I Picked My Toothpaste Based on Sparkles...

When I was 5, I diligently picked my toothpaste based on the number of pink sparkles in the paste. When I was 10, I valued the importance of cartoon characters endorsing the paste. When I was 15, taste was important. At 20 (being a starving college student), I bought the cheapest toothpaste. 

If there's anything I've learned through my training as a dentist and personal patient experiences, it's that not all toothpastes are created equal. While I can write pages upon pages about the toothpastes available on the market, I have decided to focus on concerns that many of my patients have and what toothpastes I would recommend for each.

• Sensitive Teeth: Sensodyne is my go-to choice for sensitive teeth. Sensitive teeth are usually the result of exposed dentin (i.e. the inner layer of the tooth) which is a very porous surface. As these pores are exposed to temperature changes/air/etc., they activate the nerves in the tooth, which causes sensitivity. Sensodyne works by blocking these pores and protecting the tooth (namely through the potassium ions from the 5% potassium nitrate). As a plus, this desensitizing toothpaste also contains fluoride to help remineralize teeth and prevent cavities.  

• Canker Sores: Tom's Gentle and Clean would be my choice. One of the ingredients in most toothpastes is Sodium Lauryl Sulfate (SLS). This ingredient a) increases the effectiveness of fluoride (which works better in combination with this surfactant), b) helps "foam" the toothpaste to clean plaque away and c) has some anti-bacterial properties. However, some patients have sensitivity to SLS, which may irritate tissues and cause canker sores. If you find this to be your case, consider switching to Tom's Gentle and Clean (which is a SLS-free toothpaste). Comes in two flavors: peppermint and fennel! 

• You Have Lots of Restorations: Crest Cavity Protection (Regular) seems to me to be one of the least abrasive toothpastes available. When there are many bonded restorations (white fillings, veneers, all-porcelain crowns), we want to make sure that a less abrasive toothpaste is used to ensure the integrity of the restoration's margin. 

• You Have a Baby: Biotene F1rst Teeth Baby Toothpaste is wonderful apple-banana tasting toothpaste for the little one (three months and older). This all-natural toothpaste does not contain any artificial flavors or preservatives so it's safe to swallow! Note that there is no fluoride in this toothpaste (which has may cause tummy aches if swallowed). However, there are calcium and protective milk enzymes which help keep teeth strong. While this tube is a bit more expensive, it's a great introduction to oral care for your teething one!

• Whitening: Rembrandt (Intense Stain) is a toothpaste that I use in between whitenings to prevent day-to-day stains from food and drink.The ingredient PVP (or Polyvinylpyrrolidone Polymer) is a hydrogen peroxide complex which helps remove and prevent stains on teeth. The trick with whitening toothpaste is to use it consistently. The toothpaste is only effective if you use it every day, twice a day, for several months. 

• All Around Toothpaste: Crest Pro-Health product line would be my choice. Reduces cavities, plaque, sensitivity and bad breath. I'm there!

I hope this guide will give you a bit more information on the toothpastes currently available. Of course, the effectiveness of these toothpastes depend greatly upon proper brushing techniques, consistency, and duration. Please contact me with any questions you may have about your 'paste.

Wishing there were more sparkles in adult toothpaste,
Dr. Lynda Tran

^{*As the products and research for toothpastes evolve, so will the recommendations. And of course, I am not associated with any of these brands. Please consult with your dentist if you are thinking about switching to a new toothpaste.} 

Invisalign Day: Your Healthier, More Beautiful Smile!

As a dedication to promoting innovative services to patients, Petaluma Dental Group is having our Invisalign Day. If you're interested in finding more about Invisalign, I encourage you to visit the Invisalign website. It has a wealth of information about the benefits of having your teeth aligned with clear trays. For a small preview, below are just a few of the benefits:

• Healthier Gums - Invisalign aligners are removable so patients can brush and floss normally which can help prevent periodontal disease and tooth decay. Research has shown that gingival health may improve during treatment.
• Easier Cleanings - The chances of having plaque retention, tooth decay and periodontal disease can be reduced with properly aligned teeth. 
• Less Stress - Properly aligned teeth are less stressful on the supporting bone and provide better function. Invisalign offers an alternative to aggressive, restorative solutions for orthodontic problems.

