2016 - Reception Room TFDA

Mouthguards Staining Teeth Dental Care Parent Guide Baby Teeth: 101

e v o L ! t e s i W t n e D r u o 2016 Annual Reception Issue

2016 RECEPTION ROOM ISSUE

ORAL HEALTH ONLINE! Trusted Sources for Oral Health Information

floridadental.org/public Benefits of Seeing an FDA Member Dentist Find an FDA Member Dentist Low Cost Dental Care Today’s FDA Reception Room Issue Fluoridation Helpful Links

mouthhealthy.org Find an ADA Seal product Age-related information Nutrition Symptom Checker Dental Care Concerns ACA Checklist for Dental Plans Dental Emergencies And, much more!

contents We Love Our Dentist!

columns

features

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President’s Message

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Off the Cusp

8 Mouthguards

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The Science of Genuine Smiles

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Which Foods Actually Stain Your Teeth and Which Don't

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Dental Care Parent Guide

20 Ethics in Dentistry ... Does it Matter?

24 If Life Hands You Lemons, Maybe Your Name is Rona 26 Baby Teeth: 101 30 What is Water Fluoridation?

For information on oral health care, visit: www.mouthhealthy.org.

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

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FLORIDA DENTAL ASSOCIATION RECEPTION ROOM 2016 VOL. 28, NO. 4

EDITOR Dr. John Paul, Lakeland, editor

STAFF

THE FLORDIA DENTAL ASSOCIATION RECOGNIZES THE SERVICE AND COMMITTMENT OF THE 2016 FDA AWARD WINNERS. PRESIDENT’S AWARD Dr. Ralph C. Attanasi Jr. FDA DENTIST OF THE YEAR Dr. Andrew Brown J. LEON SCHWARTZ LIFETIME SERVICE AWARD Dr. Nolan Allen FDA LEADERSHIP AWARDS Dr. Yvette Godet Dr. Steven Bryan NEW DENTAL LEADER AWARD Dr. Brittney Craig DENTAL TEAM MEMBER AWARD Mrs. Cheryl Lopez PRESIDENT'S CHOICE AWARD Dr. Ethan Pansick FDA PUBLIC SERVICE AWARDS More Health Inc. Pinellas County Dental Association Mrs. Delores Barr Weaver DANIEL J. BUKER SPECIAL RECOGNITION AWARD Mrs. Carrie Millar

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

BOARD OF TRUSTEES Dr. Ralph Attanasi, Delray Beach, president Dr. William D’Aiuto, Longwood, president-elect Dr. Michael D. Eggnatz, Weston, first vice president Dr. Jolene Paramore, Panama City, second vice president Dr. Rudy Liddell, Brandon, secretary Dr. Richard Stevenson, Jacksonville, immediate past president Drew Eason, Tallahassee, executive director Dr. James Antoon, Rockledge • Dr. Andrew Brown, Orange Park Dr. Jorge Centurion, Miami • Dr. Robert Churney, Clearwater Dr. Richard Huot, Vero Beach • Dr. George Kolos, Fort Lauderdale Dr. Jeffrey Ottley, Milton • Dr. Howard Pranikoff, Ormond Beach Dr. Barry Setzer, Jacksonville • Dr. Beatriz Terry, Miami Dr. Stephen Zuknick, Brandon Dr. Ethan Pansick, Delray Beach, speaker of the house Dr. Tim Marshall, Weeki Wachee, treasurer • Dr. John Paul, Lakeland, editor

PUBLISHING INFORMATION Today’s FDA (ISSN 1048-5317/USPS 004-666) is published bimonthly, plus one special issue, by the Florida Dental Association, 1111 E. Tennessee St., Tallahassee, Fla. 32308-6914.

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 2016 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, 1111 E. Tennessee St., Tallahassee, Fla. 32308-6914.

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, 1111 E. Tennessee St., Tallahassee, Fla. 32308-6914.

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.

Advertising must be paid in advance.

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

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@Ralph RALPH C. ATTANASI JR., DDS, MS

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Visiting Your FDA Dentist

Taking proper care of your teeth and gums provides you with a lot more than fresher breath and a pretty smile!

Your dentist is a member of the Florida Dental Association (FDA) and is committed to helping you maintain and improve your oral health. As we know, the oral cavity is the gateway to overall health. Strong, healthy teeth and gums allow you to eat a variety of nutritious foods that contribute to your overall well-being. Taking proper care of your teeth and gums provides you with a lot more than fresher breath and a pretty smile! Medical studies have shown that periodontal (gum) disease has a strong correlation to cardiac disease — ask your dentist about this!

Your FDA dentist takes great pride in caring for his or her patients, but they also provide dental care for patients who are not in their

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practices. For example, the FDA held the Florida Mission of Mercy (FLA-MOM) event in Jacksonville in April this year. During this event, every person who showed up received free dental care — from cleanings to X-rays to fillings or removal of painful teeth — regardless of where they live or how much or how little income they have.

