From the moment you walk into Kwong Dental, at 333 California Ave, your first experience begins in the waiting room; with a one-on-one meeting with Dr. Kwong. He will then discuss your past dental history and current dental concerns, in private. He wants to make sure that he addresses all of your main concerns before moving forward, “we address that issue first [and] then take care of the rest of the mouth as a whole functioning unit.”
Dr. Kwong and his staff take time to listen to their patients, “if the patient tells us it hurts, we believe them and work towards making them more comfortable.” However, he tends to be more conservative when looking at problems and their solutions. Dr. Kwong prefers not to drill or extract a tooth if it is truly not warranted.

He is also choosy when it comes to the labs and materials he uses. For example, if a patient needs a crown, Dr. Kwong goes above and beyond to make sure that the crown shade is a perfect match, by sending the patient directly to the lab he uses. That helps alleviate any issues during the procedure and it takes the worry away from the patient.
Kwong Dental also promotes the natural process of re-mineralization, “where calcium and phosphates are absorbed by the tooth and used to strengthen damaged tooth structure,” he said. This all adds to the stress-free environment, which Dr. Kwong provides.

Now that he has his own practice, he is able to spend more quality time with his patients and it gives him the freedom to explore the kinds of methods and procedures that work best for his patients, and their well-being.

When he first got out of school, Dr. Kwong started working in private offices in California, but found that many of them were ethically questionable in their practices. He started working for Western Dental and fell into a position where he only performed extractions. Then, he was promoted into a managing dentist role and relocated to Sparks. This is where he gained experience in operating a business, as he ran the office. He also built connections with other local dentists, labs and patrons within the Reno/Sparks area.

From playing violin, Valedictorian of his high school, to finishing his undergraduate and dental schooling in just six years; Dr. Cyrus Kwong offers the same dedication in his dental care to his patients. “I love working with people and helping [them],” he stated.

A Holistic Approach to Herbs for Healthy Teeth and Gums

A great many herbs and natural substances promote tooth and gum health by tightening the gum tissue, promoting circulation, and removing plaque and debris from the mouth. To name just a few, these include resins such as myrrh and the anti-viral bee product, propolys, which stimulates the production of new mouth tissues, usnea, a lichen stronger than penicillin against strep and staph bacteria, bloodroot, and plantain, a common weed which eases mouth abscesses and inflammation. High-tannin-content herbs such as krameria and oak apples also enhance tooth and gum health. Hawthorn extract, used over time, tightens the gum tissue. Echinacea extract, an antimicrobial immune strengthener, fights bacteria in the mouth. Extract of aloe vera also soothes and benefits the mouth tissues. Licorice root is anti-inflammatory and antibiotic, inhibits plaque growth, and tastes pleasant, so it is often added to toothpastes and mouthwashes. The essential oils of many healing plants are naturally antibacterial, antiviral and antifungal, and increase blood flow to the gums. Dental-health-enhancing essential oils include tea tree, peppermint, spearmint, eucalyptus, orange, clove, cinnamon, ginger, sage, rosemary, thyme, anise and fennel, to name a few.

Many traditional cultures make natural, disposable toothbrushes and gum stimulators from the twigs or roots of healing plants. Bay, fir, juniper, eucalyptus, oak, willow, and neem-tree twigs have served this purpose, as well as the roots of marshmallow, horseradish, alfalfa, and licorice. Health-food stores often sell a rough equivalent, wooden toothpicks soaked in healing essential oils. You can even make your own by placing undyed wooden toothpicks in a glass jar and covering them with a dental-health-enhancing essential oil. Let them soak in the oil overnight, then allow them to air-dry.

To prepare a simple homemade toothpaste, mix a small amount of baking soda with just enough hydrogen peroxide to form a paste. Apply this paste to the gum line, both inside and out, then place the rubber point of the gum stimulator between the teeth, and rotate in a circular motion for several seconds. Repeat this routine twice a day. Many tooth and gum problems occur when the pH inside of the mouth is too acidic, and baking soda alkalinizes the mouth. You can also add small amounts of zinc sulfate, folic acid (you can grind these to a powder in a coffee grinder or using a mortar and pestle), liquid vitamin E, one to two drops of peppermint or tea-tree essential oil, or hawthorn, echinacea, or aloe vera extracts. Experiment to find the particular mixture that best suits you. Other effective tooth powder ingredients are alum, salt, blackened eggplant, myrrh gum, turmeric, and white-oak or prickly ash bark. In some cases of severe gum disease, wrapping tooth powders in gauze and placing them in the corners of the mouth nightly has healed the condition in just a few months.

Herbal teas or extracts can replace water in your oral irrigator or serve as mouthwashes, for added benefits. Even the commercial mouthwash, Listerine contains anti-bacterial thymol, which is derived from the thyme herb. Since thymol reduces gingivitis, Listerine also works well in the oral irrigator. You can also prepare homemade mouthwashes by steeping dried herbs in vodka or apple cider vinegar. Good mouthwash herbs include cloves, coriander, dill, sage, peppermint, spearmint, eucalyptus, cinnamon, rosemary, fennel, sage, basil, cardamom, parsley, ginger, blackberry leaf, calendula or chamomile flowers, echinacea or marshmallow root, mint, raspberry leaf, basil, sage, thyme, and yarrow, to name a few.

As this overview shows, you can easily enhance your tooth and gum health naturally by combining herbs with proper diet and nutrition. For further information, including specific recipes, consult the sources listed below.

