Dental Glossary for Patients Kissing Chewing Gum Flossing
Is Your Selfie Self-deceiving? 2017 RECEPTION ROOM ISSUE
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Dental Glossary for Patients
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Nervous About Visiting the Dentist?
President's Message
31 Off The Cusp
12 Dental Care Parent Guide 14 The Link Between Selfies and Unneeded Dental Procedures 16 How to Become a Dentist 19 DMD or DDS? 20 Does Kissing Affect Your Oral Health? 24 Gum Chewing: Is it Helpful or Harmful? 28 Only Floss the Teeth You Want to Keep
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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
Drink to good health!
RECEPTION ROOM 2017 VOL. 29, NO. 4 EDITOR
Recognized as one of the 10 Greatest Public Health Achievements of the 20th Century
WATER FLUORIDATION Provides $43 in savings for every $1 invested Helps adults fight tooth decay that occurs as gums recede with age Helps prevent tooth decay — the most common chronic childhood disease Reduces dental decay by 20-40 percent Helps prevent the loss of approximately 51 million school hours due to dental disease
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Today's FDA
Reception Room Issue 2017
Dr. John Paul, Lakeland, editor
STAFF Jill Runyan, director of communications Jessica Lauria, communications and media coordinator Lynne Knight, marketing coordinator
BOARD OF TRUSTEES Dr. William D’Aiuto, Longwood, president Dr. Michael D. Eggnatz, Weston, president-elect Dr. Jolene Paramore, Panama City, first vice president Dr. Rudy Liddell, Brandon, second vice president Dr. Andy Brown, Orange Park, secretary Dr. Ralph Attanasi, Delray Beach, immediate past president Drew Eason, Tallahassee, executive director Dr. James Antoon, Rockledge • Dr. Steve Cochran, Jacksonville Dr. Richard Huot, Vero Beach • Dr. Jeannette Pena-Hall, Miami Dr. George Kolos, Fort Lauderdale • Dr. Jeffrey Ottley, Milton Dr. Paul Palo, Winter Haven • 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, Spring Hill, 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 2017 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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PRESIDENT’S MESSAGE BILL D'AIUTO, DDS
FDA Dentists Protect the Public Trust
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As FDA member dentists, we make your entire health — not just dental health — a priority.
As president of the Florida Dental Association (FDA), I’d like to welcome you to the office of your FDA member dentist. It may come as a surprise to you that your family dentist and dental specialists are members of the largest professional dental organization in Florida. They made a “conscience decision” to do so. It’s not required that your dentist become a member in good standing of the most recognized dental organization in the state, but it is a good thing for you — a Florida citizen — that they are. You see, by being a member of the FDA, your dentist also has joined forces with the American Dental Association (ADA) to do what dentistry was created, as a profession, to do more than 170 years ago: protect the public trust. As FDA member dentists, we make your entire health — not just dental health — a priority. It has been said that the oral cavity is the window to your general health. Recently, the FDI World Dental Federation, the principal representative body for more than one million dentists worldwide, issued
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a definition of oral health, which has been adopted by the ADA: Oral health is multifaceted and includes the ability to speak, smile, smell, taste, touch, chew, swallow and convey a range of emotion through facial expressions with confidence and without pain, discomfort and disease of the craniofacial complex. It also attributes oral health as a fundamental component of health and physical and mental well-being, and a reflection of the physiological, social and psychological attributes that are essential to the quality of life. This new definition encompasses the full scope and impact of oral health on an individual’s health, well-being and ability to contribute to society, and reiterates the importance of ensuring that all Floridians have the opportunity to achieve optimum oral health. The FDA and its members endeavor to enhance the public trust and health through its signature outreach initiative, Florida’s Ac-
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tion for Dental Health (FADH). FADH is a comprehensive effort developed by the FDA to improve the oral health, and resulting overall health, of all Floridians. It’s accomplishing its mission through the efforts of more than 8,000 members who work to implement its many strategies. We hope you are proud of the choice your dentists have made in supporting these efforts to serve not only your needs in the private setting, but also those less fortunate through volunteer endeavors, such as the Florida Mission of Mercy, Project: Dentists Care and Donated Dental Services. These three programs are offered through the direction of the FDA Foundation. Yes, my fellow citizens, you have chosen your dental office wisely.
