From a Memorial: What Cancer Cannot Do

We went to a beautiful memorial for a dear neighbor--a good man--who passed away recently.  In the program was the following poem:

Cancer is so limited.....

It cannot cripple love.

It cannot shatter hope.

It cannot corrode faith.

It cannot eat away peace.

It cannot destroy confidence.

It cannot kill friendship.

It cannot shut out memories.

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

Periodontal Bone Regeneration and Smoking

A scientific analysis of the review of 10 articles, as reported in the Journal of Periodontology. looked at the clinical and radiographic indicators of bone regeneration for the 12-month period following periodontal therapy. Smokers and non-smokers were compared with regard to the healing of intrabony defects and furcation defects.

The general conclusion was that smoking negatively influenced bone regeneration after treatment of a periodontal defect. Since smoking is recognized as an important risk factor for periodontal disease, and smoking has been previously shown to have a negative influence on soft tissue healing after periodontal therapy, it now has been associated with negative affects on bony healing also.


Source: JADA, 144(5), 531-532


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

Cleft Palate? See A Prosthodontist!

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


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

Coalition for Oral Health for the Aging

Compendium reported a survey conducted by the Coalition for Oral Health for the
Aging (www.micoha.org). 

As patients age, and their manual dexterity and cognitive skills decline, maintaining oral health becomes more of a challenge.

It focused on how to prepare aging patients for their future decline in oral care. Preparing for the future involves educating patients before their retirement regarding the benefits of routine care visits in the prevention of problems.

The effects of increased use of prescription medications on oral health need to be understood.  The truths vs myths of aging teeth need to be discussed.

 Dental Treatment Planning for the Future 

Preparing for the future includes dental treatment planning for 50 to 70 year of age for restorative work, when they are healthy and able to have it completed, that will withstand the total failure of oral care that can occur as part of the aging process. By focusing on prevention, patients need an oral hygiene protocol of daily oral care, fluoride application and regular professional cleanings. In the elderly population, the primary goals of oral health include removal of infection and strategic preservation of what can be restored and maintained.  A stable bite and a focus on function are important to ensure the ability to have a healthy diet.

To read about the survey in greater detail, see Compendium, Feb 2013, vol 34, no 2, pp150-151, or go to www.dentalaegis.com/cced

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

Lung Problems and Lupus Sufferers

According to the Johns Hopkins Lupus Center, 50% of people with lupus will experience lung issues during the course of their disease. Although, the underlying connective tissue disease is the root cause of lupus-related lung problems, the exact mechanism differs for each of the most common conditions:

• pleuritis (pleurisy)--inflammation and fluid buildup between the lungs and chest wall, causing pain
• pneumonitis--inflammation of the lung tissue itself caused by an infection
• pulmonary emboli (blood clots)
• other kinds of problems having to do with the blood pressure of lung vessels

The two most common symptoms are shortness of breath and pain with breathing.  Treatment centers around the specific lung problem.

More information is available at:  www.lupus.org

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

S-T-R-E-T-C-H!!!

Many of us have strenuous  jobs.  Dentistry is one of them.  For the last 30 years, I have found considerable benefit from treatment by chiropractors.

They believe there are five health-related components of physical fitness:

• muscular strength
• muscular endurance
• cardiorespiratory endurance
• body composition
• flexibility

Flexibility is the ability to move your joints and muscles through a normal range of motion, and a regular flexibility and stretching program has the following benefits:

• increased circulation to muscles, nourishing them, eliminating waste products and decreasing recovery time after injury
• improved posture with loose muscles and less discomfort
• better coordination due to improved range of motion to maximize balance and mobility
• stress relief, because loose muscles are less likely to spasm during periods of tension

Several health-related web sites have simple stretching programs available.  Finding a routine that best fits your lifestyle can make you feel better and younger!


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

Old Enough for a Dental Implant?

What is the minimum age for a dental implant?  

This is especially important for boys and girls who have congenitally missing teeth.  Dental implants should not be placed until after skeletal growth is complete.   Once placed, an implant and the bone which surrounds it do not change, so we don't want the jaws and teeth around the implants to continue to develop.  In general, boys mature skeletally between the ages of 17 and 19, girls between 16 and 18.  

How do you really tell?  

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

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

Denture Stomatitis and Fungal Infections

Denture stomatitis is a common disorder affecting denture wearers.  It is characterized as inflammation and redness of the tissues covered by the denture.  It is often asymptomatic; only a minority of sufferers experience pain, itching or burning.  It is primarily identified during a dental examination as the presence of inflammation and swelling under the denture.  It is associated with poor denture fit, increased age of the patient, increased age of the denture, continuous wearing of the denture and poor denture hygiene.  