References:

1. “Herbal Care of Teeth and Gums,” by Karta Purkh Singh Khalsa, in The Herb Quarterly, Issue 79, Summer 1998.
2. “A Natural Remedy for Gingivitis, Toothaches, and Mouth Sores,” by Rudy Silva, on ezinearticles.com.
3. “Herbs for Dental Health” by Christopher Hobbs L.Ac., A.H.G., on www.healthy.net.
4. “Periodontal Disease” by Janet Zand L.Ac., O.M.D. on www.healthy.net.
5. “Herbal Therapy in Dentistry,” by Flora Parsa Stay D.D.S., from The Complete Book of Dental Remedies.
6. Beauty By Nature, by Brigitte Mars.
7. Living on the Earth, by Alicia Bay Laurel.

Debbie Hart is a writer, teacher, and student of nutrition and alternative healing. She co-runs the online University of Yourself for the study of dreams and the I Ching, with Dr. Ron Masa, www.universityofyourself.com/contact.html.

by Debbie Hart |

Modern studies and centuries of use show that a wide variety of herbs, essential oils, and other natural substances improve oral hygiene and help prevent and heal many tooth and gum disorders. Many herbalists advocate a preventative, holistic approach to mouth care that combines herbs with an improved diet and an effective daily oral-hygiene routine.

Dental-health professionals agree that the most important factor in tooth and gum health is diet. Since the bacteria in the mouth thrive on sugar, it is best to reduce or eliminate refined simple sugars from the diet, and eat primarily fresh foods free of chemicals, additives, and preservatives. Eating whole grains and high-fiber foods like raw carrots, and chewing them thoroughly, stimulates the gums.

Nutritional supplements also improve dental health. Antioxidants, including vitamins C and E, zinc, selenium, and beta carotene improve oral health, and folic acid reduces plaque, inflammation, and bleeding in the mouth. Daily doses of Coenyzme Q10 combat receding gum lines. Supplemental vitamins and minerals are important, since the body takes needed calcium from the jaw bone first in the event of a deficiency, which can lead to loose teeth. Eating kelp daily promotes healthy teeth and gums, since it is rich in vitamins, minerals and trace elements.

In addition to diet, a thorough, consistent oral-hygiene routine is important for healthy gums and teeth. Since gum disease and tooth decay stem largely from excess bacteria residing between the teeth and gums to form plaque and tartar, the main goal of oral hygiene is to remove excess bacteria from the mouth. Dental professionals recommend brushing your teeth at least twice, and flossing at least once, daily. Since bacteria can also collect on the tongue, cleaning the tongue with a toothbrush, a commercially-available tongue scraper, or even an upside-down soup spoon, eliminates twice as much bacteria from the mouth as just brushing the teeth. It is also beneficial to thoroughly brush the gums, as well as the insides of the cheeks. Over time, bacteria can inhabit your toothbrush and reenter your mouth with each brushing, so dental-care professionals advocate changing your toothbrush twice a month. You can also buy a toothbrush sterilizer, or soak your toothbrush in an antibacterial mouthwash between uses. Electric rotary brushes have been shown to remove significantly more plaque than regular brushes.

Rubber-tipped gum stimulators also further aid in cleaning, stimulating and massaging the gums to keep the tissues healthy. Brushing and flossing alone cannot always remove enough bacteria from deeper gum pockets, so dental-care providers often recommend oral-irrigation devices such as the “Water Pic” and “proxi-brushes,” very small brushes resembling bottle-brushes or pipe cleaners. These tools can clean hard-to-reach areas between teeth, around braces and other dental work, and inside spaces caused by receding gums.

If you wish to maintain healthy teeth and gums naturally, you can easily incorporate natural and herbal tools and preparations, such as natural brushes or picks, powders, pastes, teas and mouthwashes into your daily oral-hygiene routine. Many preparations are easy to make at home, and health-food stores sell their own varieties that include the same herbs and ingredients. It is important to exercise care when using herbs. Some herbs can be toxic if used for too long or in too great amounts. In addition, the active ingredients in some herbs are not recommended for certain health conditions, and can react negatively with prescription medications or other remedies. It is therefore recommended, especially if you are pregnant, wish to treat a child, have special health conditions, or are taking prescription medications, that you research the herbs that interest you before using them, and consult a qualified professional if you have questions or doubts.

References:

1. “Herbal Care of Teeth and Gums,” by Karta Purkh Singh Khalsa, in The Herb Quarterly, Issue 79, Summer 1998.
2. “A Natural Remedy for Gingivitis, Toothaches, and Mouth Sores,” by Rudy Silva, on ezinearticles.com.
3. “Herbs for Dental Health” by Christopher Hobbs L.Ac., A.H.G., on www.healthy.net.
4. “Periodontal Disease” by Janet Zand L.Ac., O.M.D. on www.healthy.net.
5. “Herbal Therapy in Dentistry,” by Flora Parsa Stay D.D.S., from The Complete Book of Dental Remedies.
6. Beauty By Nature, by Brigitte Mars.
7. Living on the Earth, by Alicia Bay Laurel.

by Kevin J. Andrews DDS, MS- Orthodontics |

The Damon System…Braces for Adults

Do you remember how big and bulky braces used to be? Well, thanks to current orthodontic technology, brackets are smaller than ever. In fact, downsizing the overall dimensions of the braces and needing less forces to move and align teeth has made orthodontics more popular and much more comfortable. There are many types of brackets and styles patients can select. One such type is the clear translucent braces or the clear aligners to straighten teeth. Today smiles can be made wider without the need for palatal expanders (a metal screw device that fits up in the palate or roof of the mouth).

Expanders have been an excellent appliance that allowed orthodontists to treat many more cases without the need for extraction of permanent teeth. These expanders create more space for the teeth to align and increase the width of the jaws by loosening and separating the palatal bones. The smiles in today’s society are bigger and brighter than ever thanks, in large part, to expanding dental arches. While most patients are willing to avoid extractions and choose to insert expanders, there are some disadvantages to using expanders: they can be obstructive to the tongue and may temporarily cause difficulty in speech and swallowing.