Dr. D’Aiuto is the FDA President.
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Glossary
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
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Glossary metal, ceramic or polymer materials, or a combination of such materials. Edentulous: having lost most or all the natural teeth. 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; grinding teeth, having large crowns and broad chewing surfaces.
Occlusion: any contact between biting or chewing surfaces of maxillary (upper) and mandibular (lower) teeth.
Root canal: the chamber within the root of the tooth that contains the pulp (blood vessels and nerve tissue).
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.
Root canal treatment: procedure to remove the diseased pulp from the root of a tooth, then clean and seal the canal.
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.
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.
Sources: http://www.ada.org/en/publications/cdt/ glossary-of-dental-clinical-and-administrative-ter http://www.knowyourteeth.com/infobites/ glossary/ http://www.mouthhealthy.org
Resin: plastic material used in bonding, restorative and replacement procedures.
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Anxiety
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Anxiety
Nervous About Visiting the Dentist ? www.floridadental.org
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Anxiety
What to Do if You Are By Sharon Paul, LMHC, NCC
Many people have a least some degree of anxiety about dental visits; some are so fearful, they avoid dental care altogether. People with dental anxiety feel embarrassed, ashamed and may be concerned that they are mentally unstable. If you are nervous about visiting the dentist, you can overcome your fear, keep your appointments — and your teeth — and have the confidence that a healthy smile will bring.
What Causes Dental Anxiety?
There are numerous causes of dental anxiety. This includes factors both related and unrelated to dentistry. Some people have difficulty tolerating a specific procedure. Many feel uncomfortable, helpless or claustrophobic during treatment; others feel self-conscious and fear being scolded about the appearance of their teeth. Some people are reluctant to admit that they have dental anxiety. Simply acknowledging your fears may be the only thing you need to do to overcome them.
Find the Right Dentist for You
Talk to friends, family, visit websites and read reviews. Go to the Florida Dental Association’s website (http://learn.floridadental.org/ find-your-dentist) to find dentists in your area. Schedule a consultation to discuss your fear and treatment goals before making your appointment. Once you are familiar with the office and have established rapport with your dentist, your anxieties about upcoming procedures will decrease.
How to Cope with Your Fear During Dental Appointments
Congratulations, you have scheduled your appointment! Still feeling anxious? Remember, all of us have been able to get through stressful situations in our lives. Acknowledge that dental procedures have improved — there are many new methods for diagnosis and treatment. Many dental practices specialize in creating a calming environment of trust that helps their patients relax so they can get the dental care they need.
Communicate with Your Dentist
The key to coping with dental fear is to talk to your dentist. Develop a relationship before something hurts. Talk about your fear, share past experiences and ask questions about anything that worries you. Some fear is related to the unknown; knowing what to expect is sometimes all we need.
Relaxation
The relaxed body has a sense of well-being and mastery over fear. Relaxation promotes feelings of calm, lowered blood pressure and takes less time than you think. Meditate, breathe deeply, be present, reach out to friends and family, laugh and celebrate your accomplishments. Relaxation is a process that decreases the effects of stress on your body and mind, and can be called upon when needed in day-to-day life or in the dental chair.
Relaxation is a process that decreases the effects of stress on your body and mind, and can be called upon when needed in day-to-day life or in the dental chair. 10
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Distraction
Many dental offices offer in-house distraction amenities — aromatherapy, television, headphones, pillows and blankets, and glasses to block light. Develop a list of your own distraction activities: count backwards by sevens; recite a poem; focus your attention on the environment; name the colors in the room; practice mindfulness; and focus, on your breath.