During this event, 2,930 patients received care valued at $2.7 million from 2,465 volunteers, including almost 600 dentists.

The FDA also supports water fluoridation projects throughout the state. While it may seem funny that your dentist would try to reduce the numbers of cavities that he has to fill, this is exactly what fluoridation does!

Drinking fluoridated water has been proven

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to reduce the number of cavities in the public, making their teeth and bodies healthier.

Your FDA dentist holds himself or herself to the highest ethical standards and, by being an FDA member, agrees to follow the ethical principles of the American Dental Association. You’re in great hands!

Dr. Attanasi is the FDA President.

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Genuine Smiles

The Science of G 6

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Genuine Smiles

By Dr. Alina Lukashevsky

A beautiful, authentic smile is an involuntary form of self-expression. Universal in its message, a smile can communicate joy, excitement and caring — all without language.

From a dentist’s perspective, the essence of smiles is in their anatomy as well as cosmetic artistry. However, instead of writing about veneers, whitening, or any of the other many services and techniques that can enhance a smile, I thought it might be interesting to present some research on the phenomenon of the smile itself.

In 1862, the French neurologist G.B. Duchenne studied the muscles that cause us to smile and arrived at some interesting conclusions. A necessary characteristic of any smile, he found, is that the corners of the lip pull up with the help of the cheek muscles (zygomatic major). However, true joy is expressed on the face by the combined contraction of the muscles around the lips and — very importantly — muscles around the eyes (orbicularis oculi). Of the two types of smiles, one being voluntary, Duchenne said, “the first obeys the will, but the second is only put into play by the sweet emotions of the soul.” Artificial smiles can be performed at will because the brain signals that create them come from the conscious mind, prompting contraction of (zygomatic major) muscles in the cheeks. Real smiles come from another part of the brain and in addition to the zygomatic major muscles, also cause the orbicularis oculi muscles to contract around the eyes, as mentioned in Psychology Today.

This might be why we use the expression “sparkle in the eyes” when we talk about someone who is truly happy.

There are two main types of smiles, and an authentic smile correlates with overall health, emotional fulfillment and longevity. Psychologists LeeAnne Harker and Dacher Keltner analyzed 141 college yearbook photos of women, and then matched up the smile ratings with personality data collected during a 30-year longitudinal study. Women who displayed true, Duchenne-worthy expressions of positive emotion in their 21-year-old photos had greater levels of general well-being and marital satisfaction at age 52, than those whose smiles were not Duchenne-worthy.

In a more recent study published in the Journal of Psychological Science, Ernest Abel and Michael Kruger of Wayne State University extended this line of research from emotional outcomes to a biological one: longevity. Abel and Kruger rated the smiles of professional baseball players captured in a 1952 yearbook, then determined each player’s age at death (46 players were still alive at the time of the study). The researchers found that smile intensity correlated to longevity, with those smiling the biggest living longer than those who didn’t smile at all.

The Duchenne smile is perceived as more sincere, honest, friendly and approachable. Cultivating such a smile would have a positive influence on a person’s feelings, state of being, and may influence his or her interpersonal relationships. So regardless of your age or sex, if you want to live a long and happy life, the Duchenne smile may be the most valuable gift you can give another person — or yourself.

Dr. Alina Lukashevsky practices dentistry in New York City. This article first appeared on the Huffpost Healthy Living blog. Reprinted with permission from Dr. Alina Lukashevsky.

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Mouthguards

Sporting Activities If you participate in any of the following activities, the American Dental Association (ADA) and the Academy for Sports Dentistry recommend that you wear a properly fitted mouthguard:

m Acrobatics m Baseball m Basketball m Bicycling m Boxing m Equestrian events m Extreme sports m Field hockey m Football m Gymnastics m Handball m Ice hockey m Inline skating m Lacrosse m Martial arts m Racquetball m Rugby m Shotputting m Skateboarding m Skiing m Skydiving m Soccer m Softball m Squash m Surfing m Volleyball m Water polo m Weightlifting m Wrestling www.floridadental.org

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Mouthguards

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Mouthguards help reduce injuries by acting as shockabsorbing devices that spread the force of a traumatic blow away from the point of initial contact.

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Mouthguards

By Dr. Terry Buckenheimer FDA PAST PRESIDENT

Mouthguards?!

Who needs one of those? Well, if you or one of your children is playing a contact sport, then the answer is YOU! Participation in contact sports — such as football, basketball, hockey, soccer, lacrosse, boxing, rugby, baseball, softball and wrestling (29 activities in all) — carries a considerable risk of sustaining dental injury. Orofacial injuries (those of the mouth, teeth, lips, jaws and supporting structures) are the most common sports-related injuries. Cut lips or slightly chipped teeth may not produce high levels of concern. But, a broken or completely knocked out tooth, a torn lip or tongue, or a broken jaw require immediate attention and significant and costly treatment.