Orthodontists who utilize the Damon System of Braces can expand both the upper and lower dental arches significantly with small, light archwires only and on most cases do not require the use of expanders. This system has been clinically proven to expand and widen smiles as much as 11mm (on adults or children) and more without excessive pressures that expanders can place. This is a much more comfortable method with a lot less hardware involved. So, how does this system with such light forces widen and expand bone?

Conventional brackets require the wire to be “tied into the slot” either with steel wires or colorful elastic type rings. With these systems, there can be anywhere from 400 to 700 times more friction bound up by “tying in” or holding tightly the archwires into this slot of the bracket. The key to changing arch forms and widening smiles is to reduce the friction between the wire and the slot on the brackets (braces). This is accomplished by using high-tech heat activated archwires (with memory of their shape) passively in Damon braces that have a door to lightly hold the archwires. There is less friction and tension between the interface of the wire and the slot of the bracket and the wires are allowed to slide freely through these small doors. In fact, by reducing this friction, there is less pressure required to loosen the bones allowing the teeth to move easily with bone tissues remodeling around teeth. It is incredible! Simple, gentle forces generate big smiles.

So, with smaller brackets and no expanders, Orthodontists can comfortably create big wide grins with a lot less tin in your mouth, which is great for adults considering orthodontic work. That gives you something to smile about!

References:

1. “The Damon System vs. conventional appliances—a comparative study”, Tagawa D. Clinical Impressions 2006; 15-1.
2. “Treatment time, outcome and patient satisfaction comparisons of Damon and conventional brackets”, Eberting JJ, Straja SR, Tuncay OC. Clinical Orthodontics and Research 2001; 4(4):228-234.
3. “Self-ligating brackets and treatment efficiency”, Harradine NWT. Clinical Orthodontics and Research 2001; 4:220-227.

For more info, contact Dr. Kevin J. Andrews DDS, MS- Orthodontics at (775) 674-1444.

Neuromuscular dentistry is a treatment philosophy that looks beyond teeth to the other structures and tissues that are indirectly altered in an individual’s attempt to bring their teeth and jaws together.

Neuromuscular dentists deal with the delicate interplay between the upper and lower teeth, right and left jaw joints, and muscles of the face, neck, and shoulders as they all relate to a stabile, strong spinal alignment. The actions of the lower jaw are very dynamic, and its ability to move in six dimensions is well documented. When these movements and positions are restricted, deflected, or otherwise altered so as to not allow a natural, whole-body alignment, a breakdown of overall structural system occurs.

Symptoms of an unbalanced bite show up as muscle pain or trigger points from the shoulder blades upward; a popping noise around or in the ear; or a limited range of motion of the jaw. Very often, we see a forward-leaning head posture, and middle ear symptoms including plugged ears, vertigo/dizziness, and ear ringing.

Neuromuscular dentistry began in the 1960s with the advent of instrumentation that allowed us to look and measure specific movements and functions of the jaw and muscles. It has been said if something can be measured it is a fact; otherwise, it is just opinion. With the use of this instrumentation a new world was opened for those who were willing to explore it. Additionally, this period brought about the discovery of a “zone of neutrality,” which is basically a resting jaw position where the chewing muscles are physiologically relaxed and the temporomandibular joint (TMJ) is normalized for optimum function and comfort. In this balanced, neutral zone, the upper cervical vertebrae are stable and not torqued, which really allows the body to begin to “unwind” and heal in an attempt to return to homeostasis.

When patients visit a neuromuscular dentist and describe migraines, teeth-grinding, receding gums, sensitive teeth, tooth loss, breaking of teeth or popping in the ear/jaw, what is typically happening is the tug of war of powerful, opposing forces brought into play by an unbalanced bite. In these cases, the physical demand on the body is constant and significant, marshalling resources that could be better utilized for athletic performance, higher energy levels or feeling better on the job. All of this goes on whether the individual experiences pain or not. What’s more, an unbalanced bite and its effects can often disrupt many other systems, including the endocrine, neurological and balance, or Obstructive Sleep Apnea (OSA). Any of which can increase the overall “load” on the body, making the individual feel less than optimally healthy. A simple half-hour exam by a neuromuscular dentist can detect any bite imbalances and set the patient on the path to total wellness in a remarkably short period of time.

References:

1. Neuromuscular Dental Diagnosis and Treatment, Jankelson, R.
2. Travell, J. Myofacial Pain and Dysfunction, Vol, 1

For more info, contact Dr. Mannikko at (775) 825-8366

by Dr. Manniko, DDS |

The incidence of airway obstructions causing a stoppage of breathing during sleep, affects some 15 million people in this country, and 90 percent have not been diagnosed. Harvard-trained physician John Remmer, MD believes that sleep apnea will become the most chronic disease in all industrialized countries. Consider some of these facts about Obstructive Sleep Apnea (OSA):

• 65-85 percent of all stroke victims suffer OSA.
• Systemic inflammation is increased with OSA and platelets are more likely to adhere, accelerating the process of atherosclerosis.
• An OSA is responsible for a 10-point drop in IQ of children.
• Untreated OSA results in a 20 percent drop in life expectancy.
• OSA person is 23 times more likely to have a heart attach (MI) than a healthy person.
• 60-80 percent of snorers will test positive for OSA.
• A person does not need to snore to have OSA.
• There are more persons with OSA that are not overweight.

Many people are walking around unaware of what may be happening. The most common type of sleep apnea occurs when the airway is actually obstructed during sleep. As air intake is interrupted, the body struggles to function due to lack of oxygen in the blood. Symptoms can be very subtle, with periods of drowsiness often present. Additionally, an affected person may notice heartburn or GERD (gastroesophageal reflux disease), or a persistent cough for no apparent reason.

