04.29.21 Health Matters

HEALTH MATTERS THE OBSERVER’S GUIDE TO YOUR BEST YOU

APR IL /M AY 20 21

MIRACLE OF LIFE Brown Fertility, which opened its 10th clinic last year in Winter Garden, is in the business of helping couples become parents. Inside, meet two women who realized their dreams of becoming a mom thanks to the work of Medical Director Dr. Samuel E. Brown and his team.

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APRIL 2021

PHYSICIAN SPOTLIGHT

Dr. Niral Patel Dr. Niral Patel has dedicated his life to caring for others. But when he’s taking some time for himself, he loves to travel. He has experienced time abroad in 25 countries and is planning to travel to another 25 in the next 10 years. This summer, he and his family are going to the Hoover Dam, Grand Canyon and national parks in Utah.

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What are your hobbies?

Traveling and golfing.

When did you first decide you wanted to become a doctor?

Why? I knew I wanted to be a doctor in first grade, so I could make a difference in people’s lives. I grew up with my parents helping total strangers, and I saw the impact that it made in those people’s lives. Becoming a doctor was a way to continue doing the same.

What are some of the advancements in your particular specialty about which you are particularly excited?

For many years, primary care was taking the backseat in the management of patients, as care was being driven by specialists. This left patients without having coordination with their primary care doctors. In the past few years, this focus has changed; patient care at this time is being driven through their primary care physician. This shift results in a lower cost of care and better compliance for patients to allow for completion of preventive care measures such as colonoscopies, mammograms, age-appropriate blood work, diabetes management, etc.

Courtesy photo

What is the most rewarding aspect of your work?

The most rewarding impact of my work has been the opening of my practice in 2014, giving thousands of patients access to health care in a community that had very few primary care physicians.

What do you love most about serving patients in the West Orange community?

It’s very gratifying to serve a community that I live in, treating many neighbors and friends.

Describe your earliest memory of going to the doctor.

The earliest memories of going to the doctor initially were filled with fear, because it always meant getting a shot. But seeing my doctor have such an impact on his patients only reinforced how badly I wanted to be a doctor.

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Practice: Windermere Medical Center, 11600 Lakeside Village Lane, Windermere Specialty: Internal medicine Years in practice: 15 Education: Undergraduate degree at the University of Pittsburgh with a double major in biology and psychology; doctoral degree from Ross University School of Medicine in Dominica.

Who are some of your most important influences and role models and why?

My parents have been the most influential and are my role models. I grew up seeing my parents help many people throughout their lives. They worked very hard to make the possibility of me becoming a physician a reality.

What are some of your favorite TV shows or movies?

Because I always have to be a singer, I love watching talent shows such as “American Idol” and “The Voice.”

What are some of your favorite local restaurants or cuisines?

My favorite local restaurant is Bella Tuscany.

If you were stranded on a deserted island, what three books would you want with you?

The only thing I would be doing on a deserted island is enjoying every minute I have and not spend one minute reading any books.

— AMY QUESINBERRY

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APRIL 2021

When the nose doesn’t know Loss of smell one of the most common COVID-19 side effects. But if you’ve lost yours, take heart: There are ways you can help bring it back.

One of the telltale symptoms of COVID-19 is loss of smell and taste. And some patients are left with long-term loss of smell or even smell distortions.

It’s why the topic of smell training and other potential therapies have come to the forefront of many conversations regarding regaining the ability to smell, a sense that is much more important than some may think.

Dr. Steven Munger — director of the University of Florida’s Center for Smell and Taste, and co-director of the UF Health Smell Disorders Program — said a loss of sense of smell from COVID-19 or smell disorders are more common than many realize.

In fact, 12.4% of people over 40 years old, or more than 16 million people, in the United States suffer from either the inability to smell (anosmia) or distorted smell (parosmia). That’s about four times the prevalence of uncorrectable vision impairments in the same age group.

What’s more, the diagnosis can present much more significant concerns than merely the inability to enjoy your favorite scents.

“Smell disorders are serious health issues,” Munger said.