That is why the Florida Dental Association (FDA), along with the American Dental Association (ADA), highly recommends the use of mouthguards in all contact sports. A strong emphasis was placed on mouthguard use in the 1990s when the Save That Smile program was launched by the FDA Foundation. It was created to show what a mouthguard is, what it’s designed to do and why it’s so important to use in contact sports to prevent the occurrence and severity of dental injuries. Since that time, there has been an incredible increase in the use of mouthguards in football, basketball and hockey.

You see many professional athletes wearing their mouthguards with pride. They also show their big beautiful smiles in their postgame interviews. Could you imagine these same professional athletes with a missing front tooth or two? It’s no longer cool to be a hockey player with a toothless smile. But, there is still plenty of room for improvement.

Did you know that studies have shown that the incidence of dental trauma is highest in children between the ages of 6-12 years? And, that participation in sports accounts for about 31 percent of those traumas? An athlete has about a 10 percent chance of having orofacial trauma each season of play and a 33-56 percent chance of receiving an orofacial injury during his/her playing career.

Mouthguards help reduce injuries by acting as shock absorbing devices that spread the force of a traumatic blow away from the point of initial contact. They provide a cushion to the hard and sharp surfaces of the teeth, and dramatically reduce cuts and bruises to the

lips, cheeks and tongue; chipped, fractured or knocked out teeth; and, broken or dislocated jaws.

Mouthguards are made from a variety of vinyl/rubber materials and come in three varieties.

Custom-fitted Made by a dentist over a dental model that is an exact replica of the person’s mouth. It provides a mouthguard that fits precisely to the teeth and therefore, allows ease of wear and greater retention and comfort.

Mouth-formed Also known as a “boil and bite” mouthguard — as they are made from a thermoplastic material that is immersed in hot water and molded around the teeth. These are the most popular due to their low cost, ease to make and availability.

Stock Preformed with no ability to modify its fit. They require clenching of teeth to keep in place. This, then causes problems with speaking and breathing. These are the least popular, unless it is a strap version connected to the face guard of a helmet.

Sports dentistry has become a popular area of dentistry. It involves the prevention and treatment of orofacial athletic injuries, and supports the research and data collection of such injuries. Over the past 35 years, I have provided coverage (on the field of play or on call) for many sports programs of various high schools and colleges in the Tampa Bay area. I also have been the Team Dentist for professional football and soccer franchises and the Outback Bowl every New Years’ Eve since its inception. I have seen teeth that have been chipped, cracked, fractured at the gum line, pushed inward and avulsed (teeth that have been knocked out). I have seen fractures of both the upper and lower jaws from elbows during basketball games and “headers” during soccer matches. All of these injuries occurred because the individual wasn’t wearing a mouthguard during their participation in a contact sport. The treatment for these injuries was significantly expensive and time consuming. Most of these individuals who received injuries listened to me after the fact — they now wear their mouthguards!

You can obtain more information about sports-related dental injuries at www.academyforsportsdentistry.org or www.aapd.org.

Dr. Terry Buckenheimer is a past president of the FDA.

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Staining Teeth

Which Foods Actually St

By Alexandra Duron

Like scoring a big promotion or a date with your longtime crush, a luminous, white smile is the stuff that dreams are made of. And it’s no wonder, considering how much the appearance of our teeth affects our image.

Case in point: Research shows people with whiter teeth are perceived as more socially competent, smarter, more satisfied with their relationships and more psychologically adjusted. Another study (full disclosure: It was commissioned by Crest© 3-D White™ Whitestrips) suggests that a brighter smile may lead to more success in both your professional and personal life.

Needless to say, we were curious to find which foods and drinks lead to a more radiant smile — and which ones tint and tarnish our pearly whites. If you’re seeing tons of stains, try to cut your intake of the foods on the “naughty” list below to every other day — max, says Dr. Sally Cram, a periodontist in private practice in Washington, D.C., and spokesperson for the American Dental Association. And most importantly, stay on top of your regular dental habits, like flossing daily, brushing twice a day and popping into your dentist’s office for regular checkups. Read on for the foods that dull your smile and which ones will make it sparkle.

Worst Foods for Your Teeth Citrus and Acidic Foods: If you notice a yellowish tinge to your teeth, acidic foods (think citrus fruits and tomatoes) might be to blame. Even though they’re nutrient-packed, these colorful eats can erode the enamel, which might expose the yellow-hued dentin — aka the tissue beneath the enamel made up of mostly calcium and phosphate crystals, Cram says.

Coffee: Sorry, java junkies: Your favorite cure for tired mornings contains tannins (acidic polyphenols) that lead to staining and discoloration, Cram says. Plus, because it’s acidic, it alters the pH balance of the mouth, making any acidic foods you eat afterward

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Staining Teeth

Stain Your Teeth ... and Which Don’t damage the teeth much more quickly, explains Dr. Kourosh Maddahi, a cosmetic dentist based in Beverly Hills.

