Monday, September 17, 2018

Welcome to Dr. Anna Lee’s monthly newsletter,



Soon 2018 will be coming to a close, and so will your yearly dental benefits. We would like to remind you to schedule your dental hygiene, exam and/or any other dental procedures as soon as possible in order to fully utilize your 2018 insurance benefits. These benefits, as well as healthcare flexible spending accounts, may expire at the end of December.
Unlike medical insurance, healthcare flexible spending accounts, and most dental insurance plans, do not roll over to the following year. As such, any unused benefits dollars for 2018 will be lost.
We know how busy families are today, but by coming in for regular dental hygiene appointments and exams you may avoid dental complications that may cause you to exceed future dental benefits. We are committed to the prevention of dental disease, and exams and dental hygiene are essential in that effort.
As the end of the year approaches, calendars get busy and things get put off. We kindly ask you to call 626-335-5114 today so that we may schedule your appointment as soon as possible. We want you to maximize your benefits and have the best dental treatment available. Remember, it is always best to catch dental problems early.
We look forward to seeing you soon.
P.S. Don’t forget that most dental insurance plans are “use it or lose it!” Don’t put it off any longer-

Dr. Anna Lee & Staff

Sunday, September 16, 2018

Amalgam and Composite fillings



What are amalgam fillings?
Amalgam fillings are also known as “silver fillings.”  Dental amalgam is a combination of mercury, silver, tin, copper and small amounts of zinc, indium or palladium.  Mercury makes up 50% of the filling material and it binds all the other metals together to provide a strong, safe and durable filling.
What are composite filling?
Composite fillings are also known as “tooth-colored fillings” or “white fillings.”  Composite is a blend of plastics and small glass particles that are used to do small and large fillings for front and back teeth.
Pros and Cons of amalgam and composite fillings
Pros: Amalgam fillings
·       Proven-most popular and effective filling material used in dentistry for the last 150 years
·       Economical-cost less than composite fillings
·       Durable
Cons: Amalgam fillings
·       Unesthetic & Noticeable-black/grey teeth
·       Allergies-some people are sensitive to the metals in amalgam
Pros: Composite fillings
·       Esthetic-natural looking, match the color of natural teeth
·       Easy adhesion-bond directly to the tooth surface
·       Preserves maximum amount of tooth structure, less drilling, and less tooth structure reduction
Cons:  Composite fillings
·       More frequent replacement, they don’t last as long as amalgam fillings
·       Placing a composite filling is more involved and it is a longer appointment
Why is mercury used in amalgam and is it safe?
·       Mercury is used in amalgam because it binds all the other metals together to provide a strong, safe and durable filling. Mercury also helps making the filling material pliable. When mercury is mixed with alloy powder it becomes soft enough to mix and press into the tooth.  Amalgam filling hardens quickly and can withstand the forces of biting and chewing.
·       In 2009, Food and Drug Administration (FDA) evaluation and research concluded that amalgam fillings are safe for adults and children ages 6 and above.


Are amalgam fillings a problem?
·       In 1998, the American Dental Association’s (ADA) Council on Scientific Affairs published the scientific literature on dental amalgam and concluded that amalgam continues to be a safe and effective restorative material.  
·       In recent years, tests show very small amount of mercury (vapor) can be released as the amalgam filling wears in the mouth over time.
·       Several reviews of the research concluded that any amount released from amalgam in the mouth is very low.
·       Other studies showed that the amount of mercury people are exposed to from the fillings is less than the amount that people are exposed to in their environment and their foods.
When should amalgam fillings be replaced with another type of dental material?  What material? 
·       Patients should remove their amalgam fillings if tooth is breaking, chipping, decaying or when the filling is worn.  There is no need to replace the amalgam if amalgam is intact with no tooth problems.
·       Removing good amalgam fillings can cause unnecessary loss of healthy tooth structures and can release more mercury (vapor).
·       Depending on the size and locations of fillings; your options are composite fillings, porcelain fillings (inlays/onlays) and others
Dr. Anna Lee is a general & cosmetic dentist in Glendora, CA.  She is knowledgeable about different types of dental material for fillings. If you have any questions about amalgam and composite fillings, please visit us at www.annaleedds.com or call for a dental checkup at 626-335-5114. 



