2019 - Reception Room TFDA

2019 Dentists’ Day on the Hill - March(DIY) 11-12, 2019 - Page Check Out the FDA's Do-It-Yourself Dentistry Issue 2

VOL. 31, NO. 3 • RECEPTION ROOM ISSUE 2019

A PUBLICATION OF THE FLORIDA DENTAL ASSOCIATION

How Does Fluoride Benefit You? Does Kissing Affect Your Oral Health?

6 Habits That Harm Your Teeth

6 DIY Whitening Trends That Ruin Your Teeth Are You Brushing Your Teeth The Wrong Way?

DON'T CLOWN AROUND WITH YOUR TEETH!

FLORIDA'S ADVOCATE FOR ORAL HEALTH VOL. 31, NO. 3 • RECEPTION ROOM ISSUE 2019

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It Really is ALL About YOU!

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Dental Glossary for Patients

A PUBLICATION OF THE FLORIDA DENTAL ASSOCIATION

Are You Brushing Your Teeth the Wrong Way?

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6 Habits That Harm Your Teeth

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ADA Coloring Worksheet

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How Does Fluoride Benefit You?

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The Florida Board of Dentistry is Looking for Someone Like You!

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Does Kissing Affect Your Oral Health?

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Marijuana and Your Dental Care

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DIY Dentistry: Don't Clown Around With Your Teeth

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ADA Crossword Puzzle Worksheet

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No Thanks, I‘ll Do it Myself

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6 DIY Whitening Trends That Ruin Your Teeth

Reception Room Issue 2019

Today's FDA

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FLORIDA DENTAL ASSOCIATION RECEPTION ROOM 2019 VOL. 31, NO. 3

EDITOR Dr. John Paul, Lakeland, editor

STAFF Jill Runyan, director of communications Jessica Lauria, communications and media coordinator Lynne Knight, marketing coordinator

Awards

2019

2019 AWARD RECIPIENTS

BOARD OF TRUSTEES Dr. Jolene Paramore, Panama City, president Dr. Rudy Liddell, Brandon, president-elect Dr. Andy Brown, Orange Park, first vice president Dr. Dave Boden, Port St. Lucie, second vice president Dr. Gerald Bird, Cocoa, secretary Dr. Michael D. Eggnatz, Weston, immediate past president Drew Eason, CAE, Tallahassee, executive director Dr. Karen Glerum, Boynton Beach • Dr. Jeannette Pena Hall, Miami Dr. Bernard Kahn, Maitland • Dr. George Kolos, Fort Lauderdale Dr. Eddie Martin, Pensacola • Dr. Jeffrey Ottley, Milton Dr. Paul Palo, Winter Haven • Dr. Howard Pranikoff, Ormond Beach Dr. Rick Mullens, Jacksonville • Dr. Beatriz Terry, Miami Dr. Stephen Zuknick, Brandon • Dr. Ethan Pansick, Delray Beach, speaker of the house Dr. Tim Marshall, Spring Hill, Treasurer • Dr. Rodrigo Romano, Miami, Treasurer-elect Dr. John Paul, Lakeland, editor

 PRESIDENT’S AWARD

Dr. Jolene O. Paramore • Panama City



FDA DENTIST OF THE YEAR Dr. Gerald W. Bird • Cocoa

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J. LEON SCHWARTZ LIFETIME SERVICE AWARD Dr. Terry L. Buckenheimer • Tampa

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NEW DENTAL LEADER Dr. Angela McNeight • Merritt Island

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FDA LEADERSHIP AWARDS Dr. Eva Ackley • Spring Hill Dr. Leo Cullinan • Naples

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DENTAL TEAM MEMBER Ms. Dianne Parisi • New Port Richey

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FDA PUBLIC SERVICE Mr. Clay Archer • Jacksonville Ms. Elizabeth Burwell • Jacksonville Dr. Michael A. Pikos • Palm Harbor

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HELPING MEMBERS SUCCEED TEAM IMPACT AWARD Ms. Brooke Martin • Tallahassee

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OUTGOING TRUSTEES Dr. Suzanne Ebert • Chicago Dr. George Kolos • Fort Lauderdale Dr. Roger Robinson • Jacksonville Dr. Rodrigo Romano • Miami Dr. Clayton Roth • Palm Beach

PUBLISHING INFORMATION Today’s FDA (ISSN 1048-5317/USPS 004-666) is published bimonthly, plus one special issue, by the Florida Dental Association, 545 John Knox Road, Ste. 200, Tallahassee, Fla. 32303 .

FDA membership dues include a $10 subscription to Today’s FDA. Non-member subscriptions are $150 per year; foreign, $188.

Periodical postage paid at Tallahassee, Fla. and additional entry offices. Copyright 2019 Florida Dental Association.

All rights reserved. Today’s FDA is a refereed publication.

POSTMASTER: Please send form 3579 for returns and changes of address to Today’s FDA, 545 John Knox Road, Ste. 200, Tallahassee, Fla. 32303.

EDITORIAL AND ADVERTISING POLICIES Editorial and advertising copy are carefully reviewed, but publication in this journal does not necessarily imply that the Florida Dental Association endorses any products or services that are advertised, unless the advertisement specifically says so. Similarly, views and conclusions expressed in editorials, commentaries and/or news columns or articles that are published in the journal are those of the authors and not necessarily those of the editors, staff, officials, Board of Trustees or members of the Florida Dental Association.

EDITORIAL CONTACT INFORMATION All Today’s FDA editorial correspondence should be sent to Dr. John Paul, Today’s FDA Editor, Florida Dental Association, 545 John Knox Road, Ste 200, Tallahassee, Fla. 32303.

FDA office numbers: 800.877.9922, 850. 681.3629; fax 850.681.0116; email address, fda@floridadental.org; website address, www.floridadental.org.

ADVERTISING INFORMATION For display advertising information, contact: Jill Runyan at jrunyan@floridadental.org or 800.877.9922, Ext. 7113.

For career center advertising information, contact: Jessica Lauria at jlauria@floridadental.org or 800.977.9922, Ext. 7115.

Today’s FDA is a member publication of the American Association of Dental Editors and the Florida Magazine Association.

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leadership

IT REALLY IS

ALL ABOUT

YOU

PRESIDENT’S MESSAGE JOLENE PARAMORE, DMD FDA PRESIDENT

Did you know your dentist is a member of the Florida Dental Association (FDA)? Why should you care?