His solution: Drink your coffee with a to-go lid — not using a straw. Doing so will cut back on the acidic-environment situation that coffee causes in the mouth and also prevents the fine lines that form when you pucker your lips to sip from a straw.

Sweets: According to Dr. Cram, that whole sugar-will-rot-yourteeth-out thing? It’s a bit dramatic, but kind of hinged on fact. The sugars in delicious treats like cookies and hard candy (and even snack foods like chips) latch onto your teeth and become the main meal for the bacteria in your mouth. When the bacteria feed off these sugars, they release acids that lead to tooth decay, which may be dark and cause back holes in your poor teeth.

Soda: Sugar-laden beverages act the same as sugar-laden snacks, giving the bacteria in your mouth plenty to feed off of (and thus releasing damaging acids), Cram says. Sodas are especially dangerous, since anything carbonated also is acidic and will create holes in the teeth — and this includes sugar-free versions, too, according to Dr. Maddahi.

Please see STAINS, 14

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Staining Teeth STAINS from 13

Tea: Just like coffee, tea also contains the staining saboteurs known as tannins, so sipping on a cup of chamomile may lead to stains, Cram says. But there’s even more to it than that — like the hue it turns your teeth, for instance. “Green tea stains teeth gray, and black tea stains them yellow,” Maddahi explains. If green tea’s your go-to, he suggests investing in a high quality option — the lower the quality, the worse the stain it’ll cause.

And if you just can’t bid the brew adieu, use Maddahi’s to-go lid trick like you would if you were drinking coffee. Also, consider adding a dash of milk to your cup. Research suggests that adding milk to your tea slashes its ability to stain your teeth.

Blueberries, Blackberries and Pomegranates: While they may be chock-full of antioxidants, these richly pigmented berries have a serious stain game. Maddahi’s rule of thumb when it comes to these little superfoods: If it’s difficult to remove their stain from clothing, it’s going to be difficult removing it from teeth.

Red Wine: Wine may be responsible for teeth that’ve turned shades of gray — which, unluckily, is a harder hue to remove than yellowish stains, Maddahi says. The culprits? The same pesky tannins that we see in tea and coffee. But there’s a silver lining: While your favorite Malbec may not help your pearly whites stay that way, recent research suggests that it may actually help fight cavities. So go on and pour it up — in moderation, of course.

White Wine: Cue the sad violin. As it turns out, sipping on sauvignon blanc also can steal some of the white away from your smile. One study suggests that the lighter type of vino may make tooth stains darker. So while it doesn’t actually cause the stains, its acid content creates little pockets on the surface of the tooth that allow other beverages to seep in deeper, the study’s researchers explain.

Best Foods for Your Teeth Fibrous Fruits: High-fiber fruits, like pears and apples, may help whiten your teeth, Maddahi says. Not only do they boost saliva flow (which helps keep teeth clean), but their fiber content removes some stains by scrubbing the surface of the teeth, he explains. Just be sure you brush your teeth after having your apple a day — fruit still contains sugars, and you don’t want that sticking around longer than it has to.

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Staining Teeth

Baking Soda: Scrubbing with the white powdery stuff will whiten teeth naturally, Maddahi says. Simply wet your toothbrush and dip into the powder. One caveat: Don’t make it an everyday habit. Since the abrasive properties of baking soda may cause damage to the enamel of your teeth, he recommends using this method once a week.

Strawberries: Strawberry fields forever may be the way to go if you’re looking for a natural way to whiten your smile. The red berries contain malic acid, which may be responsible for this effect, Maddahi says. You can even double up and mash them with baking soda for DIY whitening solution. However, science says that while it does seem to make your teeth look whiter (since you’re removing some of the plaque), it doesn’t penetrate the enamel to provide real, long-lasting results.

Cheese: Good news, cheesemongers: You may be fighting cavities with every delicious bite. Research suggests that eating the savory stuff may lead to a higher pH level in the mouth, which slashes the risk for cavities.

Water: Water does more than just keep you hydrated. Research suggests that drinking plenty of H20 keeps the teeth and gums healthy, and fluoridated water in particular helps battle tooth decay. And if you can’t brush after a meal, simply swish around some water to clear sugars and acids.

Nuts: We’re nuts about nuts around here, and for good reason: These small but mighty bites boast a slew of health benefits, from boosting weight loss to fighting aging and more. And now, we can add one more to the list: strengthening our teeth. Because of their protein content, nuts protect our teeth and keep them strong, Cram says. Plus, the chewing it takes to eat each one helps stimulate saliva production, so they also help clean the mouth, she adds. On the flipside, some research suggests that nuts may cause tooth decay and could have been to blame for dental disease in our hunter-gatherer ancestors, so check with your dentist to see what he or she recommends before going too, well, nuts.

Reprinted with permission. Originally published on Greatist.com in April 2015.

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DENTAL CARE PARENT GUIDE

DENTAL CARE IS CRITICAL FOR CHILDREN

WHEN TO START SEEING A DENTIST (And What to Do Until Then)

CHOOSING A DENTIST

TIPS FOR A SUCCESSFUL TRIP TO THE DENTIST

HEALTHY SMILES FOR A LIFETIME!