As part of Invisalign Day, we will be seeing patients for complimentary consultations! If you decide that Invisalign is for you, we will provide you with:

• $500 off your Invisalign treatment
• Free Whitening (so your teeth look their absolute best)
• IPOD Shuffle

So, please contact the office to make an appointment for your consultation. I look forward to discussing your most healthy and beautiful smile! Here is more information on the event:

• When: Saturday, November 20th   9:00am - 1:00pm
• Where: Petaluma Dental Group (1430 E. Washington Street, Petaluma)
• Details: Appointments are limited. Please call today to reserve your consultation appointment! 
• Appointment: Call the office at (707) 762-0067 and ask for an Invisalign consultation with Dr. Tran!

As always, I am available to answer your dental questions (contact me). I look forward to your Invisalign questions and comments!

Trick-or-Treat,
Dr. Lynda Tran


Note: Please note that you have to sign-up for Invisalign treatment on or before Saturday, November 20th in order to partake in the Invisalign Dental Special.

Dimples on My Golf Ball, Not My Teeth!

I am going to share with you something that few patients know: With the exception of chewing and swallowing, our teeth should not be touching. Our teeth were not designed to be constantly working on each other. However, more and more patients are experiencing the consequences of clenching and grinding. As a result of the incessant clenching or grinding, patients usually have what is often called “golf ball molars” because of the dimple wear patterns (see above).

Additionally, bruxism (name for the condition of grinding teeth) may lead to your jaw feeling stiff, teeth becoming sensitive to cold, and jaws being tired after a night’s rest. Without diagnosis and immediate intervention of this condition, several things can occur:

• Teeth become extremely sensitive to cold liquids and food. 
• Compromise of existing fillings and crowns because these restorations are not strong enough to counter the impressive strength of our muscles and teeth.
• Increase risk of cavities. The more yellow surface of the tooth showing through is dentin. Unfortunately, dentin is not nearly as strong and cavity resistant as our outer enamel.
• Additionally, the teeth become shortened and flat. (see below) 

There are several believed causes of bruxism. Namely, it is attributable to a) stress and/or b) the way teeth fit together. Due to activities occurring in your life, you may have a tendency to grind/clench during the day or night. Or, if your teeth do not properly fit together, the teeth may be compensating for the discrepancy by wearing each other out.

In either event, please consult with your dentist. He/she will be able to assess the potential causes of your bruxism and develop a treatment that would cater to your unique case. Upcoming articles, I will be going more in depth on two possible treatments: night guards and braces (traditional and Invisalign).

While dimples are excellent on golf balls and babies, let’s keep them away from your teeth!

Happy golfing,
Dr. Lynda Tran

Golf Ball Anatomy: Golf balls with dimples are able to achieve “truer” flight than those that are smooth. While most dimples on golf balls are circular, it is believed that hexagonal dimples provide balls more lift.

Ca$h for Candy - Turn Sweets into Cheese

With the ever rising numbers of children developing obesity and cavities, it’s important this Halloween to focus on the amount of candy your child consumes. In an effort to remove the excess candy from your household this Halloween, Petaluma Dental Group and Synergy Dental are holding Ca$h for Candy. At this fabulous event, we will buy back every pound of unopened candy for a dollar with a chance to win great raffle prizes! Additionally, we hope to promote nutrition awareness for children in a fun, healthy way. Here are more details of this exciting event:

• When: Monday, November 1st from 2pm - 6pm
• Where: 1430 East Washington Street, Petaluma 94954

For more information, please click on link above. I look forward to seeing you there with your pounds of candy!

Best,
Dr. Lynda Tran

Clear Frame: Alternative to Metal Partials

As a family dentist, I believe that it is critical that all patients know and understand all of the options available to them. Once you are aware of all the options available (and the benefits/risks associated with each), you can truly make an informed decision for yourself and/or your family. Along those lines, I hope to introduce you to new products/techniques that are currently available in dentistry. While not all these options may be applicable to your unique case, it is important that you know these options exist.

As we age, there comes a time when a root canal fails, a tooth fractures, or the bone around the tooth is gone, leading to the unfortunate extraction of a tooth. As more and more individuals are losing multiple teeth, it is important for you to understand the options for replacing these missing teeth. Not everyone may be able to have their teeth replaced by implants and/or a bridge (due to financial constraints, medical health restraints, time requirements, etc.) and this leads to the option of replacing teeth with a removable partial denture (also known as a "partial"). 

Sample of Metal Framework Partial

For more than 100 years, dentistry has produced partials using metal frameworks, which has been shown to still be a practicable option. Partials provide stability through clasps/plates/rests which curve around or sit on a tooth, keeping it from causing sore spots on tissues. Unfortunately, there are times when the clasp required shows in your smile, causing this to be an unaesthetic option. Additionally, if a you are worried about the biocompatibility of the contents within the metal framework, then this option comes as a health concern.