Control
Set appointment times when you are less likely to be rushed or under pressure. Establish a signal (raising your hand) whenever you are uncomfortable, feel pain, need to rinse your mouth or simply need to catch your breath. Regardless of your own personal experience, understand that you are not alone. Dentists see anxious patients every day. Daily oral hygiene combined with regular dental visits will not only help you overcome your fear of the dentist, but also prevent tooth decay and serious health conditions. Find the right dentist for you. Communicate your concerns to your dental team and use healthy coping skills to manage your symptoms. If your anxiety is so overwhelming that it is causing significant problems in important areas of your life, occupation, relationships or health, it may be time to get help from a mental health professional. Therapy can help you uncover the underlying causes of your worries and fears, look at situations in new, less frightening ways, and develop better coping and problem-solving skills. Ms. Paul is a licensed mental health counselor and nationally certified counselor. She can be contacted at sharonlmhc@gmail.com.
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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.
L i n k ...
Selfies
By Dr. F. Michael Firouzian
Humans have always been obsessed with capturing images of themselves. It’s evident from the tracings of human hands on cave walls to self-portraits, the invention of the camera, and of course — the smart phone. Taking selfies has become utterly entwined in our modern-day lives, so much so that the Oxford English Dictionary declared the word “selfie” their word of the year in 2013. Some people claim that selfies are not so harmless, though, as some studies have shown a small correlation between taking selfies and narcissistic behavior. While there is nothing inherently wrong with wanting to look good, many dentists have been noticing an increase in people coming into their practices wanting to address their “horse teeth.” Dentists have been talking many of those people out of unnecessary cosmetic dentistry, and believe that selfies may be to blame.
The Selfie/Dental Connection So, what exactly is the connection between selfies and a distorted perception of your front teeth? There are a lot of factors that come into play. Think about the key differences between a selfie and when someone takes your picture. The most obvious one is the distance between you and the camera. Unless you are using a selfie stick, the camera is going to be close to you when you are taking a selfie. On the other hand, when someone else is taking your photo, the camera is often farther than arm’s length away from you. The cameras on smartphones are small and use some significant lensing to extend their light intake into something similar to a normal camera. But when you’re close to the camera, this also can lead to significant distortion of your face, including making your teeth appear larger. Another thing to consider is what is in the center of the image. Unless you are making the much maligned “duck face,” your teeth will be at the center of the image in a selfie. We normally associate smiling with a release of anxiety, but since your teeth are now the center of attention, they can sometimes become a source of anxiety and overanalysis. Any little imperfection is going to be immediately clear to you, and your brain will likely pick up on things that are not even there — hence, the horse teeth issue.
Don’t Jump the Gun! It is important to remember that imperfections are not inherently wrong. If you find that you are unhappy with your teeth, then you should consider visiting a cosmetic dentist, but it is important to be receptive to input from others, especially your dentist. It is natural for your front teeth to be slightly longer and a little more dominant than your surrounding teeth. This gives you an aesthetically pleasing, curved smile. Plus, it’s a feature of a youthful smile, whereas teeth that have been worn flat look older.
The
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If you are unhappy with the appearance of your smile, either in the mirror or in selfies, please consult your Florida Dental Association member-dentist, who can give an honest, professional opinion. Reprinted with permission. This article first appeared on Feb. 25, 2016 on https://www.columbuscosmeticdental.com/.
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Selfies
Between Selfies and Unneeded Dental Procedures
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TO GET INTO DENTAL SCHOOL: 1.
Graduation from college with a four-year degree weighted heavily in the sciences, biology, chemistry, physics and mathematics, with a high GPA 3.3-3.8.
2. Score well on the Dental Aptitude Test, a national entrance exam. 3. Show community service, organize events and show management skills. Spend at least 100 hours shadowing more than one dentist in a variety of specialties.
CHOOSE A RESIDENCY. MORE SCHOOL!
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4. Interview with dental schools.
ATTENDING DENTAL SCHOOL: 5. Spend four years in dental school taking more science courses and clinical courses to be able to perform dentistry. There are additional science classes dentists must take that physicians do not take — specifically, materials and dental anatomy courses. 6. Dental students purchase many of the instruments necessary to provide dental treatment and this alone can cost $3,000$10,000. Dental school now costs $150K to $300K. 7.
PASS A REALLY HARD TEST.