Bacteria and fungi (primarily Candida Albicans) are likely included.  Patients can see it themselves when their tissues are fiery red under the denture and the redness follows the outline of their denture.  Not removing dentures at night while sleeping allows a biofilm of bacteria to colonize on the inside denture surface without being properly removed.  Treatment of the acute phase requires antifungal medications.  Rapid recurrence of the condition will occur unless the denture is properly disinfected and thereafter a daily denture hygiene regimen of removing the dentures and soaking them in a commercial disinfectant solution or diluted sodium hypochlorite.  Routine follow-up visits to assess that the denture maintains proper fit and function is important in reducing the risk for developing stomatitis.

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

The Best Thing About Dental Implants

Is It Time for a New Set of Dentures?

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 one universal truth about alveolar bone is that it resorbs (shrinks) when teeth are removed, because it 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 (map)

Alcohol-Free Chlorhexidine Mouthrinse

Chlorhexidine mouthrinse is a prescription rinse that specifically attacks the bacteria that cause gum inflammation, and is commonly used in patients with periodontal conditions.

A study by Todkar compared the efficacy of alcohol-free chlorhexidine mouthrinse, chlorhexidine containing alcohol and a placebo of water in terms of controlling gingival plaque and reduction of gingival inflammation in patients with gingivitis.

Measurements were made at the beginning, after 14 days and after 28 days.
The study concluded that the alcohol-free rinse was as effective as the one containing alcohol in controlling plaque and reducing gingival inflammation, and can be recommended for periodontal patients, especially those for whom the use of alcohol may lead to side effects.

Reported in: Dentistry Today, Feb., 2013, from Oral Health & Preventive Dentistry, Fall 2012, vol 10, issue 3, pp 291-296.


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

Heart Attack Cause and Prevention

What you need to control

There are major risk factors for a heart attack that you can control:

• Smoking:  quit or cut back
• High blood pressure:  your doctor can prescribe medicine to
  keep it under control
• High cholesterol:  medication, a diet low in saturated fats,
  trans fat, cholesterol, sodium and added sugars
• Overweight or obesity:  lose unwanted pounds
• Diabetes:  control blood sugar with medication and diet
• Lack of physical activity:  become as active as possible

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

Garlic VS Milk

How to prevent garlic breath with milk?

According to research noted by ScienceDaily, a study in the Journal of Food Science published by the Institute of Food Technologists (IFT) found that drinking milk while eating garlic-heavy food can reduce the bad breath associated with garlic consumption.

They found fat-free and whole milk lowered the concentration of odor-emitting compounds from garlic both in the nose and mouth.

For further details, go to:  www.sciencedaily.com/releases


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

Osseointegration Study Club

Osseointegration Study Club of Japan meeting

www.facebook.com/OJOsseointegrationStudyClubOfJapan

Robert Tupac participated in the 25th anniversary meeting of the Osseointegration Study Club of Southern California and Osseointegration Study Club of Japan meeting. A selection of nationally and internationally known presenters focused on the parameters of minimally invasive to total arch regeneration and the latest research on implant surgery and loading. Selected topics included clinical practice of minimally invasive implant dentistry, minimally invasive sinus augmentation procedures, CAD/CAM zirconia abutments, three dimensional bone augmentation, long term clinical results of the All-on-Four concept, experimental determination of peri-implant mucosal stability and its interpretation, the benefits of reduced diameter abutments and implant/soft tissue connection, and the future of implant dentistry. 

With 25 years of experience with implant placement and prosthetics, Dr. Tupac has witnessed the evolution of implant design and surgical technique and prosthetic designs and restorative approaches. These issues affect the short and long term realities of implant restorations, their maintenance and the prevalence and management of complications support for a screw retained provisional fixed bridge placed at the same time the implants are placed. The technique may also be performed at the same time natural teeth are extracted.

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

What Modern Dental Technology Can Do In a Single Visit

NobelBiocare and Procera Technology

We just checked a patient who had her remaining lower teeth extracted five days ago and four
implants placed and we converted her lower denture to a provisional fixed bridge. She had walked in with failing teeth and a partial and walked out with implants and a fixed bridge, in a single visit. This is a service called All-0n-4, as described on our website and done with NobelBiocare implants and Procera technology. 

Kim was born with a cleft palette and lip. Up until she was 38 years old, she suffered from repeat infections of the sinuses, gums and tissue. It took the right team of people orechetrated by her Prothodontist, to make all of the difference in Kim's dental health.

Kim's story is a good example of why patients go to a Prosthodontist. Prosthodontics is one of nine dental specialties recognized by the Dentist industry.