From Kellar Laboratories comes a product that gives you stability and metal-free aesthetics in a partial called ClearFrame. This product has several significant benefits, including:

• Metal-free aesthetics. 
• Semi-rigid stability.
• The material used to make the partial helps prevent buildup of biological materials, odors, and stains.
• Reassuringly, the product does not contain Bisphenol A.
• For the financially constrained, this option may be a cheaper option as well (depending on the case type). 

This product is new and its long-term success is still being evaluated, but the earliest cases are approaching three years of use success. While this option may work for many, it is not for everyone (particularly individuals who are allergic to acrylic). Please discuss with your dentist to see if this is an option for you.

Best,
Dr. Lynda Tran

Disclaimer: I am not affiliated with Kellar Laboratories. I am describing an option that is currently available to patients. If you have any specific questions about ClearFrame, please contact the lab. 

Mouthwashes Can CAUSE Bad Breath

Listerine has been a popular mouthwash for decades. In 1914, it was the first mouthwash to be sold over-the-counter. It was named after Dr. Joseph Lister, who was one of the first to use disinfectants in rooms and instruments during surgery. Many of the patients I have met and treated continue to use Listerine despite the burning sensation they receive from the contents of the wash (particularly its high alcohol percentage).

The unfortunate thing is that it is still questionable as to whether mouthwashes actually disinfect (i.e. kill bacteria). However, we do know that most dental diseases are caused by plaque. Our oral hygiene goals should be aimed towards removing the plaque. And based upon studies, brushing and flossing are still the most effective means of achieving a healthy mouth¹.

Mouthwashes do have a purpose though. They can aid in bringing oxygen into crevices that cannot be reached by brushing and flossing, which can definitely help heal gum inflammation/disease. With that said, it's important to take a second look at what's in your mouthwash, especially those with alcohol. Alcohol may help in killing bacteria, but it has a drying effect on the mouth which can promote bacteria growth and bad breath. That's right, your mouthwash may cause bad breath!

With that in mind, I am always promoting alcohol-free mouth washes to patients and their families (especially the ones with fluoride in it). Needless to say, I was very excited when Listerine came out with their new product: Listerine Zero. There are many other kinds of mouthwashes without alcohol; search for the one that's right for you.

"But...what about my bad breath?", you might ask. Well, studies have shown that mouthwashes that contain antibacterial agents such as chlorhexidine and cetylpyridinium chloride have the ability of reducing levels of bad-breath-causing bacteria on the tongue². But be careful with these rinses since they often cause staining on teeth that can only be removed with a dental office cleaning.

That's probably more than you'll ever want to know about mouthwashes, so I'll leave it at that. Remember to look for alcohol-free, fluoridated mouthwashes the next time you pick up some rinse. As always, please contact me or your dentist with any questions you might have.

Happy swishing,
Dr. Lynda Tran


¹ Haps, S., Slot, DE., Berchier, CE., Van der Weijden, GA.. The effect of cetylpyridinium chloride-containing mouth rinses as adjuncts to toothbrushing on plaque and parameters of gingival inflammation: a systematic review. Int J Dent Hyg. 2008 Nov; 6(4): 290-303.

² Kumar, S., Byrne, G.. Some evidence shows that certain mouthrinses can reduce halitosis. Journal of American Dental Association. 2010 Aug; 141:1008-1009.

Dental Diary -The Ultimate Tooth Widget

From the Academy of General Dentistry, Dental Diary is a useful desktop widget that brings dentistry to you. This awesome widget (which sits cozily in your taskbar - see above) allows you to set reminders for you and your family about upcoming dental appointments, personal reminders (e.g. games, meetings, etc.) and when to throw out your toothbrush (which we all too often forget to do).

In addition to the reminders, you have quick, at-your-finger-tips access to dental information to help answer any questions that you might have. Finally, on the upper left hand corner of the widget, you can click on a tooth that leads you to the Interactive "Life of a Tooth" Timeline. This timeline you an idea of what things you should be looking for and expecting at different stages of your (and your family's) life.

You can download the free widget here (also available for Mac). As always, please feel free to email me with any questions.

Have a great Tuesday,
Dr. Lynda Tran

Gravenstein Apple Fair - 100th Anniversary

This weekend Sebastopol will be celebrating the 100th Anniversary of the Gravenstein Apple Fair! Gravenstein apples are one of my favorite treats. What a delicious way to celebrate Sonoma agriculture!