Why does that matter, you ask? Because first and foremost, an FDA dentist is committed to helping you improve your oral health. It’s all about you.

Your dentist must have successfully completed the required education: four years of college followed by four years of dental school — more if they are a specialist. They must pass a comprehensive licensure examination to receive a dental license in Florida. To be an FDA member, they must pledge to uphold the American Dental Association’s Code of Ethics. As FDA members, we are required to put the best interests of our patients first while providing the highest quality of care. It’s all about you.

The FDA provides member dentists with scientific resources and clinical continuing education. This allows FDA dentists to know the latest tests and techniques to identify, prevent, diagnose or treat a variety of diseases. Your FDA dentist is a lifelong learner. Oral cancer screening, discovering oral signs of other diseases or disorders, and understanding the link between your oral health and your overall health are lifesaving skills your dentist uses every day. And they have nothing to do with restoring teeth. It’s all about you.

Your dentist cares enough to go above and beyond. They don’t have to be a member to be a good dentist.

They want to be an FDA member to be held to a higher standard. They want to give you their absolute best efforts, so you can be healthy. I hope you find the messages throughout this journal to be valuable.

Should you have any questions, I’m sure your dentist will be happy to answer them.

It really is all about you.

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glossary

Dental Glos A visit to the dental office can sometimes feel like you’ve traveled to a foreign land — the dental terminology the dentist and staff use to describe the parts of your mouth, dental procedures and oral health issues can be downright confusing to patients. We’ve put together a dental glossary for patients on frequently used terminology, which also can be found online at bit.ly/2JPJRst.

Abscess: acute or chronic localized inflammation, probably with a collection of pus, associated with tissue destruction and, frequently, swelling; usually secondary to infection.

Amalgam: a mixture of silver, mercury, tin and copper that provides a strong, hard, durable filling; sometimes described as “silver-colored” fillings.

Bicuspid: a premolar tooth; a tooth with two cusps.

Bleaching: cosmetic whitening of teeth using peroxide.

Caries: cavities; tooth decay.

Cavity: the destruction of your tooth enamel, the hard, outer layer of your teeth. A cavity may be due to decay, erosion or abrasion.

Composites: tooth-colored restorative materials.

Crown: an artificial replacement that restores missing tooth structure by surrounding the remaining tooth structure, or placing on a dental implant. It is made of metal, ceramic or polymer materials, or a combination of such materials.

Sources: ada.org/en/publications/cdt/glossary-ofdental-clinical-and-administrative-ter knowyourteeth.com/infobites/glossary mouthhealthy.org

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Do-it-yourself (DIY) dentistry: any kind of dental treatment that is not executed under the expert care or supervision of a dentist or specialist. This includes at-home treatments, such as teeth whitening and straightening kits, veneers, or alternative treatments like using charcoal or oil pulling on your teeth.

Edentulous: having lost most or all the natural teeth.

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ssary for Patients Endodontics: the branch of dentistry that is concerned with dental pulp and the nerves, blood vessels and tissues surrounding the roots of a tooth.

Extraction: the process or act of removing a tooth or tooth parts, usually because of disease, trauma or crowding.

Filling: the restoration of lost tooth structure by using materials such as metal, alloy, plastic or porcelain.

General dentistry: primary care for patients in all age groups for the diagnosis, treatment, management and overall coordination of services to meet patients’ oral health needs.

Gingivitis: the early stage of gum disease.

Gum disease: an infection of the tissues that surround your teeth; caused by a buildup of plaque; also known as periodontal disease.

Implants: a replacement for the roots of your teeth that can anchor crowns or dentures to your jaw bone so they behave more like natural teeth.

Incisor: a tooth for cutting or gnawing; located in the front of the mouth in both jaws.

Malocclusion: improper alignment of biting or chewing surfaces of upper and lower teeth.

Mandible: the lower jaw.

Maxilla: the upper jaw.

Molar: teeth posterior to the premolars (bicuspids) on either side of the jaw;

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grinding teeth, having large crowns and broad chewing surfaces.

Occlusion: any contact between biting or chewing surfaces of maxillary (upper) and mandibular (lower) teeth.

Oral and maxillofacial surgery: the specialty of dentistry that includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and aesthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

Orthodontics: the specialty concerned with the diagnosis, prevention, interception, guidance and correction of tooth positions and bone development.

Palate: the hard and soft tissues forming the roof of the mouth.

Pediatric dentistry: an age-defined specialty that provides both primary and specialty oral care for infants and children through adolescence, including those with special health needs.

Periodontics: the specialty of dentistry that encompasses the supporting structures of teeth, as well as diseases and conditions that affect them.

Plaque: a soft, sticky film that accumulates on teeth composed largely of bacteria and bacterial derivatives that can contribute to tooth decay and gum disease.

Prophylaxis: removal of plaque, calculus and stains from the tooth structures; professional cleaning of the teeth by a hygienist.

Prosthodontics: the dental specialty pertaining to the restoration of the natural teeth and/or the replacement of missing teeth with artificial substitutes.

Resin: plastic material used in bonding, restorative and replacement procedures.

Root canal: the chamber within the root of the tooth that contains the pulp (blood vessels and nerve tissue).

Root canal treatment: procedure to remove the diseased pulp from the root of a tooth, then clean and seal the canal.

Scaling: removal of plaque and calculus from below the gumline.

Sealant: a thin, protective coating (made from plastic or other dental materials) that adheres to the chewing surface of your back teeth. Sealants are meant to prevent cavities by blocking sticky foods from lodging in the grooves of the back teeth.

Third molars: wisdom teeth.

Temporomandibular Joint (TMJ): the connecting hinge mechanism between the base of the skull (temporal bone) and the lower jaw (mandible).

Veneers: thin, custom-made shells crafted of tooth-colored materials designed to cover the front side of teeth.

They are an option for correcting stained, chipped, decayed or crooked teeth.

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fluoride

How Does Fluoride Benefit You?

DR. JOHNNY JOHSON

Fluoride is a mineral that is found naturally in almost all water. It is the 13th most abundant mineral in the earth’s crust. Water picks up fluoride from rocks in the ground as the aquifer flows across the rocks and fluoride is released into the water, soil and air.

How did we discover the cavity fighting benefits of fluoride?

In 1901, Dr. Frederick McKay opened his dental practice in Colorado Springs, Colo. after graduating from dental school. He began to see in patients that were born in Colorado Springs, or had moved there as infants, a brown stain on their teeth that couldn’t be easily removed. He also observed that this did not occur in adults that were not born there or moved there after childhood.