Friday, September 7, 2018

Obstructive Sleep Apnea


                
                                    
  I have attended several sleep apnea seminars in the past, but the Dr. Radar seminar that I attended in August 2018 was the most informative and practical seminar compared to others.  There was plenty of information that kept me awake throughout the entire seminar.   I want to share the information that I have learned about sleep apnea with my patients.
What is obstructive sleep apnea (OSA)?
Sleep apnea is a serious medical condition in which breathing repeatedly stops and starts while the patient is asleep. Obstructive sleep apnea (OSA) is the most common sleep disorder.  It is estimated that 22 million Americans suffer from OSA, with 80 percent of the cases of moderate and severe OSA undiagnosed.  OSA can affect people of any age, including men, women and children.  OSA is a treatable medical condition.  There are treatment options for OSA which includes Positive Airway Pressure Devices (CPAP), oral appliance therapy (OAT) and surgery.
What are the signs and symptoms of OSA?
One of the most common signs of OSA is loud and chronic, ongoing snoring.  Pauses may occur in the snoring; choking or gasping may follow the pauses.  Other signs and symptoms:
·       Excessive day time sleepiness, at work or while driving
·       Impaired cognition, memory or learning problems, not able to concentrate
·       Depression
·       Irritability/mood Disorders
How does sleep apnea affect your health?
Harvard Medial, May 2011:  Study by the American Academy of Sleep Medicine (AASM) found that patients untreated for moderate to severe sleep apnea had a decrease life expectancy of 8-11 years as opposed to patients that were treated for the same condition.
·       Higher risk of stroke: 65% of stroke patients have sleep apnea
·       Higher risk of heart diseases: 40-83% patients with hypertension have sleep apnea. Studies show sleep apnea increase the heart rate and blood pressure
·       Higher risk of diabetes: 48% of type 2 diabetes patients have sleep apnea
*Patients with OSA have 23x higher risk of Heart Attack compared to a healthy patient.                                      
How do people get diagnosed with sleep apnea?
·       ONLY a physician can diagnose OSA
·       Physicians typically do not look in patients’ mouths.  Physicians do not recognize the common oral facial signs and symptoms of OSA
·       DENTTISTS have a right to SCREEN for OSA and treat with Oral Appliance Therapy (OAT) per Dental Practice Act
Dental Practice Act (Business and Professions Code Section 1625-1636.6):                                                            
Dentistry is the diagnosis or treatment, by surgery or other method, of diseases and lesions and the correction of malpositions of the human teeth, alveolar process, gums, jaws, or associated structures; and such diagnosis or treatment may include all necessary related as the procedures as well use of drugs, anesthetic agents, and physical evaluation.

Sleep Tests
Sleep test is needed for the physician to diagnose the sleep disorder. Sleep test can be performed at home or hospital sleep lab.
·       Home Sleep Test (HST)-patient is provided with simplified tests to be used at home to diagnose sleep apnea.  These tests involved measuring the heart rate, blood oxygen level, airflow and breathing patterns while the patient is sleep.  It is usually 2 nights of testing.  The test result is read and diagnosed by Board Certified Sleep Physician.
·       Hospital Sleep Lab-test is performed in the hospital sleep lab and is hooked up to equipment that monitors the heart, lung and brain activity and breathing patterns while the patient is sleep.
What are the options of treatment?
·       Positive Airway Pressure Devices (CPAP)-the most widely used treatment for Moderate and Severe Sleep Apnea. They are endorsed by the AASM.  It is the most common and reliable method of treating sleep apnea, but some people find it cumbersome and uncomfortable.  The problem with CPAP is patient compliance; estimates about 24-40% compliance. 
·       Oral Appliance Therapy (OAT)-best for Mild to Moderate Sleep Apnea.  AASM recommends OAT for patients with severe OAT who are not unable to tolerate wearing CPAP devices.
*Combination Therapy-wearing CPAP and OAT together to help reduce the pressure on the CPAP machine, making it more comfortable to use.
·       Surgery-an option for patients after other treatments have failed.  The goal of the surgery is to enlarge the airway through the nose or throat that may be causing the blocking of the upper airway passages.
Dr. Anna Lee is a dentist trained in sleep apnea. She conducts a full evaluation of your teeth, mouth and temporomandibular joint (TMJ) and screen for sleep apnea.  Sleep test is necessary for the physician to diagnose the sleep disorder.  Dr. Anna Lee can then help you with different option treatments of the sleep disorder.  Please visit our sleep website at www.glendorasleep.com or call our office for a free sleep consultation at 626-335-5114. 

