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What’s in Your Water?

December 5th, 2018

First things first…we hope everyone had a great Thanksgiving!  Hopefully those who travelled had uneventful trips with nothing approaching Planes, Trains and Automobiles.  But now it is time to return to the business of this blog, TEETH!

We are going to answer 2 questions today.  Do you know if you have fluoridated water?  And what does fluoride have to do with teeth?  

The first question is easily answered.  If you have well water, there is a very strong chance that you do NOT have fluoridated water.  If you have community water (Canton City, Massillon, etc.) then chances are you DO.  

Our second question will take a tad longer and requires some history and science.  Stay with me, it isn’t that boring.  Fluoride was first added to select water supplies in 1945, with The US Public Health Service recommending that water fluoridation be instituted nationwide in 1962 (more on that later).  

The science is very simple.  Fluoride acts much like Calcium in that, when ingested, it collects in certain areas of the body (specifically the bones and teeth).  For children whose permanent teeth are still being formed, the fluoride helps form a compound called Hydroxyapatite, and that gets incorporated into the enamel portion of the new tooth.  Hydroxyapatite makes the tooth stronger and more resistant to the formation of cavities, which is the main benefit of fluoridated water.  Adults also benefit from fluoridated water because Fluoride provides a way to ‘heal’ damaged enamel surfaces through a process called ‘remineralization.’  

Alright, hopefully you are still with me because now I can explain why we decided to talk about this in the first place.  Remember that the US Public Health Service recommended the nationwide implementation of fluoridated water (I only mentioned it 2 paragraphs ago)?  Well without going too deep into our Constitution and the concept of Federalism, local communities have the authority to determine whether their water gets fluoridated, not the Federal Government.  And every November (i.e., election time) the American Dental Association (ADA) sends a newsletter stating that some communities have decided to stop fluoridating their water supply.  It just so happens that this year multiple communities voted to stop!  Why?

It turns out there are two common reasons.  The most common one is the existence of ‘studies’ attempting to connect the presence of fluoridated water with autism and various types of cancer.  These studies are poor at best.  The other often cited reason is a fear of a government putting things into the water supply.  I really don’t feel I need to rationalize that statement…just throw away the tin-foil hats.

In reality, the effects of fluoridated water have been vigorously studied by both the government and private researchers.  And the results are quite clear.  With over 50 comprehensive studies and 25 systematic reviews (think studies of the studies), there is no strong link to cancer or autism.  Water fluoridation has been a resounding success because dental cavity rates have significantly declined since 1962.  The CDC even cited water fluoridation as one of the top 10 most significant public health programs of the 20th century!  

Ok, lets wrap this up.  Obviously we feel that fluoridated water is a tremendous benefit to a growing child’s teeth.  Teeth are going to be stronger and more resistant to cavities.  Adults also see the same benefits but at a more superficial level.  So here is some homework.  You can find out about your water supply by contacting your water company.  Ask them if the water is fluoridated, and what is the concentration.  The current recommendation is 0.7mg/L (that’s milligrams per Liter).  If you have well water, you should ask your Dentist (or Orthodontist) if supplemental vitamins would be beneficial for your kids.  

If you have any questions about this, please don’t hesitate to contact us. 

-Drs. Nate, Theresa and Nick

Thanksgiving Reflections

November 19th, 2018

I sit here on a (very early) Sunday morning planning what is a short work week for our team.  It is hard to believe that Thanksgiving is already here!  I envisioned a dental-focused post about water fluoridation, but that will have to wait until next week.  Instead I find my thoughts drifting towards Thanksgiving. 

Thanksgiving has always been a favorite time of year for our family, as I am sure it is for yours as well.  So please indulge me while I touch on two of the most important things we are thankful for this season. 

First and foremost, we want to thank our patients and their families for the opportunity to serve them daily.  You are our motivation and the reason we strive to improve.  We are continually humbled by the opportunity you have given us.

Secondly, as doctors we are so thankful to work with such an amazing team.  We are extremely grateful to have a team so dedicated to our patients.

We sincerely hope your family has a wonderful Thanksgiving.  And I will leave you with the quote from the great philosopher, Charlie Brown…

“What if, today, we are grateful for everything?”

-Sincerely,

Drs. Nate, Theresa and Nick

 

 

Do-it-Yourself Orthodontics!!!

November 1st, 2018

Welcome back everyone.  While there are still so many topics to discuss, I wanted to briefly touch on one of the newest, and worrisome, fads today in Orthodontics.  