“They impact nutrition as your perceptions of food flavors are altered. They put you in danger

— DANIELLE HENDRIX

of hazards (such as) fires, gas leaks and spoiled foods. And they disconnect you from the world around you, changing the way you interact with other people and your environment. Depression is not uncommon with the advent of a smell disorder like anosmia.”

Aside from smell disorders, scientists are still working to pinpoint exactly how COVID-19 causes the loss of smell.

“Our best evidence at the moment suggests that the virus infects supporting cells in the olfactory epithelium, the tissue inside your nose containing the sensory cells that can detect odors and send that signal to your brain,” Munger said. “We suspect that this infection of the sensory cells disrupts the local environment and damages the sensory cells, hampering their ability to pass on the odor signal.”

Munger even wrote an op-ed for USA Today last month explaining

why a loss of smell from COVID-19 deserves more attention.

Anosmia, he said, is much more than just an inconvenience. For example, those suffering with loss of smell might find meals unpalatable and a chore to eat without an accompanying aroma.

“Good nutrition is compromised, as some increase their intake of sugar, fat and salt to enhance food palatability while others find it challenging to eat at all,” Munger wrote in his oped. “Older adults with hyposmia or anosmia even have a significantly higher rate of death over the long term. These are consequential health issues that cannot go unaddressed.”

Although COVID-19 has wreaked havoc on millions worldwide, Munger wrote, the pandemic may give scientists the opportunity to finally help millions of people who have suffered without smell long before the coronavirus was a thought.

SMELL THERAPIES

The problem with regaining sense of smell is that therapeutic options are limited and vary depending on the cause, Munger said.

For example, those whose loss of smell stems from nasal polyps and other impediments to proper air flow in the nose might find success in surgical treatments.

Topical steroids may be effective in some cases of inflammatory sinonasal disease, he said.

However, there is no clear-cut therapy for lose of smell stem-

HEALTH MATTERS

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SMELL TRAINING 101

NEW DISCOVERY!

Learn How Katie Lost 65 Painful Pounds with Hypnosis THE ONLY JOY IN MY LIFE WAS FOOD “Everything revolved around food. That’s all I thought about between meals was what am I going to eat next. I started wearing leggings every day. Jeans were uncomfortable, tight fitting clothes were really uncomfortable.

THE WEIGHT WAS PAINFUL Walking around all day was very hard for me to do. It was painful. That daily struggle with food just isn’t there anymore. That’s what hypnosis is all about, it becomes automatic.

GOING SHOPPING NOW IS SO MUCH FUN! I have this energy and I can move and my clothes feel comfortable. They feel good on my body. Going shopping now is so much fun!

Getting used to the new body that I have has been really exciting.

I SAVED MONEY I think about how much money medical bills are for being unhealthy or having diabetes, it was definitely worth investing in myself.

entists are hard at work researching ways to treat anosmia. Munger said laboratories in the UFCST are developing gene-therapy strategies to treat anosmia in those born without a sense of smell, and stem-cell therapies also hold great promise, though both are still in the preclinical research stage.

“At the UFCST, we are also working to develop better smell testing that will make it easier to diagnose smell disorders or even to screen for associated health issues such as COVID-19,” he said.

THIS REALLY HAS CHANGED MY LIFE That internal struggle, should I do this or should I do that, is so much easier now. This is by far the most I’ve ever lost. The most I lost before was 20 pounds.

My habit was lose it and then gain it all back, plus more. This time it’s a completely different experience. I’m 65 pounds down and I can’t even imagine going back.

I’ve accomplished so much and that feels really great knowing that I’ve come so far.

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ENERGY TO DO THINGS Before it was all about what I was going to watch on TV and what I was going to eat.

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APRIL 2021

ADVERTORIAL

Although more research is needed to determine whether smell training is an effective therapy for COVIDassociated smell disorders, a British study from the University of East Anglia’s Norwich Medical School found it can be helpful for those suffering from parosmia — or odor distortion.

What is smell training? It’s a practice that involves actively sniffing the same four scents every day, spending about 20 seconds on each scent and concentrating on what you’re doing.