An additional and enormous finding was that these patients with the brown stain, had almost no cavities. For 1901, that was unheard of. McKay contacted his professors who stated that they’d never seen this before.

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The U.S. Public Health Service, as it is known as today, began to research this unusual phenomenon. It was headed up by Dr. H. Trendley Dean. The medical health of the residents was not affected by this discoloration. The teeth were not affected in their ability to function properly, and there was no discomfort associated with it.

So basically, it was a cosmetic effect.

Over the next several years, other communities like Dr. McKay’s were found with brownish stains and low cavity rates. An interesting finding along the way was when they began to find areas of low cavities and no brown stains. The only color change of the enamel that could be seen were tiny white flecks that were visible under a dental light and with the teeth dried off.

What did these communities have in common? Everyone drank from the same water supply. Water testing revealed nothing out of the ordinary. However, the one measurement that could not be taken was the level of fluoride, as a fluoride testing device had not yet been invented.

In 1930, a chemist invented a method to measure fluoride in water.

Immediately, samples of the water from Colorado Springs and the communities where cavities were low with no brown staining were sent to this chemist for testing. The results were amazing. The fluoride content of the water in Colorado Springs was 2-12 mg of fluoride per liter of water (mg/L, ppm [parts per million]) while

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Fluoride is Naturally Occurring l

13th most abundant mineral in the earth’s crust

l

Surface water (rivers): typically low concentrations, 0.2 mg/L (ppm) or less

l

Groundwater (wells): higher concentrations, 0.1 mg/L to over 5.0 mg/L

l

Ocean water is typically 0.8 to 1.4 mg/L

Information provided by the American Fluoridation Society as adapted from CDC information.

that in the communities with no stain was about 1 mg/L of fluoride.

It was now known what was causing this brown stain in the teeth.

At lower levels, the fluoride greatly benefitted the teeth by reducing cavities without any unsightly stains. At higher levels, brown stains were noted.

Gainesville, Fla., was the first city in our state to fluoridate its water in 1949. As of the latest statistics, 77% of Floridians on community water systems receive optimally fluoridated water, 0.7 ppm. That represents more than 13 million out of 17 million Floridians receiving the cavity-fighting benefits of fluoride.

In 1945, a research project was implemented in four paired cities to replicate what Mother Nature had taught us. Four of the cities had their natural level of fluoride adjusted to 1 ppm, while their paired cities did not adjust their natural fluoride levels. In just a few short years, cavity rates dropped off 60-70% in the cities where the fluoride was adjusted to 1 ppm.

What is water fluoridation?

Community water fluoridation (CWF) is the process of adjusting the amount of natural fluoride in water to achieve the right level for cavity prevention. This optimal level of fluoride is 0.7 ppm.

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SEE PAGE 8

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fluoride FROM PAGE 7

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Community water fluoridation is the single most effective method for preventing a significant proportion of cavities for everyone living in the community.

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CWF reduces cavities by simply drinking the tap water, using it to reconstitute concentrated and powdered infant formula, beverages prepared with it, and cooking with it. It reduces cavities by at least 25% above and beyond those already reduced by fluoridated toothpaste, mouth rinses and professionally applied varnishes. It is the most cost-effective way to deliver the right amount of fluoride to every person in the community without a change in daily behavior.

Simply drink the water and reap the benefits.

CWF is socially equitable. It levels the playing field for everyone.

CWF benefits people regardless of age, race, socioeconomic status, ethnicity, level of education or access to dental care.

How does fluoride work?

Fluoride works in two manners: 1. Systemically: Fluoride works by drinking CWF water and becoming incorporated into the developing permanent teeth of children before these teeth come in. This incorporation of fluoride into the developing tooth structure makes the tooth more resistant to acid attack from the bacteria in plaque, thus rendering them stronger from the inside out. This occurs up to age 8 years old.

2. Topically: l Fluoride works on the outside of the tooth to help prevent and even reverse early cavities that have started. This fluoride comes from fluoridated toothpaste, mouth rinses and professionally applied varnishes. l Additionally, drinking CWF allows fluoride to become incorporated into the saliva of the salivary glands. Fluoride comes out in a low amount in the saliva to bathe the teeth 24/7/365. It is this constant contact with low levels of fluoride from the saliva that makes a major impact on cavity reductions of adults and children.

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Both topical and systemic fluorides are important and complimentary. One does not replace the other. Think of it like this. When air bags came out, we didn’t stop wearing seat belts. They both work in tandem to add to the protection of our bodies. The same is true for topical and systemic fluoride.

How is fluoride added to water?

The amount of fluoride that is naturally present in most water is typically too low to prevent cavities. Therefore, community water systems working with the Florida Department of Health (DOH) determine how much fluoride needs to be added at the water plant to deliver the optimal level of fluoride for cavity reductions. Like any water additive, including chlorine, these levels are constantly monitored and adjusted to maintain optimal levels.

Is CWF effective and safe?

YES! In more than 70 years of CWF in the U.S., and more than 6,500 research studies and publications, the effectiveness in reducing cavities has consistently been demonstrated to remain important today.

Likewise, these studies and scientific reviews published in highly respected health journals have shown that the fluoride level used for CWF is safe. This level has never been shown to cause a single adverse health effect in anyone. With more than 70 years of CWF, if there were any problems, we would know it by now.

What if I am not on a community water system?

Some families in our state and around the country are on well water.

Remember that fluoride is picked up from rocks as the water flows over it. Well water will contain some level of fluoride in it. Some wells contain too low of an amount, some the optimal amount and some at levels higher than what is recommended.

your children with a fluoride tablet daily. While fluoride tablets are effective, it is not the ideal method to have the permanent teeth to get maximum benefits from CWF. Additionally, adults do not benefit from fluoride tablets. When fluoride levels are too low to prevent cavities, adults and children should use fluoridated toothpaste, and may add a fluoride mouth rinses (children over 6 years old as younger children may swallow it) and professionally applied fluoride varnish.

Summary Community water fluoridation is the single most effective method for preventing a significant proportion of cavities for everyone living in the community. It is inexpensive, safe and provides the only preventive dental care that some children and adults will receive. Those living at or below poverty level have up to twice the number of cavities than others. CWF helps to level the playing field. Approximately 50% of our population across the U.S. has not had a dental visit within the past year. With cavities being the No. 1 chronic disease of children and teenagers, we must use every tool in our toolbox to prevent this infectious and transmissible disease.