Thursday, July 26, 2018

Frequently Asked Questions About Teeth Whitening


       


Teeth whitening is a very popular cosmetic procedure.  Most people want to whiten their teeth for a whiter and brighter smile.  There are different options to achieve the smile.  Dental professionals educate their patients about their teeth and assess whether teeth whitening is an appropriate option to achieve the white smile.  Here are some of the frequently asked questions by the patients about teeth whitening:
What are the different options of teeth whitening?
·       The use of over the counter whitening products is one of the most popular options to whiten the teeth.  They are available everywhere and can be purchased at the drug stores and on-line.  The American Dental Association cautions patients to use accepted whitening products under professional supervision for safety.
1.     Whitening toothpastes rely on mild abrasives to remove surface stains
2.     Whitening strips rely on peroxide to bleach teeth.  They are clear strips that adhere onto the teeth (6 upper and 6 lower front teeth) for about 30 minutes a day for one to two weeks.
3.     Brush-On Whitening products are painted directly onto the teeth with a small brush and sometimes are left overnight.
·       Bleaching trays-Dental staff takes impressions of the upper & lower teeth to fabricate bleaching trays.   The whitening gel is loaded into the custom fitted bleaching trays for the upper and lower teeth.  Depending on the varying concentration of the bleaching ingredients, the treatment can be completed in one to two weeks.
·       In-office (chair side) Whitening is performed in the dental office for about 60-90 minutes.  Prior to the procedure, an informed consent discussion form is reviewed and signed.   The discussions include patient’s diagnosis, proposed treatment, risks & benefits, pre-existing condition/shade of teeth, and patients’ expectations prior to treatment.  There are several teeth whitening products available to dentists.  These products contain hydrogen peroxide in concentrations ranging from 10 percent to 40 percent. Whitening results may vary depending on the conditions of patients’ teeth.
Should I whiten my teeth? Am I a candidate for teeth whitening procedure?
Most people will notice some improvement of whitening of their teeth.  If the teeth surface stains caused by coffee and tea and the discoloration are yellow, brown, or orange, you are likely a good candidate for teeth whitening.  If the discoloration is gray and it is caused by the use of tetracycline (antibiotic) and fluoride while teeth are forming, the whitening may not be as effective.  Talk to your dentist before the whitening procedure and discuss your expectations.
·       How long do the teeth whitening effects last?  
Teeth whitening is not permanent.  People who eat foods and drink beverages that cause staining may notice the whiteness start to fade in as little as one month.
·       What kind of foods do people avoid so whitening lasts longer?
Tea, coffee, chocolate, blackberries, soda, wine and others
·       How often does the teeth whitening need to be touched up? 
People who avoid foods and beverages that stain teeth may be able to wait one year or longer before another whitening procedure or touch-up is needed.
·       What can people do to maintain their bright smile?
1.     Brush or rinse immediately after consuming stain-causing foods and beverages
2.     Brush 2x/day and floss daily.  Use a whitening toothpaste 1-2x/week only to remove surface stains and use regular toothpaste the rest of the time.
3.     Regular dental checkup and dental cleaning at minimal every 6 months
What are the risks associated with teeth whitening?
The two side effects that may occur are temporary tooth sensitivity and mild irritation of gum tissues during and after the whitening procedure. Irritation of gum tissues is probably caused by the bleaching gel leaking through the barrier during the bleaching procedure.  Both the tooth sensitivity and gum irritation are temporary and resolves shortly after the end of the procedure. 
If patients continue to have tooth sensitivity after the treatment, your dentist may recommend toothpaste that contains potassium nitrate to relieve the tooth sensitivity.
·       Does teeth whitening damage tooth enamel?
No, studies show that whitening products that contain 10% of carbamide peroxide showed no effect on the hardness or mineral content of a tooth’s enamel surface.
·       Does teeth whitening damage existing dental restorations (fillings/crowns)?
No, clinical studies showed that over 10 years use of whitening products that contain 10% carbamide peroxide cause no damage to existing restoration, such as fillings or crowns.
·       Does teeth whitening cause damage to a tooth’s nerve?
No, there is no evidence to date that whitening products cause harmful effect on the health of a tooth’s nerve.
·       Will my teeth and gums be sensitive after whitening?
Sometimes after whitening procedure, teeth and gums can be sensitive.  Contact your dentist about the tooth and gum sensitivity.
Will insurance cover the teeth whitening procedure?
Most likely not, teeth whitening is a cosmetic procedure.  Contact your dental insurance and find out about your benefit coverage.

