Dear Patient,

Are you guilty of bruxing? Sounds pretty harsh, doesn't it - but, in fact, "bruxing" is just another way of saying "grinding your teeth."

As reported by Michael Winerip in the attached New York Times article (Dealing With the Nightly Grind, dentists throughout the country are seeing a significant increase in grinding, especially among middle-aged men. Typically, dentists treat more women than men for grinding, but now men are fast catching up.

What's taking its toll on these men, according to sources cited in the article, is the stress of the recession and its accompanying problems. Owners of companies, for example, have had to deal with shrinking business, significant layoffs, and reduction in income - Stress with a capital S.

Most people aren't aware that they're grinding their teeth. It's an unconscious behavior that often takes place during sleep. They become aware of the problem only when they notice worn-down, chipped or broken teeth. Other symptoms include headaches first thing in the morning, biting your tongue, painful mouth and not sleeping well.

"The pressure people put on themselves even while asleep is painful," the article notes. "Normal chewing places 68 pounds of pressure per square inch on the back teeth; intentionally clenching your teeth places 150 pounds of pressure; grinding unconsciously at night places 900 pounds of pressure." That's more pressure on your teeth in one night than in an entire month of normal wear.

If you suspect that you're grinding your teeth, we can help you take remedial action by making a customized night guard to wear during sleep. We also may recommend other corrective work. Please don't hesitate to make an appointment to discuss this growing problem.

Paul Tanners, D.D.S.

Dear Patient:

Usually we call your attention to articles about oral health but, with the recent article from The New York Times, we´re starting to send news of interest about general health and well-being. Most of our patient letters still will pertain to dental matters, though some will be broader in scope.

The headline on the Times article, Big Benefits Are Seen From Eating Less Salt sums up the latest news nicely: Researchers calculate that if adults reduced their daily salt intake by three grams, or half a teaspoon, there would be significant decreases in heart disease, stroke, heart attacks and, ultimately, death. Excessive salt intake can lead to high blood pressure, and high blood pressure, in turn, can lead to heart attacks and strokes.

According to the researchers, whose study was first reported in The New England Journal of Medicine, a half-teaspoon less of salt per day would cut new cases of coronary heart disease by 60,000 to 120,000 annually, stroke by 32,000 to 66,000, and myocardial infarction by 54,000 to 99,000 — and reduce the number of deaths by 44,000 to 92,000. Everyone would benefit from less salt, the Times notes, but people at higher risk for heart problems — blacks, people with hypertension, and people over age 65 — would benefit the most.

An added benefit, as reported elsewhere, is that the half-teaspoon-a-day reduction in salt would save the U.S. up to $24 billion a year in health care costs.

Since we´re as concerned about your overall health as your oral health, we urge you to consider selecting lower-sodium brands when food shopping, cutting back gradually on your daily use of salt, and not salting restaurant or prepared meals without tasting them first.

Paul Tanners, D.D.S.

Dear Patient,

If you think the admonition to “brush and floss regularly” is old-fashioned, think again.

In spite of all the research into methods of preventing tooth decay and gum disease, “the best way to protect teeth and gums is still through regular brushing and flossing, and by not eating too many sweets,” according to a recent article from The Wall Street Journal.

“Hygiene is still number one,” says Dwayne Lunsford, director of the microbiology program at the National Institute of Dental and Craniofacial Research, as quoted in A New Front in War on Cavities from the Journal.

That´s a message my practice has been stressing for 40 years — and it remains all the more critical today because, as the article indicates, the tooth decay rate in young children has been increasing. Probable reasons: Children are drinking more bottled water that doesn´t contain fluoride, and they have made unhealthy changes in their dietary habits.

The need to further reduce tooth decay led me to develop my own line of bottled fluoridated spring water, AquaForte, which has recently been endorsed by the American Dental Association as “a smart oral health choice.”

The article lists a number of tips for good oral hygiene, which I encourage you to read carefully. In addition to urging people to brush twice daily and floss daily, the tips include instructions on how best to brush and floss. And they emphasize, as we do in my practice, to get regular professional checkups and cleaning at least every six months to reduce hard-to-reach plaque. In fact, many of our patients are on three-to-four-month recall plans customized to their dental hygiene needs.

The staff and I look forward to serving you in this new year.

Paul Tanners, D.D.S.

Dear Patient,

You may have seen a recent article in The New York Times discussing dental implants vs. bridges (see A Dental Shift: Implants Instead of Bridges).

In the article, Jane Brody discusses implants and mentions fluoride — two of my favorite topics. Specifically, she laments having grown up without the benefits of fluoridated water, which eventually led to the loss of a decayed molar and subsequent treatment with fixed bridgework.

Regarding the use and placement of fixed bridgework, this otherwise excellent article deals subjectively with this technique, based mainly on the writer's experience. If properly executed, fixed bridgework generally lasts far longer than it did in Jane Brody's case.

As many of you know, our practice is experienced in the field of implants and recommends them routinely as the state of the art treatment, where indicated. Although effective as the ideal method for replacing missing teeth, implants are not appropriate for all such situations.

If you would like to discuss any aspect of this important article with me, please call to schedule a complimentary office or telephone consultation. I look forward to hearing from you.

Dr. Paul Tanners

Dear Patient,

The correlation between heart health and oral health will come as no surprise to my patients. We've been keeping you informed about the connection for a few years now.

Evidence continues to mount that gum disease affects not only your heart but many other organs as well. As noted in the a recent Parade article by Dr. Ranit Mishori, recent studies have found correlations between poor oral health and "conditions such as diabetes, kidney disease, preterm labor, osteoporosis, Alzheimer's disease, and even certain types of cancer."

In the case of heart disease, Dr. Mishori cites a new Journal of Clinical Periodontology report that reached this conclusion: The more severe the gum disease, the more likely the patient is to have a narrowing and hardening of the arteries (atherosclerosis). "This is true", she says, "even for young, healthy adults with no other symptoms of heart problems."

As we've explained before, gum disease is caused by bacterial infection or plaque, which releases toxins that circulate throughout the body. The toxins can cause harm anywhere in the body.

We know that gum disease can be reversed if caught in the early stages. The "intriguing" question, Dr. Mishori notes, is whether treatment "will benefit patients with narrowing of the arteries". The short answer is Yes, according to a 2007 report in the New England Journal of Medicine. Patients treated with six months of intensive oral therapy had both healthier gums and improved endothelial function.

These studies - and those I've brought to your attention in the past - make a stronger-than-ever argument for keeping your mouth as clean and disease-free as possible. And the way to do that, of course, is to brush and floss regularly and to have at least two professional cleanings a year.

Paul Tanners, D.D.S.

Dear Patient,

The dental community has long been aware of the link between dental neglect and cardiovascular problems. Recently, the word has begun getting out to the general public about the relationship between oral care and general health.

In this regard, I thought you might be interested in the attached excerpt from an article on the 10 Hidden Risk Factors for Cardiovascular Disease that appeared in a special section of The Wall Street Journal on September 30, 2009.

I look forward to serving you in the coming months for a check-up to assure maintenance of your dental health and your overall health as well!

Paul Tanners, D.D.S.