, these patients require more frequent maintenance due to their increased difficulty in cleaning their teeth and the oral side effects of their medication regimen.

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

Related: Childhood Weight--Salivary Biomarkers--Diabetes Risk

A study published in PLOS ONE reports on altered levels of salivary biomarkers in obese children which indicate the risk of developing type 2 diabetes.

The Forsythe Institute, in Cambridge, Mass., evaluated 744 11-year-old children who were underweight, of normal healthy weight, overweight, or obese.

Salivary samples were taken after fasting and analyzed for 20 biomarkers, including insulin, C-reactive protein, adiponectin and leptin.  They found that these markers changed significantly with increasing obesity.

This is another example of how salivary testing can be used in preventive health treatment.

Source: JADA, 8/1/2014, vol. 145, no. 8, 802

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

Sedation: Treatment Made Easy For Dental Phobics

Feeling especially nervous about dental treatment is very common.

For more than 35 years, Dr. Tupac has treated patients who require oral or intravenous sedation and anesthesia for their dental work.  Many patients are afraid of going for dental care, and their fear becomes compounded over time as their dental problems multiply.  Their initial anxiety can turn into a true phobia.  These patients can be given appropriate anesthetics, by a trained oral surgeon or dental anesthesiologist in Dr. Tupac's office, that allows them to be relaxed and comfortable or fully asleep as the dental treatment is done.

Anesthesia such as this benefits anxious patients, those with phobias about needles, an inability to comply with necessary treatment, low or altered pain threshold, difficulty getting numb, an overactive gag reflex, and significant medical conditions which require more sophisticated monitoring for safety.  Patients who desire to be stress-free and comfortable this way may inquire at the office.

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

How To Reduce Bad Cholesterol By Diet Planning

This blog has previously shown evidence that lowering cholesterol levels has been demonstrated to lower the risk of heart disease.

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

"Bad" 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 other tips, also:

• saturated fat in dairy products (butter, milk and cream) can be reduced 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 donuts, 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 that 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

5 Candy Alternatives That Will Keep Trick-or-Treaters Smiling

The fall season brings an amazing amount of fun activities for you and your family. From the excitement of Halloween, to school fall festivals, kids and parents alike look forward to the cool weather and family memories. Unfortunately, Halloween and fall festivals can also do a number on your child’s teeth. Hard candies, sweet treats and sugary snacks can be cavities waiting to happen. Handing out Halloween candy doesn't mean you have to hand out oral health disasters. There are a number of healthy alternatives to the candy bars and licorice- some that trick-or-treaters might even enjoy more than the sugar rush. The days of handing out apple slices and pennies to avoid contributing to tooth destruction are gone! Take a look at some of these creative trick-or-treat alternatives that will leave all the little ghosts and ghouls smiling throughout the year.

Applesauce Pouches

Applesauce is still a sweet treat, and not nearly as hard on the teeth. Not only that, they’re portable, affordable and a great way to avoid the mess of some other treats. You can get a pack of 48 pouches for about 35 dollars on Amazon, which is enough to give all the trick-or-treaters something healthy to smile about.

Mini LaraBars

Larabars are gluten free, vegan, kosher and only have about 8-11 grams of sugar per bar. They also come in mini form, making them perfect to hand out on Halloween. The great thing about these treats is that the kids won’t even know they’re healthy! LaraBars have flavors such as cherry pie, apple pie and cashew cookie and are just as delicious as the other mini candy bars that will be weighing down their bag. If you can’t find LaraBars, or they’re a little too pricey for you, granola bars of any kind will be a better choice than chocolate.

Vegan Rice Crispy Treats

Rice crispy treats are a delicious sweet treat for trick-or-treaters, but you don’t have to use all the sugary marshmallow to make them amazing. There are a number of recipes you can follow which swap out a few classic ingredients for something a little healthier in order to create the perfect Halloween snack. By using brown rice syrup instead of marshmallow, brown rice crisps instead of white rice and coconut oil instead of butter- you can make delicious, healthy treats that many claim are better than the original. Check out one of the recipes here. 