Cavities are the most common chronic disease found in school-age children.

In fact, dental disease causes children to miss more than 51 million school hours each year.

The American Academy of Pediatric Dentistry (AAPD) recommends that a child go to the dentist by age 1 or within six months after the first tooth comes in.

But even before your infant’s teeth come through, dental care is important.

After feeding, thoroughly clean your infant’s gums with an infant washcloth or gauze pad to remove any food and stimulate the gums.

When your baby’s first teeth begin to grow in (typically around six months), brush them gently with a soft-bristled toothbrush.

When choosing a dentist, you may want to call or visit more than one dentist to find the right match for you and your child.

When you choose an FDA member dentist, you know your dentist: •

has gone through a thorough licensing process and is held to a legal standard by the Florida Board of Dentistry.

•

follows a code of ethics committed to integrity and promoting the highest professional standards.

•

is actively involved in furthering his or her own professional development to stay at the forefront of innovative trends and best practices for providing care.

For younger children, try NOT to schedule an appointment during naptime (or after naptime if your child is typically cranky after waking up.)

For older children, try to avoid cramming in a dentist appointment right after a full day of school or camp, as they may be too exhausted.

Make sure your child isn't hungry by planning to eat before the appointment (while avoiding anything heavy and being sure to brush after).

Consider taking your child to your dental cleaning or an older sibling’s to show them good patient behavior.

Keep calm if your child gets upset or won’t cooperate. Assess why your child is acting out, then work as a team with your dentist to keep the visit going. Allow the dentist and your child to build a good relationship.

Ethics

Ethics

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Ethics

Ethics in Dentistry ...

Does it Matter

By Dr. Larry Cook

?

The subject of ethical thought seems to only come in the minds of people or in the media when a person has done something that is seen as wrong or which is deemed unethical. Yet, the dental profession teaches principles of ethics to dental students from the very first day they arrive at dental school and continues that emphasis throughout the career of a dentist. Ethical thought and action are promoted by the dental profession because ethics is at the very core of a professional relationship between a patient and their dentist. As a patient, you expect that your dentist thinks and acts in an ethical manner in all areas of the doctor/patient relationship, just as you should. The profession has identified core principles of ethics that act as a guide or directive to challenge the members of the profession to consider the way they walk their journey as a professional.

Ethics are the moral principles or virtues that govern the character and conduct of an individual or group. Ethics also can be seen as the systematic study of what is right and good with respect to character and conduct. The dental professional has a specialized body of knowledge and skills in the practice of the profession, and each dentist is challenged to use their knowledge and skills for the benefit of another person prior to self-interest. This is what separates the health care professional from other so-called professions. If you will, it is the commitment by the dental professional to place the other person’s needs and care above their own. It is that commitment that can allow a patient to grant the professional the greatest gift in the doctor/patient relationship — which is TRUST. Without this trust between patient and doctor, there truly cannot be a sound relationship. It is on the shoulders of the dental professional to practice throughout their

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Ethics

professional lives in the highest ethical manner. They are challenged to bring honor to the profession by the manner in which they treat each person who entrusts their dental care to the professional.

The profession has identified five core ethical principles that can guide the dental professional as they make their decisions of proper care for their patients on a daily basis. First is the ethical principle of autonomy, which is respect for the fact that every person has the right to make their own decision as to just what is done to their bodies. The dental professional must provide as much information as is necessary to allow a patient to choose the course of treatment they deem proper via having full-informed consent. Second is the ethical principle of beneficence, which is the core intent of the dental professional to “do good” for the patient in all of their interactions. This principle is about the intent of the dental professional to make sure, where at all possible, that good outcomes prevail. Third is the ethical principle of non-maleficence, which is to “do no harm.” The professional is trying in every way possible to not bring harm to their patient as they provide their care for that patient; again, an intention of a sound outcome for the patient by the dental professional is the focus. Next is the ethical principle of justice, which is to bring fairness, or the giving to each, his or her own due. It is for the dental professional to balance the distribution of benefits and burdens in practice. It is to practice the profession with a commitment to equality to all seeking care from the professional. Lastly is the ethical principle of veracity, which is honesty — to always tell the truth in all interactions. This also is a two-way street because not only does the patient rely on the dentist to be honest and truthful so the patient has the ability to make a wise autonomous decision as to their care, but the dentist also must rely on the patient to be truthful in informing the dentist of facts necessary to form a proper diagnosis.

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Ethics affect virtually every decision that every person makes in all activities of their life.

“The object of ethics is to emphasize spirit (or intent) rather than law. Dental ethics applies moral principles and virtues to the practice of dentistry. The terms ‘ethical’ and ‘moral’ have been used synonymously and used to mean only that the issue, question, reflection or judgement to which they apply concerns what ought or ought not be done, or what is a matter of someone’s obligation.” 1

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Ethics affect virtually every decision that every person makes in all activities of their life.