What do you need? All you need is four different fragrances and a few minutes each day. In the UEA study, participants received smelltraining kits consisting of fragrances like eucalyptus, lemon, cinnamon, chocolate, coffee, lavender, honey and strawberry.

How long does smell training last? In the UEA study, participants sniffed their four fragrances twice a day every day for several months.

They were tested to see how well they could smell their fragrances at the start of the trial and after six months of smell training.

ming from viral infections such as COVID-19.

“A process called ‘smell training’ has shown some promise to improve smell function in some individuals with post-viral smell loss, but more studies are needed to confirm its effectiveness (especially in COVID-19 cases) and to understand for what types of cases it might be most effective,” Munger said.

Smell training, or olfactory training, involves actively sniffing the same four scents every day, concentrating on spending around 20 seconds on each scent.

There is hope, though, and sci-

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WEIGHT LOSS STOP SMOKING STRESS REDUCTION PAIN MANAGEMENT

THE SCREENING WAS A COOL EXPERIENCE The free screening was interesting, I was pretty surprised by it. The power of suggestion is so strong and I could see it in that moment. It was a physical reaction based on a thought and that really struck me. I thought, wow this is cool!

I LEARNED A LOT I learned how powerful your frame of mind is.

The practice of getting yourself in that mindset can really affect your mood and decisions.

EVERYBODY WANTS A PIECE OF IT My mom said “I can tell that your thoughts on food have changed.” It’s amazing how much support I’ve gotten. I’ve been sharing my story, they are seeing the amazing results and all of a sudden everybody wants a piece of it.

They see that this is something that is actually working. They send me messages and say “how are you doing this, I want to know your secret.” I’m glad that I can be that kind of role model and a source of inspiration.

And that’s the best part, is inspiring change in other people.

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APRIL 2021

DR. SAMUEL E. BROWN Dr. Samuel E. Brown is the medical director and founder of Brown Fertility, headquartered in Jacksonville.

He completed his reproductive endocrinology and infertility fellowship at Jones Institute for Reproductive Medicine under IVF pioneers Drs. Georgeanna and Howard Jones, Jr. He is dually board certified in obstetrics and gynecology, as well as reproductive endocrinology and infertility, providing patients more than 20 years of training and experience.

Brown has been directly involved in the management of more than 10,000 in-vitro fertilization cycles. He was the first surgeon in Florida to pioneer minimally invasive robotic gynecological surgery for treatment of infertility.

DR. RAFAEL A. CABRERA Board certified in reproductive endocrinology and infertility, Dr. Rafael A. Cabrera offers more than 20 years of experience as an infertility specialist.

He completed his fellowship at Jones Institute for Reproductive Medicine.

Cabrera, who is fluent in Spanish, is a native of Puerto Rico and received his undergraduate and medical degrees from the University of Puerto Rico. He completed his internship at the Naval Hospital in Oakland, California, and residency in obstetrics and gynecology at the Naval Medical Center in Portsmouth, Virginia. He was a practicing OB/GYN before pursuing subspecialty fellowship training in reproductive endocrinology and infertility.

Cabrera’s expertise is seproductive surgery and high-quality IVF for women with decreased ovarian reserve.

NOVLENE HILAIRE WILLIAMS-MILLS Courtesy photos

Jamari and Jameir, the sons of Jovlene Hilaire Williams-Mills and Jameel Mills, at 10 months old. The boys are now 1.

MIRACLE MAKERS Brown Fertility, which opened its 10th clinic last year in Winter Garden, is in the business of helping couples become parents.

AMY QUESINBERRY COMMUNITY EDITOR

A

s a fertility doctor, Dr. Samuel E. Brown sees an entire range of emo-

tions in his patients.

“Every day is different in our world, as we find ourselves on this roller coaster called life, filled with hopes and dreams and, sometimes, disappointment,” he said.

But couples go to Brown Fertility with an intense desire to become parents, willing to do whatever it takes to create a family.

There are times, too, when even a fierce hurricane won’t stop a couple and their doctor.