Sugar Free Gum

While sugar free gum may not be the most exciting item in your child’s bag, it’s still a quality alternative to all the junk they’ll be getting. You can get tasty sugar free gum such as Dubble Bubble and throw a few pieces in along with other healthy treats. Parents will appreciate the lack of sugar, and the kids (especially those kids who love their chewing gum) will be happy with a full bag of “candy.”

Toys

If you want to skip the food items altogether, many parents have opted to hand out toys instead. There are a number of items you can get in bulk for cheap such as pencils, erasers, stickers, mini water guns, temporary tattoos, mini play dough, sidewalk chalk, bouncing balls, bubbles and more. The possibilities are endless and none of these things will land your child in the dentist’s chair. If you’re thinking of skipping the candy and handing out toys, head to your local dollar store to find amazing deals on bulk items.

There’s also the option of handing out pre-made veggie and fruit snacks, however this may only be a good idea if you’re close with the surrounding neighbors. Parents are often a little leery of pre-prepared snacks and the time and money you spent might simply end up in the trash. These days there really are dozens of candy alternatives that don’t skimp on the flavor. Do your own research to find what works best for you and your family, have fun with it, and get everyone involved. Keep in mind that most trick-or-treaters will be over-flowing with the sugary stuff- so its good practice as a parent and oral health advocate to provide something that will keep their smiles healthy throughout the year.

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

Enjoy Healthy Habits, Live Longer--Details

There is a fun and informative site at Hive Health Media.

A blog post by Doug Robb detailed how adults who perform at least 150 minutes of moderate physical activity each week live longer than those who don't.

Check it out: www.healthhabits.ca/2012/12/18/how-to-live-longer-and-better/

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

All-on-4 Success

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

All-on-4

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


Why only 4?

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


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

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

American Heart Association Says Sugar Is Bad News

The American Heart Association explains how sugar drinks and heart disease go together. A study compared men who did and did not consume sugar-sweetened beverages and risk of coronary heart disease.

Researchers followed 42,883 health professionals for a period of 22 years.  They adjusted for age, smoking, physical activity, alcohol, multivitamins, family history, diet quality, energy intake, BMI, pre-enrollment weight change and dieting.

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

circ.ahajournals.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

Picture Perfect Smile With Veneers

Fixing your four front teeth with porcelain veneers to make them whiter, straighter and get rid of the spaces, wear facets and acid ridges can make your smile picture perfect!

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

Conservative Porcelain Veneers For Fractured Teeth

A simple slip and fall can result in fractured teeth.  Sometimes the most conservative method for restoring the result of this kind of trauma is porcelain veneers, made in our in-house laboratory.

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 since your last visit, and possibly bring a relative or friend with you to remind you of questions or help you remember information.

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

If You Are A New Patient, You Deserve...

...the best prosthodontic care we can give in Bakersfield, California!

Each dental office you may visit has its own character.  That character is often defined in the office's mission statement, which reflects the doctor's and team's attitudes towards patients, their dental health, and the manner in which they will be cared for.  In ours, our goal is to be empathetic regarding your dental wishes.

Time:  we strive to be well rested and have the patience to listen to all you have to say.

Objective:  we can't change your dental past and we won't make judgments about it.  We will use our energy in a positive direction for you.

Choices:  we offer the balance of current knowledge and techniques, up to date technology, and long term clinical experience.  Our specialty training offers you options to choose from.  We consider examination, diagnosis and treatment planning to be the foundation of our relationship with new patients and a key to successful 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

Harvard's Tips For Coping With Prostate Enlargement

After the age of 25, the male prostate gland begins to enlarge.  This natural process is called benign prostatic hyperplasia, or BPH.  The enlargement, in itself, does not lead to cancer.  50-60% of men may never develop any symptoms, but the most common are: hesitant or weak urination, urgency or leaking, incomplete emptying, or more frequent urination.