Ethics affects relations, relationships between doctor, patient, office staff and the public at large. To answer our question: Ethics in Dentistry, Does it Matter? It is a resounding YES, ETHICS MATTER! Ethics is the bedrock foundation of all learned professions. May we all seek to walk our lives in the highest ethical manner!

Ethics Handbook for Dentists; American College of Dentists; Gaithersburg, Maryland. Revised 2013; p.3.

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Dr. Larry Cook is a professor at The University of Florida College of Dentistry.

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FDAF Fundraising Disclosure Statement: All contributions to the FDA Foundation are tax deductible. All contributions, including those to named funds, are considered unrestricted unless a specific purpose is designated by the donor. The FDA Foundation Inc. is a tax-exempt organization under s. 501(c)(3), Internal Revenue Code, soliciting tax-deductible private contributions for the benefit of the public. The Foundation is registered to solicit charitable contributions with the appropriate governing authorities. The organization is located at 1111 E. Tennessee St., Tallahassee, FL 32308. Financial and other information about the Foundation’s purpose, programs and activities can be obtained by contacting the Director of Foundation Affairs, 1111 E. Tennessee St., Tallahassee, FL 32308 or by calling 800.877.9922. A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSMER SERVICES BY CALLING TOLL FREE, WITHIN THE STATE, 800.HELP.FLA OR VIA THE INTERNET AT WWW.800HELPFLA. COM. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL OR RECOMMENDATION BY THE STATE. SPONSOR’S REGISTRATION NUMBER IS CH2435. NO CONTRIBUTIONS ARE RETAINED

BY PROFESSIONAL SOLICITORS; THEREFORE, 100 PERECENT OF ALL CONTRIBUTIONS ARE RECEIVED BY FDAF.

DONATE!

Your donations support these programs: Florida Mission of Mercy, Project: Dentists Care, Donated Dental Services To make a donation, go to www.floridadental.org/foundation

Dental Lifeline

If Life Hands You Lemons, Maybe Your Name is Rona

Left to right: Carlos from a Fla. volunteer lab, Dr. Karen, Rona and Dr. Carlos

If life hands you lemons, maybe your name is Rona.

Rona’s had a rough stretch, but this 72-year-old, Boca Raton assistant teacher of children with autism found a way to make lemonade. Diagnosed with Stage 4 non-Hodgkin’s lymphoma in 2011, Rona received intense chemotherapy treatments.

The chemo resulted in a side effect called xerostomia, which halts saliva production and caused her teeth to fall out. Rona began to lose her ability to speak clearly and she feared losing the work she loves.

Fortunately, some powerful helpers lined up at Rona’s lemonade stand. Unable to afford the dental treatment she desperately needed, Rona relentlessly applied for help for two years. She was turned down repeatedly by her own insurance company and 30 other agencies, but was referred to Florida Donated Dental Services (DDS). A program of Dental Lifeline Network • Florida,

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Rona with Dr. Thomas

DDS operates in partnership with the Florida Dental Association Foundation. A large and highly skilled team of DDS volunteers guided Rona through a year of dental treatment that changed her life.

The key to the success of Rona’s care was Dr. Thomas, a DDS volunteer periodontist who devised the treatment plan, which included extracting 25 of Rona’s teeth and placing the implants needed to anchor full upper and lower dentures.

“We were more than happy to help Rona,” said Dr. Thomas. “She went through chemo and really struggled with cancer. When you hear someone go through that, survive it and have another issue as a result— you would like to do whatever you can.”

Also participating in Rona’s treatment were Drs. Karen and Carlos, two general dentists who shared the responsibilities of fitting Rona with upper and lower dentures. In addition, two volunteer dental laboratories fabricated her dentures and two manufacturers donated materials. Dr. Karen noted that what Rona has overcome is truly amazing and they were happy to help.

“I am almost myself again,” she wrote to DDS, “but most importantly, I can smile when I go into work and have my colleagues, family, friends and students smile back at me. Thank you from the bottom of my heart for giving me life once again.”

With the help of Florida DDS and its volunteers, Rona’s life turned from lemons to lemonade. She is ecstatic with her new teeth and smile, and her cancer is in remission.

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Dental Lifeline

To the volunteer dentists: “You exceeded my every expectation and managed to get me through the entire process with the least pain possible and wonderful explanations about every procedure. We need more people like you in this world who are willing to give of themselves and take lessons on the trials many people endure because they are unable to afford help. I want to thank you for putting a smile on this grateful woman’s face and being the wonderful dentists you are.”

— Rona, DDS patient To DDS: “Having my teeth fall out, along with nausea, baldness and the complete feeling of helplessness from the cancer left me utterly devastated. You put me in touch with the most marvelous dentists.

“I am almost myself again, but most importantly, I can smile when I go into work and have my colleagues, family, friends and students smile back at me. Thank you from the bottom of my heart for giving me life once again.”