“One wild story that we recall took place during Hurricane Matthew,” Brown said. “We stayed open and actually had patients from other practices call us to do their retrieval here because their clinics had canceled their cycle after they had started the cycle with medication. We did five IVFs in those two days while the hurricane was passing.

“Key staff and I stayed at the hotel next door to the clinic and came by multiple times — including the middle of the night — to make sure everything was OK,” he said. “I was in constant contact with the five patients, and they literally drove in the middle of the hurricane storm to make it to the clinic.

“While everyone was sheltering in place away from the storm’s fury, our office remained open, and our extremely dedicated embryologist in Jacksonville stayed overnight to proceed with making babies since we were right in the middle of several IVF cycles and everything in our field is time sensitive,” he said. “The best part? All five patients got pregnant that month.”

Brown has been treating patients in the Central Florida area since 2006. The Orlando practice has welcomed more than 20,000 local patients through its doors. This includes previous employees who had treatments and are now parents, as well as a current employee who froze her eggs with the Orlando office three years ago.

In early 2020, the Winter Garden location became the 10th site for Brown Fertility and includes the most state-of-the-art medical equipment and technology for those undergoing in-vitro fertilization.

Brown was a scientist at Virginia Polytechnic Institute and State University when he discovered the field of infertility and women’s health care appealed to him.

“I really liked the positivity of this area of medicine and wanted to make a difference in families’ lives,” Brown said. “To this day, I never looked back.”

This work is important to Brown, who said helping create families gives him incredible satisfaction.

“Every day I work hard to upkeep our Christian-based mission to do our very best to make patients and their families’ dreams come true,” he said. “I am motivated daily by our success in the creation of family success, which I cherish as my contribution to the community.”

INFERTILITY WORKUP

Infertility is usually diagnosed if a patient under age 35 doesn’t conceive after one year of unproSEE PAGE 8

WINTER GARDEN Olympic medalist Novlene Hilaire Williams-Mills, of Winter Garden, went to Brown Fertility after she and her husband had tried unsuccessfully for a year to get pregnant.

The Jamaica native and University of Florida graduate had won multiple world championships and Olympic medals, including track competition while undergoing treatment for breast cancer.

In 2018, Williams-Mills started her IVF journey in her late 30s, knowing she was “racing against the clock.” Her treatment, including removing fibroids, proved successful in 2019, and she gave birth to twin boys last year.

The boys just turned 1.

“Everyone’s journey is different,” she said. “But it doesn’t mean that it’s not equally hard.”

Williams-Mills said she is “lucky and blessed to have my kids” as a breast cancer survivor, especially since others in similar situations aren’t so lucky. A former motivational speaker, she plans to return to her “purpose” of speaking out on the importance of education and planning in starting a family and inspiring others to keep on going.

“If she can do it, I can do it,” she said she wants others to think.

Her initial reaction to finding out she was having twins during the ultrasound: “I thought at first they must’ve read something wrong. I asked them ‘Are you sure there were two heartbeats?’ Then, when I realized it was true, I was thinking about buying two of everything.

There was some time that we had to wait to make sure both twins would remain viable, but needless to say we were excited.’

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NATALIE ROSE ORTIZ

ORLANDO “My journey of infertility was not an easy one; however, it was proven that it was not an impossible one,” Ortiz said. “Lots of laughter, prayers, hope and tears were shed in this process to only end with the best gift ever — my little piece of heaven in my arms.”

Ortiz was a newlywed in 2006 and was excited to become a mother, but a diagnosis of polycystic ovarian syndrome seemed to crush those dreams. One doctor told her she had less than a 3% chance of conceiving.

“I remember I cried the entire way home; I felt so hopeless and alone, like I was not worth anything,” Ortiz said. “I couldn’t even do what women are basically called to do. I could not reproduce.”

After much research, Ortiz discovered Brown Fertility. She attended a seminar, met Drs. Samuel Brown and Rafael Cabrera, and felt this was the right path. “(Dr. Cabrera) had so much patience and so much compassion towards me (and) I immediately told my husband I wanted to continue this journey with Dr. Cabrera and see where it took me,” she said. “Actually, Dr. Cabrera saved my life. In the mist of his testing and reviewing all my records, he discovered I had adult congenital hyperplasia. “ She got her health stabilized and returned to Dr. Cabrera in 2018, asking him to keep her from giving up.