The fair will take place Saturday, August 14th (10am - 6pm) and Sunday, August 15th (10am - 5pm) at the Ragle Ranch Park. This is my first time at the fair, so I'm über excited. (Yes, I said "über" because one of the places the Gravenstein apple grows is in Germany.) As soon as I heard there'll be apple pie eating contests, sheep shearing, music, and funnel cake, I made sure to get tickets. If there's one thing you'll learn about me, it's that I love funnel cake.

So check it out and hope to see you there! Proceeds from ticket sales go to the Sonoma County Farm Trails Map & Guide and Farm Trails' promotional and educational programs.

An apple a day doesn't keep this doctor away,
Dr. Lynda Tran

Protect Your Choppers While Flexing Your "Guns"

Absolutely love my Brooks Addiction 9!

I write today's entry in hopes that individuals of all ages are looking to amplify their daily activities. With our expanding waistlines, it's imperative that we get movin'...literally. There are a multitude of activities that you can partake in and it all starts with turning away from your couch.

Personally, with a long incriminating family history of women developing osteoporosis, I am doing what I can to keep my bones healthy. Recently, I've got back into running and all it took was a pair of shoes. Start there and you'll see how addictive fresh air becomes.

But as you try new sports, make sure you keep your choppers in mind. Not all sports are dangerous to your teeth, but for the most part any sport that involves contact or collision with an object or person is a suspect for causing injuries to your teeth, jaws, and/or tissues. You know who the usual suspects are: football, basketball, biking, skateboarding, etc..

Beyond wearing a helmet and other protective gear when participating in high impact sports, remember to protect your choppers with a mouthguard. In particular, have a customized mouthguard that will fit perfectly to your upper teeth and will not dislodge as compared to generic mouthguards. These 'guards protect you from broken teeth and jaws, cutting your lips and bruising your cheeks, and even from concussions and neck injuries.

If you should experience an injury to your mouth/gums/lips/jaw, make sure you get medical attention ASAP. If you break or lose a tooth (often times teeth change color when they've been traumatized), contact your dentist immediately. Time is of the essence when it comes to teeth. The sooner that you seek dental care, the better your chances are to getting your tooth/teeth fixed.

So the next time you're in the dental chair, tell your dentist about your new activities and what you've been unto. Ask him/her for great tips on how you can protect your mouth, head, and neck while having fun.

See you on the "out"side,
Dr. Lynda Tran

National Fresh Breath Day - August 6th

Courtesy of JasonLove.com

Today's National Fresh Breath Day! Are you about excited as I am? In celebration of NFBD, we'll discuss what more than 80 million people are experiencing...bad breath. The more technical term is halitosis (hal-i-toh-sis), which mostly originates from our gums and tongue.

When it comes to determining what causes halitosis, anything goes! For many of us, bacteria, decaying food, and other debris cause bad breath. There are also medical reasons that lead to bad breath such as a medical infections, kidney problems, liver malfunction, xerostomia (dry mouth) and diabetes. But truly, anything can lead to this embarrassing condition such as stress, dieting, snoring, age, and hormone changes.

But it's not all from within, foods that we consume also influence the harshness of our breath. Spicy foods (onions and garlic) and coffee typically have their odorous effects for 72 hours after consumption. There have even been studies where garlic was rubbed in subjects' feet and then detected in their breath!

Since nearly anything can cause bad breath, how do we combat such a putrid opponent? Our number one weapon is our spit! Saliva washes away all the bacteria and food debris, leaving us a nice neutral mouth. However, when we're snoozing, the amount of saliva entering the mouth decreases which leads to the wonderful "morning mouth". Morning mouth is the result of our fasting while we sleep. It's important to note that for individuals who skip breakfast, bad breath will reappear even after brushing in the morning! So don't skip breakfast if you want fresh breath.

Other ways to combat halitosis are:

• Rule of 2's: Brush and floss twice a day, brush for two minutes, and visit your dentist at least two times a year.
• Remember to brush your tongue and cheeks as well. Consider buying a tongue scrapper to help remove remnants on your tongue. 
• Chewing sugar-free gum may also help control bad breath.
• If you wear dentures, retainer, or a removable partial, remember to always thoroughly clean it everyday before and after wearing. 
• With respect to mouthwashes, check with your dentist. Some washes only mask the smell and some are more superior than others. 

 I wish you all a wonderful Fresh Breath Day!

To fresh breath,
Dr. Lynda Tran

Colgate Wisp Infomercial

You might have seen this, but it's just so silly. *Wisps*

Check it out,
Dr. Lynda Tran

Aloe Vera - It's Not Just for Your Skin

Staying in tune with the summer heat, we're all aware of the soothing effects of Aloe vera for our sunburns. We might even use it for the occasional cut or two. However, this medicinal plant has gradually become a popular, useful "tooth gel". Patients are turning to Aloe vera to cleanse and soothe their gums. But the real kicker is that Aloe vera can fight cavities!