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PASS ANOTHER REALLY HARD TEST & GET A DENTAL LICENSE.
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Pass written national boards (Parts 1 and 2).
8. Pass a state or regional licensing exam.
PASS A REALLY HARD TEST. FOUR YEARS OF COLLEGE.
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HOW TO BECOME A DENTIST
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OR PRACTICE DENTISTRY – AT LAST!
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OR EARN A GRADUATE DEGREE. MORE SCHOOL!
DENTAL OFFICE
MORE SCHOOL! FOUR YEARS IN DENTAL SCHOOL.
THEN YOU CAN DECIDE TO SEEK A:
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9. Residency — a chance to practice what you learned for four years and add a some skills, like general anesthesia, while being supervised by instructors.
SPEND UP TO $310,000 ON TUITION & INSTRUMENTS.
10. Graduate degree — specialize in one aspect of dentistry, which takes from two to four years
6 3 LOTS OF COMMUNITY WORK. SHADOW A DENTIST.
11. Job with an established dentist or company, or start your own practice.
4 INTERVIEW AT DENTAL SCHOOLS.
DENTAL OFFICE
DENTAL OFFICE
DENTAL OFFICE
DENTAL OFFICE
DMD
DENTAL OFFICE
ADA-RECOGNIZED DENTAL SPECIALTIES: •
DENTAL PUBLIC HEALTH: the study of the sources and causes of dental disease in large populations and of social health policies.
• •
ENDODONTICS: root canal therapy and study of diseases of the dental pulp.
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ORAL AND MAXILLOFACIAL RADIOLOGY: study and radiologic interpretation of oral and maxillofacial diseases.
• •
ORAL AND MAXILLOFACIAL SURGERY: extractions, implants and facial surgery.
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PERIODONTICS (ALSO PERIODONTOLOGY): study and treatment of diseases of the gums (non-surgical and surgical) as well as placement and maintenance of dental implants.
• •
PEDIATRIC DENTISTRY (FORMERLY PEDODONTICS): dentistry limited to child patients.
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ORAL AND MAXILLOFACIAL PATHOLOGY: study, diagnosis, and sometimes the treatment of oral and maxillofacial-related diseases.
ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS: the straightening of teeth and modification of midface, and monitoring the growth of the lower jaw.
PROSTHODONTICS: dentures, bridges and the restoration of implants. Some prosthodontists further their training in oral and maxillofacial prosthodontics, which is the discipline concerned with the replacement of missing facial structures, such as ears, eyes, noses, etc.
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DDS
DMD OR DDS?
DMD
By Jessica Lauria, FDA Communications and Media Coordinator Most people have a general idea when it comes to the various specialties in dentistry, but don’t know the difference between a DMD and DDS. To be honest, I wasn’t even entirely sure until I researched it for this article. First thing’s first: a DMD is a Doctor of Dental Medicine and DDS is a Doctor of Dental Surgery. But wait — what’s the difference? Nothing, actually. It turns out, the two degrees mean the exact same thing and have the exact same schooling and requirements — so no need to worry which one your dentist is. According to the American Dental Association (ADA), “There is no difference between the two degrees; dentists who have a DMD or DDS have the same education. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry.”1 So, why the two different titles? Originally, DDS was the only dental degree. In 1840, the world’s first dental school, the Baltimore College of Dental Surgery, was founded and the DDS degree was established.2 However, that changed when Harvard University opened its dental school — the first major university to do so — in the late 1860s. Traditionally, Harvard granted its degrees in Latin, but the translation — Chirurgae Dentium Doctoris — did not share the same initials as the DDS degree. After some discussion, the Scientiae Dentium Doctoris degree, which would leave the initials of DDS unchanged, was then considered (the word order in Latin is not fixed, only the inflections: Scientiae Dentium Doctoris = Doctoris Dentium Scientiae).3 This was rejected, however. Harvard consulted a Latin scholar and finally came to the decision
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that Medicinae Doctoris be modified with Dentariae. This is how the DMD, or Doctoris Medicinae Dentariae degree, was started. And the rest, as they say, is history. More universities followed Harvard’s approach, while others continued awarding the DDS degree. It’s up to the universities to determine what degree is awarded, but both degrees use the same curriculum requirements set by the ADA’s Commission on Dental Accreditation. Despite the difference in name, however, one is not superior to the other. The distinction that does make your dentist stand out is their membership in the Florida Dental Association (FDA). FDA member dentists make a special commitment to uphold the highest ethical principles, practice standards and mission of the FDA. When you or your family visit a dentist that’s an FDA member, you know your smile is in the best hands. So, regardless of what initials follow your dentist’s name, the three letters that are most important when it comes to your dentist are “FDA.” References: 1. http://www.ada.org/en/education-careers/careers-in-dentistry/ general-dentistry 2. http://www.ada.org/en/about-the-ada/ada-history-and-presidentsof-the-ada/ada-history-of-dentistry-timeline 3. Koch, Charles R.E.; et al. (1910), History of Dental Surgery: History of the development of dentistry, operative dentistry, prosthetic dentistry, orthodontia, oral surgery, dental literature, dental journalism, dental education and dental colleges, 1, National Art Publishing Company, p. 463, LCCN 09017597.