Lukas Ortiz’s newborn photo shoot included IVF needles.

“I had so much faith and trust in Dr. Cabrera,” Ortiz said. “He was like a father figure to me.

When he spoke, I listened. When he gave instructions or lectures, I accepted every word no matter how deep, happy or sad it may have been — because I knew he spoke to me with such compassion and from his heart.”

She became pregnant with her first artificial insemination in 2019, but it was an ectopic pregnancy and had to be terminated, she said. That summer, after an unsuccessful artificial insemination, she and her husband began in-vitro fertilization via frozen embryo transfer. Ortiz became pregnant with twins, but both died before reaching full term.

Determined to become a mother, Ortiz began a second round of frozen embryo transfer in May 2020.

“My miracle was born Jan. 26, 2021, at 38 weeks and 4 days,” she said. “My heart is and will forever more be so grateful to Dr. Cabrera and his staff for allowing and helping my dream of becoming a mother come true.”

Natalie and Francisco Ortiz exuded joy during their pregnancy photo shoot.

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Brown Fertility CONTINUED FROM PAGE 6

tected intercourse or a patient 35 years old or older doesn’t conceive after six months. Patients concerned about their fertility or with obvious medical problems affecting their ability to conceive should begin an infertility workup immediately.

To initiate an infertility workup, patients begin with a new patient consultation to discuss their specific circumstances. A comprehensive medical history is obtained from both partners to identify any potential causes of infertility. Both males and females undergo physical examinations and analysis.

“It’s important to remember that one in seven couples experience difficulty getting pregnant,” said Cris Duschek, director of public relations at Paradise Advertising & Marketing, which manages the Brown Fertility account. “While it’s easy for patients to lose hope, 85 to 90% of infertility cases are treated with conventional medical therapies such as medication or surgery.”

MAKING A DONATION

One of the largest areas for growth for Brown has been that of frozen embryo donation cycles. The clinic has built one of the biggest embryo banks available in the United States, Duschek said.

Brown has one of the largest and most diversified donated embryo banks in the country, as well as the ability to freeze and store embryos on site. Brown currently holds thousands of embryos and has a portfolio of donated embryo families that patients can choose from, she said.

Brown Fertility has more than 60 egg donors to choose from, as well. A minimally invasive procedure is used to retrieve the eggs from the donor’s ovaries, and then these eggs are fertilized with the recipient partner’s sperm (or donor sperm) in-vitro (in the laboratory), by insemination or intracytoplasmic sperm injection. If fertilization is done in the lab, the embryos are then transferred to the recipient.

“We are confident that the recipe of our success is reflected in our pregnancy success rates — among the highest in the nation — our highly affordable treatment costs and the emphasis we place on individual care for each one of our patients,” Duschek said. “Our

ABOUT BROWN FERTILITY Founded by Dr. Samuel E. Brown, Brown Fertility is a comprehensive fertility clinic offering patients results through personalized care and treatment plans. There are multiple locations throughout Florida — including a new clinic in Winter Garden — and more than 60 years combined experience managing more than 10,000 IVF cycles.

Brown fertility physicians and embryologists consistently achieve fertility and pregnancy success rates above the national average. Brown Fertility offers advanced reproductive technology services, such as in-vitro fertilization, intracytoplasmic sperm injection, testicular sperm aspiration, egg/sperm/embryo cryopreservation, egg donation, and gestational surrogacy; basic infertility services, such as ovulation induction, intrauterine insemination, reproductive endocrinology disorders and semen analysis and other gender-specific diagnostic testing; and other reproductive surgical services are offered such as tubal reversal, fibroid removals, laser pelvic surgery, and laparoscopy and hysteroscopy procedures.

For information, visit brownfertility.com.

