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

CDC: Effects of Chronic Alcohol Use

The Centers for Disease Control and Prevention lists the effects that alcohol use can have over time:

• Neurological problems, including dementia, stroke and neuropathy
• Cardiovascular problems, including myocardial infarction, cardiomyopathy, atrial fibrillation and hypertension
• Psychiatric problems, including depression, anxiety and suicide
• Social problems, including unemployment, lost productivity, and family issues
• Multiple emergency room and physician office visits
• Cancer of the mouth, throat, esophagus, liver, colon, and breast.  The risk of cancer increases with increasing amounts of alcohol
• Liver disease, including alcoholic hepatitis and cirrhosis (among the 15 leading causes of all deaths in the United States).
• Gastrointestinal problems such as pancreatitis and gastritis.

The Centers offers information for seeking 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

ADA: Managing Dry Mouth

Xerostomia (dry mouth) is caused by salivary gland reduced function and results in less salivary flow.  It can be caused by chronic disease, medication use, and medical treatment, such as head and neck radiation or chemotherapy treatment.  Chronic dry mouth increases the risk of tooth sensitivity and decay, gum disease, oral fungal infections and detracts from a patient's quality of life.

The ADA recommends a systematic approach to the evaluation, diagnosis, and management of the condition.  This includes patient education, lifestyle changes, palliative measures, and pharmacological treatment with salivary stimulants, topical fluoride tooth treatments and the use of sugar-free chewing gum to relieve symptoms and improve the patient's quality of life.

Source:  JADA, 8/1/2014. vol. 145, no. 8, 867-873

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

Big Tobacco Enters the E-Cigarette Business

The Future of Smoking Tobacco

The e-cigarette market is rapidly expanding and lucrative.

The New York Times has reported that Altria, which produces Marlboro cigarettes, will produce Mark Ten e-cigarettes, and Reynolds American, which produces Camel cigarettes, is producing Vuse e-cigarettes.

A national marketing campaign is also planned.

Smoking is a contributing factor to tooth decay.

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

Common Dilemma: Retreat or Testify

As a Board Certified Prosthodontist, our office is considered the end of the line in the treatment of complex dental problems.  Often also, we are faced with the task of retreating dental work previously done by another dentist.

The California Dental Association Code of Ethics is very clear: it is unethical for a dentist to be both a treating dentist and an expert witness at the same time.  Why?  Because of the inherent conflict of interest--it is too tempting to testify in a cause of action if financial gain can be gotten.  Money has no morality.

In addition, both patient and practitioner must understand that not all dental work lasts forever.  The temptation to think that failure (or the need for retreatment) implies fault, and the progression from blame to the supposition of negligence is not consistent with the fact that, in dealing with human beings, no guarantees are possible.  The science and art of dentistry is continually evolving with a better understanding of the reasons that things done today can be better that than things done in the past.

So, being Board Certified and seeing these patients all too often, I long ago decided the best way to approach them is to be open and honest:  I can't and won't treat you if you want me to testify on your behalf.  It's one or the other.

My lifelong preference has been to treat, not to testify.  The satisfaction of making a patient whole again is the best testament to the fact that Prosthodontics can make most patients comfortable, functional and aesthetic.

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

Should You Take Antibiotics For A Cold?

A study reported in the journal Lancet of 2,547 adults with clinical signs and symptoms of rhinosinusitis (nasal discharge, discomfort in the cheeks and/or face, cough, cold) looked at how many of these patients were prescribed antibiotics after seven days of symptoms.

The basis of the study was the concept that antibiotics are effective against bacterial infections, but not against viral infections.  It was unclear whether the doctors could distinguish the cause of the upper respiratory infections, but still 80% of the patients were given a prescription for antibiotics.

The Centers for Disease Control maintains that "colds, flu, most sore throats and bronchitis are caused by viruses.  Not only will antibiotics not help fight viruses, but, if taken unnecessarily, they can increase the risk of later getting an infection that resists antibiotic treatment."

The conclusion of the study was that, in general, adults with upper respiratory tract infections should not be prescribed antibiotics regardless of their symptoms.

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 New Smile From Your Board Certified Prosthodontist

Your Board Certified Prosthodontist uses the latest techniques and technology to perfect your smile.  In our in-house laboratory, with its 3-D scanning capability and milled all- zirconia porcelain, we restore teeth to their natural form, color and function.

Aesthetic restorations can help you achieve a more natural looking smile and improve your teeth's natural beauty and strength.

We replace stained, chipped, worn or missing teeth with inlays, crowns, veneers, bridges, and implants using the most advanced aesthetic restorations to bring back your beautiful 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

Guided Surgery: Upper Teeth In A Day

We have the technology to take you from a complete denture to an implant supported fixed bridge in a single appointment.

This denture patient had a CAT Scan of her upper jaw.  We applied a computer program to that scan to design implant locations, and a clear guide to be used in the mouth to place the implants without making any incisions. The guide was secured in her mouth and the implants placed.

The computer program also designed her fixed bridge in advance, and we made it in our own in-house laboratory.  After we placed the implants, the bridge was screwed into place.

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

The Future: Lasers Repair Teeth

A Harvard team of researchers has used a low-power laser to induce human dental stem cells to form dentin, the internal structure of a tooth.  They also described how it worked on a molecular level.

The procedure involves introducing the laser into holes in rodent molars, while they are in the mouth, to treat the tooth pulp that contains adult dental stem cells.  After twelve weeks, high resolution radiographic imaging confirmed the laser treatments triggered enhanced dentin formation.

Human clinical trials are proposed.

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 Warning Labels for Tanning Beds

The statistics are alarming:  32% of all 12th grade girls report using tanning beds. Because such exposure poses the highest risk for skin cancers for young persons under the age of 18, the Center for Disease Control and Prevention has issued new guidelines for visible warnings on tanning beds and booths.

The FDA has reclassified the devices from ow-risk to moderate-risk devices and requires warnings that these devices put users at a greater risk of skin 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

Staying Healthy

Healthypeople.gov is your source for information regarding the importance of oral health as an essential part of staying healthy.  Good oral health allows a person to speak, smile, smell, taste, touch, chew, swallow, and make facial expressions to show feelings and emotions.  A healthy, attractive looking smile can increase your confidence and self esteem at any age.  Poor oral health affects Americans at all life stages, from infancy through older adulthood.  Oral diseases ranging from dental decay to oral cancers cause pain and disability for millions of Americans.  Children and adolescents:  tooth decay affects more than 1 in 4 U.S. children age 2 to 5, and 1 in 2 adolescents age 12 to 15.  Adults:  1 in 7 adults age 35 to 44 has gum disease; after age 65, the rate increases to 1 in 4.  Older adults:  1 in 4 age 65 or older have lost all of their teeth.  More than 7,800 people die from oral and pharyngeal (mouth and throat) cancers each year.  A growing body of evidence has linked oral health, particularly periodontal (gum) disease, to several chronic diseases, including diabetes, heart disease, and stroke.  In pregnant women, poor oral health has also been associated with premature births and low birth weight.  These conditions may be prevented in part with regular visits to the dentist.    

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