What is Vaping?

                                                                 

Vaping means smoking an e-cigarette.  E-cigarettes are battery-powered devices that deliver cigarettes electronically and in an array of flavors and vapors.  The 3 most common ingredients in e-cigarettes are propylene glycol, vegetable glycerin, and nicotine.  These are harmful ingredients that may cause harm to your health and your dental health.  Center of Disease Control (CDC) reports that there is an increase of e-cigarette use, especially among kids; an increase of 78% among high school students and an increase of 49% among the middle school students between 2017 and 2018.  This is a big concern and more studies are needed to find out the effects of long term exposure to e-cigarettes.

Health risks of Vaping
Nicotine is delivered through vaping.  Nicotine is an addictive substance that is also a carcinogen, and it is known to cause cancer.  Nicotine can cause tumor growth in the following:
Lung cancer
Gastrointestinal cancer
Pancreatic cancer
Breast cancer
Some early studies show data that vaping may cause bodily harm:
Impacts the health of the lungs and DNA
Damages the blood cells
Increases the risk of heart disease
Weakens the immune system
Dental health risks of Vaping
The 3 most common ingredients in e-cigarettes are propylene glycol, vegetable glycerin, and nicotine.
Oral tissues exposed to a mixture of propylene glycol and flavoring ingredients in e-cigarettes can lead to dry mouth.
Research shows when teeth are exposed to a mix of vegetable glycerin and flavoring ingredients, teeth have four times more bacteria than teeth that have not been exposed to e-cigarettes.
Vaping can cause deterioration of tooth enamel, cavities, periodontal disease, gum recession, tooth loss, and other dental health problems.
White spots on the teeth-these are decalcifications that show the beginning of enamel softening
Red or white patches on the gums or the inside of the cheek.  They can be precancerous cells and sometimes they do become cancer cells.
Oral thrush-white patches on the tongue or mouth or redness inside the mouth. This can be a sign of thrush.

Vaping increases the risk of periodontal disease. These are some of the symptoms to look out for:
Ongoing bad breath (halitosis)
Red, puffy, bleeding gums
Receding gums
Tender or swollen gums
Teeth mobility

Minimize the risk of developing dental problems
Stop vaping
Brush with fluoridated toothpaste at least twice per day.  Wait 20 minutes before brushing your teeth after vaping
Floss daily
Avoid dry mouth, drink water often.  Use a moisturizing mouth spray containing xylitol, which helps to stimulate saliva production.
See the dentist every 4 to 6 months for check-up and cleaning.
Researches

The increased number of people vaping as an alternative to traditional cigarette smoking is a growing concern.  More studies are being done now to find out the health and dental health risks of vaping.     Food and Drug Administration (FDA) asked the National Academies of Sciences, Engineering, and Medicine (NASEM) to report on the potential public health consequences of vaping. NASEM researchers were unable to find any link between e-cigarette use and periodontal disease.  They provided limited evidence that e-cigarette aerosol can cause cell damage in oral tissue.
More researches are needed to find out the long term health and dental health impacts of vaping and e-cigarettes. 

Dr. Anna Lee is a general & cosmetic dentist in Glendora, CA.  She is experienced in all phases of dentistry.  She treats patients of all ages.  If you notice any of the symptoms of periodontal disease, call our office for a dental checkup.  Call our office at 626-335-5114 for a dental appointment or visit us at www.annaleedds.com.

Benefits of Smiling

Your smile is one of the first things people notice.  Your smile can make a memorable impression from the very first start.  People who smile may be perceived as more happy, successful and trustworthy. Smiling has both health and social benefits.

Some of the health benefits of smiling

1.     Improved  mood

·       Smiling can boost your mood and may be beneficial for people struggling with depression and anxiety.

·       Smiling and having positive thoughts can help to lift your spirits.

2.     Lower blood pressure

·       Smiling/laughter-muscle relaxation and decrease in heart rate and blood pressure

·       Reduce risk of developing heart disease.

3.     Stress relief

·       Lower heart rate during stressful tasks

·       Smiling releases endorphins which are a group of hormones that help to relieve pain and stress

4.     Stronger immune function

·       Mayo Clinic reports that laughter and positive thoughts release molecules in the brain that fight stress and illnesses.