The gold standard in Medicine for unraveling the mysteries that occur when we sleep is a “sleep study,” or polysomnogram (PSG). The PSG provides information enabling a sleep physician to diagnose OSA as mild, moderate, or severe. Diagnosis of any level of OSA is typically treated with the Continuous Positive Airway Pressure, or CPAP. This device provides a constant flow of oxygen past the obstruction to keep oxygen levels from falling. Unfortunately, while effective, the CPAP is obtrusive, noisy, and can create loss of intimacy in a relationship, as well as irritations of the face and throat. As a result of these drawbacks, compliance typically decreases over time.

Under the new guidelines of the American Academy of Sleep Medicine, oral appliances are now considered to be the first line of defense for mild to moderate sufferers. Oral appliances maintain an open airway during sleep by not allowing the lower jaw to fall back and block the airway. According to published studies, the percentage of patients who continue using a CPAP device is fairly low, in the 23-45 percent range, while the percentage of patients who continue using the much more comfortable oral appliance is in the 90-95 percent range.

Oral appliances have their own challenges and are often easy to fix. Excessive salivation appears to be the number one problem. Tooth movement can also come with short and long-term wear, due to improperly fitting appliances. Changes in the bite are more common. As the person wears the appliance, it holds the jaw in an improved position, often improving the health of joints and muscle comfort.

The physiologic cost of living with an untreated sleep disorder is high, and its role in causing or compounding other health issues often goes unchecked. A visit with a neuromuscular, TMJ, or sleep-apnea trained dentist can ease your mind and possibly even save your life if you suspect you suffer from sleep-disorders such as sleep apnea.

References:
Sleep and Health Journal, Shapira, I, 7/09
Mcardle N et al. AJBCCM 1999
Gozal D, MD, lecture Univ of Louisville
Remmers J, MD, lecture
Smith, K DDS, lecture Sleep Disordered Breathing, 2008

For more info, contact Dr. Manniko at (775) 825-8366.

TMJ is not a condition itself; rather it stands for the Temporomandibular joint—the jaw joint. This joint connects the temporal bone (the side of the skull) with the mandible (the jaw bone). When this joint has symptoms of pain, or is not functioning properly the condition is called TMD (Temporomandibular Disorder) or TMJ Syndrome.

Symptoms of this condition include pain, popping, grinding, spasms, ringing in the ears, headaches and sinus problems. Also, pain can occur in the muscles and joints of the jaw that sometimes radiate into the face, neck and shoulders. There are often problems opening the mouth and noises during chewing and movement of the joint.

How does TMD disorder or TMJ syndrome occur? Hitting the head or face in an accident (car, bike, sports, skate board, etc.). Stress and anxiety can cause tension in the neck, shoulders, face and head acting as a precursor to TMD. Tension from chewing, grinding, or clenching teeth is another cause.

TMD disorder or TMJ syndrome solutions can be mild to extreme in treatments. Some treatments available today involve splints, surgery, drug treatments, diet change, chiropractic adjustments and physical therapy.

• Drugs help decrease the symptoms for a while, but won’t fix the problem. If you stop the drugs, the symptoms come back and you are left to deal with the side effects of the medications in your body.
• Surgery is needed in some cases but in most cases is not necessary.
• Splints can help, but sometimes your bite changes because of the splint and then you start grinding and clinching harder, causing more symptoms or complicating your TMD.
• Diet changes are needed in all cases. For example, no gum chewing, NO apples, (unless you cut them up into smaller pieces), no biting hard candies and no ice, just to name a few.
• Chiropractic Adjustments in conjunction with Physical Therapy work to re-align and help reduce or remove the muscle imbalance or spasms. I’ve found that diet changes, cranial skull manipulations and home care has been by far the most cost effective and successful treatment to achieve the best results.

Whether you have been formally diagnosed with TMD, Temporomandibular Disorder, TMJ Syndrome, or suffer from any of the symptoms associated with them, an opportunity to finding a solution can be found through alternative therapies such as chiropractic, dental and diet changes.

References:

1. Balch, Phyllis A. Prescription for Nutritional Healing, fourth edition. Penguin Group Ltd. New York, NY, 2006.
2. www.chirocommunity.com/tmj

For more information contact Dr. Tony Jensen, DC of Jensen Chiropractic at (775) 323-1222

Amalgam, the metal mixture of copper, tin and mercury that many of us grew up having for our tooth fillings, can quickly and easily damage your teeth in the plaque, saliva and blood-rich environment called the human mouth. For example, most of us know that metals, in the presence of water, can corrode and break down. Metals also expand and contract with temperature changes, resulting in cracked teeth, and they can leak, causing further decay. This process significantly breaks down your teeth, leading to fractures, root canals, tooth loss, and pain. What is more important, exposure to some of these metals, such as mercury, can have far-reaching negative health effects, so much so that when a conscientious dentist needs to remove damaged amalgam they use a dental-dam apparatus and strong suction to carry away these metals and protect the patient from these unnecessary contaminants.

What is the solution? Today, as a patient, you clearly have a choice. You can ask if your dentist practices “adhesive dentistry,” or the dental procedures and techniques that use porcelain veneers or dentine-bonded crowns, rather than metal fillings, to repair the teeth. In adhesive dentistry, a tooth-colored composite material is used to repair chipped, cracked, fractured, worn, or broken teeth — even “off-color” teeth that have lost their enamel and appear a shade or two darker than their neighboring teeth.

Adhesion, or the ability to adhere materials to tooth structure, has been studied extensively for over 50 years, and the science has advanced tremendously over the last decade, allowing treatment to be much more conservative and aesthetically pleasing.

Studies show that approximately 40 percent of all teeth show signs of cracks and fractures that are often asymptomatic, meaning that the patient does not realize he or she has a problem. All too often, these teeth are ground down unnecessarily, when adhesive dentistry options exist to not only repair the broken-down tooth but to strengthen and reconstruct it to original strength.