Patients are so happy and excited when they see their whiter and brighter looking teeth and smile.  It is the greatest reward for a dental professional as me to share that joy and happiness with my patients.  I love to share that joy with you.  If you have any questions about teeth whitening, please contact the office for a free consultation at 626-335-5114 or visit us www.annaleedds.com


Wednesday, June 27, 2018

Dental Tips for Travelers

  
Vacation Time!  Whether you are on a vacation for a few days or months away out of the country; here are some dental tips for travelers to maintain good oral care:
Make Time for a dental checkup before travel
·       Thorough oral exam to take care any dental problems before the travel
·       Your dentist should check fillings, crowns or dentures in your mouth.  Air traps in the teeth can expand at extreme altitudes; it can cause pain, inflammation and even loose fillings, crowns or dentures
In case of emergency/emergency overseas
·       Make sure to have the dentist’s contact information handy or keep a business card in the wallet
·       If you are out of the country, get a dental referral/recommendation from the local consulate or U.S. embassy
Pack Dental supplies (toothbrush, toothpaste, floss)
·       Ventilate toothbrush-Store the toothbrush after use in a sealable plastic bag and keep it clean and out of contact with other things. As soon as you reach the destination, take the toothbrush out for air dry.
·       Toothpaste and floss-keep these supplies in the glove compartment, purses, containers, plastic bags, carry-on
·       Bring extra, portable/disposable supplies-go small, the more compact the oral hygiene items, the more likely you are to keep them handy
Eat healthy snacks
·       Cut up fruits & vegetables, baby carrots, celery sticks, sliced apples, string cheese, whole grain crackers, trail mix
·       Chew sugarless gum for 20 minutes after a meal can help prevent cavities.  It gets saliva flowing and washes away cavity-causing bacteria
·       Drink water
Brush with bottled water
·       If you are in a country that the water supply may be compromised, use bottled water to brush your teeth.  It reduces the risk of getting sick
·       Clean the toothbrush with bottled water.  It reduces the risk of getting sick
Stick to your routine
·       Brush your teeth 2x/day and floss daily
·       End of day with a thorough brushing and flossing. 
Dr. Anna Lee is a general & cosmetic dentist in Glendora, CA.  She has been taking care of adults and children’s dentistry for over 25 years.  Call our dental office for a thorough dental examination before leaving for your vacation.  If you and your family have any questions about dental care, please contact Dr. Anna Lee at 626-335-5114 or visit us at www.annaleedds.com.