·       Laughter therapy increases immune responses in postpartum women.

5.     Pain relief

·       Mayo Clinic reports laughter causes your body a higher pain tolerance.

·       Smiling/laughter increases pain threshold and creates a higher pain tolerance.

Some of the social benefits of smiling

1.     Smiles are contagious

·       Smiles make you feel good. Smiles make others feel good

·       Smiles are great first impression and relationship builder

2.     Better relationship

·       People who smile are perceived as being more likable than those who don’t smile

·       Being likable makes it easier to build and maintain better relationships

3.     Attractive & sociable

·       People who smile are viewed as more attractive and sociable

·       You don’t have to have perfect looking teeth but a smile reflects your self confidence

4.     Confidence & self-esteem

·       Your smiles tell people some things about you: self-confidence and self-esteem.

·       May get better job opportunity, promotion, and better/higher pay.

5.     Trustworthy

·       Your smile is the first impression people notice.

·       Some job interviewers say they can tell from the first impression whether or not the job applicant would be a successful and trustworthy employee.

Smiles are contagious. When you smile, people respond with a smile back.  It is a good and wonderful feeling when you can smile with confidence.  Dr. Anna Lee is a general & cosmetic dentist in Glendora, CA.  Contact Dr. Anna Lee for a consultation at 626-335-5114 or visit our website at annaleedds.com and find out how you can get the smile that you want.

Orofacial Myofunctional Therapy before and after Laser Frenectomy

What is orofacial myofunctional therapy (OMT)?

·       Orofacial myofunctional therapy (OMT) is a program of specific exercises that target the facial muscles for chewing and swallowing.  These exercises help to strengthen the tongue muscles after the frenectomy procedure. 

Why is orofacial myofunctional therapy necessary before & after laser frenectomy?

·       Karen Wuertz, D.D.S. and Brooke Pettus, COMS are authors of the article published in Laser focus in DSP, fall 2018 wrote, “The removal of oral restrictions is necessary to attain optimal orofacial function and must be combined with regular pre- and post-frenectomy orofacial myofunctional therapy (OMT).”

·       OMT helps re-educate the tongue and orofacial muscles during movement and at rest to create new neuromuscular patterns for proper oral function, including chewing, swallowing, speaking, and breathing. 5,6

5. Guilleminault C. Huang YS, Monteyrol PJ, Sato R, Quo S, Lin CH.  Critical role of myofascial reeducation in pediatric sleep-disordered breathing. Sleep Med. 2013 Jun; 14(6): 518-25.  Doi: 10,1016/j.sleep.2013.01.013.

6. Guimaraes KC, Drager LF, Genta PR, Marcondes BF, Lorenzi-Filho G. Effects of oropharyngeal exercises on patients with moderate obstructive sleep apnea syndrome. Am J Respir Crit Care Med. 2009 May 15;179 (10):962-6. Doi:10.1164/rccm.200806-981OC.

*Case example by Karen Wuertz, D.D.S. & Brooke Pettus, COMS

Patient: 29 year old female

Clinical exam & symptoms:

·       Temporomandibular Disorder (TMD) symptoms with jaw deviation, clicking/popping on the right side

·       Neck pain and frequent headaches

·       Low facial muscle tone, a short upper lip

·       Mouth breathing all night, regular night time drooling, restless sleep

·       Complained of daytime fatigue & never waking well rested

·       Frequent congestion

·       Forward head/neck and forward rolled shoulder posture

·       Tension in the neck and shoulders

·       Tongue thrust during swallowing

·       Dry, chapped lips and the habits of lip licking, cheek biting and clenching

Intraoral examination:

·       Narrow, high palate

·       Tight upper labial frenum and attached gingiva

·       Tongue is short and wide with a tight, restrictive lingual frenum

·       Range of Motion (ROM) was 28mm from tongue tip to incisive papilla

Laser Surgery:

·       CO2 laser frenectomy was performed to release lip and tongue restrictions

·       Patient was asked to lift, extend, and lateralize the tongue

·       ROM was measured at 47mm.  Patient gained 19mm in the ROM with tongue tip to incisive papilla (gum tissue between upper 2 front teeth).

