Dental X rays And Health Damage

This is in response to the  article published recently in many reputed news organisations in the country.Please read the article below. ttp://thechart.blogs.cnn.com/2012/04/10/brain-tumors-linked-to-dental-x-rays/?hpt=hp_t3 First of all, patients have to be aware of one thing when it comes to medical treatments. Seeking a Medical/Dental treatment or not,  is  always a choice between risk to benefit ratio. There …

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The Sugar Rush Of The Twenty First Century

Most people are wary about acid rain and  the climate change. But I am not certain if they are even aware of  the effects of “Sugar reign”, across the country and rest of the world. This white powder is wreaking havoc. Its on the shelves of all supermarkets, in all the foods and drinks, on …

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How to have a Celebrity Smile without Rich Life Style.

Its a myth that you have to be rich in order to have good teeth.Most articles link good teeth to prosperity, and we are all bombarded with Hollywood celebrity smiles constantly, and associate beautiful smiles with rich life styles. Lot of patients in my office complain that they did not have dental insurance growing up …

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Smile Makeover Hype

I respectfully disagree with all the hype over Smile Makeovers being done across the country. Just because you have a good surgeon, it does not necessarily mean you have to go under the knife. Most Americans want white teeth, what we call in dental profession “chiclet Smile”. Since mid- nineties demand for dental services has …

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Dental X rays And Health DamageThe Sugar Rush Of The Twenty First CenturyHow to have a Celebrity Smile without Rich Life Style.Smile Makeover Hype

Apr
12

Dental X rays And Health Damage

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This is in response to the  article published recently in many reputed news organisations in the country.Please read the article below.

ttp://thechart.blogs.cnn.com/2012/04/10/brain-tumors-linked-to-dental-x-rays/?hpt=hp_t3

First of all, patients have to be aware of one thing when it comes to medical treatments. Seeking a Medical/Dental treatment or not,  is  always a choice between risk to benefit ratio.

There is rarely a drug used or a procedure performed without having side effects or unwanted outcome. Patients need to be informed and knowledgeable about the pros and cons of choosing, versus denying any procedure be it  diagnostic, preventive or interceptive.

Again every patient needs are different and the outcome of the treatment is always not consistent based on genetics, habits environment etc.

Health care providers have to try their best in tailoring treatment according to individual needs by thoroughly understanding patients conditions, closely monitoring them taking into account family history, habits, past medical /dental history, diet, environmental as well as social habits.

So let me make a few suggestions in relation to this article in general and also more specifically.

Routine dental exams are needed to prevent and treat conditions that otherwise may need extensive and expensive treatments. As part of diagnosis, dental radiographs are usually ordered to better able to diagnose conditions that would be undetected without the aid of xray  films.

The question is how often??
This is where caution and prudence needs to be applied. As I mentioned earlier all patient details with regards to habits, diet, history (medical,dental,family etc) becomes important.

Let me give an example.

I see  most of patients on a six month recall basis. Most patients that tend to get routine care are the ones that usually  are on top of their oral health.That being said if I notice that, every time they come in with some problem with teeth and gums….I order radiographs to be able to treat effectively.
On the other hand if  most appointments are routine preventive procedures on  patients, and have been that way for a period of time, I do not order radiographs.  Patients themselves would request for less exposure and I agree with them. But as part of diagnosis I always ask if any medical, dietary or  social habits have changed that affect oral health.

I would like to remind patients that no matter what, practice of medicine is “not an exact science” and we can never be perfect and expect to arrive at the same result like mathematics.

Let me explain why..

I have for instance based on patient history and my own experience with my patients have followed the principle of minimal diagnostic radiographs on patients that are regular and been healthy for quiet sometime. To my surprise a  very small sample  of that pool have taken me by surprise as they have ended
needing either large fillings or even root canals as they were not symptomatic
and by the time symptoms were detected clinically.(as there was a time lag for radiographic
diagnosis).

So the take home lesson is…Its foolish to jump to conclusions as every patient is unique and a lot more thought and dedication is needed on part of the doctors and Dental Xrays are one but sometimes needed tool in diagnosis, prevention and treatment of conditions.

So for CNN and Yale to publish articles without explaining fully “all parameters” that go into care of patients is substandard Journalism and a poor approach to validate a finding that may  or may not be be of great importance.