— Rona, DDS patient DDS changes lives every day. Florida DDS volunteers include 428 dentists and 216 dental laboratories. A full-time Florida DDS Coordinator is funded with help from the Florida Dental Association Foundation. Dental Lifeline Network • Florida, which operates DDS, is part of the national DLN organization, a charitable affiliate of the American Dental Association. DLN serves patients in all 50 states and the District of Columbia.

You or someone you know may qualify for the Florida DDS program. Applications are being accepted in Miami-Dade County from individuals with a permanent disability, or age 65 or older, or qualify as medically fragile and lack adequate income to pay for dental care. Applications are being accepted statewide from individuals who qualify as medically fragile and lack adequate income to pay for dental care. To apply, contact Florida DDS Coordinator Megan Manor at 850.577.1466 or mmanor@DentalLifeline.org. For more information on Florida DDS, visit http://dentallifeline.org/florida/.

Supported by the

www.floridadental.org

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Baby Teeth

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When you provide proper home care and begin your infant’s dental visits and cleaning by their first birthday, you will provide them with the best chance for a bright and healthy dental future.

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Baby Teeth

By Dr. Steve Cochran

Baby teeth are just as important as adult teeth. Strong baby teeth help children chew and speak properly, as well as hold space for their future adult teeth. Unfortunately, cavities in children have become one of the most common diseases in childhood. Cavities are caused by the bacteria that live in the mouth. These bacteria change sugars in foods and drinks into acid. After too many acid attacks, cavities form. The good news is that cavities are largely preventable. Establishing good dental home care and finding a dental provider early are key to cavity prevention.

The American Academy of Pediatric Dentistry (AAPD) recommends that every child have their first dental examination within six months after the first tooth erupts and no later than their first birthday. This early dental examination and cleaning is recommended to review the child’s risk factors for tooth decay, to instruct in proper brushing techniques and healthy nutrition, and to assess growth and development.

These early measures are key in preventing tooth decay in infants and children.

The first dental visit can be a very positive experience. Keys to a successful visit include scheduling a morning visit when your child is rested.

If possible, give your child a sneak preview. Take them with you to your next dental checkup. Play around taking turns being the patient and the dentist. Once at the office, try to make your child’s visit an enjoyable outing. Getting started with these early dental checkups will lead to a lifetime of good dental health.

Around two years of age, it is recommended that your child visit the dentist every six months for their dental examination, oral hygiene instructions, cleaning and fluoride application, as well as any X-rays prescribed by their dentist. Around six years of age, most children’s permanent front teeth and first permanent molars will begin to erupt. The dentist will recommend placing cavity-protecting sealants on the biting surfaces of these teeth. The sealants will fill the rough, groovy, hard-to-clean surfaces of these teeth and protect them from cavities.

The AAPD’s guidelines for home care include wiping your infant’s mouth with water and a soft washcloth or infant brush. Once the primary teeth begin to erupt, you should begin brushing your child’s teeth with a smear-sized amount of toothpaste containing fluoride. Once your child reaches two years of age, a “pea-sized” amount of toothpaste is recommended. Brushing the teeth twice a day is encouraged, as well introducing dental flossing once the spaces in their molar regions begin to close. Parents should brush their children’s teeth until they have the dexterity to do it themselves. An indicator of proficient dexterity is when your child can handle a knife and fork on their own. Once your child is able to predictably spit, they can use a fluoride mouthwash on a daily basis.

The Florida Dental Association supports community water fluoridation. However, in some areas of our state the water may not be fluoridated. Check with your dentist to see if a fluoride supplement is suggested. Using fluoride supplements in non-fluoridated areas can greatly reduce the risk of cavities. It’s also recommended to wean the infant away from the bottle around 12 months of age to decrease the chance of cavities. Constant sipping on juices, sodas and other sweetened liquids also should be avoided. Frequent exposure of these substances can lead to tooth decay.

In summary, when you provide proper home care and begin your infant’s dental visits and cleaning by their first birthday, you will provide them with the best chance for a bright and healthy dental future.

Dr. Cochran is a pediatric dentist in Jacksonville, Fla.

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Fluoridation

What is Water

By Dr. Johnny Johnson

Nearly all naturally occurring water sources contain fluoride, which is a mineral that has been proven to prevent — and even reverse — cavities.

Water fluoridation is the precise adjustment of the natural levels of fluoride in the water to the level that prevents cavities. This level, called the optimal level of fluoride in water, is 0.7 mg of fluoride per liter (ppm=parts per million). In Florida, most communities have 0.2 ppm of fluoride in the water.

This amount comes from the rock formations in the earth’s crust that the water passes through on its way to our aquifer.

At 0.7 ppm, 20-40 percent of all cavities that children and adults would experience are prevented. Not only are 20-40 percent of the cavities prevented, but the severity of those cavities is greatly reduced, thereby reducing the pain and suffering that these cavities can cause. Put simply, by drinking the water, everyone in a community benefits from water fluoridation without a single change in their daily behaviors.