Postoperative care and healing:

·       Almost immediately, patient reported less neck and shoulder tension

·       Could stand up straighter

·       Her airway felt more open when breathing

·       Able to close her mouth without straining on her upper lip

·       Able to elevate the middle and posterior portions of the tongue to the palate

·       800mg ibuprofen was taken twice the day of and once the day after

·       Soft, bland diet for 48 hours

·       Continue orofacial myofunctional therapy (OMT) regimen after the revisions

-OMT helped the patient retrain and re-pattern neuromuscular movements that had been foreign to her and helped her integrate them into her everyday life

Results:

·       Proper oral posture (tongue to palate)

·       Lip (no open mouth posture at rest)

·       Nasal breathing got increasingly easier

·       Better posture, more energy, eats less, feels rested in the morning

·       Sleeps through the night

·       Tongue thrust eliminated

·       No more night time drooling

·       Decreased in clenching and biting the sides of her tongue at night

Summary:

Optimal orofacial functions in adult patients can be achieved through laser lip and tongue frenectomy procedures and regular pre- and post-frenectomy orofacial myofunctional therapy.

*“The Importanace of Orofacial Myfunctional Therapy Before and After CO2 Laser Frenectomy in Achieving Optimal Orofacial Function” by Karen M. Wuertz, DDS, ABCDSM, ABLS, FOM, and Brooke Pettus, RDH, BSDH, COMS

Dr. Anna Lee is a general & cosmetic dentist in Glendora, CA.  Dr. Anna Lee is an experienced provider for laser frenectomy.  If you have any questions about lip and tongue ties, please visit us at www.annaleedds.com or call for a consultation at 626-335-5114.

Periodontal Disease = Gum Disease

Periodontal disease is also known as gum disease is a bacterial infection of the gum tissues and bone that hold the teeth in place.  It is caused by the bacteria in plaque, a sticky and colorless film that forms on the teeth. The early stages of gum disease can often be reversed and maintained with proper brushing, flossing and regular dental cleaning & check up with the dentist.  Gum disease that is left untreated would lead to tooth loss and other periodontal complications and problems.

This is the American Academy of Periodontology (AAP) classification of Periodontal Disease:

Type I  Gingivitis

·       Earliest stage of gum disease

·       No loss of attachment, no bone loss

·       Bleeding on probing may be present

·       At this early stage in gum disease, damage can be reversible since there is no bone loss.

·       Proper brushing, floss and regular dental cleaning help to remove plaque

Type II  Early Periodontitis

·       Pocket depths or attachment loss: 3-4mm.  Bone loss is present.

·       Periodontal pockets are formed as the dental tissues (gums and supportive ligaments) begin to pull away from the tooth.  These pockets trap bacteria and causes gum infection

·       Localized area of gingival recession; gums pull away and exposes the root

·       Bleeding on probing may be present

·       Damages caused by gum disease is irreversible

Type III  Moderate Periodontitis

·       Pocket depths or attachment loss: 4-6mm.   Bone loss is present.

·       Bleeding on probing

·       Furcation involvement

·       Teeth show mobility (loose)

·       Damages cause by gum disease is irreversible

Type IV  Advanced Periodontitis

·       Pocket depths or attachment loss: greater than 6mm.   Bone loss is present.

·       Supporting tissues and bone are destroyed. 

·       Bleeding on probing

·       Furcation involvement

·       Teeth show increased mobility (loose).  Some teeth are so loose that they may need to be extracted.

·       Damages caused by gum disease is irreversible

Signs of Periodontal Disease

·       Gums are red, swollen or tender

·       Gums that bleed during brushing or flossing

·       Teeth that look longer due to gum recessions

·       Formation of deep pockets between teeth and gums

·       Loose or shifting teeth

·       Persistent  bad breath or bad taste in the mouth

·       Changes of the teeth fit together when biting (occlusion)

·       Changes of the fit of the partial denture

Gum disease can occur at any age.  If gum disease is detected and treated at early stages, it can be reversed and maintained.  Currently, there is no cure for gum disease. 

If you notice any signs of periodontal disease, please contact Glendora Dentist, Dr. Anna Lee for a dental checkup.  You don’t have to lose teeth to periodontal disease.  Dr. Anna Lee can help to save your teeth. Call and schedule a free consultation at 626-335-5114 or visit us at www.annaleedds.com