Ms. Lauria is the FDA Communications and Media Coordinator and can be reached at 850.350.7115 or jlauria@floridadental.org. Reception Room Issue 2017
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Kissing
t c e f f A g n i s s i ? K h s t l a e Doe H l a r O r u Yo 20
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Kissing
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Rest assured, it’s not all doom and gloom! Research into passionate kissing has uncovered many valuable health benefits.
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Kissing
By 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?
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Is a complete dental exam required before kissing someone?
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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 cavitycausing food particles that accumulate after meals. In addition to the digestive role saliva plays, this cleansing process is very important to oral health. The problem lies in the fact that kissing also may 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. Herpes infection viruses that are considered part of the herpes family include EpsteinBarr, 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 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.
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Kissing
More Serious Diseases The hepatitis B virus also may 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. 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.
See your doctor about immunizations. Vaccines are available to prevent some infectious diseases, such as chickenpox, hepatitis B 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. http://connecticutsedationdentist.wordpress. com/2012/01/14/hpv-and-oral-cancer-riskimportant-information-from2. www-connecticutsedationdentist-com/ http://www.health.vic.gov.au/immunisation/ factsheets/meningococcal-group-c.htm 3. http://en.wikipedia.org/wiki/Varicella_zoster_virus
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.
Reprinted with permission of Dentaltown Magazine and Dentaltown.com. Originally ran in Today's FDA 2013 Reception Room Issue.
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 percent of the bacteria in saliva are common to everyone and 20 percent 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.
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. He can be reached at tpeltzer@snet.net.
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.
maintain good oral hygiene and visit your dentist regularly.
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Chewing Gum
Gum
Chewing: Is It
Helpful or
Harmful
? Chewing Gum
Chewing Gum
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Studies have shown that chewing sugar-free gum after meals and snacks can help rinse off and neutralize the acids released by the bacteria in plaque, which are harmful to tooth enamel.
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Chewing Gum
When it comes to chewing gum, it’s the type of gum you chew that makes a difference in whether it’s helpful or harmful to your teeth. While chewing gum containing sugar may actually increase your chances of developing a cavity, there is clinical evidence that demonstrates just the opposite for sugar-free gum. And there’s even better news when it comes to chewing sugar-free gum that is sweetened with xylitol.
Sugar-free Gum Helps to Clean Teeth Both the act of chewing and the flavor of the artificial sweeteners in the gum stimulate 10 times the normal rate of saliva flow. Not only does the increased saliva flow neutralize the acids in your mouth, it also washes away food particles, helping to keep your teeth clean.
Xylitol Reduces Decay-causing Bacteria Sugar-free gum sweetened with xylitol has the added benefit of inhibiting the growth of Streptococcus mutans, one of the oral bacteria that causes cavities. In the presence of xylitol, the bacteria lose the ability to adhere to the tooth, stunting the cavity-causing process. With xylitol use over a period of time, the types of bacteria in the mouth change and fewer decay-causing bacteria survive on tooth surfaces.