Adhesive dentistry has several benefits, including functionality, aesthetic value, minimal invasion, tooth reinforcement, longevity (10-20+ years), and biocompatibility, which no other reconstructive process offers. If you or your child needs a metal dental filling replaced or repaired, ask your dentist about modern adhesive dentistry. Your smile and your health will both be better off.

References:

1. Molar Fracture Resistance after Adhesive Restoration with Ceramic Inlays or Resin- Based Composites; Bremer BD, Geurtsen W, Am J Dent 2001; 14:216-220
2. Fracture resistance of teeth directly and indirectly restored with composite resin and Indirectly restored with ceramic materials, Dalpino P, Francischone C, Ishikiriama A, Franco E, AmJ Dent 2002; 15:389-394
3. A Prospective Clinical Study of Indirect and Direct Composite and Ceramic Inlays: Ten year results, Thordrup M, Isidor F, Horsted-Bindslev p, Quint. Int’l, 2006; 37: 139-144
4. Academy of Cosmetic and Adhesive Dentistry. Cosmetic Dentistry; Composite Fillings. www.acadorg.com/Procedures_CompositeFillings_402551.aspx
5. www.nature.com/vital/journal/v3/n4/full/vital513.html
6.  www.carteryokoyamadds.com/html/info.html

For more info, contact Dan Mannikko, DDS at (775) 825-8366.

Written by Dan Mannikko DDS |

At first glance, teeth really do seem simple. We use them to chew and we use them to smile, and if you brush them once in a while, you may not think too much of them until they hurt. What many people fail to realize, though, is that in oral health, pain is often a symptom signaling the later stages of disease. For example, with high blood pressure and high cholesterol, you can have silent, irreversible damage to the body and heart, but you feel no pain until it is too late. The same is true for dental health, and that’s why dentists recommend regular visits to catch little things before they become big ones. Science has brought to light more interesting facts about dental health in recent years, some of which are commonly known and some not.

Poor Gum Health

If you have bleeding gums that are infected with bacteria, you have an increased risk of heart attack, stroke, diabetes and tooth loss.

Poor Bite

An estimated 80 percent of the population suffers from an unbalanced bite, which has been shown to be a factor in physical stress on the body and posture problems that affect every muscle in the body. An unbalanced bite can also affect whole body balance, the middle ear, the airway, longevity of your teeth, the health of your gums, and migraines and other types of headaches.

Poor Airway

Intertwined with an unbalanced bite (which can cause the face and jaws to develop in ways that negatively impact breathing) we often see symptoms including snoring, sleep apnea and related low oxygen levels in the blood. Airway problems have been implicated in an increased risk of stroke, heart attack, cancer, diabetes, and a shortened life span by as much as 20 percent, learning difficulties, attention span/ability to focus, and the overall quality of sleep. In sum, airway problems create tremendous strain on the body and affect the emotional side of a person, too.

From a neuromuscular dentistry standpoint, the teeth are the building blocks of good health. Most people start with 32 adult teeth. When the “wisdom teeth” are taken out, many people lose these four teeth because of lack of room or small jaws. Some may believe that losing a few teeth is no big deal because they have a couple dozen “others” and that “no one will notice anyway because the removed teeth are in the back,” and so on.

The problem is, if we think of a stack of blocks ten blocks high, they are pretty stable as long as they are placed solidly one on top of the other. If we alter the top block to overhang the others, we lose stability of all the blocks. To improve the stability of the group, we slightly move the others to support the top block that was initially moved out of place. Other blocks take more stress because of their altered position. In the human body, the head is the top block. Keeping the head (eyes) level with the horizon is paramount for our survival (balance). Additionally, when our nose is partially or completely obstructed, we will alter our head position (top block) forward, rolling the head back to open the oral airway to maximize the amount of air we can bring in.

Mouth breathing alters the growth and development of the face/jaws due to altered tongue posture from the mouth being open. As the tongue misses its place to direct growth of the face in a forward direction, the upper/lower jaws and nose fall down and back giving us longer faces, smaller airways, detruded jaws, crowded teeth and TMJ — all driven by the need for air. Fortunately, recent advances in neuromuscular dentistry allow us to diagnose and treat many root causes of these symptoms in ways we couldn’t do in the past. The bottom line is, teeth are important; therefore, well cared for teeth and a balanced bite are vital to your overall health.

References:

1. Neuromuscular Dental Diagnosis and Treatment, Jankelson

2. Facial Characteristics of Children who breathe through the mouth, Bresolin, Pediatrics

53(5): 1984

3. IAO meeting, Stack Brendan M.D. April 2007

4. Gozal D., M.D. University of Louisville

For more info, contact Dan Mannikko, DDS at (775) 825-8366.

Written by Sara Piccola |

It was a pleasant surprise walking into Dr. Dan Mannikko’s office, being greeted with a relaxing atmosphere and an elegant waiting area with only 4 chairs. Was this a dentist’s or a massage therapist’s waiting room?

There is no doubt Dr. Mannikko is a dentist. In 1997 he graduated from the University of Pacific Dental School in San Francisco, and has been practicing ever since. Continuing his education, Dr. Mannikko has had additional training from the Las Vegas Institute for Advanced Dental Studies, acquiring certifications in orthodontics, neuromuscular training, TMJ training, anatomy, physiology and neuromuscular dentures, to name a few. Although he focuses on neuromuscular dentistry, he is also a certified general dentist, ensuring he can meet all his patients’ dental needs.

Dr. Mannikko always knew he would end up in the medical field. Wanting to focus on a single part of the body, he chose to pursue dentistry. Realizing the mouth is one of the most complicated parts of the body, he found his passion in its relation to the whole body; affecting posture, spinal health, balance, flexibility and coordination. When practicing general dentistry, Dr. Mannikko noticed holes in his own training and found neuromuscular dentistry to be the answer to his questions.