The article itself has cautioned not to draw any conclusions…yet.
If that is the case more comprehensive approach is needed where the purpose of findings is to instill caution on part of providers, and at the same time inform patients to be better educated and not be afraid of seeking treatment.

These sort of attacks  from  Medical profession on Dentistry are nothing new.
Working together and  sharing valuable information and legislating “standards of care”  through proper channels like ADA (American Dental Association) to better serve patients should be the goal rather than driving patients away already lacking courage in seeking dental care .

DR.Satish Gottumukkula.

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Feb
03

The Sugar Rush Of The Twenty First Century

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Most people are wary about acid rain and  the climate change. But I am not certain if they are even aware of  the effects of “Sugar reign”, across the country and rest of the world.
This white powder is wreaking havoc. Its on the shelves of all supermarkets, in all the foods and drinks, on our desks at work, at our homes, and even in our children’s school bags and lunches.

Take a look at  all the types of healthy foods that are being rendered unhealthy. For example to name a few, sugar, chocolate, and caramel coated fruits.  Even breakfast cereals with good nuts and dried fruits are being sugar coated negating their initial inherent benefits.

Also fruit juices are  being rendered unhealthy with added sugars and preservatives, flavored wines, mixed alcoholic drinks, sweet meats, fruit flavored drinks with no fruits in them, and the list goes on and on.

As a nation we consume  2.5 billion tons of sugar every year and is increasing by about 2 million tons yearly. Whats next? Are we going to attempt to  pass a “clean mouth act” like the clean air act of the 1990’s, trying to regulate this one as well?

Nobody saw it coming.The availability of fluoride decades ago seemed to foretell an era free of cavities.  Experts predicted by 2011 that children would need minimal dental care.

As a Dentist I see the effects of excess sugar consumption  first hand, on a daily basis, and the toll it is taking at an early age on the population.

Its saddening to witness destruction of teeth that sometimes results in serious infections warranting hospitalisations on young children and adults.

I am put in a delicate situation when school nurses send notes to me about parental neglect and I am asked to report child abuse.  I sit down with parents and try my best to educate them and take on the role of a dietitian.

I am further concerned for this generation especially the children who are constantly bombarded with advertisements. I am alarmed when I see sugar products raining down literally on TV ads, showing fruit drinks and cereals.(Remember the cereal ad “its raining fruity pebbles”,and some other artificial fruit jelly and fruit drink ads).

Adam & Eve and could not resist the temptation of biting  into the Apple.
Do not expect children to resist the temptation of biting into, a caramel coated golden delicious apple next time you are walking down the aisle of your favorite grocery store.

Parenting is a challenge; We cannot expect our children to develop good and healthy habits until we practice what we preach. I will provide in my next article an alternative guide to the sugar diet that is reasonably easy to implement and fun to eat.

The gold rush of the eighteen hundreds brought fortune and promise to this country and it seems like the sugar rush of the twenty first century is going to reverse all of it.
Refer to Time magazines …http://healthland.time.com/2012/02/02/should-sugar-be-regulated-like-alcohol-and-tobacco/

http://www.guardian.co.uk/science/2012/feb/01/tax-regulate-sugar-alcohol-tobacco

http://parenting.blogs.nytimes.com/2012/02/01/should-we-regulate-sugar/

http://www.cbsnews.com/8301-504763_162-57369857-10391704/sugar-should-be-regulated-like-alcohol-tobacco-commentary-says/


Dr.Gottumukkula ,Satish.

 

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Jan
14

How to have a Celebrity Smile without Rich Life Style.

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Its a myth that you have to be rich in order to have good teeth.Most articles link good teeth to prosperity, and we are all bombarded with Hollywood celebrity smiles constantly, and associate beautiful smiles with rich life styles.

Lot of patients in my office complain that they did not have dental insurance growing up or currently do not have one  and blame bad teeth due to lack there of.

There is a saying that Death knows not color or age or sex.
Also true  is that disease knows not the same and it knocks on all doors.
Most dental conditions are not hereditary and you as a patient is in total control. I remind my patients about, how  conditions like Heart problems, diabetes and cancer to name a few are not in their control completely, thus cannot be cured, but  can only be managed.