CWF is the closest thing to a magic bullet that we have.

Eat a balanced diet, brush with a fluoride toothpaste, floss, get regular dental checkups, have dental sealants placed on the crevices of teeth to prevent cavities and check your annual water quality report to make sure that your fluoridated water is still fluoridated at 0.7 ppm. If not, please bring it to the attention of your dentist or physician.

If you don’t have CWF, please contact us so that we can help you in your efforts to get it started.

Yours in good oral and general body health, Dr. Johnny Johnson

If you are on well water, contact your local Florida Department of Health office to ask to have your water tested. Once it is, you can speak with your dentist or physician about the need to supplement

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Dr. Johnson is a pediatric dentist in Palm Harbor, Fla. and the president of the American Fluoridation Society. For more information, please go to americanfluoridationsociety.org.

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THE FLORIDA BOARD OF DENTISTRY IS

LOOKING

FOR SOMEONE LIKE

YOU

Did you know there currently are two open positions on the Florida Board of Dentistry (BOD)?

A dentist position and a consumer position are vacant. The BOD is responsible for licensure,

monitoring and ensuring the safe practice of dentists and dental hygienists in their service to the people of the state. The BOD consists of 11 members appointed by the governor and confirmed by the Senate. Seven members must be licensed dentists actively engaged in clinical practice;

two members must be actively practicing dental hygienists; and two members must be consumers employed in a field or occupation that is not related to the dental profession. The BOD meets four times a year at various locations around the state and the various committees and councils meet via conference call in between those meetings.

If you’re interested in becoming a board member, flhealthsource.gov/board-members contains material that provides insight into the duties and responsibilities of the role.

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g n i s s i K s l e a o r D O r u o Y t ? c h e t f l f a A e H kissing

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erupted. The virus can be “shed” (spread to others) from the site of blisters even when they have healed. Chickenpox easily spreads from person to person by direct contact, droplets or airborne spread.

DR. THOMAS PELZER

You have a special someone in your life and you want to express it.

Just what are the benefits and consequences from kissing as far as oral and systemic health are concerned?

Medical and dental researchers know these benefits may be more important, healthwise, than you might think. Saliva washes out the mouth and helps remove the cavity-causing food particles that accumulate after meals. In addition to the digestive role saliva plays, this cleansing process is important to oral health.

The problem lies in the fact that kissing may also transmit a small number of diseasecausing bacteria and viruses through the oral cavity. Bacteria and viruses in the saliva or blood of one person can be spread to another person by kissing. Some diseases are more easily spread through kissing than others. Is a complete dental exam required before kissing someone? How healthy your mouth is plays an important role in just how significant this problem may be.

Some Viruses That Can be Spread by Kissing Upper respiratory tract infections like colds are easily spread through a kiss. Many different viruses are responsible for causing the common cold. Colds are believed to be spread by direct contact with the virus. You could catch the respiratory infection from airborne droplets or from direct contact with secretions (fluids and mucous) from the infected person’s nose and throat.

In addition, glandular fever, also known as the “kissing disease,” is the common term for a viral infection called infectious mononucleosis. It is caused by the Epstein-Barr virus. The virus is spread through saliva and infection occurs when it comes in contact with saliva. Yes, your probability of contracting one of these viruses is dependent on the health of your immune system. So take care of yourself!

More Serious Virus Transmissions Varicella-Zoster virus (VZV) is one of eight herpes viruses known to infect humans and other vertebrates. It commonly causes chickenpox in children and adults, and herpes zoster (shingles) in adults but rarely in children. Other publications have shown significant correlation of several herpes viruses with oral cancer.

More Serious Diseases The hepatitis B virus may also be transmitted via kissing under certain conditions, although blood has higher levels of this virus than saliva. Infection can occur when infected blood from bleeding gums comes into direct contact with someone else’s bloodstream via mucous membranes (mouth, tongue, gums.) People are more likely to be infected when kissing if they have open sores in or around the mouth. Additionally, be aware that warts in the mouth (human papillomavirus virus) can be spread through kissing, especially if there are areas of recent trauma.

Bacteria Certainly are Transmitted Through Kissing Meningococcal disease is a potentially life-threatening condition, which includes meningitis, inflammation of the membranes (meninges) that surround the brain and spinal cord and septicemia. These bacteria can be spread either through direct contact or via droplets.

Studies show that, with respect to kissing, only “deep kissing” seems to be a risk factor.

Herpes infection viruses that are considered part of the herpes family include Epstein-Barr, Varicella-Zoster (causes chickenpox) and herpes simplex (causes cold sores). Herpes simplex virus can be spread through direct contact with the virus when kissing. Herpes is most easily spread to others when the blisters are forming or have SEE PAGE 14 floridadental.org

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kissing

“

Around 80% of the bacteria in saliva are common to everyone and 20% are unique to you.

FROM PAGE 13

Periodontal disease (gum infection) can be transmitted through saliva. That’s why the American Academy of Periodontology recommends that if one family member has periodontal disease, all of the family members should be screened as well.

The bacteria that cause tooth decay aren’t found in the mouths of newborn babies! A baby’s mouth can be infected with another person’s saliva, which can be passed by a kiss on the lips from someone affected with active tooth decay.

Passionate Kisses are Good for Your Oral Health!

Rest assured it’s not all doom and gloom! Research into passionate kissing has uncovered many valuable health benefits. In a healthy mouth, saliva contains substances that fight bacteria, viruses and fungi. Deep kissing increases the flow of saliva, which helps to keep the mouth, teeth and gums healthy.

Around 80% of the bacteria in saliva are common to everyone and 20% are unique to you. The exchange of saliva in kissing stimulates your immune system to create antibodies to the foreign bacteria, a process called cross-immunotherapy, which helps you fight infection.

”

maintain good oral hygiene and visit your dentist regularly.

See your doctor about immunizations. Vaccines are available to prevent some infectious diseases, such as chickenpox, hepatitis B, herpes zoster (shingles) and group C meningococcal infection.

Don’t let the potential dangers stop you from kissing! Just be sure to practice good oral hygiene before you begin. Your loved one will thank you for it!

References: 1. connecticutsedationdentist.wordpress.com/2012/01/14/hpv-and-oralcancer-risk-important-information-from2. health.vic.gov.au/immunisation/factsheets/meningococcal-group-c.htm 3. en.wikipedia.org/wiki/Varicella_zoster_virus

This article appeared in the the 2013 Reception Room Issue and was originally reprinted with permission of Dentaltown Magazine and Dentaltown.com.