Neuromuscular dentistry, practiced over 40 years, focuses on the teeth, muscles, nerves and joints as a physiologic system and how they all work together. No longer are they looked at as a mechanical hinge. Treatment can now lead to whole body change.

According to Dr. Mannikko, one of the most important things in life is being balanced. When we think of balance and good posture we think of our shoulders and hips being level with the ground, our teeth being straight and level as well. It’s hard to believe the teeth have anything to do with balance; however, while teeth go front and back and move with the jaw, the jaw itself is unique in that it has different dimensions. It’s when you focus on the jaw that you discover the imbalance that can be caused by a poor bite.

Our balance organ functions within our ear. Dr. Mannikko explains the relationship between the mouth and the balance organ as a wiring system in our jaw. The wiring between the jaw muscles feed into the same wires that go to the balance organ. When there are imbalances in the bite, those muscles become overworked, overloading the wires. This in turn interrupts the wiring that goes back to the ears. Although very subtle, it is the source of imbalance which leads to many other painful symptoms such as headaches, neck aches and back pain.

Dr. Mannikko stressed that the importance of the teeth has been devalued forever, mainly because people have become adaptable to symptoms such as headaches and refer to it as being normal, when it is not normal and can be resolved with neuromuscular dentistry.

Although neuromuscular dentistry can be expensive depending on the patient’s needs – Dr. Mannikko believes you can’t put a price on the quality of life. Neuromuscular dentistry eliminates pain and the impact throughout the body. The level of care is elevated, more so than general dentistry.

Neuromuscular dentistry can also improve the patient’s appearance. Many people feel they are being too vain when concerned about their appearance; studies show that the smile is the first thing people notice when they see someone. An improvement in self-esteem is a result Dr. Mannikko sees very often.

It can be difficult to understand how the bite can relieve chronic pain and be the cause of many daily symptoms found in people. Everything Dr. Mannikko talks about and has done for patients he has done for himself. He has seen the benefits and knows he can offer the best in treatment that is available.

“I’m only in this game to make people better,” said Dr. Mannikko. “Every dentist needs to realize they are the gatekeeper of people’s overall health, and proper dental treatment increases the quality and length of life.”

Written by Zeny N. Ocean, DDS |

The clear links between dental health and heart disease just got a lot stronger, which may now be a motivational factor for many to improve oral hygiene. People with bleeding gums allow entry of up to 700 different types of bacteria directly into their circulation, increasing the risk for a heart attack. The new research was presented by several groups at the Society for General Microbiology’s autumn meeting held at Trinity College, Dublin, Ireland.

Dr. Steve Kerrigan from the Royal College of Surgeons explained how this works,  “If you have an open blood vessel from bleeding gums, bacteria will gain entry to your bloodstream. When bacteria get into the bloodstream they encounter tiny fragments called platelets that clot blood when you get a cut. By sticking to the platelets bacteria cause them to clot inside the blood vessel, partially blocking it. This prevents the blood flow back to the heart and we run the risk of suffering a heart attack….In other words it doesn’t matter how fit, slim or healthy you are, you’re adding to your chances of

getting heart disease by having bad teeth.”

Kerrigan’s research team presented new findings showing that once bacteria enter circulation they actually use platelets to form a protective shield around themselves so as to hide from your immune system or a germ-killing compound. This causes little “mini clots” to form, which are more likely to stick together in a larger clot and cause a heart attack.

Other research presented at the conference focused on how bacteria lead to plaque formation in the arteries. Professor Greg Seymour from the University of Otago, Dunedin, New Zealand looked into a new angle on this issue and discovered that common stress-response proteins produced by both bacteria and inflamed human cells tend to confuse the human immune system. This leads to immune cells inappropriately targeting the inflamed cells lining the circulatory system, a factor that helps drive the process of artery hardening. Thus, a confused, overworked, and inefficient immune system response to ongoing low grade infection from poor dental hygiene could be a major risk factor for plaque accumulation in the arteries.

The two studies taken together provide several mechanisms by which poor oral hygiene leads directly to heart disease. While this concept has been reported for a number of years, these precise mechanisms that explain the process are new and open doors to protecting yourself.

Clearly, brushing your teeth and flossing takes on a new priority. Clearing out debris in your circulatory system will help your immune system work better and platelets not stick together, protecting the lining of your arteries with fat soluble antioxidants (vitamin E), and using natural germ fighters (like oregano oil) will be the foundation of this approach. Many other factors could easily interact with these mechanisms, including toxins from any source including pollution, too many inflammatory stress chemicals, and your immune system struggling with other infections (especially low grade chronic infections). This data also means that an acute infection could tax this already strained system and trigger a heart attack.

References:

1. Richards Byron,CCN Wellness resources “ New Data on Dental Health & Heart Disease” September 16,2008

2. Mattila KJ, Nieminen MS,et.al., Association between dental health and acute myocardial infarction, British Medical Journal 189 ;298 :779-81

3. American Academy of Periodontology, Heart disease and stroke,http://www.perio.org/consumer/mbc.heart.htm

For more info, contact Zeny N. Ocean, DDS at (775) 329-1333, specializing in biological and biocompatible general and cosmetic dentistry.

Written by Dan Mannikko, DDS |

What is your physical potential? Weekend warriors and professional athletes alike are always pushing their physical limits. How would instant improvements in balance, flexibility, and strength help your performance?