Why is Water Fluoridation Important?

Cavities are caused by certain bacteria in the mouth. When a person eats sugar and other refined carbohydrates, these bacteria produce acid that removes minerals from the surface of the tooth. Fluoride helps to remineralize (re-harden) tooth surfaces and prevents cavities from continuing to form.

Water fluoridation is just one of the tools to fight cavities. Brushing your teeth twice a day with fluoridated toothpaste, flossing, eating a well-balanced diet and the use of topical fluorides like mouth rinses and fluoride varnish, all work together to prevent even more cavities than by water fluoridation alone.

Fluoridation has been practiced safely and effectively in the U.S. for more than 71 years, and more

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Fluoridation

Fluoridation? than 13 million of the 17 million Florida residents who are served by community water systems (or 78 percent), receive optimally fluoridated water. We continue to strive to expand coverage in our state to bring this valuable public health measure to the poorest of our rural areas, where cavity rates remain extremely high.

Fluoridation is: safe. There are no known adverse health effects from water fluoridation at optimal levels. effective. At optimal levels in the water, at least 20-40 percent of cavities for children and adults are prevented by simply drinking the water. cost-saving. Fluoridation benefits everyone regardless of socioeconomic status, race, age or educational level. For every $1 spent on fluoridation, $43 is saved per person per year in dental treatment costs.

Fluoridation benefits adults more than children by preventing cavities on their root surfaces as well as the crowns of their teeth.

Opposition to Fluoridation: A small, but vocal group to opponents of fluoridation have been in existence since fluoridation was first introduced in the U.S. in 1945.

Today, this group uses the Internet to voice their personal opinions about fluoridation in an attempt to invoke fear in the public, to make them think that it is evil and harmful. Nothing could be further from the truth. In fact, nearly every major scientific organization in the world supports water fluoridation as safe and effective.

No credible scientific group supports a single claim made against fluoridation that is made by those who oppose it.

Please see FLUORIDATION, 34

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Put simply, by drinking the water, everyone in a community benefits from water fluoridation without a single change in their daily behaviors.

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FLUORIDATION from 33

Resources: u American Academy of Pediatrics: http://ilikemyteeth.org/wp-content/ uploads/2012/05/QandAonCommunityWaterFluoridation_v1b.pdf u Centers for Disease Control and Prevention (CDC): http://www.cdc.gov/fluoridation/index.htm u Florida Dental Association: https://www.floridadental.org/public/theimportance-of-water-fluoridation u American Dental Association: http://www.ada.org/en/home-ada/public-programs/ advocating-for-the-public/fluoride-and-fluoridation u American Fluoridation Society: http://americanfluoridationsociety.org/

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Sources for Credible Information on Fluoridation: Google and other search engines are very good resources to establish a starting place for a lot of research, but not when it comes to medical science. The Internet has given everyone the ability to promote their own opinions as facts without anyone to differentiate truth from myth. In short, everyone can be perceived as an “expert� by simply composing their own website.

We must look at the source of the information to determine whether it is trustworthy or not.

Trust the resources that we trust the health of our children and families with: the American Dental Association, the American Academy of Pediatrics and the Centers for Disease Control and Prevention (CDC).

Dr. Johnny Johson is a pediatric dentist in in Palm Harbor, Fla.

www.floridadental.org

The Plaqster, Den and Buck are sure having fun! You can join in.

Can you find 25 differences between the two pictures?

2014 American Dental Association

The Plaqster and Flossy can use a little help!

Can you find all the hidden words?

They can be up, down, diagonal, backward and forward!

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CAVITY DENTIST ENAMEL FLOSS SEALANT GUMS CANINE

MOLAR PLAQUE MOUTHGUARD TOOTHBRUSH TOOTHPASTE MONSTER SMILE TONGUE

TEETH GINGIVITIS MOUTH CROWN HYGIENIST ROOT JAW

2014 American Dental Association

OFF THE CUSP JOHN PAUL, DMD, EDITOR

The Best

Dental Insurance

Every week somebody asks me, “What’s the best dental insurance I can get?”

The best dental insurance comes in two parts.

First, establish a relationship with a dentist. Find someone you can trust and who puts your interests before their own. Find someone you can count on to answer your call when you have an emergency on a weekend. That’s a true doctor-patient relationship.

Second, practice prevention. “You’ve got to stick the brush in your mouth and wiggle it.” That’s the very simple, but honest truth. Most of the disease I treat could have been prevented with proper daily brushing and flossing at home and fluoridated water. It’s something you have to start early — as soon as you have teeth — and it may be one of the greatest gifts you can give yourself and your children.

Your smile should last your entire life.

Dr. Paul is the editor of Today's FDA.

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Most of the disease I treat could have been prevented with proper daily brushing and flossing at home and fluoridated water.

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THE SIGN OF A PROFESSIONAL!

Member dentists of the American Dental Association and Florida Dental Association are committed to a code of ethics and professional conduct that puts patients first.