Dr. Thomas Peltzer is a sedation dental specialist serving patients throughout Connecticut, Massachusetts, Rhode Island and New York. Visit his website at www.connecticutsedationdentist.com.

Prevention Tips While Kissing There are a number of things you can do to reduce the risk of passing on — or catching — an infection while kissing. You should try to:

avoid kissing when you or the other person is sick.

avoid kissing anyone on the lips when you, or the other person, have an active cold sore, warts or ulcers around the lips or in the mouth.

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marijuana

Marijuana

and

Your Dental

Care

DR. PAMELA J. SIMS

In the late 1800s to early 1900s marijuana (cannabis) was used as a medicine. It was usually available as an extract of the cannabis plant.

During that time, cannabis extract was marketed by several pharmaceutical companies for sleep, pain and to improve appetite. The prescribing of cannabis in the United States significantly declined in the first 30 years of the 1900s due to the difficulty in producing reliable, standardized preparations and the inability to isolate the active ingredients. During that same time, other medications that were effective to treat the same conditions were introduced. In addition, medical use of cannabis was heavily taxed and government regulation of substances that had a potential for abuse was implemented. In 1970, marijuana was categorized by the federal government as a substance that was highly addictive with no medical value or safety.

In 1996, California passed Proposition 215 to allow the medical use of marijuana. Currently, 34 states, Washington, D.C., Guam, Puerto Rico and the U.S. Virgin Islands have approved comprehensive, publicly available medical marijuana/cannabis programs. In addition, 12 states allow

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the use of low delta-9 Tetrahydrocannabinol (THC), high cannabidiol (CBD) products for medical reasons. As the medical use of marijuana is implemented in many states, experts offer the following for consideration: Medical use and non-medical use of marijuana are unrelated.

For example: Heroin can be legally prescribed in Canada to relieve suffering in terminally ill cancer patients. This doesn’t suggest that heroin should be available for non- medical use.

Marijuana is not used as a first-line therapy for any therapeutic indication.

Marijuana’s greatest therapeutic potential comes from treating patients with chronic conditions non-responsive to standard therapies.

There are several federally approved marijuana-related drugs on the market in the U.S. Since 1985, dronabinol, a synthetic THC, has been marketed as Marinol® capsules and Syndros® solution to treat loss of appetite in patients with AIDS and for nausea and vomiting during cancer treatment. Nabilone® capsules are another THCrelated drug marketed since 1985 for nausea and vomiting during cancer treatment. More recently, cannabidiol (CBD) oil was approved in 2018 to be marketed as Epidiolex® solution to treat certain severe forms of childhood epilepsy. Nabiximols, a 1:1 mixture of THC:CBD already marketed in other countries, currently is being evaluated in the U.S. to treat muscle control problems in patients with multiple sclerosis.

THC, one of the two primary active ingredients in marijuana, increases in activity when heated (smoked or cooked). It has the greatest psychoactive effects and greatest ability to relieve pain. It may be beneficial for migraine headaches and chronic nerve pain, to reduce the use of opioid pain relievers and to reduce inflammation. Its major metabolite produced in the body is more potent that THC itself. CBD, the other primary ingredient, has the broadest therapeutic potential, is not psychoactive, and may be beneficial to reduce anxiety, relieve pain, treat nausea and vomiting, reduce anxiety and treat some forms of epilepsy.

In Canada and the Netherlands, pharmaceutical-grade smoked cannabis is grown by a single contractor under strict, controlled and documented conditions and licensed by the government. In those

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countries, the THC and CBD content are regulated by the government. In the U.S., the content of THC and CBD in marijuana grown for medical or recreational purposes is not regulated, but the content of THC in cultivated industrial hemp is. In addition to states allowing the use of medical marijuana, 10 states and Washington, D.C. have legalized certain amounts of marijuana for recreational use and others have decriminalized the possession of a certain amount of marijuana.

Marijuana often is inhaled by smoking or vaping or eaten in prepared food products. Inhaling versus ingesting impacts how quickly the effects of marijuana begin to be experienced, how great of an effect is caused and how long the effects last. Inhalation usually is preferred by users over ingesting. When marijuana is vaporized rather than smoked, exposure to possible cancer-causing ingredients is reduced and there is a less harm to the lungs.

For your dentist to care for you properly, it’s important for you to tell the dentist and their staff what type of marijuana product(s) you use and the method, amount and frequency you use the product(s).

It’s also important for you to tell them when you last used the marijuana and when you next plan to use it. The dentist and their staff will use this information to make decisions regarding your care including: the risk for tooth decay the need for professional and home dental care

the choice of/effect on any medications you are given for your dental care to help you relax

the choice of/effect on medications used to control your pain in the dental office or following your visit the choice of/effect on medications used to numb your mouth.

As you prepare for your dental visit, it’s important to understand that the use of medical marijuana is associated with an increase in fatal automobile accidents. Therefore, it is best for you to have a driver for your transportation to and from the dental office.

Dr. Sims is a professor in the Department of Pharmaceutical, Social and Administrative Sciences at Samford University School of Pharmacy.

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DON’T CLOWN AROUND WITH YOUR TEETH ­— TRUST A PROFESSIONAL WITH YOUR SMILE!

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diy Considering do-it-yourself (DIY) dentistry? Talk to your dentist and learn about the risks.

The Florida Dental Association (FDA) and our 8,000+ member dentists want to keep you and your mouth healthy. When considering any dental treatment, we encourage you to talk to your member dentist.

From Youtube videos on DIY dentistry hacks to viral charcoal teeth whitening posts to ads promoting at-home teeth straightening and whitening kits, there is a lot of misinformation being shared by sources who are not trusted experts on dental health. That is leading to a growing trend of DIY dentistry use that can cost patients time and money and at worst can cause irreversible damage to patients’ teeth and mouths.

DIY dentistry is any kind of dental treatment that is not executed under the expert care or supervision of a dentist or specialist. This includes at-home treatments, such as teeth whitening and straightening kits, veneers, or alternative treatments like using charcoal or oil pulling on your teeth.