Traditionally, mouth guards have been used to protect an athlete’s teeth and jaws, mainly in high-impact activities. While we all know that teeth are used for chewing, smiling, and aid us in speech, their presence/absence in our mouths affect us in profound ways. The fact is, teeth are an integral part of the “posture chain” and support proper head position on the spine. When the posture is unbalanced it will cause improper alignment of the teeth/jaw, conversely, the unbalanced teeth/jaw condition will induce a cascade of events down the posture chain that influences every muscle in the body. For athletes, the effects can be significant. Always overlooked and underappreciated, an athlete’s bite is a critical component to proper posture, airway, and core balance.

Are you one of the estimated 80-90% of the population that has an unbalanced bite? A neuromuscular examination may be a fix for years of pain, discomfort, injuries or sluggish performance on and off the playing field.

Neuromuscular dentists who treat patients exhibiting symptoms of what is commonly called TMJ or TMD find that in a vast majority of cases, by balancing the bite, the patient experiences a decrease in pain and discomfort and a marked increase in strength, flexibility, and balance.

Professional and recreational athletes who have been fitted with the only neuromuscular product currently on the market, the PurePower® Mouthguard (PPM), report improvements in posture, strength, balance, and control. Among these athletes are Terrell Owens, Shaquille O’Neal, and PGA Tour pro Scott McCarron. McCarron, who had been in a bit of a slump, placed 5th and 2nd in Tour events within weeks of being fitted—and took home an additional $800,000 in prize money which he credits to the PPM.

Clearly, the alignment of a person’s bite—whether in high-performance athletics or ordinary daily activities—has a great impact on the quality of his or her “game.” A simple, painless examination can determine the condition of your bite and set you on the path to better health, well-being, and physical performance.

References:

1. Orthocranial Occlusion, Carlson, J.

2. Thomas, N., Neuromuscular Occlusion, Aurum Newsletter, Vol. 18, Issue 3.

For more info, contact Dan Mannikko, DDS at (775) 825-8366.

Periodontal disease and diabetes—are dentists doing enough? With a growing population of diabetics (presently 25 million) and pre-diabetics (60 million), we are falling short. Gum disease plays an important role in diabetes. There is significant evidence that periodontal (gum) disease may contribute to higher rates of premature death in diabetics. While many people know about diabetic complications of the eyes, kidneys, nerves, blood vessels, and heart, few know much about the connection between periodontal health and diabetes. This is why we as dentists must step forward and educate our patients about the correlation between gum disease and diabetes.

People with diabetes, particularly those with chronic high blood glucose levels, are more susceptible to bacterial infections everywhere in the body, including in the mouth. In addition to making a person susceptible to infections, high blood glucose levels also inhibit the healing of infections. When an infection in the mouth tissue is not controlled, the teeth can become loose, and chewing can become painful or difficult. An uncontrolled infection can eventually cause tooth loss.

High blood glucose levels can raise the risk of periodontal disease in another way as well: When blood glucose levels are high, the glucose levels in all body fluids, including saliva, become very high. Certain bacteria feed on sugar and grow readily in the mouth, particularly when saliva glucose levels are high. Having higher levels of these bacteria in the mouth increases the risk for both periodontal diseases and dental decay.

One early complication of diabetes—namely, changes in the blood vessel walls—can also increase the risk of developing periodontal diseases. In short, the vessel walls become thicker. Blood is necessary to bring oxygen and nutrients to all body tissues and to remove waste products made by cells in the body tissues. Thicker blood vessel walls slow down these processes and weaken resistance to infection. Without a good blood supply, the periodontal tissues become too weak to fight infections.

The average person has 1500 billion bacteria in the mouth, comprised of 800 species of microbes living under the gums and along the roots of the teeth. When the microbes increase to proportions of high viral, bacterial and fungal loads they spill into the blood and travel to all parts of the body. In their New York Times best seller “You: The Owners Manual” Michael F. Roizen, M.D. and Mehmet C. Oz, M.D. state that “you need to combat gingivitis and periodontal disease which can cause inflammation in your body and aging of your immune and arterial systems.”

A number of studies show a correlation between periodontal (gum) disease and systemic diseases such as cardiovascular (heart) disease, diabetes, sinus problems and multiple other concerns. So the mouth really is connected to the rest of the body! It has been suggested that all diseases start orally and the challenged immune system shows up as problems in the mouth. Gum disease or periodontal disease is a chronic inflammation and infection of the gums that destroys the supporting bone and tissue around your teeth. It is the major cause of adult tooth loss, bad breath, and affects three out of four people after the age of 35. It provides a direct path for bacteria to enter your blood stream on a daily basis.

Do you know if you are at risk for diabetes? To determine your risk for diabetes, consider being seen by a dentist who is an expert in diabetes and periodontal disease for a periodontal evaluation and diabetic risk assessment. Remember, early treatment is the key to your total health. If you are a diabetic, your treatment team should consist of your primary care doctor, nurse educator, eye doctor, other specialists and your dentist. Communication between these health care professionals is necessary for your total health care. We must build a comprehensive and complete program designed to monitor a healthy outcome for diabetes control and prevention.

References:

1. American Diabetes Association, Total Prevalence of Diabetes & Pre-diabetes, www.diabetes.org/diabetes-statistics/prevalence.jsp, accessed 10/9/08
2. Joan I. Gluch, R.D.H., Ph.D., Susanne K. Giorgio, R.D.H., More than a pretty smile. Oral health for people with diabetes. : article, Diabetes Self-Management, pp 57, 58, November/December 1999
3. Loe H, Genco RJ, Periodontal disease and mortality in type 2 diabetes, Oral Complications in Diabetes, http://care.diabetesjournals.org/ogi/reprint/28/1/27
4. Maria Gifford, Get In The Game, How to build your winning diabetes health care team. Diabetes Forecast, pp. 51-53, April 2008

By Dan Mannikko, DDS |

The Temporomandibular Joint, or TMJ, is located just in front of the ear openings on both sides of the head. This joint is the connection point of the lower jaw to the skull, and with contraction and relaxation of the muscles, the lower jaw can move in many different dimensions. The TMJ joint is very unique in that it is the ONLY joint that can rotate and slide. This is very important for the movements necessary for talking, swallowing, chewing and supporting the head on the spine.