To Chew or Not to Chew Although chewing sugar-free gum can be beneficial in most instances, there are some cases in which chewing gum is not recommended. For example, if you are experiencing any type of jaw pain or temporomandibular disorder symptoms (TMD/TMJ), you should refrain from chewing gum and talk to your dentist about what options are available to you. For most people, chewing sugar-free gum (especially gum sweetened with xylitol) can be a good preventive measure in situations when toothbrushing and flossing aren’t practical, but sugar-free or not, chewing gum should never replace good dental hygiene practices. Information courtesy of the Academy of General Dentistry and Delta Dental Insurance Company. Originally ran in Today's FDA 2014 Reception Room Issue.
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Flossing
Only Floss the Teeth You Want to Keep
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Flossing
By Drs. Matthew Waite and Michael Tesmer
We are constantly bombarded with the need to floss. Your mom, dad, hygienist, dentist, etc. constantly remind you. The American Dental Association (ADA) recommends cleaning between your teeth once a day with an interdental cleaner, and that interdental cleaners — which includes floss — “are an essential part of taking care of your teeth and gums.” But what does this all mean? Is this the reality? And even if I can manipulate my hands like a contortionist and floss all my teeth, how do I know that I am even doing it correctly?
Dr. Matthew Waite
Dr. Michael Tesmer
Recently, some have questioned the benefits of cleaning between your teeth, stating that the evidence for flossing is “weak, very unreliable,” of “very low quality” and conveys “a moderate-to-large potential for bias.” The latest U.S. government dietary guidelines have even gone as far as removing flossing from their recommendations. However, before you start picketing in front of your beloved dentist’s office, it is important to understand that the results of such studies, as well as the Department of Health and Human Services’ decision to not include flossing in its recent recommendations, should not suggest that the importance of flossing is any less than it ever has been. This only goes to prove the difficulty of conducting a study to specifically provide irrefutable proof of the effects of flossing. The beneficial impacts of flossing might be clearer if researchers focused on patients with the highest risk factors for developing periodontal disease, including diabetics and smokers. Also, many people use floss incorrectly, moving it in a sawing motion instead of up and down the sides of the teeth, making it difficult to qualify patients with unmonitored home care. Most importantly, just because the benefits of flossing may not be supported by strong evidence, does not mean flossing is ineffective; on the contrary, it may help patients prevent otherwise unnecessary treatment.
The ADA vigorously defends flossing. Flossing is low risk and low cost, so even if there is a small benefit, it’s valuable for our patients, given that about half of all Americans exhibit some form of periodontal disease. As dental professionals, we recognize that there’s more than just a possibility that it works, so we feel comfortable recommending interdental cleaning to our patients. We know the bacteria in dental plaque cause gum disease. A toothbrush works by physically removing this plaque from your teeth with its soft bristles. But brushing has one big drawback: A toothbrush’s bristles can’t adequately clean between the teeth or under the gums. Brushing alone can miss out on cleaning nearly 40 percent of the tooth’s surface. That’s where floss comes in. Floss can remove plaque from the tight spaces between the teeth and under the gums. The places where the gums and teeth meet are where flossing plays its major role. Food particles and plaque in this area will harden and grow over time to form calculus, a thick, hard bacterial deposit that only a dental professional can remove. Calculus buildup can lead to gingivitis — red, bleeding, swollen gums that are the first stage of periodontal disease. If left untreated, this bacterial biofilm can spread even deeper below the gum line, causing periodontitis — a severe form of periodontal disease characterized by severe inflammation and eventual bone and possible tooth loss. There is a myriad of reasons why your oral health, specifically periodontal health, is beneficial to your systemic well-being. Extensive research has shown that the bacteria that flourish in an unhealthy mouth can harm the rest of the body, leading to heart disease, diabetes and respiratory illness. If the shear risk of disease doesn’t make you want to floss, how about the fact that flossing may save you money. According to research by the Children’s Dental Health Project (CDHP), dental preventive care now can pay Please see FLOSSING, 30
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Flossing
Fig. 2. Hold the floss tightly between your thumbs and forefingers.