Patients attempting DIY dentistry put themselves at risk for costly, long-term issues including jaw problems, abnormal bite, tooth loss, gum disease, or gum tissue that becomes stripped or receded. For example, DIY teeth straightening can cause infection, tooth loss or permanent bite damage. DIY teeth whitening trends, such as charcoal scrubbing or baking sodahydrogen peroxide paste, can wear away tooth enamel — actually causing teeth to dull or look more yellow.

Recent news in Florida includes stories of patients who have been at risk for serious issues resulting from DIY dentistry. One patient in South Florida risked losing a tooth as a result of teeth aligners that were not properly fitted.

It’s harder than ever to determine what information is reliable and trustworthy. FDA member dentists, which includes specialists such as orthodontists, have the training and knowledge to ensure the highest quality and safest delivery of care for your smile. Talk to your member dentist before using any unconventional dental products or at-home treatments. When choosing an at-home dental product, look for the American Dental Association Seal of Acceptance. More than 200 products have been researched and awarded the seal.

Remember — your FDA member dentist is ready to answer your dental-related questions and keep your smile healthy and shining!

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DIY WHITENING TRENDS THAT RUIN YOUR TEETH

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What do berries, curries, tomato sauce, balsamic vinegar, coffee and red wine have in common?

They all can stain your teeth. There are many things we enjoy eating and drinking that can stain teeth, so it’s no surprise that people are looking for fast ways to get whiter smiles. Teeth whitening is a popular cosmetic procedure that many people use to brighten their discolored smiles. However, not everyone turns to professional teeth whitening.

Some prefer to go the do-it-yourself (DIY) route instead. Although DIY tips can be helpful in other situations, many “natural remedies” to whiten teeth do far more harm to your teeth than good.

Touted by social media, bloggers and YouTube videos galore, these DIY whitening trends have all the appearance of shiny success. While surface stains may be removed, it’s due to their acidic, abrasive consistencies etching the surface layer of teeth that makes teeth appear whiter. This exposes and permanently damages the protective layer of enamel. Although tooth enamel is the hardest substance in the body, it can be damaged. When damaged, the next layer of your tooth can become exposed — a softer, darker and more opaque tissue called dentin.1 Not only can this lead to cavities, but your teeth also will feel more sensitive and look more yellow than ever since every substance you eat or drink is able to penetrate the deeper layers of your teeth.

Let’s take a look at some of the most popular DIY teeth whitening trends and the damaging effects they have on your teeth.

1. Activated Charcoal This seems to be all the rage in beauty and wellness products — from skin and hair care to medicinal purposes. And now, even teeth. What exactly is activated charcoal? It’s a finely milled black powder made from bone char, coconut shells, peat, petroleum coke, coal, olive pits or sawdust.

The charcoal is “activated” by processing it at very high temperatures. The high temperatures change its internal structure, making it more porous than regular charcoal.2 Although this makes it effective in absorbing toxins in some applications, it can be

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disastrous when used on teeth if you don’t know how abrasive your brand of activated charcoal is — and there may be no way for you to find out.

Using materials that are too abrasive — like some brands of activated charcoal — on your teeth can make them look more yellow. Though it might remove some surface stains, you are actually wearing away your teeth’s enamel, exposing the surface underneath (the dentin), which is yellow-colored.1 So, despite any temporary whitening affects you might see, it can lead to enamel erosion.

diy

2. Apple Cider Vinegar Apple cider vinegar is popularly used as a daily cleanse and is praised for aiding digestion, helping with weight loss and making hair shinier. Some even use it as a mouthwash, claiming it whitens teeth and removes stubborn plaque. There are plenty of good uses for apple cider vinegar, and some of them are healthy and perfectly safe. But that’s not the case when it comes to your teeth.

Using this on your teeth may remove stains, but this highly acidic substance also is removing the enamel on your teeth. The danger apple cider vinegar poses to your teeth and gums comes from its high acidity, and daily consumption can lead to extensive enamel erosion.3 Braggs, the most popular brand of organic apple cider vinegar, clocks in with a pH level just under 3. To put that in perspective, the pH scale runs from 1-14; any pH level lower than 7 is considered acidic. Apple cider vinegar is a little more acidic than soda, about on par with lemon juice, and not quite as acidic as stomach acid and battery acid.4 Does that sound like something you’d want to put on your teeth? In addition to weakening and damaging tooth enamel, which makes your teeth vulnerable to decay and sensitivity, it also can cause swelling and burns inside the oral cavity and on gums.

3. Baking Soda and Lemon Juice

MS. JESSICA LAURIA

Ms. Lauria is the FDA Communications and Media Coordinator.

References:

1. mouthhealthy.org/en/az-topics/w/ natural-teeth-whitening 2. healthline.com/nutrition/activatedcharcoal#section9 3. Gambon DL, Brand HS, Veerman EC. Unhealthy Weight Loss. Erosion

by Apple Cider Vingear. Ned Tijdschr Tandheelkd., 2012 Dec;119(12):589-91.

4. epa.gov/sites/production/ files/2015-10/documents/1622624.pdf 5. smilecoproducts.com/wp-content/ uploads/2017/04/Toothpaste-Abrasiveness-RDA-List.pdf 6. Ciancio, Sebastian G. Baking soda dentifrices and oral health. J Am Dent Assoc. 148 (11 suppl), 2017 Nov.:1S-3S. doi.org/10.1016/j.adaj.2017.09.009 7. ada.org/en/member-center/oralhealth-topics/toothpastes 8. healthline.com/health/baking-sodaand-lemon#teeth-whitening 9. malmin.co.uk/hot-water-lemonbad-teeth/ 10. Walsh, LJ. Safety issues relating to the use of hydrogen peroxide in dentistry. Aust Dent J., 2000 Dec;45(4):257-69; quiz 289.