Most likely you have read/heard about Direct-to-Consumer (D2C) companies.  To make sure everyone is on the same page, I will briefly explain.  D2C companies are those that market their goods and services directly to the public.  There are no middlemen (think stores), and as such they are able to reduce their costs AND therefore sell their products more cheaply.  

For this reason D2Cs have exploded in popularity.  Chances are you have heard of (if not bought from) some of the most successful D2C companies.  Do the names Casper (mattresses), Warby Parker (glasses) and Dollar Shave Club sound familiar?  For the record I have purchased items from some of these companies and am thrilled with their products.  Alright, now that we are all caught up…

Dentistry and orthodontics are not immune from the D2C trend.  These companies specifically market do-it-yourself (DIY) treatments.  There are dental labs that will produce snoring appliances, removable dentures, and different versions of veneers to make someone’s smile appear whiter and brighter.  Those are all treatments that have the potential to permanently change teeth, bone and gum tissue!  Even in orthodontics there are now a few companies advertising to produce clear aligners (trays) to straighten teeth!  

The American Dental Association (ADA) and American Association of Orthodontics (AAO) have both released statements regarding these D2C companies.  Obviously consumers, when using D2Cs, are bypassing the doctor’s essential role in diagnosing and treatment planning.  What could possibly go wrong with this scenario? 

Well, apparently many things have gone wrong and now the American Dental Association (ADA) is working with the FDA on helping consumers report their problems.  Check out the article here.   

In our own practice we have re-treated 5 people in the past year who have tried their luck with DIY orthodontics.  Also, one of our colleagues recently posted a video of a patient who was seeking his orthodontic expertise to correct a DIY treatment gone bad.  I was going to include it but it was recently taken down because the D2C company is suing him!  Go figure.  

Obviously we discourage anyone from pursuing DIY dental or orthodontic treatments.  Without proper oversight, these seemingly “simple” and “easy” treatments can lead to irreversible harm at worst, or simply a very expensive re-treatment at best.  Unfortunately I don’t believe we can now close Pandora’s box.  DIY treatments will remain, especially as their marketing budgets swell and consumers remain largely uneducated on the necessity of doctor-based care.  

So, why write something like this?  Well maybe you will share it with someone who is thinking about DIY orthodontics.  If nothing else perhaps it will persuade them to dig a little deeper with their research.  Consumer education is everything, and hopefully this helps.   

What I did on Vacation

July 13th, 2018

Dr. Nate here today.  So, here we are in the middle of Summer...We sincerely hope everyone has had a great start to their Summer activities!  Our whole family just got back from our yearly beach vacation, and while we were there I was finally able to catch up on the latest Orthodontic news. 

My last post focused on a supposed revolutionary vibration device designed to make Orthodontic treatment go faster.  If you want to re-visit that, click here.  I had concluded that there was no substantial evidence this system would make teeth move faster.  And now I have some semblance of vindication...

There is an Orthodontist in England named Kevin O’Brien who writes a very good blog about Orthodontics.  He is a professor of Orthodontics and a talented writer who has made quite the name for himself, even in the US.  In his most recent post (which is here) he mentioned that the British government, namely the Advertising Standards Authority (ASA), forced the company promoting their Orthodontic vibrating device to remove their ads for a very serious reason.  Instead of summarizing, I will pull the important quote.

“The ad must not appear again in its current form.  We told OrthoAccel Technologies Inc. not to make claims that their AcceleDent device could move teeth faster and reduce the pain for brace wearers unless they held adequate evidence to support such claims.”

When I finished Dr. O’Brien’s post, and then read the full ASA document, I could hardly believe it!  And then I became frustrated for two reasons.  First, the same standards haven’t been applied here in the US.  Treatments without excellent research results should not be presented to the public through advertisements!  Secondly, as a supposed learned specialty within Dentistry, Orthodontists should be able to discern good quality research from poor research.  That is our responsibility to the public...don’t treat patients with something that doesn’t work!

If you have made it this far, you should know that I fully understand that this rant has been more cathartic for me than entertaining for you.  Selfish?  Of course.  But my (and Dr. Theresa’s and Dr. Nick’s) standards are very high when it comes to treatment decisions.  Ask us why we do this treatment, and not that one.  We will be glad to tell you, and show you the research backing it up.  

New technology is great, but not always effective.  That is an important distinction. 

Some beach vacation...

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