Based upon peer-reviewed articles from the Academy of General Dentistry (AGD), when compared to two leading toothpastes, Aloe vera gel has been shown to be just as or more effective in controlling cavities¹.

In addition to its sugar-bug-fighting powers, Aloe vera is a very effective pain reliever and anti-inflammatory (due to the anthraquinones within the plant) which means that its the ideal alternative for individuals with sensitive gums and/or teeth.

Sample of Aloe Vera Tooth Gel

But before you run out to your local store and stock up on Aloe vera for your oral care, make sure that the Aloe vera used is stabilized (that is, not excessively heat treated). The heat destroys the "healing" components of the plant and therefore would be of little benefit to you and your family. To help you out, there is an International Aloe Science Council that helps you pick out quality, certified products.

As always, make sure to consult with your dentist prior to changing your oral care routine.

And as a quick reminder, this Sunday, August 1st is Neighbors in Health hosted by United Way of Wine Country. See last entry for more information. Would love to see you there!

Best,

Dr. Lynda Tran

¹ George, D., Bhat, S., Antony, B. Comparative evaluation of the antimicrobial efficacy of aloe vera tooth gel and two popular commercial toothpastes: An in vitro study. General Dentistry May/June 2009. Pg. 238-241.

Neighbors in Health

Awesome event coming up this Sunday hosted by United Way of Wine Country. Neighbors in Health provides a day of free health care for uninsured children in communities in and surrounding Santa Rosa. Last year, more than 400 children participated in Neighbors in Health. Children receive medical care which includes getting their immunizations, check-ups, dental exams/screenings and lots of health education. There'll even be jump houses! Here are the details:

• When: Sunday, August 1st 
• Where: Kaiser Permanente (401 Bicentennial Way, Santa Rosa)
• Why: For the kids, of course!

If you are free this Sunday, please consider volunteering. You can find out more here. I'll be there from 11am to 5pm in the Dental Area. Come by and say "hi"!

Hope to see you there,
Dr. Lynda Tran

Fabulously Fashionable Fontanella

Just wanted to post about a wonderful event coming up at Fontanella Family Winery. 10-30% of proceeds go to Aldea (an organization dedicated towards providing child welfare services and mental health care). Space is limited, so please contact Stacey to RSVP.

Cheers, 

Dr. Lynda Tran

Mr. Sun, Please Shine Down on Me!

We’re in the midst of summer and what’s hotter than Vitamin D? While I would always urge everyone to use high-SPF sunscreen and to judiciously expose themselves to the sun, there are tons of teeth-related benefits to upping your Vitamin D. Let’s explore.

It’s been well established that there is a strong link between periodontal disease (aka gum disease) and Vitamin D. The details of this link are still a mystery, but we know that lack of Vitamin D = greater risk of gum disease. The link lies within the bones. As you may already know,  your teeth are being held in by bone. When there is a deficient amount of Vitamin D, the genes that express gum disease are activated, causing the bones to be come weak and teeth to become loose.

In addition to Vitamin D’s control of these gum-disease-expressing genes, BU Goldman School of Dental Medicine has shown that Vitamin D has an anti-inflammatory effect. Basically, Vitamin D helps reduce the inflammation in your gums which would have (if not stopped) led to gum disease.
On top of all the great benefits for your gums, Vitamin D also keeps your teeth strong by reducing the risk of cavities. In the event that an individual who severely lacks Vitamin D (e.g. rickets), there is an overwhelming increase in cavities (see AAP Article).

Beyond the scope of the mouth, lack of Vitamin D has also been linked to heart disease, osteoarthritis, diabetes, and a multitude of cancers.

Despite the title of this article, there are three main ways you can beef up your Vitamin D.

1. Foods – Mainly, seafoods (e.g. salmon, mackerel, tuna, and cod liver oil) which also contain awesome good-for-your-heart omega-3 fatty acids) and fortified foods such as milk.
2. Supplements – Reliable source of Vitamin D. Make sure that you choose a supplement made with the D3 form (aka cholecalciferol).
3. Sun – Granted, not the most reliable or safe way of achieving your Vitamin D intake but the next time you’re out in the sun, you can smile at the fact that you’re helping your teeth and gums out!

Disclaimer: Before changing your eating habits or supplement intake, please consult with a dentist or physician. And, please, do limit your exposure to the sun.

Best,

Dr. Lynda Tran