11. King, Anthony. Bad Science: Oil Pulling. Br Dent J. 2018 Apr 13;224(7):470. doi: 10.1038/ sj.bdj.2018.281.

12. mouthhealthy.org/en/ada-sealproducts/what-is-the-ada-seal

Baking soda is an inexpensive, common household product with a variety of uses. It has an abrasive composition, which makes it a great cleaner around the house. To an extent, this applies to oral

SEE PAGE 22

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Enamel damage is irreversible, so protect your teeth by using a whitening toothpaste with the ADA Seal of Acceptance.

use as well. Baking soda is a relatively mild abrasive; the American Dental Association (ADA) rates its relative dentin abrasiveness around 7 on a scale where toothpastes that score 0-70 are considered low abrasive.5 However, although pure baking soda can remove surface stains, when you combine abrasives (baking soda) with acids (lemon juice), it can be too rough for teeth. It can wear away tooth and gum tissue, and leave a lingering gritty texture and slight burning sensation after use. In addition, pure baking soda doesn’t have fluoride or any of the additional beneficial ingredients found in toothpaste. Because of this, the ADA does not approve the use of baking soda as a toothpaste. However, the ADA does approve baking soda to be used as an ingredient in toothpaste. In formulated toothpastes, there are small, precise amounts of baking soda combined with other ingredients, such as fluoride, to make it safe and beneficial, to strengthen teeth and maximize oral health.6 If you want the cleaning benefit provided by brushing teeth with baking soda, but also want the added protection provided by a toothpaste that contains fluoride and protects against cavities, use a toothpaste with the ADA Seal of Acceptance.7,12 Lemon juice is highly acidic, which gives it excellent bleaching abilities. When used for teeth whitening purposes, it’s not only dissolving stains, but it’s also dissolving enamel. Combine it with baking soda, and

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you have a recipe for disaster — brushing with both together can have a very destructive effect on tooth enamel. Many proponents of using baking soda and lemon juice for whiter teeth insist that the harmful acid in lemon juice is balanced out by the high pH of baking soda. However, there’s no evidence that baking soda completely neutralizes the acidity of lemon juice.8

4. Hot Water and Lemon Drinking hot water and lemon has become a popular beverage to have first thing in the morning, and it has many benefits. It’s said to be rich in vitamin C, which boosts the immune system, as well as encouraging the production of bile to aid digestion and even assist with weight loss. However, sipping on this makes the lemon’s acidity linger on your teeth and soften the enamel. This, as discussed in the previous method, can lead to enamel erosion. So, if you decide to drink this, it’s advised that you never brush your teeth afterward, as this removes enamel while it is soft. Instead, you should brush your teeth before breakfast to create a protective fluoride layer against acidic foods.9

5. Hydrogen Peroxide Hydrogen peroxide is another common household staple. It has multiple uses due to its disinfecting and cleaning properties.

While many teeth whitening products contain hydrogen peroxide, that doesn’t mean you should swish it around your mouth — especially undiluted. Used regularly or

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incorrectly, it can cause chemical irritation and damage to your gums. Hydrogen peroxide is a highly reactive substance that can damage oral soft tissues and hard tissues when present in high concentrations and with prolonged exposure.10

6. Oil Pulling Oil pulling originates from ancient Ayurvedic medicine in India. It involves swishing coconut oil around the mouth to allegedly eliminate toxins from the mouth and body. Various websites advocate coconut oil pulling as an effective way to whiten teeth and remove bacteria, and some suggest it can treat tooth decay, kill bad breath, heal bleeding gums, prevent cavities and even prevent heart disease. However, there is no scientific evidence that oil pulling can prevent cavities, detoxify the body, strengthen teeth, treat cancer or reduce headaches, despite the claims made online.

Many of these reputed benefits promise exceptional health rewards without scientific evidence to support them.11 The ADA has stated that there is insufficient evidence to support the practice of oil pulling. While coconut oil has value in other uses, swishing it around in your mouth for 20 minutes isn’t one of them. Oil pulling won’t cause any harm to your teeth or gums, but it won’t benefit you either, so it’s a waste of time.

DIYs Don’t Live Up to the Whitening Hype We all want sparkling, pearly white teeth, but these DIY “natural remedies” don’t live up to the whitening hype. With the exception of oil pulling, all the methods mentioned are disastrous for your teeth and gums by eroding the enamel and damaging the gums. Their abrasive nature may remove surface stains, but the whitening effect is short-lived and wreaks havoc on your teeth — ultimately making it easier for stains to return and leaving your teeth worse off than when you started.

Enamel damage is irreversible, so protect your teeth by using a whitening toothpaste with the ADA Seal of Acceptance. What does that mean? The ADA Seal lets you know the toothpaste you choose is safe, effective and won’t damage your teeth. Every oral health product with the ADA Seal has been scientifically evaluated by independent experts to be safe and effective. To receive the ADA Seal, companies often are asked to meet higher standards than what is required by law. Products that don’t meet these tough guidelines don’t get the ADA Seal, period.12 For a list of oral health products that have the ADA Seal of Acceptance, go to mouthhealthy.org/en/ada-seal-products.

The safest way to whiten your teeth is to see a professional. Talk to your FDA member dentist today about getting that sparkling smile the safe way.

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brushing

Are

You

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Your Teeth the Wrong

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WYATT MYERS

Brushing your teeth may seem simple, but a variety of problems are tied to incorrect brushing technique. Check out these top mistakes and get tips to brush correctly.

It’s something we all learned as kids, and we do it twice (or more) a day. So when it comes time to brush our teeth, surely we’re not making any toothbrush mistakes … or are we? Actually, dental health experts say that improper brushing technique is more common than most people realize. And the result is that healthy teeth are not as common as they should be.

One of the first things you can do, says Dr. John Dodes, a dentist in Forest Hills, N.Y., and author of “Healthy Teeth: A User’s Manual,” is recognize that brushing isn’t the only requirement for having healthy teeth.

“A common misconception about oral care habits is that brushing is enough, when in fact brushing alone misses more than half the germs in your mouth,” he says. “People also forget that it’s important to clean between the teeth, as well as your tongue, cheeks and the floor of your mouth.

Your mouth has more germs than [there are] people on earth, so it’s important to make sure you brush, floss and rinse to ensure you’re cleaning every surface.”

Here are more top toothbrushing mistakes people make: Using the wrong style of brush.

“Some people still like medium or hard toothbrushes, but soft, round-ended bristles are the way to go,” says Dr. Matthew Hyde, a dentist in private practice in Plainview, N.Y. “When the plaque is soft, it will come off with a soft brush. Once it hardens into tartar or calculus, it won’t come off with brushing no matter how hard the brush, but you can damage the delicate gum tissue by using those types of brushes.” floridadental.org

Not replacing an old brush. You should replace your toothbrush every three to four months for dental health, but many people let it go way beyond this point.

“When the bristles become splayed out, they cannot properly clean the various surfaces of your teeth,” says Dr. Shawn Frawley, a dentist in private practice in Beverly Hills, Calif. “In addition, many of the power brushes lose cleaning power as the brush head ages.”