Temporomandibular Dysfunction, or TMD, and Craniomandibular Dysfunction are terms used to describe the effects that occur when the lower jaw opens or closes abnormally in the body’s attempt to bring the teeth together to function properly. The bite is also influenced by abnormal postural influences from below the neck. As a result, the muscles attached to the jaw and the TMJ are forced to accommodate that position, regardless of whether that position is good or bad for your overall health and well-being. The fact of the matter is, a great variety of local and systemic symptoms caused by an improper bite can mimic other unrelated conditions, which is why TMD is called The Grand Imposter.

All the muscles throughout the body have a resting level of activity known as muscle tone. Tone holds the body or a body part in a particular position so it is “at the ready” to perform a particular movement or function. The awareness of the body and its movement in space is relayed to the brain through nerves and special sensors located within muscles, joints, and tendons. This awareness is also known as proprioception, and it is constantly being signaled to the brain so that human beings always have a “feel” of how their body (or body part) is positioned in space.

When body parts that aren’t aligned correctly signal the brain, some of the information is garbled, so the brain doesn’t get proper feedback.

For example, in the case where a person has incorrect posture, the upper and lower teeth may not close together correctly, causing sliding or grinding. The associated pain and irritation sends useless sensory and motor information through a tiny network of nerves located in the brain stem, called the Reticular Activation System (RAS). The RAS has profound influences on our awareness and how we think, learn, and act. Symptoms of improper proprioception can include anxiety, depression, inability to concentrate, and insomnia.

What science has shown us in recent years is that people who had upper airway problems as young children often have upper and lower jaws that developed too far back in the face, which led to an unbalanced bite. In later life, this unbalanced bite causes the head, neck, and jaw muscles to work too hard and spasm, resulting in many of the symptoms that have been lumped together as TMD.

TMD, The Grand Imposter, is very influential on the body. In fact, modern medicine is only now beginning to understand the far-reaching effects of an unbalanced bite. Here are some examples.

High Blood Pressure - Because of the instability created in the cervical spine with an unbalanced bite, as well as the unique vulnerability of the Atlas (c1), the likelihood of c1/c2 being out of proper alignment is very high when the bite is off. These anatomical abnormalities are associated with relative ischemia of the brainstem circulation and increased blood pressure.

Headaches – Headaches and Migraines are very common with unbalanced bites, because the muscles of the head and neck have to work extra hard to swallow, chew, talk, and support the head on the spine.

Ear symptoms – An unbalanced bite is also implicated in tinnitus, hearing impairment, ear pain, plugged or pressure-filled ears, popping/grating/crunching, and roaring/rushing sounds.

Meniere’s Disease – Patients who come to the doctor with symptoms of vertigo, tinnitus, ear pressure/pain, fluctuating hearing impairment, and/or hearing loss can reasonably expect partial or complete recovery with proper treatment that takes into consideration the possibility of an unbalanced bite.

The systemic and biochemical changes brought about by an unbalanced bite can be global, causing anxiety, depression, irratic moods, and sleep disorders. Patients with a history of these and other symptoms that haven’t been relieved by traditional therapies should ask their neuromuscular dentist to perform a simple manual and/or sensor-based exam to see if an unbalanced bite is at the root of the problem. The results of the test will provide your dentist with the necessary information so that he or she can help you get relief for many commonly misdiagnosed symptoms affecting your health and well-being.

References:

1. Cooper, B. Establishment of a Tempromandubular physiological state with Neuromuscular orthosis treatment affects reduction of TMD symptoms in 313 patients.

2. Bergamini, M. Dental Occlusion and body posture, ICCMO, Cranio 2008 Jan; 26(1)25-32

3. Bakris, G. Atlas vertebra realignment and achievement of arterial pressure goal in hypertensive patients, Journal of Human Hypertension (2007), 1-6.

4. Ramirez,A.L Theories on Otic Symptoms in Tempromandibular Dirorders: Past and Present, Int. J.Morphol.,23(2):141-156. 2005.

For more info, contact Dan Mannikko, DDS at (775) 825-8366.

By Dr. Zeny Ocean |

A Short Primer:

People who have diabetes are at a higher risk of developing gum disease. In diabetics, periodontal disease is typically worse than people who don’t have diabetes. Research confirms that diabetes makes gum disease more severe. The effects include deeper pockets in the gum around the teeth, more loss of bone and more loss of periodontal ligaments that connect the teeth to the alveolar bone. This is especially true of those whose diabetes is not under control and for those who’ve had diabetes for many years. The earlier a person develops diabetes and the longer they have had it, especially if they have had problems controlling it, the more susceptible they are to periodontal disease.

And, once they get it, the more destructive it is.

The diabetes-periodontal disease connection forms a closed loop and may be the strongest connection in medicine. Just as diabetes makes gum disease worse, gum disease affects how well diabetics can control their blood glucose levels.

If you are not diabetic, do you know if you are at risk?  It is recommended, at the very least, that you have a diabetic risk screening and a periodontal (gum) evaluation to determine your risk and to develop a treatment plan.

References:

1. Grant-Theule DA, Periodontal disease, diabetes and immune response: a review of current concepts, J West Soc Periodontology Periodontal Abstr, 1996;44(3):69-77

2. Taylor GW, Burt BA, Becker MP, et al. Severe periodontitis and risk for poor glycemic control in patients with non-insulin-dependent diabetes mellitus. J Periodontology 1996:67(supplement 10):1085-93

For more info, contact Dr. Zeny Ocean at (775)329-1333, specializing in biological and biocompatible general and cosmetic dentistry.