BROWN FERTILITY IVF Center - Orlando, 2200 Fowler Grove Blvd., Winter Garden PHONE: (888) 696-0122 WEBSITE: brownfertility.com

physicians and caregivers put patients first, above all else, and we take great pride in not being a baby factory.”

BABY OF THE MONTH

Each spring, the clinic posts a “casting call” for children of all ages born from treatment at Brown Fertility. The photo shoots begin in June to prepare for the following year’s calendar.

“It’s a lengthy process, but it has become our ‘staple,’ and OBGYN, urology and family practice offices really look forward to receiving them every year,” Duschek said.

Is it Time for a Nephrologist?

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HEALTH MATTERS

OrangeObserver.com

KITTEN SEASON Although “kitten season” sounds cute, it’s another major reason that pet overpopulation exists.

Kitten season is the time of year when cats begin reproducing and continue to have several litters — usually when the weather is warmest, from springtime to early winter. Animal shelters typically receive a large influx of intakes between kittens and mother cats during kitten season. Underage kittens are extremely susceptible — especially in shelter conditions — to diseases. And there’s no guarantee of finding a home for each one.

Every unspayed female cat, on average, could have about three litters per year, and female cats can reach sexual maturity as early as four months old.

Think about one unspayed female cat, her mate and all of their offspring, producing two litters per year, with about three surviving kittens per litter. That means this many more cats over the span of nine years:

12

Year One

67

Year Two

376 Year Three

2,107 Year Four

11,801 Year Five

66,088 Year Six

370,092 Year Seven

2,072,514 Year Eight

11,606,077 Year Nine

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APRIL 2021

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Population problem DANIELLE HENDRIX ASSOCIATE EDITOR

Not many people can resist an adorable puppy or kitten. In fact, they’re often the animals most likely to find new homes at animal shelters.

The problem? There are too many of them.

That may sound strange, but pet overpopulation is real and occurs when there are more homeless pets than there are available homes for them.

A primary factor that plays into pet overpopulation is allowing cats and dogs to reproduce with little chance of finding homes for their offspring. Another issue is when owners relinquish their pets because they either no longer want them or can care for them.

According to Animal League, more than 70,000 puppies and kittens are born daily in the United States. Because of pet overpopulation, more than 3.7 million animals are being euthanized annually in shelters across the country.

At Orange County Animal Services — the county’s only openadmission animal shelter — staff accepted more than 12,000 homeless pets in the last fiscal ye a r.

Although every effort is

made to find homes for these animals, it isn’t always possible.

The good news is that the liverelease rate for dogs in Fiscal Year 2020 was up 2% from the previous year — 96% as opposed to 94% in 2019. For cats, the live-release rate jumped up 9% from 2019 — 83% as opposed to 74%. The bad news?

Pet overpopulation still exists, and it’s a big reason why live-release rates, especially for cats, isn’t closer to 100%.

“The sheer volume of abandoned and discarded animals coming into our shelter day after day signals a problem,” said Diane Summers, manager for Orange County Animal Services. “The remedy is accessibility for spay and neuter, to prevent pets from having unwanted litters of puppies and kittens and to help their owners obtain these essential veterinary services.”

SPAYING IT FORWARD

Spaying (females) and neutering (males) are surgical procedures that take away the pet’s reproductive abilities and prevent unwanted litters. The more spayed and neutered pets there are, the fewer homeless animals there will be.

Last year, OCAS launched the Spay It Forward program to help combat the issue of pet overpopulation on a local level. The initially grant-funded program provided

spay-and-neuter vouchers for qualifying low-income pet owners, and demand was great. Thus far, a total of 525 vouchers have been issued.

According to OCAS, 92% of pet owners surveyed after redeeming their voucher said they wouldn’t have been able to obtain spay/neuter services for their pets without the Spay It Forward program.

Prices for a spay or neuter range from as low as $50 for cats at lowcost clinics up to several hundred dollars for large dogs.

“A portion of our Orange County residents are already living paycheck to paycheck, so while $50 or $100 is undoubtedly a reasonable price for the procedure, the price still puts it out of reach for many,” Summers said.