Harvard Health Publications reports on the treatment of the condition, from various medications to surgery, and also offers lifestyle changing tips to reduce symptoms:

• stress reduction through regular exercise and relaxation techniques
• taking the necessary time to void completely when urinating
• adjust medication intake in consultation with your physician
• reduce evening fluid intake, especially caffeine and alcohol

Source: Harvard Medical School 2014 Annual Report on Prostate Diseases

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's The Number One Bacteria Source On Your Body?

Your mouth is full of bacteria--more than any other part of your body--because the digestive process starts there.  Brushing and flossing lowers the bacterial count from tooth surfaces, 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

What Is A Prosthodontist?

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

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

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

Dr. Tupac is the only full time Board Certified Prosthodontist in Bakersfield.

Source:  American Board of Prosthodontics

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

Prosthodontists Restore Surgical Defects

Removal of a boney tumor from the jaw leaves a large intraoral defect.  It is the province of the Board Certified Prosthodontist to restore function and aesthetics for these patients.

This gentleman lost 13 lower front teeth and a large volume of bone both vertically and horizontally.  Instead of having to wear a removable partial denture of tremendous bulk, five dental implants were placed in the remaining lower jawbone and the implants supported a screwed in place prosthesis which replaced the missing teeth and gums, thus restoring chewing function, normal speech and pleasing aesthetics.

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

Before You Have Your Bite Adjusted

As a patient, you should know that "bite adjustments" are sometimes controversial in dentistry.

Dentists frequently make simple alterations in your bite--with a new filling or crown, or a fixed bridge or removable partial--and your mouth's adaptability to the change takes care of things. However, if you have symptoms--jaw joint pain, head and neck muscle strain or pain, or even tooth pain--then it is necessary that a Prosthodontist diagnose of the cause of the symptoms before any alterations are made.

Diagnosis involves the appropriate film studies, of the teeth and joints, and examination of your occlusion (how the teeth come together) by means of models study mounted on a device (articulator) that reproduces your jaw movements.  It also involves an in-depth discussion regarding parafunctional activities, such as bruxism (teeth grinding) or clenching.

Removable custom bite appliances are used both as a diagnostic and treatment tool, to determine whether changes in your bite could be beneficial before making permanent alterations to your teeth.
The goal of any bite alterations is to relieve or eliminate symptoms and minimize stress to the joints, muscles and 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

Benefits of Daily Low-Dose (Baby) Aspirin

Physicians have long recommended that adults, beginning at the age of 50, take a daily low-dose, or baby, aspirin for cardiovascular health.

Now, the Annals of Oncology has reported that for an individual aged 50 to 65 years at average risk who took aspirin daily for ten years over the fifteen year period, had a relative reduction of 7% (women) and 9% (men) in the number of cancer, myocardial infarction, or stroke events, and a 4% reduction in all-cause mortality over a twenty year period.

Annals of Oncology, doi:10.1093/annonc/mdu225

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 Prepare For Surgery

An article in the AARP magazine notes that the average American has nine operations during a lifetime and suggests ways to shape up before surgery:

• Get blood sugar under control--a fasting blood glucose test will disclose elevated blood sugar levels, which, if untreated, triple the risk of postsurgical infection and quadruple the risk of death during heart surgery
• Discontinue smoking--nicotine constricts small blood vessels and increases the risk of heart attack during surgery and hampers wound healing.  Smoking cessation for a month prior to surgery brings healing into a normal range.
• Mild exercise--walking, even a mile, without becoming overly fatigued, promotes better recovery
• Decrease alcohol--alcohol withdrawal can cause seizures, nervous system damage, irregular heartbeat, respiratory failure, and death during surgery
• Stop herbal supplements--for at least two weeks before surgery, especially ginkgo biloba, ginseng and valerian
• If you have sleep apnea--breathing problems during surgery and recovery are common
• Review medications--especially blood thinners, beta blockers, and review with your surgeon
• Prescription drink supplements--for five days before surgery to be properly nourished, reduces the risk of postsurgical complications

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