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

Happy 100th Full-Arch Dental Implant Placement

Beneficial Success!!

Dr. Robert Tupac celebrated the placement of his 100th full-arch implant supported full arch prosthesis. 

"While some dental implant details and prosthetic techniques have changed since the first of these in 1986, what remains the same is the beauty of implant restorations. They are tremendously successful and are the best choice for patients for replacing missing teeth. The greatest benefit for patients is that the implants help retain their jawbone. Implant prostheses are a tried and true method for restoring comfort, function and appearance, and give patients the self-esteem they had with their natural teeth." 

As Bakersfield's only full time Board Certified Prosthodontist, Dr. Tupac provides a complete range of implant therapy.

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

How Prosthodontists Are Like Quarterbacks

Many like to think of Prosthodontists are the "quarterback" of a dental treatment plan. They regularly lead teams of general dentists, specialist and other health professionals to develop solutions to your dental needs. Prosthodontics is the dental specialty pertaining to the diagnosis, treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance and health of patients with clinical conditions associated with missing or deficient teeth and/or oral and maxillofacial tissues using biocompatible substitutes.

Specializes in the esthetic (cosmetic) restoration and replacement of teeth. Receives three to four years of additional training after dental school.

Restores optimum appearance and function to your smile. The treatment planning and restoration of implants, (TMJ and TMD), and rehabilitation of occlusion with prostheses all fall under the field of prosthodontics. Dr. Robert G. Tupac spent ten years on the Board of Directors of the American College of Prosthodontists.  In 1981, Dr. Tupac passed the exam to become a Board Certified Prosthhodontist. To this date, there are only about three thousand Board Certified Prosthodontists in the world which gives you an idea of how important and exclusive this specialty designation is.

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

Trained in emergency preparedness by the CDA

First Responder

Robert Tupac, DDS, FACP, was trained as a first responder for community disaster emergency preparedness at the annual California Dental Association Convention in Anaheim, California. As a health care provider, Dr. Tupac is one of several dentists prepared to offer his services in the event they are needed at the local level.

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

NobelBiocare Technology Workshop Participant

Extensive Experience in Restorative Procedures

Robert Tupac participated in a removable implant overdenture lecture and hands-on workshop at the NobelBiocare headquarters in Yorba Linda, California. Dr. Sam Strong, in his presentation of removable implant treatment for the fully edentulous patient discussed pre-surgical considerations and prosthetic therapy, implant integration period therapy and guidelines for bar retained and attachment retained overdentures. Dr. Tupac's extensive experience with these restorative options with multiple implant systems gives patients the ability to be managed and maintained even with implant systems that are no longer in current use. His in-house laboratory concentrates on technical precision and individual attention to patient's needs and desires.

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

How Do You Know You're Having A Heart Attack?

How heart attacks develope

Heart attacks are a leading killer of men and
women in the United States. They occur when
the flow of oxygen-rich blood to a section of
heart muscle suddenly becomes blocked.
Typically,  coronary artery disease involves
a buildup of plaque inside the arteries over time,
and when an area of plaque breaks open, a
blood clot forms that can block blood flow in
the artery.  If the blockage isn't treated quickly,
the portion of heart muscle fed by the artery
begins to die.

Treatment works best at the earliest sign of
symptoms to limit damage to the heart.

Symptoms include:

• Chest pain or discomfort in the center or left side of the chest that often lasts for more than a few minutes or goes away and comes back.  It can feel like pressure, squeezing, or fullness and can be mild or severe.  It can feel like nausea or heartburn.
• Upper body discomfort in one or both arms, the back, neck, jaw or upper part of the stomach.
• Shortness of breath, with o before chest discomfort.
• Nausea, vomiting, light-headedness or sudden dizziness, or breaking out in a cold sweat.
• Sleep problems, fatigue, or lack of energy.

Signs and symptoms can develop suddenly or sometimes slowly (over hours, days or weeks) and quick treatment is the key to the best recovery.

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

Cardiopulmonary Resuscitation Dentistry (CPR) Approved

CPR and AED Certified Staff

Robert Tupac and all of his office personnel 
have been trained in advanced CPR/AED (Cardiopulmonary Resuscitation/Automatic External Defibrillator) for the Professional Responder and Health Care Industry as certified by the American Red Cross. His office has an automatic defibrillator available for emergency use. His surgical suite features an array of vital signs monitoring equipment, as well as oxygen and nitrous oxide delivery systems. Dr. Tupac also offers the availability of a physician anesthesiologist for intravenous sedation during restorative dentistry or implant surgery.

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