To help prevent pet overpopulation, the best thing to do is ensure pets are spayed or neutered — and encourage others to do the same.

Statistics show that sterilized pets often lead longer, healthier lives, and the procedure has a low complication rate.

There also can be behavioral benefits, according to the ASPCA. Spayed female pets won’t go into heat, and male dogs will be less likely to roam away from home to find a mate. Sometimes, the neutering process also helps deter unwanted behaviors such as spraying.

SPAY AND NEUTER Benefits of Spay/Neuter: bit.ly/3s55f2F OCAS Spay/Neuter Information: orangecountyanimalservicesfl.net/ProgramsServices/SpayNeuter Find Low-Cost Spay/Neuter Clinics: bit.ly/3cT5R74

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HEALTH MATTERS

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OrangeObserver.com

APRIL 2021

BRAINFOOD

The Observer answers kids’ burning curiosities.

What is a cavity? I Troy Herring // Sports Editor

FIXING A CAVITY STEP 1: Find the cavity

In the world of dentistry, cavities are often one of the most commonly treated conditions that an individual can suffer from. But what, exactly, is a cavity?

How do you prevent it from occurring? And if you have one, how is it treated?

WHAT IS A CAVITY?

STEP 2: Numb the area

According to the Mayo Clinic, cavities — also called tooth decay or caries — are “damaged areas in the hard surface of your teeth that develop into tiny openings or holes.”

These enamel breakdowns — or holes — are caused by a number of things, including bacteria in your mouth, sugary snacks and drinks, and not brushing. As these holes in your teeth get larger, they can lead to many symptoms, such as tooth sensitivity, toothache and staining on the decaying tooth.

If a cavity isn’t fixed, it can get bigger and go deeper into your tooth.

“It’s really important to fix the teeth before doing a filling before it gets worse,” said Dr. Lissette Bernal, who specializes in pediatric dentistry at Winter Garden Smiles. “Sometimes, people delay it, and then they end up needing to get root canals or extracting the teeth, which we try to avoid.”

FIXING A CAVITY

STEP 1: The first thing Bernal said she does is to look in the patient’s mouth. Often, a cavity can be seen with the naked eye. However, not all cavities — especially smaller cavities, and those between the teeth — can be easily seen, so Bernal will use an X-ray machine.

STEP 2: After she finds the cavity, Bernal will use a local anesthetic to numb the area. For children, Bernal uses a laughing gas that helps numb the pain.

“It’s not really the needle that hurts — it’s the liquid,” Bernal said. “Once the solution of anesthetic is going into your mouth, because it’s a lot of it and expanding the tissues, that’s what’s causing the discomfort.”

STEP 3: Clean out bacteria

STEP 4: Fill the cavity

STEP 3: The dentist will clean out the bacteria and decay by using a specialty drill and water — which cleans out the area and cools off the drill bit.

STEP 4: With the cavity cleaned out, the next step is deciding whether to place a filling or crown — also known as a cap — on the tooth. According to the U.S. Food & Drug Administration, fillings are made from dental amalgam, a “mixture of metals, consisting of liquid (elemental) mercury and a powdered alloy composed of silver, tin and copper.” Meanwhile, caps, which are stronger, are made of metals, porcelain, resin and ceramics. The deciding factor on which to use depends on the situation.

“It depends on the size of the cavity and how much structure is left,” Bernal said. “If you have a huge filling on a tooth and you bite something, it could end up breaking — versus a crown, which will protect a tooth a lot better. Sometimes, people come in with huge fillings, and these fillings could easily break. When that’s the case, we normally talk about doing a crown on the tooth.”

AVOID THE DENTIST’S CHAIR There are a many things you can do to avoid having to end up in a dentist’s office dealing with cavities, Bernal said.

“It’s a combination of things,” Bernal said. “It would be oral hygiene — making sure you brush your teeth two times a day for two minutes and flossing. And then your diet plays a really big part in avoiding cavities.”

Cutting out sugary drinks — especially energy drinks and Mountain Dew — and snacks also can help, Bernal said.