Fig. 3. Guide the floss between your teeth using a gentle rubbing motion. Never snap the floss into the gums.
Fig. 4. When the floss reaches the gum line, curve it into a “C” shape against one tooth. Gently slide it into the space between the gum and the tooth.
Fig. 5. Hold the floss tightly against the tooth. Gently rub the side of the tooth, moving the floss away from the gum with up and down motions. Repeat this method on the rest of your teeth. Don’t forget the back side of each tooth.
mouth. But, for dental floss to effectively remove plaque from your teeth, you need to be sure you’re using the correct technique. We will illustrate this technique below with images to guide you. The type of floss you use is just a matter of personal preference, as long as you are using the correct technique. There are many types of interdental cleaners to choose from, and you can even choose a variety of types of floss as well as interdental brushes to meet your needs and those of your family members. Small interdental brushes have proven superior to flossing for cleaning the area in between the teeth where there is space to do so. In these areas where the teeth may have shifted apart or the gum tissues have receded, floss may actually be of little value and an interdental brush may become the most effective instrument.
So, although the latest U.S. government dietary guidelines have removed flossing from their recommendations, the ADA still insists that interdental cleaners, including floss, “are an essential part of taking care of your teeth and gums.” The recommendation from the ADA also continues to be that patients brush twice a day with a fluoride toothpaste, floss or use interdental cleaning once a day, and see their dentist on a regular basis. In my opinion, this is still the best advice we can give patients to maintain their oral as well as systemic health.
Fig. 1. Because you’ll be putting your fingers into your mouth, be sure to wash your hands before you begin. Break off about 18 inches of floss and wind most of it around one of your middle fingers. Wind the remaining floss around the same finger of the opposite hand. This finger will take up the floss as it becomes dirty.
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significant dividends down the road. Researchers reported that in populations that statistically tend to rely on emergency room care instead of doctor visits, the cost for dental emergency visits can be as much as 10 times the cost of regular checkups over a given period. In an era of rising health care costs and diminishing insurance benefits, it pays to take steps to reduce your medical expenses. So, you’ve decided to start cleaning between your teeth. Great! The ADA suggests that flossing before you brush helps make brushing more effective: With less plaque caught between your teeth, the fluoride in toothpaste can get to more parts of your
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Drs. Waite and Tesmer have a periodontal practice in Tampa.
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OFF THE CUSP JOHN PAUL, DMD, EDITOR
Congratulations, You Are Here! If you are reading this, chances are you are a patient in a dental office and looking for something to occupy a little of your time. Thanks for choosing my magazine rather than watching cat videos. Let me congratulate you for being in a dental office. Having a regular dental home is one of the best things you can do for your health. Let me tell you a little bit about the doctor you are waiting for. I’ve said this before to their face: Dentists are weird. They chose to work in a profession that, on a good day, gives most others the heebie jeebies. They chose a profession where they would work in a small, dark place no bigger than a tennis ball, crouched over, with loud tools that will likely cost them their hearing. It’s hot, wet, often smelly and sometimes a direct danger to their health. They didn’t just choose to be dentists — they begged for it. They fought through four years of college, making above average grades in difficult science courses. Then they went into debt — as much as it costs to buy a house at the beach — just to get the education to be a dentist. The strange thing is, that dentist will be happy to share everything they know to help you prevent the very disease they spend their time learning to repair. They fight city hall on your behalf to make sure your water is fluoridated so you and your children will be less likely to need the restorative services they provide. You will never need “dentures in a day” if you can prevent disease in the teeth you got at birth. Take advantage of what your dentist has to offer. Tell your dentist what’s important to you. Ask questions and expect answers. We love what we do and sometimes we get a bit excited, so if your dentist veers into Latin, ask them to translate it back into something that makes more sense. Develop a partnership to maintain your health — not just your teeth — but the whole you.
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Dentists will be happy to share everything they know to help you prevent the very disease they spend their time learning to repair.
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Dr. Paul is the editor of Today’s FDA.
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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.