Brushing back and forth. Often, the brushing mistake has to do with brushing technique itself. “You should brush in a circular motion, angling the bristles of the brush at a 45-degree angle to the gum line and focus on a couple teeth at a time,” says Dr. Frawley. “This enables you to clean under the gums, where most plaque is present and causes the most harm. This also helps avoid over-brushing.”

Moving all around. People don’t always follow a set order as they move around their mouth brushing. “When we brush in this fashion, we tend to miss various surfaces of the teeth because it is hard to know where we have and have not brushed,” Frawley says. “You should brush your teeth with a systematic approach. There are four quadrants of the mouth and three surfaces to brush per tooth. You should brush all the surfaces of one quadrant of the mouth at a time.”

Brushing too aggressively. Not a lot of force is needed to do a good job brushing, says Dr. David S. Keen, a dentist in private practice in Beverly Hills, Calif. “Most people forget that bacteria and food particles that remain on the teeth after eating a meal are soft in texture,” he says. “Therefore, gentle brushing is all that is needed to remove the bacteria and food.” If you use an electric toothbrush, keep in mind that it was designed to do it all. “Vigorous movement

of the electric toothbrush against the teeth and gums and using heavy arm pressure can negatively affect the condition of your teeth and gums and can even cause gum recession,” explains Dr. Keen.

Not brushing long enough. According to Keen, this is a big problem. “Most people, when asked how long they brush, typically say about one to two minutes, when in reality they typically brush for only 30 seconds,” he says. “It is important to access all the areas of the mouth and all surfaces of the teeth to effectively clean the tooth surfaces of bacteria and food, and to coat each tooth surface with the cleansing toothpaste.”

Using too much toothpaste. The flip side of the previous tip is that most of us slather way more toothpaste onto our toothbrush than we actually need. “You just need a pea-sized amount for most toothpastes,” says Dr. Hyde. “The rest is wasted.”

Not using an electric toothbrush. For the most thorough brushing job, most dentists agree that it’s time to make the switch if you haven’t already. “Power brushes are affordable these days and are certainly worth the investment,” says Frawley. “There is no possible way to brush your teeth as effectively or thoroughly with a manual toothbrush as compared to a powered brush.

Many of these brushes indicate if you are brushing too hard and have timers on them to ensure you are brushing for long enough.

It makes brushing easier because you just need to hold the brush in the proper position and let the brush do the work.”

Medically reviewed by Lindsey Marcellin, MD, MPH. Reprinted with permission from Everyday Health. This article was previously printed in the 2013 Reception Room issue.

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Visit MouthHealthy.org/ToothTeam for more activity sheets.

HEALTHY SMILE TIPS

Brush your teeth twice a day with a fluoride toothpaste.

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Clean between your teeth daily.

Eat a healthy diet that limits sugary beverages and snacks.

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See your dentist regularly for prevention and treatment of oral disease.

floridadental.org ALL RIGHTS RESERVED.

© 2017 AMERICAN DENTAL ASSOCIATION

Visit MouthHealthy.org/ToothTeam for more activity sheets.

HEALTHY SMILE TIPS

Brush your teeth twice a day with a fluoride toothpaste.

floridadental.org

Clean between your teeth daily.

Eat a healthy diet that limits sugary beverages and snacks.

See your dentist regularly for prevention and treatment of oral disease.

© 2017 AMERICAN DENTAL ASSOCIATION

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ALL RIGHTS RESERVED.

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off the cusp

No Thanks, I'll Do It Myself JOHN PAUL, DMD, FDA EDITOR

Doing a few things myself makes me feel useful. I’m not talking chores like making the bed or bringing in the garbage cans. I mean things like changing the headlights in my car or building shelves for my house. You can look these things up on YouTube and be pretty sure you know most of what you need to know to be successful. I think we can all agree you don’t need to call an electrician to change a light bulb. Unless that light bulb is 30 ft. off the floor and 15 ft. from the nearest wall. For a couple of bucks, I’ll let the electrician be responsible for getting that job done right or doing it over at their expense.

If you’re looking around on YouTube or even at some shopping malls and major department stores, you can find a way to do dentistry on yourself. No one (probably) thinks it’s a good idea to get out dad’s BLACK&DECKER and go to work on their own pearly whites — that’s way out there. But you just want to move them a little bit. Make them straighter and prettier and whiter. The advertising says it’s easy and the results are great, and why pay a dentist all that extra money? It’s just like the dentist uses, right? It must be safe because they wouldn’t let them advertise if it wasn’t, right?

Maybe it is and maybe it isn’t. Maybe all those people in the weight loss ads lost 40 lbs. and got huge beach muscles in two weeks without changing anything they eat!

What they don’t tell you when you make your own impressions and order a kit online to move your teeth is that you are accepting all the responsibility. If you don’t like the results you either live with it, change it yourself or find a dentist who can fix the new problem. If you move a tooth out of bone, because you weren’t a good candidate

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for this type of procedure in the first place, you can’t sue the dentist for malpractice and you can’t put the tooth back where you started.

So, maybe you realize do-it-yourself ortho is beyond your skill set, but whitening, that’s easy, right? It certainly makes sense that the blacker a thing I use, the whiter my teeth will get. I don’t know how abrasive that charcoal you’re brushing your teeth with is, and you don’t want to find out it was too harsh when your teeth look more yellow because you stripped the enamel off them.

The Florida Dental Association (FDA) and I personally advocate every person having a good dental home: p a dentist you trust, who cares for your well-being and wants you to be healthy your entire life p someone who can tell you if your mouth has disease and if certain treatments are right for you p a professional you can rely on to take responsibility for the advice they give and the services they provide There is plenty of dentistry you can and should do yourself: brush and floss, eat healthy foods, drink fluoridated water, teach your children to do the same. When it comes to bigger issues, get the advice of an educated and licensed FDA member.

JOHN PAUL, DMD, EDITOR, TODAY'S FDA

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Today, more than 200 over-the-counter dental products sold to consumers carry the ADA Seal of Acceptance. Participating companies commit significant resources to test and market products in the Seal program. These products can be used with assurance that they have demonstrated safety and efficacy according to ADA requirements. To find accepted products, go to https://bit.ly/2TJCdnY.

DENTAL OFFICE

TRUST A PROFESSIONAL WITH YOUR SMILE!

The Florida Dental Association and our 8,000+ member dentists want to keep you and your mouth healthy. When considering any dental treatment, we encourage you to talk to your member dentist.

Straightening Kits Teeth Whitening Veneers

DON'T CLOWN AROUND WITH YOUR TEETH!