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HEALTH MATTERS

OrangeObserver.com

Budget basics Taking the first steps toward financial health will set you and your family up for a lifetime of enjoying your money by taking control of it.

DANIELLE HENDRIX ASSOCIATE EDITOR

Budgeting is a valuable tool in the world of personal finances, but only 41% of American households follow a budget, according to U.S. Bank.

Having a personal budget is a crucial piece to getting a handle on your finances — especially when you’ve found yourself in a situation where you have “too much month left at the end of your money” more than once.

Your budget, put simply, is a plan for how you’ll spend your money during a certain time period — usually either in a two-week period or in one month. Budgets begin with your income, from which you then subtract your expenses.

It’s a great way to tell your money where to go. But before you can tell your money where to go, you need to first have an idea of where it’s been going.

Cyndia Rivera, a Clermontbased certified professional finance coach who owns Family Finances Redesigned, said the first step is tracking where your money goes.

“They may have to go back two or three months and look at bank statements or credit cards (to) go back, track their expenses and look at where all of their money is going,” Rivera said. “When we sit down and start talking about

where their money is going, not everything is included. You forget things. You’ll say, ‘I spend money on food, groceries, toiletries,’ but they forget the times they’ve gone to restaurants and all the other things in between. When someone is not tracking, they don’t really know where it’s all going.”

Once you’ve reviewed your previous spending and have a better picture of where your money has

TIPS AND TRICKS n Got a raise? Rather than viewing the extra money as more to spend, you can further your financial goals by throwing it at debt or putting it into savings. n For couples who are able, try living on one income. If you can do that, that extra income can be used for throwing at debt, saving, investing or other things you want to do, Rivera says. n It’s never too early to begin saving for retirement. Talk with your financial planner about options for retirement savings. Some employers will match your contributions to your company-sponsored 401(k) retirement savings account — something to take advantage of.

gone, you can begin working on your budget and create a plan for telling your money where to go now.

There are different ways to budget. Some people use apps such as Mint, EveryDollar or You Need A Budget. Others create a simple spreadsheet. Still others prefer the traditional pen-and-paper method. Rivera said the most important thing is finding a budgeting method that works for you.

“Make it simple,” she said. “It does not have to be anything complicated. What you want is something that you feel comfortable with that you can follow for the long term.”

The first part of creating a budget is listing your income and then your expenses. This includes things like bills, groceries, gas, toiletries, cell phones, subscriptions and extracurricular activities.

Include each payment’s due date and set aside money for each budget category. If there is debt in the picture, you’ll also need to determine the method you want to use for paying it off.

“You don’t want to have a deficit,” Rivera said. “You want to either be a zero balance, which is fine, or have a surplus. If there is a deficit, then you have to look at two things: Where am I spending more money, and what do I need to cut out? And those are what we call the variable expenses which are the things you can control — groceries, gas, things like that.”

Once you determine the best budgeting method for you and create a plan of attack, the most important thing to do is stick with it.

“The whole point of a budget is to forecast where your money is going to go before it comes in,” Rivera said. “It’s a plan.”

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APRIL 2021

DOs AND DON’Ts OF PERSONAL FINANCE DO n Create a buffer in your budget. Put a small amount of money aside for any unexpected expenses that could come up throughout the month. n Start with the most important categories first.

This includes giving, saving and the “four walls” — food, shelter and utilities, basic clothing, and transportation. n Set some goals. What are you hoping to achieve by taking control of your money? n Pay off your debt. Choose a method that works for you and stick with it. n Live below your means. n Track your progress. Be sure to track your spending and saving.

DON’TS n Create a budget that’s too restrictive. Leave some wiggle room for unexpected expenses and for “fun money.” n Get into more debt. Part of taking control of your finances is acknowledging the debt you already have and avoiding digging deeper into it. n Use credit cards like they are cash.

Rivera advises clients who use credit cards only to use them if they have the money to immediately turn around and pay it off. n Carry a balance on your credit cards. Interest adds up. n Give up. It may take a few months of trial and error, but don’t give up on your budget. With time, you can develop a realistic plan that will help you live the life you want to live.

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