On the other hand dental problems are self induced and can be reversed with proper prevention and care.
While its true that dental decay is epidemic and associated with low socioeconomic status, let us not forget the fact that it has mostly to do with lack of care rather than access to it. This is more of a serious issue.
If prevention is instituted with proper education with regards to diet and brushing and flossing it will result in elimination of dental decay and gum disease to great extent regardless of access to care.
Dental disease can occur only with presence of teeth,bacteria and food.
If you eliminate any,  you break the symbiotic cycle and eliminate the  disease completely. That is why you do not see dental disease in people with artificial teeth and dentures.

I stress the importance  of limiting  “sugar diet” as much as brushing to all my patients. I have seen in my initial stages of my practice a lot of patients follow my prescription of preventive care with regards to brushing and flossing, and yet suffer from lot of decay  during regular check ups and recall. I was as frustrated as my patients and started investigating about the dietary habits.To my astonishment I realised the crucial role of Limiting sugar diet or eliminating it in some instances for patients especially prone to Dental decay. The results were very promising and encouraging.

I have vowed to educate every patient since then about diet and hardly a day or even an hour goes by where I am  not lecturing patients in my practice and persuading  them into changing their diet.

I am a big proponent of brushing and flossing after every meal rather than only twice a day. This is a must especially for patients who have a tendency to have recurrent caries in spite of best efforts.
Again most patients blame it on family and how their  parents and grandparents and siblings have bad teeth.
Most patients say “Bad teeth run in my family” when asked about why they let it get to this stage.
Let me instill hope in all patients that you do not have to accept is as “fate” to have bad teeth.
I believe proper education and laying the facts bare will improve lives of thousands of people who otherwise have given up on their smiles and dreams of having confident beautiful smiles.

Yes.. you need to spend time and money at your Dentist for the damage already done,but going forward there is hope and the reality is that no one needs to spend as mush money as they do now to maintain good health and beautiful smiles for a life time.

My philosophy of treatment in my practice is “prevention through proper education,Information and enabling patients to make informed decisions to maintain optimal dental health for life for all”.

Take home lesson is Your diet plays an equal role or in some instances a larger role in controlling dental decay as much as your brushing and flossing habits.
Now you can Smile all the while you can and be the Celebrity that others envy and wish to be.

 

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Dec
09

Smile Makeover Hype

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I respectfully disagree with all the hype over Smile Makeovers being done across the country. Just because you have a good surgeon, it does not necessarily mean you have to go under the knife.

Most Americans want white teeth, what we call in dental profession “chiclet Smile”.
Since mid- nineties demand for dental services has ballooned and there is more money being spent in elective procedures  along with need based dentistry.

Dozens of  Professional journals have sprung into edition with all the experts commenting about the advancement in Dentistry and how it has changed and bettered lives of thousands of people.

While I do not disagree with the progress, it would be  delusional to accept it  as fact in totality. Numerous Journals written by reputed dentists  sometimes show before and after treatment pictures, and I shudder every time I see almost perfect teeth being put under the drill, permanently damaging them and replacing them with crowns and veneers.

In the ongoing saga of the patients wanting better smiles and Dentists wanting to provide them this is the brutal reality.

I agree completely that there are numerous options in treating a particular condition and that there is much disagreement in the profession with any particular approach. But I strongly believe that most people in my profession would agree on when not to over treat.
Morality is tough subject. We do not live in an Utopian society.

So here is a list of things every potential patient should go through.

1. Make sure your dentist offers   braces as an option to correct crooked teeth  and whitening before drilling teeth to restore them with crowns or veneers.
2. Do not push your dentist to correct the problem as seen on TV. It’s not one size fits all.
3. Do not let your dentist talk you into cosmetic procedures unless you were conscious of your smile before. Beauty lies in the eye of the beholder.
4. Always take a second opinion for major procedures. In fact I routinely encourage my patients to do so.
5. Do not ask for the whitest teeth possible. Rule of thumb is, your teeth should never be lighter than the white of your eye, so that people are drawn to  make eye contact  first rather than your teeth.

The most important  is the Fiduciary responsibility of the dentist, in dissuading a misled patient from getting unnecessary treatment from wrongly perceived benefit.I heard a reputed dentist in 2005 Midwinter ADA conference ,brag about his philosophy of treatment.“Treat people as they want to be treated.” Growing up I was taught to “Treat fellow beings as you  would want to be treated.”

I strongly believe that this holds true for Dental and Medical professions as well; because patients are not equals in terms of knowledge and expertise.
Guidance is what they are looking for and they should get the right one.

Dr.Gottumukkula,Satish

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